In talking to my patients over the years and through dealing with my own experiences, I’ve found that getting help for conditions like depression and anxiety can be hindered by several obstacles. The main ones I find prevalent are stigma, time, money, and our own preconceived beliefs about what mental help is.
Stigma is a negative idea we associate with a particular thing, like how some associate bad luck with black cats. In the case of mental health, the stigma can be the label “crazy,” or perhaps judgment or abandonment by friends and family. Fearing these stigmas is a very normal response and a very real feeling, so I’ll validate that for you right now. Now to validate means to tell you that the fears you have are not irrational and do in fact make sense given your situation. However, what to validate does not mean is that the stigmas themselves are justified. It is never justified to call you crazy.
Let’s take that the fear of being called crazy as an example. Similar labels of stigma can be nuts, bipolar (incorrectly used!), psycho, deranged, selfish, insane, even lazy. Why lazy? Because some people assume depression and anxiety disorders are something you can just snap out of. If it were so easy to change, though, we wouldn’t need doctors, therapists, medications, and other remedies. No, let’s deny right here that depression and anxiety disorders are a simple matter of willpower, for they are not.
The stigma we may fear most might not be judgment from a loved one or their giving us a bad label, but being left behind or forsaken by those we consider closest. We might care what society at large thinks about us, such as what our professors, co-workers, employers might say. But in my experience, the biggest fear concerns those we actually love, those we have affection for. We in fact forget while in our depression and anxiety that those we love already love us back. In the midst of sadness of worry, their love can seem so distant, especially when satan dangles stigma right in front of our eyes, blocking out the beautiful vision of our friends, our siblings, our parents, even our children.
Let me validate you again. Some people will react adversely to your suffering, even cut you out of their lives. But the fact remains: this does not mean you’re not worthy of love. It means that person himself has a problem, too: perhaps they are overwhelmed by the revelation, or they deal with mental issues themselves. You’d be surprised how many times someone who leaves you has left because they couldn’t ever help themselves, so they don’t know how to help you. That is their reasoning, anyway.
But that’s why professionals exist, to help those who can’t help themselves. Imagine performing gallbladder surgery on yourself by your lonesome, guided only by a few Youtube tutorials and by using kitchen utensils. That’s what it’s like to relying only on self-help, so the ones who left you may have mangled themselves already and given up. Not on you, but on themselves. But you don’t have to be like that. You can get better, even one day be the support others need. I say this because our goal of recovery is not just to feel good, but to be good.
Time and Money
These are two reasons that keep many people who want help from getting help. We have to admit: our healthcare system is unjust. The people with pockets full-grown get better access and better quality. On the flip-side, countries with free healthcare may get wider access, but they also get lower quality, not to mention longer wait times. Think of our Medicaid system and you’ll see the shortcomings of so-called “free.” I’ve lived through it myself, having grown up on Medicaid and charity healthcare. And my parents had to work hard to provide basic needs, reducing time available to seek healthcare services anyway. Simply put, we didn’t go to a doctor unless we had a gaping laceration across the back.
Now many people who suffer from depression, anxiety, and other disorders live busy lives for the sake of covering up their symptoms. They may be afraid that if they stop to look for help, even take a single moment to admit they have a problem, the problem will only get worse. And they feel they have to stay strong for those who depend on them. I’ve seen so many parents with depression and anxiety that don’t seek care because they want to take care of their kids first—a noble trait, indeed. But just like on an airplane, when the emergency masks drop and a parent must put on their mask first in order to be strong enough to save their child, a parent must make their own mental health one of their priorities. As I tell parents and other caretakers, “You’re not being selfish in taking care of yourself. You make yourself good first so you can help others.”
Still, even if you had all the time in the world, financial barriers always exist for those seeking mental health help. My mission as a provider is to treat everyone with the same high quality of care no matter their financial situation. I don’t care what class you are and what card you carry, you will be treated the same as my Lord commands. I wish the rest of the healthcare system could follow this, and there’s a myriad of arguments against and for my view of justice in healthcare access and quality. But that’s beside my point. My point is that as the systems exist right now, it’s difficult for patients to find the help they need. Particularly for mental health patients.
Our Own Prejudices
I like to tell patients that their disorder is just as real as, say, diabetes. I point to my brain and then my pancreas and say, “Both depression and diabetes have something to do with low amounts of a chemical. In the case of diabetes, my pancreas isn’t making enough or any insulin. In the case of depression, my brain isn’t making enough of certain neurotransmitters. Medication can help change both.”
I say this to put patients at ease; their disorder isn’t some magically unconquerable condition. There is in fact science behind the medications, treatments, and techniques available to them, just like there is science in the treatment of diabetes, high blood pressure, and cancer. We mental health providers are trained in the science of these medications, treatments, and techniques to logically find what’s right for the patient. Just like a regular doctor finds what combination is right to control high cholesterol, migraines, and prevent organ transplant rejection.
Like I tell my patients, “The pancreas is an organ. The brain is an organ. There’s no reason to be ashamed your pancreas isn’t functioning at %100, so why be ashamed about about your brain?”
Yet I’m still depressed and anxious… no matter what I’ve tried
Shame is indeed a common prejudice that keeps people from seeking help. Shame says, “What about the stigma?” We’ve covered a bit on shame, so let’s take a look instead at pride, which says, “I can overcome on my own.” Pride, very sneakily, can make us think others don’t know what they’re talking about. For example, your girlfriend who is concerned that you sleep a lot, don’t eat much, are usually fatigued, and have anger outbursts (all symptoms of depression disorders!) must be nuts herself, right? Or your parents who don’t understand your attacks of anxiety, your days of elated mood followed by days of somber solitude, your sleepless and creative nights, your inability to stop spending thousands on in-app purchases—your parents are just stupid normies who don’t understand your quirky personality, right? Or what do doctors know anyway? Let’s all the use “natural” cures that have worked for millennia like the roots and oils and crystals and rocks we see advertised online. Let’s just pray away the depression and anxiety (that’s not how prayer works!) until we get happy. Let’s self-medicate with alcohol, weed, pain pills, cutting, anything—anything but a therapist or psychiatrist! Shrinks are for psychos anyway, and I’m not a psycho. I’m just fine. So I don’t need help. I don’t have anything to overcome. I’m good just the way I am now.
Pride is a form of denial. And pride does take many forms, but its common function is to hide a dysfunction. In this case, to hide your psychiatric issue from you and others. Because as I’ve written before, pride and shame are two sides of the same coin. It’s a coping mechanism to keep from being hurt any further. So let me validate you once more: your hurt is in fact real. But you deserve to not be hurt. You deserve help in overcoming what hurts. That’s where professionals like me—therapists, counselors, doctors, pastors, and priests—come in. We’re here to help you help yourself.
So that one day you can help others, too.
Next Stop: Your First Step
In the next part, I’ll talk more specifically about strategies and resources for seeking help.