I have a doctorate, but I rarely use the title “Dr.” I’ve had bosses who told me to ‘own that title’ and bosses who said my education level doesn’t matter. I’ve been told to add my title to presentations and told to remove it, mostly when others may be “Dr” as well, and there’s a fear of missing them. I’ve been embarrassed in groups when bosses highlight my degree, and I’ve felt left out when they’ve forgotten.
But you know what? I worked for that title. I started my EdD when I was at a loss for my future. A job was ending. I was a divorced, single mom with an 18-month-old. I was virtually alone in a town that I didn’t choose to inhabit but was tied to because of my ex-husband. I chose to go back to school with no real plan because I knew school was what I was good at, what I could control, what I could succeed in.
Five and a half years later, I successfully defended my dissertation. I’d wept over my studies, pushed them aside when life got too hard, given up family time on the weekend so that I could add those letters to my name. So now, why should I diminish that part of myself?
I could name a lot of reasons: I’m not good enough; I’m an impostor because I got my degree online; I didn’t conducted two years’ of rigorous quantitative research. But you know what I did? I worked hard; I pushed my boundaries when I was afraid. I made a huge financial investment in myself. I proved that I am capable.
So, I’m going to own that “Dr.” It’s part of my identity. I don’t need to make myself smaller to compensate for others’ insecurities about their own academic backgrounds. I am still the same person: deeply empathetic, deeply introverted, deeply ambitious.
But I am a Dr. I will own that sh*t. I will not make myself smaller.
May is Mental Health Awareness Month (Week in the UK). My company’s Diversity & Inclusion Steering Committee tried to promote it and mental health support, but I only saw a few posts about it on our Workplace channel. I helped my department launch a campaign for mental health awareness, but I am sad that few people participated. I was the only one to make an individual post in support of the campaign. Now I’m unsettled because maybe my peers assume that I have a mental illness because I showed more support than others, and it feels like I’m standing out too much.
It’s true that I have serious mental illnesses. I share about my bipolar disorder, depression and anxiety here and on my social media channel. So if I’m putting my SMIs out in the web universe, why does this bother me? Am I a fraud because I’m nervous sharing any of this with coworkers? Am I contradicting what I stand for?
I think I am all of those things, but here are the excuses I tell myself when I shy away from talking about mental health in the workplace.
People Don’t Understand Mental Illness
According to the Substance Abuse and Mental Health Services Administration (2020), 13.1 million U.S. adults have SMI diagnoses. While that’s 5.2% of the adult population, it doesn’t mean understanding and recognition is growing at the same rate.
SMIs take many forms. Some people can be high-functioning, hiding their SMIs from others while they control their symptoms with medicine, therapy, and self-care. I don’t believe that you can be “healed” from an SMI. Rather, like a cancer of your brain synapses and chemistry, you can go into remission. That doesn’t mean that you’re healed; it means that you’re not showing symptoms.
Yes, SMIs are being discussed more than ever, but the stigma remains. From misrepresentation in the media to stereotypes about mental health, there are so many assumptions about what SMIs look like:
Those are just a few of the assumptions that I’ve heard, and I know there are more. The stigma of SMIs is deafening, and it prevents more people from disclosing their diagnoses.
Disclosing Mental Illness at Work
I’ve been in the professional workforce for nearly 17 years now, and one of the things I’ve carried with me from the beginning is that I’m a failure and a liability if I show too much emotion. Emotion equals weakness, and weakness equals stagnation. But what happens when emotions are tied to SMIs that, at times, have been out of control?
When I had a breakdown in August 2020, I was terrified of taking vacation time. We were in the middle of a pandemic, and who takes a vacation from work then? I was hanging onto my job with my fingernails, even while I had multiple panic attacks daily. Despite hearing that my UK counterparts were taking 4-week-long holidays, people in the U.S. didn’t do that. My boss worked 12+ hours a day, so I needed to do the same. But when I couldn’t function anymore, I knew I needed time off.
So, I made the decision to talk to my doctor about taking a mandatory leave. She agreed. I should have taken more than 10 days, but I refused to allow myself more. My boss stopped me from sharing too much information with her because of privacy laws, so I focused on HR and my doctor shared only the most pertinent information.
