The first time I ever set foot in Boston University’s Student Behavioral Services was the fall semester of my freshman year. I was an eighteen-year-old whose social life consisted of binge-watching Friends alone in my apartment because I was too afraid to make friends with the other girls on my floor. I avoided talking to new people as often as I could because when I did, I felt sick to my stomach and my entire body buzzed with adrenaline. As a result, I was sad and lonely, and often prone to crying spells at the most random times (sorry, COM floor of Fall 2016).
And those weren’t new feelings, either. They were problems that had followed me my entire life. At first, my family and friends laughed them off as just part of my personality. For example, my mom’s favorite story about me as a child is the time I burst out crying because I thought I was going to die (literally) of a paper cut. But by the time I turned eighteen, it became pretty clear to me and the people who loved me that I needed more serious intervention.
Put bluntly, I needed help. Yet the first time I set foot in BU Behavioral Services for an initial evaluation, I was asked clinical questions about my sleep, my appetite, my grades, without ever being asked how I felt. And from all of that numerical data, the therapist who evaluated me determined that nothing, I repeat: nothing, was wrong with me. According to her, I didn’t appear to be suffering from anxiety or depression, but she would schedule me for an appointment anyway. As she put it, “everyone gets a first appointment.”
As soon as I left the building, I dialed my boyfriend’s number and started sobbing so hard, I was practically hyperventilating. “I’m not going back,” I vividly remember saying. “I can’t.” But he urged me to give it a second try, and so I told myself I’d go back for him because I’d lost all motivation to do it for myself. After all, I reminded myself bitterly, I’m perfectly fine. I’m just like everyone else.
There are no words to describe how awful I felt after that first appointment. I felt betrayed by the system that had promised to help me, worried that I’d said something wrong to convince the therapist I was fine and, most of all, fake, like this whole “mental illness” thing was a ploy I’d made up to subconsciously garner attention, or an excuse I’d generated to make myself feel better about not having any friends.
Me as a starry-eyed freshman, right after FYSOP ended.
For the two weeks leading up to my next appointment—because that’s how long it takes to get an appointment at BU Behavioral nowadays (which is its whole different rant, BTW)—I oscillated between feeling determined to prove that bitchy therapist wrong and swearing off therapy altogether. I rehearsed exactly what I would say, so I could “convince her” of how lost and hopeless I truly felt, only to collapse on my bed in a fit of tears, barely able to breathe.
The day of that second appointment, I remember sitting in the waiting room, unable to keep my legs still or my mind from racing. (Two notable symptoms of an anxiety disorder: feeling unable to sit still and worrying about many different things at once.)
After all of the rehearsal and all of the stress, I still wasn’t prepared to see that blonde woman’s face again. To this day, I don’t know her name, but I will always remember the cold, clinical look on her face as she interviewed me about my mental health – and it will always give me chills. The bad kind, I mean.
But when my name was called, I was surprised to hear a man’s voice – let’s call him Cliff, just because it sounds cool and old-timey and I need something cheerful to spice up this sob story. (And besides: looking back on it, he kind of looked like a Cliff, too.)
Finding a good therapist is kind of like finding a best friend or a husband: when it’s right, you just know. The first time I met Cliff, before he’d said anything but “Hello, how are you?” to me, I already liked him. He had a warm, fatherly smile and cracked jokes that eased the tension that constantly followed me like a dark cloud.
An hour with Cliff proved rewarding both for my mind and my spirit. I not only left with years of distress off my chest, but I also left with diagnoses, words to give validity and meaning to the racing thoughts and fits of panic and inappropriate crying jags I’d experienced for years: Generalized Anxiety Disorder and Major Depressive Disorder (with a hint of Obsessive-Compulsive tendencies – you know, just for good measure). I guess God took one look at me as a baby and said: “One just isn’t enough; let’s give her two-and-a-half instead.”
I felt completely and utterly crazy knowing the names of my disorders – and boy, was I relieved. Because when you suffer from an anxiety disorder and continue to perform at a high level, people tend to assume you’re fine just because you’re showing up.
I mean, I was doing pretty well as a freshman in college. Not to brag, but I was a staff writer for two different BU publications, a member of the student-run PR agency (and filling in for our team leader at that) and set to interview for an Associate Editor position for the spring. (Which I got, by the way – thanks for asking!)
To any adult who didn’t know me – which was most adults, since I rarely opened up even to the most important people in my life, such as my family – I seemed okay. Thriving, even. For instance, when adults asked me about college parties, I responded honestly with “I haven’t been to any,” only for them to laugh and say something that loosely translated to “Yeah, right.” In their minds, I was just a naive freshman who didn’t want to get in trouble for drinking; in my mind, I wondered why no one I cared about believed me when I spoke.
On the outside, I looked fine – but on the inside, I was dying. I felt isolated and alone, and I was spending nearly all of my free time alone in my room, sometimes binge-watching Netflix in my pajamas, sometimes feeling nauseous with worry and sometimes crying for no reason at all.
