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The Outside Is Always Perfect, No. 2

One of the things I say is that diagnosing mental illness is a fluid “art.” What do I mean when I say something so vague? After all, mental illness is something that runs so deep in people, can you sum it up so imprecisely? The process of navigating this art with your doctors can be a very helpful experience. Other times this fails to play out in any favorable way. It’s an art–from the first appointment to finding the correct treatment plan.

Personally, it took years to come to my diagnosis after several wrong conclusions. I spent most of my twenties trying to reach a diagnosis. What I found was that there are no physical tests that check for mental illness. Diagnoses come from the observations of the healthcare professional you choose. It’s not as clear cut as a blood test, which generally provides tangible evidence of a  disease. Due to this, mistakes are made and medication can be provided for an illness a person doesn’t actually have.

There are interview questions designed to give the doctor an idea of how you’re doing emotionally. Still, you’re at the whim of a person who, again, makes mistakes. It would be easy to give up at this point, something a lot of mental health care patients do. It can often be infuriating to drag yourself to these appointments, especially if you’re in the grips of symptoms. It can feel physically impossible to muster the energy to go, all the while knowing this appointment may not provide you answers. Even when you get a diagnosis it can be difficult to understand, to wrap your mind around. For this reason, I’ve always been insistent that a person self-educates. Research, learn, and go to support groups in order to fill your mind with knowledge. If you fully understand the illness, you can take that to your doctor(s) and work with them for a treatment plan. Rather than blindly following their recommendations, you can be involved in your care.

It’s important to remember that you’re involved in your treatment. Unless you’re being involuntarily checked into a treatment facility, you’re the key decision maker. If you’re in a position to be active in your care, take it!


There are a lot of stigmas associated with the topic of mental illness. One of the most damaging is assuming that all people with a mental illness are dangerous to themselves or other people. This can cause a person to further internalize, withdraw, and/or avoid treatment. This  profoundly baseless belief is causing patients to push aside important details, even to their doctors.

According to the National Center for Biotechnology Information, most people who’ve been diagnosed as mentally ill are not a hazard to themselves or others. Some of the most common symptoms include confusion, agitation, or withdrawal, none of which are directly linked to violence or self-harm. I believe it’s time to adjust the way we speak in front of others. Much like how hearing someone speak poorly of the LGBTQ+ community can be harmful or damaging to someone within it, the same can be said about the effects of derogatory remarks made about and heard by people suffering from mental illness. We’re quick to use terms like ‘insane,’ ‘nuts,’ ‘psycho,’ and ‘crazy as hell.’ But at what point do we start taking responsibility for unknowingly affecting the people around us with our words?  Additionally, at least one in four people (or 25%) are estimated to be affected by mental illness either directly or indirectly. That is a large number that continues to grow as we learn more about mental illnesses. The NCBI goes on to say that estimations show that 20% of Americans (or 1 in 5) over the age of 18, suffer from a diagnosable mental disorder. Furthermore, they report that 3% of that population has more than one mental illness at a time.

Depression is the leading cause of disability both in the United States and worldwide. The CDC reports that depression puts those with depression at an increased likeliness of significant healthcare needs, school problems, loss of work, and earlier mortality. They go on to say “the economic burden of depression, including workplace costs, direct costs, and suicide-related costs was estimated to be $210.5 billion in 2010.” However, hearing that can be misleading. Depression is not a single-brain disease but has 3 main components: major depressive disorder, dysthymia (mild depression), and bipolar disorder (manic-depression). The National Alliance on Mental Health (NAMI) says, “LGBTQ individuals are almost three times more likely than others to experience a mental health condition such as major depression or generalized anxiety disorder.”

The True Colors Fund (TCF) released disturbing information which states that “… up to 1.6 million youth experience homelessness each year. The statistics for lesbian, gay, bisexual, and transgender homeless youth are even more shocking, as  LGBTQ youths represent up to 40% of all young people experiencing homelessness. Considering that LGBT youth represents an estimated 7% of the total youth population, these numbers are disproportionately high.” Additionally the TCF reports that half of the teens who come out get a negative reaction from their parents. They continue with “more than 1 in 4 are forced out of their homes, from homophobia or transphobia.” The problem with mental illnesses is starting at an increasingly early and alarming age. Stresses from these events can instill depression, drug abuse and furthering risky behavior. Out of all of those numbers, only 5% of the mentally ill population has symptoms that severely interfere with their ability to function within society. Even more, not all types of mental illnesses can create such dramatic symptoms. That means a lot of the people you’re coming across have some form of mental illness. They’re in the grocery store and at the bar with you. They work with you and go to school with you. Choosing your words wisely can go a long way towards helping people diagnosed (or otherwise) feel acceptance. In our community, that is all we should be giving each other.