I felt forced into a corner to take those steps because I wanted to protect my position at the company. The Americans with Disabilities Act prevents firing because of medical leave like mine, and I was afraid of retribution because I was taking time off.
But that’s a bit irrational right? My company was pitching the boilerplate language of self-care, work/life balance, and taking time away. People in other countries were taking PTO and seemed fine with it. But that wasn’t what I knew. After all, wasn’t my boss working tons of hours? Why would I show weakness like that?
I don’t talk about taking that medical leave. I didn’t share why I needed the time. I needed more time, but again, I didn’t want to be weak.
Some things have changed since that time. I have a new boss who actively encourages taking time off. I do the same for my direct reports. The world seems more attuned to mental health in some ways. But, stigma remains. People remain quiet. And I question my actions.
When will we move forward? When will we normalize conversations about SMIs? When will we change the narrative?
I am not sure how many psychiatrists, psychotherapists, and mental health experts I have seen over the years. I’ve lost count of those visits and of the medications I’ve tried. Since we have moved several times in the past six years, I’ve had to seek new help and new prescriptions every time, and that process is so tiring. I’ve seen good shrinks and bad ones, been taken off medicine too quickly and given new meds without warrant. But one of my psychiatrists made the largest impact on my life.
I’d met Dr. Donaldson shortly after I transferred from from one college to another in a different city. Because of my multiple suicide attempts, my dad had been seeking a referral for me for months so that I could see a doctor who had a good reputation and the potential to help his struggling daughter. I did not want to go see Dr. D., insisting to my mom that I was fine and I didn’t need a psychiatrist. She didn’t buy my pleas. “Your dad had to pull a lot of strings to get you this appointment. You’re going.”
And so I did. I arrived at Dr. D’s office and sat in a waiting room that smelled like old magazines and the 1980s. Our first appointment was thorough, but talking to Dr. D. wasn’t like my previous encounters with psychiatrists. He sat behind a giant lawyer’s desk and listened to me. He asked questions in a quiet, grandfather-like voice, and after I answered a few of his queries, I noticed he seemed to be interested in what I was saying, even when I was just talking about my summer, not my mental health symptoms. This doctor wanted to get to know me as a person before he handed over a prescription. What a concept!
He did prescribe me medicine, of course. We played with a few dosages and different meds for a while, but eventually I started taking EffexorXR for my mood, Trazodone to help me fall asleep, and Seroquel to help me stay asleep. It was a good cocktail of my mental health, until it wasn’t.
I saw Dr. D. throughout my final years of undergrad, and then when I started graduate school in a different state, he agreed to help me stay on my meds if I came back to see him whenever I returned home for a break.
I fell into a chest-numbing state of anxiety in October of my first semester. I had tripped trying to walk over to the phone in The English Center, where I worked 10 hours a week as part of my assistantship, and injured my back to the point I could barely walk to classes. Visits to a chiropractor were helping, but I was embarrassed by my klutziness in front of strangers. And, as we’d been in school for just over two months, my professors were amping up the assignments and readings. Plowing through 150 pages of critical theory a night plus writing response papers and helping grade first-year composition papers was a lot. I’d sit at my IKEA desk (thank you, Justyna) in my apartment and chain-smoke while I worked. I never slept in my bed; I fell asleep on the couch watching my DVDs of Friends on a round-the-clock loop. Not good for my back or my REM cycle. Finally, as the anxiety started to pull at my body even more and as I caught myself repeating tapping patterns, turning off light switches in quick succession of fours, and washing my hands until I was certain I wasn’t going to fail my Composition Pedagogy class, I called my psychiatrist. Something was off, and I needed Dr. D.’s help.
Anyway, I called Dr. D. in October of 2003 in a panic because my anxiety was over the top and I was terrified of failing out of graduate school (having yet to earn any grade lower than an A on an assignment; anxiety lies). He was still my doctor because we’d landed on six-month appointments that I could make work during school breaks. As it was a Thursday when I finally gave in to asking for help, he asked, “Can you take a break for a couple days?” I said I thought so. I didn’t have to be on campus that Friday, at least. “Good. Take two Seroquel tonight and try to knock yourself out for the full weekend. You’re exhausted and sleep is the best option for you right now. You’re exhibiting OCD symptoms because of your anxiety. Sleep and reset.”
