coming out as a mental health client

 Trigger warning: discussions of mental health and suicidal thoughts below.

People who know me, know that I’m in substance abuse recovery. I don’t drink or do drugs, and haven’t for over forty years. I don’t keep that a secret.

I also need to “come out” on my mental health problems. I thought of waiting to do a reveal in Mental Health Awareness Month, but that’s not until May.

I’ve also had problems with suicidal thoughts. So I considered Suicide Awareness Month, but that’s September, so I missed it. There are reasons I don’t want to wait (some of those reasons are pure egotism, but there’s also some discomfort with trying to hold this stuff in), so I’m putting it out there now.

I’ve been diagnosed with an anxiety disorder by a psychiatrist who has the credentials to do so, and I’ve been on medications to manage it (the ones I used didn’t reduce the subjective feeling of anxiety much, but I’m still here, so they may have been effective in reducing the suicidal thoughts to a manageable level). Now, I’m fairly sure that some neurobiologist is gonna come along and tell me, “No, it’s impossible for things to work like that; the biology of your brain doesn’t allow that to be true.” But this is the way I think my anxiety disorder works:

To have an anxiety disorder flareup, I think you need two things:

• The event or condition that causes the anxiety, and

• The psychiatric condition that inflates the anxious feelings to an unmanageable level.

I suspect most people get some anxiety sometimes; things occur to cause worry in most lives. I don’t know what the subjective experience is like for others; I only know my own experience. Sometimes, the worry is not so bad for me; I am able to continue with my daily life without much dysfunction. Other times, when the disorder flares up, I have suicidal thoughts, pain in my thighs and the backs of my upper arms, insomnia, either poor appetite or overeating, diarrhea and (rarely) vomiting. I ruminate through the night and can’t sleep. (The worst time is often 2:00 or 3:00am, because I don’t feel like I can call anyone, and there are few things I can do at those times to distract myself or get help.)

But even when I don’t have the triggering event or condition that causes the anxiety, sometimes I think the “disorder” part manifests. I can feel a general sense of unease; I get anhedonia (nothing feels right or tastes right, or “sparks joy”); I have poor concentration; I have a hard time focusing on responsibilities, or even listening to what people I care about have to say.

I’ve been going through a bout of that recently.

Some of it has to do with my suicidal thoughts. Now, except for a short time one night a few months ago, I haven’t had a serious episode of the anxiety problem since I quit working (much of my anxiety problems are tied to either work or relationship issues luckily, the latter appear to be in good standing). Suicide screening is something I know something about (I was a mental health screener for a few years – ironic, right?). And when you’re screening for suicide, one of the things you ask about is whether the person has a plan, how close or easy to achieve that plan is, and whether the plan is likely to be fatal. For example, a person who says he or she wants to suicide by overdose, but doesn’t have the pills, and doesn’t know which pills are likely to actually be fatal, and hasn’t done any research into either question, actually has a comparatively low likelihood of suicide (although that doesn’t mean you don’t take the issue seriously). The person who intends to shoot himself (usually) or herself, and has the gun and ammunition, is a much more worrisome case.

When it was really bad, my plan was to jump off a bridge. The Morris and Donald Goodkind Bridges are the bridges that carry Route 1 over the Raritan River: the northbound bridge is named for Morris and the southbound for his son Donald. Morris has more-or-less convenient parking, and does not appear to have suicide-prevention fencing or other measures in place. That’s the bridge from which I was going to jump when I was in the worst of my anxiety.

I’m not in that anxiety anymore, and have no intention of pursuing suicide. But the plan doesn’t evaporate just because I no longer have the intention. So the answer to the question, “Do you have a plan?” is yes, and the plan is both proximate and likely to be fatal… which will make the inexperienced screener commit me. But the truth is, my life is good now, and I have no intention of suicide, which is why I’m still at large and not on unpleasant medications.

Further, most of the times I cross either Morris or David, I’m reminded that, while things were bad once upon a time, they are not so, now. Every crossing of those bridges is a reminder that I’ve successfully survived this long, even though, at times, it was not clear that I would. Every crossing is a little triumph.

And the reason I didn’t want to wait for months to post this stuff, is that I was fairly sure that writing and posting it would relieve some of the craziness I’ve been feeling – and it has worked; I’m much better for having this out there. I’m lucky in that I’m retired, and my livelihood would not be affected by my honesty about my mental health condition (and, having worked in mental health and substance abuse, I’m sure that even then, I had more flexibility than most in the workaday world, although even among my peers in that field, there is some stigma to having the same problems we treat in our clients). I know that not everybody can be as honest as this about a similar condition.

But I want to be “out” as a person who has suffered from mental health problems. It’s possible that my having been honest about this might be a disincentive for some people to seek help. But if it’s possible that my experience might get another person closer to getting the help they need… then isn’t it pretty much my responsibility to do it? Especially when I now have so little at stake?