I often think about the girl in my ninth grade class who had to take time off of school to be treated for clinical depression. At that point in my life, I had heard a thing or two about mental illness, but it was usually from the seniors at school who cracked jokes about it. I don't remember learning anything about it in health class, and I certainly don't recall my parents explaining the impact depression could have on a person's life. By the time the whole school caught wind of this girl having to be excused from school indefinitely, everyone started talking about it, as adolescents do.
"Well, it's no surprise she's, like, depressed," I overheard a junior tennis player say in the hallway. "She had no social skills."
"Yeah, she was weirdly quiet," her friend chimed in.
There was no judgment in their voice. They weren't exactly gossiping. Rather, it sounded like they were simply stating the truth, like a science teacher would share characteristics of elements on the periodic table. To them, it was a fact: Mentally ill people aren't any good in social settings.
Fast forward several years later, and I was being diagnosed with a mental illness of my own. After years of chewing off my fingernails, obsessively picking at the skin on my toes, and constantly walking around on the verge of a panic attack, a medical professional at the college clinic told me I was suffering from an anxiety disorder. An "unspecified anxiety disorder," to be exact, whatever that meant.
I was in disbelief at first, and insisted that he had gotten it all wrong. I told him I had friends. I went to parties and smiled in group pictures. I had a (sort-of) boyfriend. People liked me. If my slighter-better-than-average social life wasn't proof enough that I wasn't mentally ill, I didn't know what was. He gently assured me that wasn't how anxiety disorders work, but without much more explanation, he patted me on the back and wished me luck. I never saw him again.
I would later learn I'm far from alone: The U.S. Center for Disease Prevention and Control (CDC) reports that anxiety is the most common mental health disorder in America. Forty million individuals over the age of 18 suffer from an anxiety disorder, or 18 percent of the population. Women are twice as likely to live with anxiety than men are. On average, a person spends 55 minutes a day worrying, while a person with generalized anxiety disorder (GAD) spends 300 minutes of their day stuck in unsettling thought. The CDC says that only 25 percent of people with anxiety feel like their illness is understood or cared about by their loved ones.
It wasn't long after my diagnosis that I came to face to face with this reality myself. In the years that followed my diagnosis, I learned more about this mental illness and sought treatment from trusted clinicians. I realized that a lot of my traits that seemed to be in conflict with my anxiety disorder — outgoing, immersed in multiple tasks, hospitable — were actually symptoms of it.
One therapist suggested that I had been living with high-functioning anxiety, a form of anxiety that is imperceptible to the outside eye, since the person always appears busy and engaged in meaningful conversation. But there is turmoil brewing inside a person with high-functioning anxiety. They feel terribly nervous in the midst of every social interaction, and they're constantly doubting whether they're good enough. They appear calm on the exterior, though — an effective defense mechanism to ward off unwanted attention.
No matter what our role is, society expects us to play that role perfectly, or else we aren't taken seriously. If survivors of sexual assault don't say or wear the right thing, or react in an acceptable way by society's standards, they're deemed unreliable. If a mother doesn't wear modest enough clothes or radiates too much sexuality, she's considered a bad parent. Similarly, if a person with a mental illness doesn't live out their correlating symptoms in public, people automatically assume they aren't sick. Or worse, they're thought to be lying about the state of their mental health for attention.
Several months after the diagnosis, when I told the first few people about my anxiety disorder, they looked at me like I had lost my mind. They insisted that the doctor was either a fraud or that I had just gone to see them on a particularly bad day.
"Yeah, OK. Then I was depressed last weekend when I stayed in and charged through three tubs of ice cream," one of my friends responded to the news.
"But...you're friendly," another person said. "Like, you're really good in social settings."
I knew it was true, but I also knew that the symptoms I had been living with for the last few years were just as true, even if they were hidden. Yes, I was social, but I was also a slave to nervous sweats and chewing off skin that should never be chewed off under any circumstances. I could hardly ever get a full night of sleep, and every one of those life-of-the-party moments my friends recall were nothing more than an attempt to distract myself from the debilitating inner dialogue I didn't want to confront.
It seemed like nobody was willing to hear me out. They knew was what they saw in group settings — I didn't have a disorder. It was infuriating and frustrating. It made me feel like a fraud.
These days, if I ever feel comfortable enough to talk about my anxiety with someone, their reaction is pretty much the same. They express genuine disbelief. They sometimes roll their eyes and offhandedly mention how everyone has got some kind of anxiety in today's busy world.
I know they don't mean to diminish the daily battle I endure, but reactions like these can have a weighty effect on people who are living with a mental illness. We're already tired from the symptoms we manage, the treatment we seek, and the medication we potentially have to take. The inner landscape is turbulent enough. When you add on the judgment that comes from misinformed (and sometimes ignorant) people, recovery is a daunting process.
I still think about that girl from my ninth grade class from time to time. I often hope she received the treatment she needed. I wonder what the response would have been, though, if she had acted any differently in social settings. Would her illness have been disregarded by her peers? Would she have even been offered treatment so readily?
There is no "right" way to act when you have a mental illness, and that's something that we should all learn from a young age. Just like anything else in life — love, sexuality, likes and dislikes — mental illness can sometimes be a fluid concept that doesn't fit neatly into a rigid box. We do what we can do with what we've got, and we cross our fingers that the people around us give us the space to work through it.
As for me, I'm trying to stay confident in who I am and practice self-acceptance of my own illness. And I remind myself that while not everyone will understand the varying nuances of my anxiety, the people who truly matter in my life will try their very best to wrap their heads around it.
Images: Gina Florio