Because of all these things, I felt so relieved to hear the words “you have anxiety and depression.” At the time I was diagnosed, I didn’t stop and think about how my diagnoses might change my life, or how other people might continue to treat me differently because of my anxiety and depression. All I cared about was that I had an explanation for all my abnormal behavior, sharp mood swings, and chronic shyness.
I felt heard. I felt understood. I felt validated. Finally! I mean, after almost eighteen years of panic attacks and emotional outbursts, it was about damn time.
I was also lucky in that, for the most part, I didn’t have to worry about how my illness would be perceived by my loved ones. After all, BU is a liberal bubble, and rates of depression and anxiety on our campus far exceed the national averages. Most of my friends, like me, suffered from anxiety also (which is still true…I joke that we’re naturally drawn to each other), so they understood what I really meant when I said things like “Just go on without me. I’ll be fine.”
Until I sought psychiatric treatment in addition to talk therapy, everyone I met was completely understanding of my condition. And then, in an offhanded conversation, I mentioned my continued fatigue, low mood and worries to my new therapist and wondered aloud if medication might help ease my symptoms.
To that, my new therapist replied curtly, “I don’t recommend medication for people who are high-functioning like you.”
High-functioning. The words echoed in my head ominously like the narration of a horror movie. Again, I had a label to explain why I felt different than other people with anxiety – why my grades continued to stay high whereas other people’s dropped, or why I was pouring my heart into the student newspaper while crumbling on the inside.
Yet I didn’t feel the same sense of relief I felt the first time around. Instead, the words felt like a qualifier: “You have anxiety, but…” I felt disqualified, invalidated and crushed like a bug all over again. As if I hadn’t suffered enough, now our failing mental health system was trying to drag me down with it, claiming yet another casualty in the war on anxiety and depression.
Another sign of anxiety and depression: making self-deprecating comments like this one.
You can probably figure out the rest: I spent the next couple of visits again trying to “prove” how sick I was, that I needed medication until at last, she finally agreed that I could “try” seeing a nearby psychiatrist. Meanwhile, friends and other people I knew from home told me about their doctors, who seemed to dole out Prozac and Lexapro like it was nothing more than Halloween candy.
I never quite understood, and probably never will understand, that facet of my mental illness. Why was it so much easier for my friends, who, on the outside, all looked just as happy as I seemed to my doctors? Why didn’t they need to prove how sick they were all the time to get help? More importantly, how come I did?
Fast forward to the present day, and I’m now on 10 mg of Lexapro and 300 mg of Wellbutrin. Every. Single. Morning. All those chemicals simply to manage my mood and calm my overactive brain! (I know, right?)
Trust me, I hear what you’re thinking: many people are opposed to psychiatric medication for all kinds of reasons, both personal and medical. But for me, it’s been nothing short of a miracle. The way I see it, the medicine treats the symptoms, but not the disease: it gives me the energy, motivation, and bravery I need to keep my anxiety at bay so I can do the distressing and uncomfortable work I need to do to conquer it once and for all.
I also don’t see my unsupportive therapist anymore; instead, I see someone who constantly validates me, who pushes me outside my comfort zone and who coordinates treatment closely with my psychiatrist, instead of judging me for wanting more than just talk therapy to treat my symptoms.
But, of course, that day in my old therapist’s office still wouldn’t be the last time I felt guilty, confused by and ashamed of my “high-functioning” anxiety. Of course not. At this point, I’m convinced that there’s no such thing as a “last time” for dealing with the stigma of mental health.
Mental health professionals and school officials have denied me the accommodations all mentally ill people deserve, and professors have refused to read my psychiatrist’s notes because they didn’t come from the official accommodations office. I’ve had friends with mental illnesses talk down to me, condescend me and treat me as if my illness wasn’t as valid as theirs. Likewise, I’ve wrongfully convinced myself that my illness wasn’t as valid as someone else’s – as if unless I was the sickest person alive, my problems weren’t real.
I won’t bore you with the details – in fact, by the time this has been published, I’ve probably already had another awkward run-in with the stigma that will go without mentioning. So, instead, I’ll say this:
Not everyone feels the way I do about mental illness or knows exactly what it means to have one. But I wish they did, and I still believe in a future, far-off world where it’s possible for people to understand, and nobody assumes you’re “just fine.”
Just because an illness is invisible doesn’t mean it isn’t real. My anxiety and depression may not come out as slipping grades, dropping commitments or failure to plan ahead. At its best, my anxiety is actually an ally – the very thing that allows me to tackle all of those amazing, incredibly rewarding experiences.
And despite the difficulties I’ve faced as a result of it, I wouldn’t trade my “high-functioning” anxiety for the world. My mental illness may not define me, but it’s part of who I am, and I never want to forget that.
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