So, I did. And nearly 72 hours later, I emerged from sleep and mindless TV binging to find that I did feel better. Not perfect by any means, but I could take deep breaths again and wash my hands in a normal fashion once more. Sleep would become one of my go-to ways to combat the anxiety and depression that took hold of me over many times from then on.
I’m not sure if doctors would prescribe three days of sleep with pills now. Several doctors have urged me to rest, but Dr. D. remains the first one to recognize that I need to take a break and to calm myself. For that, I’ll always be grateful.
Finding a proper medical team is not easy. It’s painful. First you have to navigate insurance approvals, waitlists, and paperwork. Then you have to regurgitate your past mental health issues and talk about experiences that can push you back into that deep hole. And trying new meds? It’s a strain of adding new pills at different doses to the already complex cocktail of antidepressants, anti-anxiety meds, and sleeping pills, maintaining a homeostasis to ensure that everything is working together, that a new med is helping, and that side effects are minimal. It’s exhausting. But worth it if you can find a doctor like Dr. D.
I spent years fighting my brain, trying to heal myself, hide my struggles, and normalize who I am. I have come to (mostly) accept that my serious mental illness is part of who I am.
About a week ago, I received an unsolicited DM on my Bookstagram account. I had posted a photo the night before, referencing how reading books – getting lost in novels – is a refuge for my diagnosed anxiety disorder. The next morning, a probably well-meaning follower offered to send me samples of Matcha tea because she claimed that drink would soothe my anxiety and help my mental health.
Was she correct? Does Matcha help mental illness? According to a quick Google search, Neuroscience News reported in 2019 that a new study showed promising results when people with anxiety drank Matcha (read more here). Nevertheless, this seemingly innocuous DM enraged me. After deleting the DM and blocking the sender, I posted a photo of a green stack of books in support of #mentalhealthawareness that encapsulated my feelings about this unsolicited message. Here is an excerpt from that post:
I have disclosed my mental health struggles and the importance of mental health awareness. On top of sharing my love of books here, I use this little space of mine as a place to vocalize what took me decades to own (and some days I still fight it). Engagement on those posts mean[s] the world to me.
But what doesn’t help? Receiving an unsolicited DM this morning that “matcha will make you feel better” and that “you’re happy to send samples.”
Honey, don’t you think I’m trying every avenue to feel better already? Don’t you get that a serious mental illness is just that – an illness? Your DM reeks of trying to monetize my struggles, with scents of an MLM proposition on the side. Don’t capitalize on my honesty and vulnerability. Don’t @ me anymore.
Why was I so upset? Because it felt too personal and it felt like the sender was trying to capitalize off my disclosure. It’s ironic that a “hard DM / promote it on [insert mental health tag here]” comments flooded the responses to my post, comments that I promptly deleted. But the experience has me thinking about why I post about mental illness.
Mental Illness Should Not Carry Shame
I spent years fighting my brain, trying to heal myself, hide my struggles, and normalize who I am. I have come to (mostly) accept that my serious mental illness is part of who I am.
At first, as a teenager, I didn’t understand what was going on. I thought I was abnormal and hid my thoughts. I didn’t have the language to describe what was happening. Then, after a vodka-sodden night that ended in me tearfully blurting out the story of my sexual assault in college, my friends insisted that I try therapy. It wasn’t easy. Suicide attempts, psychiatric holds, and bulimia followed. But therapy and medicine helped me to find the words.
I learned that mental illness is not something to be ashamed of, just like having any physical illness should not carry shame. My brain chemistry does not work correctly. The chemicals and the neural pathways need a prescribed boost to help me deal with my clinical depression, generalized anxiety disorder, and post-traumatic stress disorder. I don’t need to explain this to everyone, but I do disclose when necessary or when I feel so compelled.
We Need to End the Stigma of Mental Illness
Aside from not understanding what was happening in my brain, the stigma of mental illness kept me from disclosing anything for a long time. Despite posting about it here and on my Bookstagram account, I don’t talk about it on a regular basis with people, other than close family. But, I am always aware of it. Completing my dissertation on mental health in the workplace helped me to understand the stigma that people with serious mental illnesses (SMIs) face. Also, I started to gather statistics to quantify the impact of SMIs in the world. I’m clearly not alone.
