Nov 092013

CC BY-NC-ND 2.0 - flickr user homelesshubDisclaimer: I am not a mental health professional but I’ve worked for a stint at a Men’s Mental Health Treatment Center in Pasadena. This post is a collection of my own thoughts on various aspects of mental health. It should NEVER be taken as medical advise. If you are in immediate distress, please call a hotline.

Gender and sexual minorities as a group have more difficulties with mental health than people who are not gender and sexual minorities. Mental health problems can create or worsen physical health problems, and vice versa. So I wanted to take a moment today to briefly discuss some issues surrounding mental health, specific mental health problems, mental health treatment, and things that you can do if you’re struggling.

What is mental health? It’s far harder to define mental health than it is mental illness. Mental health refers to how “healthy” or “unhealthy” our thoughts, emotions and behaviors are. Depending on who you talk to, a mentally healthy person may be a person who simply lacks a mental disorder…. or that may be insufficient. Am I healthy simply because I am not depressed, or does there need to be another component? Perhaps the ability to enjoy life, or feel fulfilled, or feel “happy” (whatever happiness is)? As you can see, mental health or mental wellness or psychological well-being is not an easy concept…. my thanks to the professor who taught me that in my undergraduate years.

What kinds of mental un-wellness are gender and sexual minority people susceptible to? Mostly those that have to do with stress. This has to do with the minority stress hypothesis – that simply by being a member of a minority group, your stress levels are higher, and you’re more susceptible to certain problems. So what kind of things are associated with stress?

  • Depression, which can manifest as low mood, hopelessness, low energy, lack of enthusiasm and enjoyment, and suicidality.
  • Anxiety, feeling “on the edge” or panicky
  • If the stress becomes traumatic, something like post-traumatic stress disorder or acute stress disorder can result. This is a state of hyperarousal, hypervigilence, and “flashbacks” to traumatic events.
  • The use of “escapes” or other coping mechanisms that can cause problems in and of themselves. These can be chemical (drugs), behavioral (self injury, over-exercise, under-eating), or psychological (dissociation). Other “addictions” may also fall into this grouping.
  • Psychosomatic illnesses. Sometimes mental distress manifests physically. Chronic headaches, stomach aches, fatigue, and other nonspecific symptoms may actually be psychological in origin. However! Please do see a physician and get their thoughts about symptoms like that because they could be physical in origin.

Many of these forms of mental un-wellness are categorized as a mental illness. However, not all mental illnesses are more common in minorities. Schizophrenia and autism are two prime examples.

If you are psychologically struggling, don’t despair. There are things that can help. Beware, though, because there are plenty of scams out there too.

