Caroline's Story: Breaking Down the Mental Health Stigma

As a graduate of a public liberal arts university, I was confident that I carried no stigma against mental illness. I had friends with various disorders, and I felt only compassion for them. I knew that some disorders were genetic, and that life experiences played a role as well. I knew you could never blame an individual for their mental health status. I knew medicine was often a crucial way to treat a disorder, but that sometimes medicine didn’t work. I knew there was stigma associated with all of this — with having a disorder, with the genetic connection, with the environmental element, with using medicine to address it — but I was sure I was above the stigma.

And then people started telling me I might be depressed. I knew it might be true, but I didn’t want to believe it. I’d never had health issues. I broke my arm at age one when I fell out of my stroller, and I had my wisdom teeth taken out at age 18, but those were my only interactions with the medical system aside from routine checkups and vaccinations. Confronted with my own possible mental health issue, I had no idea what I should do. I decided to double down on my healthy-living tactics: I slept at least eight hours each night. I started attending yoga class three times a week. I exercised every day. I tried meditation. I practiced gratitude. I journaled. But my depressive symptoms kept getting worse. I cried bitterly every single day, usually triggered by insignificant stressors — like the time my favorite Vietnamese restaurant forgot to put tofu in my pho takeout, or because I had to get out of bed. I sometimes cried on the way to work, even though I liked my job. I often cried myself to sleep. Getting up in the morning was always hard. When I woke up, my face would be swollen, my body lethargic — even after those eight or nine or ten hours of sleep.

I did everything I could to avoid thinking of myself as someone who was depressed. Instead of going to therapy, I hired a personal development coach to straighten out my “attitude problem.” After months of me crying to her via our weekly Skype calls, she finally suggested that I “cast a wider net” to find solutions to my issues. Somehow, that was what convinced me. Two days later I was in a clinic, and a week after that I’d started a daily dosage of an antidepressant called citalopram or Celexa.

I felt deeply conflicted about the meds. On the one hand, I knew intellectually that this was a good decision. On the other hand, I felt undeniably ashamed of needing it. Did I really need it, anyway? It shocked me to realize that I hadn’t avoided internalizing mental health stigma after all. I wanted to claim the decision as something I didn’t need to feel ashamed of, so I posted about it on Facebook. The outpouring of support I received in return was totally unexpected and hugely meaningful to me. More than a dozen people commented publicly on the post to share their own mental health struggles, and several more messaged me personally to share and offer words of encouragement. Stigma is real, it’s out there, but our generation is desperate to connect at a level that passes over any stigma. I felt that very intensely in the response I saw to my Facebook announcement, as well in the responses I saw to the podcast series I subsequently produced about depression and mental health.

I could not be happier to say that my antidepressant medication drove back my depressive symptoms. What a relief it is to not feel constantly on edge, and to not always be wondering when I’d next burst into tears! To be able to wake up feeling tentative hope for what the day might bring me, instead of a constant, generalized despair. However, I’ve not yet started seeing a therapist regularly. I’ve been appalled by how many barriers I’ve faced to taking this step. Here’s what that process has been like for me:

After finding your insurance website, you put in your zip code and download the results. Then you call provider after provider. Most of them don't answer. The ones that do answer aren't taking new patients. The ones that are taking new patients make you come in for a screening. When you get there they look it up and find out that they don't take your insurance after all. You're sitting there in the office, you've already done the paperwork and you feel like crying because you’ve already put in several hours of effort to get to this point. So you take a break for another few weeks before going back to it and trying those steps all over again.

It’s a daunting process, even for someone who has the motivation, the time, and the resources. To think about someone who's working a lot or literally can't get out of bed — someone else would have to do it for them. There's really no way they could do all those steps. I consider myself to be a highly proactive individual, someone to whom my personal health matters a lot, and I still haven’t been able to successfully find a therapist. I haven’t given up, though, and soon I’ll be moving back to my home state, where I’ll no longer be in a travel network and hopefully insurance coverage will be simpler.

In the meanwhile, I’ve committed to several therapeutic practices: I attend a monthly potluck dinner with other people in their 20s and 30s who have experienced significant grief. I continue exercising every day, prioritizing sufficient sleep, and eating mindfully. One of the things that has been most helpful for me in processing my experience is a six-part podcast series on depression I recently produced for Nashville-based startup Health:Further. Learning is a high value in my life, so it was wonderfully helpful for me to delve into the topic of mental health from a professional storytelling angle. In my interviews and research, I learned that childhood trauma (like my mom’s death when I was 11) makes an individual more likely to experience depression in adulthood. I learned that any individual is likely to experience depression in her early 20s, especially at the point of a major life transition (for me, graduating college and entering the working world). I learned more about how antidepressant medication works, more about how depressive symptoms are categorized, and more about the role of genetics. I learned about the human-built systems and institutions that surround depression and mental health. I learned about the various ways stigma inhibits mental health treatment. All of it helped validate my own experience and gave me more confidence in how I’m approaching it.

The podcast series focuses on the story of a young woman who has dealt with Major Depressive Disorder and Body Dysmorphic Disorder her entire life, but it includes bits of my own story, all interwoven with commentary from experts in neurobiology, psychotherapy, mental health economics, medical sociology, and new technologies used to address mental health issues. I’d highly recommend that anyone interested in mental health, or dealing with your own mental health issues, check it out here. Education is a key step in dismantling the stigma associated with all kinds of mental health topics!

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