The National Alliance on Mental Illness (NAMI) reported that in 2020, one in 20 U.S. adults – 14.2 million people – experienced an SMI (nami.org, 2022). And, one in five U.S. adults (52.9 million) experienced mental illness that year (nami.org, 2022). While the COVID-19 pandemic was a significant influencer of mental health in 2020 and continues to have an impact now, the numbers prior to the pandemic are just as significant:
From 2008 to 2019, the percentage of U.S. adults who had any mental illness (AMI) increased from 39.8 million people to 51.5 million people, and SMIs in the U.S. adult population increased from 8.3 million to 13.1 million people (Substance Abuse and Mental Health Services Administration, 2020). So, to break that down into percentage growth over a decade prior to the pandemic: AMIs increased by 29% and SMIs increased by 58%.
Those numbers – before the pandemic and during – are nothing to scoff at. So why does mental health stigma still exist? In my opinion, it’s a lack of education, a lack of awareness, and a deep-rooted fear that it can happen to anyone.
Mental Illness Does Not Discriminate
The research on which populations are more susceptible to mental illness varies; however, it is true that anyone can experience mental illness. The disparities exist in who is more fortunate to have access to mental health services. As a white woman whose employer provides medical insurance, who has the funds to take care of my copays and prescription costs, and who has the option to choose from a variety of doctors, I am extremely privileged. It wasn’t always like this – there was a time in my life where I did not take my medications because of the out-of-pocket expense – but I have access to the help I need.
Others are not fortunate like me.
Statistics about Demographic Groups with Mental Illness
All data provided by nami.org (2022). Of demographic groups that have any mental illness, the groups that have the highest percentage of treatment are
Lesbian, Gay, or Bisexual: 54.3%
Non-Hispanic white: 51.8%
Of demographic groups that have any mental illness, those with the lowest percentages of treatment are
Non-Hispanic Asian: 20.8%
Hispanic or Latino: 35.1%
Non-Hispanic black or African American: 37.1%
Treatment is not equalized amongst the U.S. population (or any population). All statistics available from nami.org (2022).
11 years: The average time it takes between onset of a mental illness and treatment
134 million: The number of people who live in a designated Mental Health Professional Shortage Area
11%: The percentage of U.S. adults who had a mental illness and no medical coverage in 2020
11.3%: The percentage of U.S. adults who had an SMI and no medical coverage in 2020
46.2%: The percentage of U.S. adults with mental illness who received treatment in 2020
64.5%: The percentage of U.S. adults with SMI who received treatment in 2020
Why I Need to Talk About Mental Illness
Sharing about my mental illness is not easy. It is not something I take lightly. But for all the reasons above, and more that I can’t quantify right now, I feel obligated to disclose what I struggle with. I have a tiny platform, but I have a voice. It’s important to me that I share it.
But don’t DM me with a proposition to capitalize on my decision to speak out.
Mental health matters and mental illness sucks. I have a running list of reasons I hate my mental illness. Here are four.
Mental illness sucks. There. I said it. It doesn’t just impact your brain. It makes nearly every part of your life go sideways. Here are four of the most pressing reasons why I hate having a mental illness.
Mental Illness Steals My Motivation
Do you have grand ideas of what you want to accomplish? Do you act on those ideas? Turn them in to goals that you fight to achieve?
I have grand goals that I want to achieve. I’m a driven person who seeks external validation in every part of my life. The problem is, I don’t often act on the goals that I know will make a huge difference in my life.
Give me a work project with a deadline, and I’ll attack it. Push me to do a work-related something new that will set me apart, and I am here for all of it. But, tell me that monitoring my diet and getting regular exercise will help me feel better, and I fall into a puddle of failure.
Most of the time I’ll blame this behavior on being lazy. I’ll respond with excuses and sometimes even anger. That’s a fear-based response because my brain tells me I can’t do it. Anxiety takes over and then it’s all about the overwhelming feeling of failure from before I even start. My brain lies because of my mental illness.
For example, I’ll wake up early on a Saturday morning and have grandiose plans of accomplishing my to-do list of those should-do items that I think about all week. I’ll sit with that feeling for a bit and then become exhausted. The thought of leaving the house to pick up some organizer bins or just go to the FedEx store or even have a lunch treat with my husband, and I’ll collapse under the pressure I put on myself. I’m an all-or-nothing type of person, and the “all” makes me tired. My motivation is gone. Mental illness lies and tells me that I can’t do any of it.