  • Normally the #1 thing everyone says is to get help. Let me say this, though: If you don’t want to get better, you’re not going to. There are no magic pills, and nobody can crawl into your head and force you to feel better. It just doesn’t exist. But… if you want to get better? Cool! Let’s keep going then!
  • Definitely do consider getting help. Your social network may be able to help. Your physician may be able to refer you to local resources.
  • Consider therapy carefully, and choose your therapist carefully. Remember – not all therapists can deal with gender and sexual minority issues. Check out the listings on our resource pages for some starting places, and don’t forget your local resources. Outside of the therapist him/herself, there are techniques to consider too. The psychotherapy technique best supported by research is generally Cognitive Behavioral Therapy, or a variant of it (e.g., Dialectical Behavior Therapy). Cognitive Behavioral Therapy (CBT – yes, go ahead and giggle. I did.) is based on altering the way you think about things and the way you act toward things in such a way that you improve your mental outlook. Numerous other psychotherapy forms exist though.
  • Consider medications very carefully. Despite the commercials, research indicates that they may not be any better than placebo. And they come with side effects, including sexual side effects. Some, like benzodiazepines, are addictive. The exception to this caution is if you’ve been on a medication and it’s working, or if taking a medication is recommended by your physician. Please, follow your physician’s guidance and do not stop taking prescription medications that help. Only take prescribed medications as prescribed!
  • If you’re not already, start exercising and improve your diet. If you need to/want to lose a few pounds, go for it!
  • If you have a coping method that isn’t working, or that is causing problems in your life, it’s time to reconsider it. This will likely be hard for you. If you, for example, self-injure nearly every night because you feel overwhelmed… you need to look at that carefully. Does it actually help? Is it causing you any problems (e.g., people stare at the wounds, having trouble affording bandages, etc)? Are there other ways you can handle the stress? Are you addicted to the behavior, and if so do you want to stay addicted? Remember too that continuing the behavior may prevent you from accessing resources (e.g., a therapist may refuse to treat someone who self injures) or opportunities (e.g., scars may limit your job opportunities). And please also be aware that those behaviors can have life-long psychological effects.
  • If you have chosen to stop a coping method that was causing you problems, you may have a rough road for a little bit. Stopping any kind of addictive chemical or behavior can be hard. Where appropriate do reach out for help but remember to stay responsible for your own wellness. You can do it. Kick that thing’s butt!
  • Sometimes coping methods and sexual minority behaviors overlap. A person with a history of self-injury may practice sadomasochism as a way to “scratch” the proverbial itch. A person may seek out someone to dominant them to help them solve their eating problems. I am not at all saying that that’s why people practice BDSM, nor that it’s common…. but it does happen.
  • If you’re struggling because of trauma… I really, really strongly urge you to find supportive resources. One that will help you not only deal with immediate effects but help you transcend them. One of my favorite quotes, which may apply to you, is “The best revenge is living well.” Go get some serious revenge.
  • Evaluate your life. What’s working? What isn’t working? Do you need to cut off contact with your transphobic family? Are you getting harassed at work because of the collar you wear? Stressed because you can’t bring both your lovers and your children to your family reunion? Figure it out. Fix the problem areas and increase the areas that work well for you.
  • Be very suspicious of anything over-the-counter that implies it will make you feel better. Chances are it either doesn’t work (like homeopathy) or has the potential to be problematic (like alcohol).
  • If you are actively suicidal, please don’t commit suicide. Please. Please reach out and get help.
  • Give yourself some TLC – some tender, loving care. Seriously. Kids stressing you out? Save some pennies and send them off to a babysitter for the evening. Go see a movie. Soak in a bubble bath. Whatever makes you feel good about yourself (that does not have negative effects on your life like I described above).

Even if you aren’t diagnosed with any mental illnesses or don’t have specific symptoms, it’s important to take care of your mental health. How? Everyone’s ideas about mental health vary, but here are my personal ideas of mental health: I want to keep myself balanced. I want to be able to cope with anything life may throw my way. I want to be happy, or at least content, have things I enjoy doing that I do frequently.

So what are some specific things you can do to maintain your mental health? Here are some of my thoughts…

  • Maintain your support network. Pick up that phone and call your family. Go hang out with your friends. Help them when they’re struggling. Keep in touch with your physician. Know where you can find help if you need it.
  • Get/stay physically healthy. Exercise, eat well, keep a weight that’s healthy for you. Remember – physical things can affect your mental outlook. So however you choose to exercise, do it! Don’t eat fast food all day. All that good stuff I’m sure you’ve heard this a million times before. If you haven’t heard them, your physician can help.
  • Keep doing whatever it is you’re doing. Wonderful job? Keep at it! Good outlook? Hold onto it! Awesome community that supports you and cheered when you were finally able to marry? Stay there! You’re doing well so obviously something there is working.
  • Every once in a while, stop and reflect on all the aspects of your life. What are you doing that’s working? What are you doing that’s not? What should change? Maybe you’ve been drinking alcohol a little more frequently recently and it’s time to cut back.

This blog entry is in no way complete. I’m sure I missed a lot, simply because I’m only in my head. I can’t be in yours or know what worked for you. I really encourage you to comment and let me know what’s worked for you or your loved ones. Do you have good mental health? If so, why and how? Bad mental health? Why? How? And have you been able to do anything to improve it? Let me know in the comments and let’s get that conversation rockin’!

And another friendly reminder: I am NOT a mental health professional. Don’t take this as medical advice.

As always…  Stay healthy, stay safe, and have fun!

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