Mental health was never a topic of discussion in my family.
Growing up, I overheard grumblings about some members of my family possibly having bipolar and other comments about depression, anxiety, and insomnia. But whenever I would ask questions, I was told that I should ask when I was older.
Alternately, I was brushed off or ignored.
Eventually, I stopped asking.
We never talked about what good mental health looked like, so I began to associate any discussion of it with mental illness—which my family and popular media made me fear. The idea of “going crazy” or “getting depressed” made me worry, because what would happen if I did? Would I be committed to an asylum, like the terrifying places shown on TV? Would I be like the suicidal women shown in Lifetime movies?
I didn’t want that at all.
At some point, this fear of mental illness manifested itself in an extreme distaste for antidepressants and other medications. Whenever there were ads for them on TV, my family made it clear: these pills were placebos and I would never need them, so why was I asking? Why did I care?
Turns out, as an adult, I do need medication. Because of fear and internalized stigma, I refused to consider it for a very long time. The “holistic health” trend hasn’t helped; medication, in general, has taken on an ugly, stigmatized sheen, but medicine for treating mental illness is by far the most hated.
It was difficult for me to move past that.
Honestly, it was difficult for me to even start seeing a therapist, despite the tiniest triggers sending me into full panic attacks for years after I left my abusive ex. Once I did find a therapist, things got easier with time and a lot of work.
After a year of weekly sessions, I noticed a new uptick in my anxiety as I got closer to my period. My everyday anxiety increased tenfold, which turned me into a weepy, raging monster. I couldn’t regulate my emotions and had difficulty doing basic tasks. It was like PMS, but much worse, though I didn’t recognize just how bad it was for months.
After repeated, gentle urging from my partner, I asked my therapist if she thought anti-anxiety medication would help me.
The conversation was easy and comfortable. When I described my symptoms, she gave me her diagnosis (premenstrual dysphoric disorder, in addition to generalized anxiety and PTSD), then said I should definitely consider taking meds. When I expressed reservations about going on medication, she told me to think about it like this: if I had the flu, I would take medicine to treat the symptoms and feel better; if I have anxiety, I could (and should, in my case) take medicine to treat the symptoms and feel better.
After all, mental illness is an illness.
There is no shame in taking medication to help regulate its symptoms. Somehow, I never questioned other people’s need to take medication—not my closest loved ones or my friends—but I feared taking it myself. Now, that seems so silly, because going on anti-anxiety medication has completely changed my life.
My therapist, who is also a member of the LGBT community, was easy to talk to about making this leap. However, since she cannot prescribe medication, I had to make an appointment with my general practitioner. My GP is amazing, and he has yet to disappoint me; he’s the first doctor I’ve ever had who doesn’t peg all of my health issues to my fatness, and he listens well and remembers details about my life.
I genuinely like him.
It still made me nervous to go to him with a request for anti-anxiety medication. I feared that he would tell me to lose weight first and see if it helped (though he had never made that suggestion before); that he would question the validity of my therapist’s diagnosis; that he would make me take expensive tests not covered by my insurance.
Above all, I feared being totally candid with him about the depth of my mental illness, something I had mentioned on my intake forms but never gone into much detail about.
Candid conversations about mental health with my therapist are different; that’s literally why I see her every week. Transitioning those conversations from her warm, amber-colored office to my GP’s cold, white exam room was tough. It doesn’t help that my GP is a straight, cisgender man in the medical field, which can sometimes be really frightening for people like me.
Plus, PMDD is still being studied.
It affects only 2-10 percent of people of reproductive age and is often written off as just “extreme PMS”. There’s no guarantee that anti-anxiety medication will help. For someone like me, who also suffers from related mental illness, it’s still a good start. I went to my appointment with my GP armed with this information. I remember my hands shaking as I spoke, and I remember my GP furrowing his brow and making lots of notes on his laptop.
When I was done, he met my eyes and said that he agreed with my therapist.
Then he plotted out my treatment plan and described the pill he wanted to try first, including potential symptoms. He asked me several questions, took my answers seriously, and allowed me to ask questions too.
When I saw my therapist the following week, she congratulated me on successfully navigating the appointment and on my new prescription, which was already creating a noticeable difference in my symptoms.
The experience overall was really positive, and it’s stayed positive at each visit since. Talking to my GP about mental illness still feels odd, but it’s slowly getting easier. His support made a world of difference in how I approached conversations with him, about every aspect of my health.
I’m lucky to have insurance that has solid mental health coverage, and I’m even luckier to have a therapist who belongs to the LGBT community alongside me. I’m also lucky that I have a GP who—against the odds, and in contrast to other doctors I’ve had—trusts me to know not only what I need, but to help me get it.