Finding a Medication for a Mental Illness is Frustrating
If you’ve ever had to take a medication for your mental health, you know what I’m talking about.
It can take months for the medicine to build up in your body, to be effective and make you feel better. Or, it can work from Day 2 and then taper off after a month. There is no cure-all that starts from the moment you swallow a pill, or four, and then feel stable for the rest of your life. At least, I haven’t found it. It’s like Alice taking a bite If a biscuit and morphing into a giant, her feet and arms pushing through the doors and windows of the White Rabbit’s house, and then she swallows another carb and shrinks to an eighth of her original size. In between, she nearly drowns herself with her own tsunami-sized tears.
Okay, I don’t remember the timing for all those scenes in Disney’s movie, but you know what I mean.
Finding a medicine – or a cocktail of prescriptions – is a tedious process when you’re tying to improve your mental health. I’ve been on so many different medications that I have lost track. Most recently it was lithium, that Big Daddy of the mental health world that scared me from the start. But, I’d take it for two weeks, feel great, and then the dosage would need tweaked. There’s a limit to what you can take, obviously, so we switched to something else. I’m feeling better right now with the current med cocktail, but there’s a lingering thought that the other shoe will drop and I’ll have to start all over once my body gets accustomed to another medication.
Mental Illness Makes Me Act Like a Victum
The t-shirts and the stickers are right for most people. Their mental health matters and they’re fighting through their struggles. They’re accomplishing things and sharing their stories.
I want to share my story, too. But right now, I’m in a cycle of victimhood as I blame others for the past and I’m not moving forward. I’m stuck at the blame-and-shame stage. I don’t believe that everyone can pick themselves up by their bootstraps and recover alone. You need a team, a tribe, a push forward.
I say “right now,” but if I’m being truly honest, I’ve been this way for decades. And that makes things worse. I hate that I’m not holding myself accountable for every part of this. Yes, bad things happened to me, but I haven’t made peace with those things yet. I hang on to the pain. And that exacerbates my mental illness and fills me with more lies that grow like mold in my brain.
Mental Illness Changes Your Relationships
This is the biggest reason why I hate having a mental illness. My depression and anxiety impact my family every day. I hate that my kids have become attuned to me hiding in the bedroom and sleeping away the afternoons because I’m so exhausted by life. I hate that I have to talk to them frankly about mental health. I hate that I don’t do the Pinterest and Instagram mom things because I’m mentally ill. I question if my love is truly enough when I can’t show up with enthusiasm and action unless I push up against the walls of the deep, dark hole that depression dug around me.
I hate that my husband feels he can’t talk freely without my emotions taking over in response. I hate that he’s dealt with my mental illness as much as he has. I hate that he anticipates a “no” from me before he asks if I want to do something, so much so that he’s stopped asking. I hate that I haven’t felt right with him in months because I can’t relax. I don’t know how much longer he can hang on. He knew what was wrong before we married, but my mental illness has gotten worse, and it’s incredibly unfair to him.
The Tipping Point of Mental Illness
The tipping point is near. The fear remains that I’ve gone past it and can’t go back. The lie remains that I will be this way forever. It’s not something I’m handling well. Maybe I just want to be miserable. And that’s fifth reason I hate having a mental illness.
Book Review: Broken (in the best possible way) by Jenny Lawson
Jenny Lawson writes with honesty, vulnerability, and power. She brings truth to the page as she explains what it’s like to be in the dark hole of depression and anxiety while you lose shards of your soul. She brings levity to the story as she shares her wild experiences at the dentist, in Puerto Rico, and in her backyard. Her love of taxidermy — including Allie McGraw the alligator and Daenerys Targaryen the prairie dog/squirrel — as well as her late night Twitter sessions and her insistence that her missing phone is in the floorboards (really in her pocket) are just a few of the laugh-out-loud instances from Broken.
But it’s so much more than that. Jenny is helping to end the stigma of mental illness. She is open about her dark days and shares what of feels like to walk into the light — to be unsettled when you have good days because you’re not sure when the dark will come again. There’s a reason I used up nearly all my sticky tabs and almost an entire highlighter while reading this book. Because it’s that good. And because it’s that real.