We don’t fully understand all forms of mental illness just yet. Prior to the 1930s and 40s, there was a stigma that mental health patients were deranged, possessed, or under the influence of otherworldly workings. It wasn’t until recently that  scientists and other mental health experts understood bipolar disorder enough (and we still do not fully understand it) to put patients in the grips of it on a sliding scale. Before we started to understand mental illness, society has vilified its patients. Now,  even in our own community, we shove the conversation of mental illness onto the bottom shelf. It’s an uncomfortable topic that people often avoid. Sound familiar within our community? If we’re persecuting each other in any way, placing others within categories and labeling, then we’re dividing our community. Every person should take offense, and take a stand to defend and protect the honor of where we came from. The LGBTQ+ community has gone a long way, but there is much left undone. We can’t look united and stand apart. 

After letting that sink in for some time,  there is one unavoidable conclusion: our community is still suffering in many ways.


Last week while I was shopping at my regular grocery store, I couldn’t help but hear a loud conversation. It was two girls who seemed to be very good friends. At one point from a couple of aisles over, I heard, “Come on. Let’s go. I don’t want to be around this nut job,” at which they both laughed hysterically.  I’d been coming to the same store for nearly ten years and I knew exactly of whom they were speaking. It was a gentleman by the name of Benji who works in this store.

I dropped what I was doing and raced to figure out which direction this awful phrase was coming from. . Once I reached the ignorant pair, I shot them one hell of a glare, while making my way towards Benji. I’ve always thought very highly of him. He’s not the typical person you’d seek out to have in your life. He is, however, a fulfilling person to know. While I don’t communicate with him outside of the store, he can communicate, in spite of having difficulty with speech. This  is accomplished by using hand gestures and vocalizations to communicate. He always remembers me when we meet, even if we only exchange a passing wave. He did his job well and held a photo of his mother in his wallet. He was a sweet gentleman that came off as aggressive because he tended to grunt and make other involuntary sounds while working.

So I asked myself, “How is that worth calling him a nut job?” My best thinking suggested he may have severe autism. He held a job down; and he was high-functioning enough to perform several different tasks at the store.

I made it a point to loudly call out for Benji that day last week, doing so before those girls had left the aisle. “Oh, Benji! How are you doing!” I yelled, then turned around to make sure my efforts to shame and embarrass the girls were not lost on my target audience. Sure enough, they’d slowed and both turned around. I gave them one last glare and proceeded over to Benji.

By the time he’d finished his way of saying hello and avoiding meeting my eyes directly, I could see the comment that was meant to hurt him hadn’t even registered.

Or had it? We were both too excited to see each other to let it bother us any longer.

However, I still couldn’t let it go. I failed countless times to get it off my mind. Should I have stood up and said something to those girls? Should I have demanded they apologize to Benji? My mind raced with different ways I could have handled the situation. I did speak to a manager about the situation a few days later and asked for guidance on the matter. The manager told me this, unfortunately, was a common occurrence. It never seemed to bother gentle Benji, nor ever compute to him.

This consumed me even further. I wrapped up the conversation by saying I would like them to refuse service to anyone that displays this level of ignorance. I was relieved to learn that  they already did so.

Still, there was something that I had missed in my haste to stand up for my friend.

That was that my friend wasn’t alone. A well-known cashier overheard and was shaken from the conversation. I could see her from behind the left shoulder of the person I was now struggling to pay attention to. The security guard approached us a short time later to offer his assistance if it happened again. Benji had a family in that store, and that truly changed some part of me. The entire store defended him. The entire store could see him–truly see who he was and still continues to be.

With autism, there are normally sensory input issues, leaving there to be a high likeliness that Benji never notices hateful behavior. I find myself almost envious of this. I   recall limitless times I’ve overheard conversations that are both ignorant and abusive. With Benji, this abuse doesn’t have the  chance to affect him. The thought both impressed me and terrified me. Could I live in a world where the abuse of others isn’t evident? I’m not sure that I could. The closest that I could get would be getting inside the sensory deprivation unit. It forced the question: does Benji experience the same benefits? The NCBI suggests sensory deprivation units and float therapy have many health benefits. Sensory deprivation is the mind without input. All sound and light are blocked by an encompassing tank. The tank is filled with salt water at exactly body temperature, preventing feeling.  Information provided by FloatDreams.com shows float therapy allows the brain to enter a theta state. Theta state is one of five wave frequencies of the brain, the first state in which we start dreaming. Theta healing has been found to help all people, as well as having benefits to autistic adults. Producing theta waves while awake in a sensory deprivation unit is a form of deep meditation. Specifically to autistic adults, it can actually help them to understand sensory control.

Upon further reflection, I don’t think Benji has those types of benefits from his disability. I do believe that he benefits from not understanding the abuse of others. I believe that can also go a long way towards helping him.

So, go out and see the Benjis in the world. Stand up for equal rights for every person, not just your community members. Stand one with anyone else willing to stand up with you. I’ll always peacefully fight for the underdogs. That’s because we’re all underdogs when faced with great difficulties. When continuing to gain with one another there are no failings. Be proud of yourself if you’ve ever taken a stance for someone else. If you’ve stopped someone wearing a Hijab from being verbally assaulted, have pride in yourself. If you’ve called out someone for abusing a special needs co-worker, wear it as true as your heart is beating. If you’ve taken the time to learn about mental illness that affects you or a loved one, tell the world what you know. Know you’re appreciated in what you do and that not another person could do it as well.

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