I’m a negative thinker. From what I understand, negative thinking patterns are pretty common for people with depression and anxiety. It makes sense, really. My thought patterns feed me. I want to get healthier, so I’m working on identifying and rebutting these negative thinking patterns. Frankly, I’m struggling with it all.
Negative Thinking Patterns
According to an article on VeryWellMind.com, negative thinking patterns occur when you face a situation and cause stress. In my life, I imagine these thoughts creating sneak attacks on my brain when I’m vulnerable. These attacks have been occurring for so long that I’m actually accustomed to their warfare and no longer recognize what is false and what is truth.
For example, one negative thinking pattern (also called a cognitive distortion) that I battle is mind-reading. I might tell my husband about an event in my day. He’ll be occupied with some happening in his own day, and he might not react to me in the way that I expect him to. That leads me to think that he isn’t listening, he isn’t interested, he doesn’t care, and he clearly thinks I’m stupid.
See what I did there? In reality, if I stopped for a moment and asked myself, “What is the truth in this situation?” I would have been able to figure out that my dear, loving husband was actually just busy at the moment and would have been more than happy to talk about my day at a time that was more convenient. He’s proven this again and again. The truth is that he is kind and willing to listen at nearly any moment.
Stop. Rebut. Find the truth. It would save so much time and decrease my anxiety and stress – my husband’s too.
Another cognitive distortion is catastrophizing. This means that I assume that because X happened today, then it will happen tomorrow as well, and on and on until the world ends because X happened on October 31, 2020. In fact, the world ending will solely be caused by X happening to me on this date.
Do I sound crazy yet? I think I do. But, I’m being raw and honest here. I think catastrophic thoughts regularly. I use words like “always” and “never” to describe stressful events and interactions. I assume that because a coworker criticized my work on one project, that she hates everything I do and that I’m always going to be a target of her criticism, and she’s out to get me fired.
Again, fully acknowledging the crazy here.
When I type out these examples of my own cognitive distortions, I see how ridiculous I sound. So, I guess I need to continue to write about them. To make sense of them and understand what I’m doing when I have these thoughts. And, remember: Stop. Rebut. Find the truth.
Those five words are stark on the page. Despite so much growth in mental health awareness, a powerful stigma remains against mental illness. Is she psychotic? Is she dangerous? Why can’t she just get over it? Just a few of the questions that are bounced around when people come to conversations about mental illness and aren’t familiar with what being mentally ill really looks like.
Having had mental health battles for nearly 28 years and having been diagnosed, misdiagnosed, and re-diagnosed, I have some experience with what mental illness means. I’m not a doctor or a licensed therapist, but I live in the darkness much of the time. Here are four truths I’ve come to realize about mental illness.
1. My mind lies to me.
Depression and anxiety are pretty little liars. Because of my brain chemistry and thought patterns, I’ve set up a nice home for these liars in my mind. Improving my life means I have to rebut those lies on a daily basis and start evicting them.
2. Nature and nurture play roles in my mental health.
It’s not an either/or situation. My heredity and my lifestyle impact my mental illness. I’m predisposed to having a different brain chemistry because there is a history of mental health issues in my family. Life events have caused me to be more depressed, anxious, and to even battle manic episodes at times. We’ll talk more about those at another time. Also? I haven’t done myself any favors by feeding into negative thought patterns, digging deeper trenches in my neural pathways to feed into the depression and anxiety.
3. Taking medicine does not make me weak.
This truth has been a long time coming for me. I have been under a psychiatrist’s care for more than two decades, but I’ve fought the idea of treating my mental health like an actual illness for about just as long. As my dear father once told me, “If you had diabetes, you’d take insulin. Taking care of your brain, and taking medicine for your mental health is just as important.” He was a smart man (I miss him so), and I’ve finally come to understand that using medication to help treat depression and anxiety is not wrong.
4. I’m not a bad person.
My severe depression and generalized anxiety disorder do not control my conscience or my character. They are liars. (See Statement 1.) I need to improve in different areas — as a wife, a mother, a daughter, a human being — but I’m not innately bad because of my mental health.
I know there are more truths here, but these are the four most powerful ones that I’ve realized to date. What would you add?