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We Are Not Your Model Minority: The Silent Battle of Asian American Mental Illness by Lyla Lee

Today I have my dear friend Lyla on the blog to talk about the intersections of mental health and Asian American identity in a post that I found to be incredibly eye-opening and impactful. Welcome, Lyla, who you can find on Twitter or her website!

CW: depression and suicide

I lost a friend last year.

I hadn’t seen Sarah—not her real name but let’s just call her that—since high school so I wasn’t sure if I even had the right to feel sad about it, and I wasn’t sure why I felt so deeply about someone I hadn’t spoken to in four years. Since I went to college out of state (while most of my friends, like her, stayed in Texas), I’d long accepted the fact that Facebook would be the only way I’d keep in contact with most of my childhood friends. And even then, although I liked and commented on Sarah’s posts, I never felt compelled to reach out and message her to ask how she was doing because—from what I could see anyway—she was doing really well.

But then, suddenly, she wasn’t there anymore. Well, her Facebook was—is—still there (a rather morbid byproduct of our modern age), but she ended her own life last July.

When I read her obituary page, I realized why I was affected so much by her death. It was because she, as an Asian American student that fit the stereotype of the “model-minority overachiever,” fought the same silent, secret battle with mental illness that I’d been fighting my entire life.

One of my most memorable moments as a Psychology major was when I encountered a brief section in my textbook that was solely dedicated to the Asian American stigmas towards mental illness. In that section, the book detailed how Asian patients might not even be aware that anything is wrong with them mentally…and are more likely to seek treatment because of the physical symptoms of mental illness (i.e.: digestive problems related to anxiety, back pain/neck strain because of high levels of stress, and alcoholism/fatigue related to depression.) This, the textbook explained, was because of the great levels of stigma that Asian cultures had towards mental illness. According to many Asian Americans, mental illness was something to be ashamed of and not a viable reason to see a doctor, while physical illness was.

Since Psychology is (in the US, at least) primarily a “white-people” dominated field, my first gut instinct was that the book was being racist. OF COURSE people could tell that they were mentally unwell, couldn’t they? Wasn’t saying that Asian Americans weren’t actually aware of their own illness kinda degrading?

But then I thought about my own experiences with my family and friends. Although this number has thankfully changed since then, at the time that I read this textbook, 0% of my family and friends sought professional treatment for mental health. 0%, and yet I’d spent many long nights serving as an informal suicide hotline for several POC (mostly Asian) friends in high school and college, even though I had similar problems myself.

And this all happened because none of us felt like we could turn to anyone else (I’m not even sure we were taught the suicide hotline in high school, and if we were, we never thought we could call it because it seemed like a “white people thing,” and our parents made it clear that mental illness, queerness, etc. were all stuff that “white people made up.”)

After talking with some friends about Sarah’s death, I realized the full extent of this tragic phenomenon. One mutual friend (who’d been Sarah’s roommate in college) said that he lost THREE Asian American friends (including Sarah) in the last year alone. I also saw posts on social media from friends who went to college in different parts of the US grieving the deaths of their friends (all Asian American young adults) that had died due to suicide. This was a real problem, yet no one was talking about it…at least not until after someone died.

For the longest time, I considered becoming a psychologist since I wanted to help spread mental health awareness among the Asian American community. Asian Americans (esp parents and/or those of immigrant background like my family, friends, and their families) are more prone to seek help from other Asian people, so this was an important goal of mine. But then, some personal things happened in the beginning of my senior year of college and I realized that the field wasn’t for me. So I returned to my first and longest love, writing, and began working on the novel that would later on get me my agent.

Today, I keep writing. Although I don’t know if I’ll ever get published, I write about Asian American teens grappling with mental health and/or their queer identities (which is another thing I often felt lost about as a teen). I do this because I not only want to fulfill my lifelong goal of becoming a published writer, but also because I remember the many years I spent reading books about white teens tackling LGBTQ/mental health issues in order to feel less alone, only to feel Othered because of the often racist (whether intentional or not) sentiments towards Asian Americans and other PoC.

Intersectionality isn’t always welcomed in publishing (in all honesty, it’s been an uphill battle so far), but I keep trying to get my books out there because I want them to be there for teens who need books that understand their struggles. So, I write books about Asian American teens learning to love themselves and their queer POC identities. At the expense of being told that “too much is going on” or that “[people] can’t relate” (actual feedback I received from white editors), I write about Asian American teens struggling with mental illness who seek professional help.

The world failed me and other Asian teens so that we felt alone in our struggles, but that doesn’t mean that it can’t change for future generations. And I am trying my hardest to be a part of that change.

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Happy by Troix Jackson

Hello all! Today I have my friend Troix to talk about depression, getting help and dealing with family who might not get it as a black teen. You can find Troix on Twitter, check out her blog and buy her poetry book. Let’s all give Troix a warm welcome!

CW: Depression

A majority of my family- my mother, grandmother, aunts- worked in the medical field, specifically around people with mental illnesses. One of my aunts spent most of her career as a youth counselor and aid in the children and teen ward of an in-patient center. But even with this exposure to the many facets of mental illness, there was an overwhelming belief that things like anxiety or depression “don’t happen” in black families. Mental illness was part of an outside world. My mother and aunts grew up with the Civil Rights Movement, learning early that they had to be strong in every single way to deal with the world around them, and they passed that mindset down to my siblings and my cousins.

Because of this, I didn’t deal with my depression for most of my life. Despite all the warning signs I had, I convinced myself and the people around me that I was perfectly fine, if a little bit tired and less peppy than people my age. I slept through most of my senior year in high school, then dropped out of college after my father passed away and I slept for three full days after. For everyone around me, this was just my grieving period, but I knew then that I was on a sinking ship, and if I didn’t do anything I wouldn’t see 20.

My doctor referred me to a grief counselor, as an initial “try this out”, and I answered and re-answered what felt like years of questions before she asked me something that struck me. It was nearing the end of the session, and she sat the Laptop of Questions aside and asked me about the last time I could remember being happy. I didn’t have an answer. I still don’t. To this day, I can’t name a single time that I felt true happiness, or anything other than sad or neutral. She recommended I see another professional.

So, I started therapy. I lucked out in the insurance that I have (thanks, fragile United States government) and got to see a few people before deciding on my current therapist, who I really connected with. I stopped taking depressive naps and started taking walks, which are nowhere near as comfortable or cozy but kept me from holing up in my apartment on the days between sessions.

My therapy sessions had a lot to do with me starting my own book blog, which I still run. I was encouraged to take small steps and do something that makes me feel content, and reading and writing have always been that outlet for me. It’s been almost half a year since I started my blog now, and I feel stronger as a person than I have in a long while. My depression isn’t “cured”- it is still something I struggle with on a day to day basis, and some days I feel less accomplished than others. I still have to deal with the fact that most of my family still considers my depression to be less of an actual thing and more of a “state of mind,” where I would be totally fine if I just learned to roll with the punches. And I am only where I am today because I have access to resources that others like me don’t. But I’m learning that that’s okay. I want to use the resources I have to help people who don’t have what I do, and I want to support people who are succeeding and have come from a similar background as me. I am extremely lucky that being part of a strong online community has helped to greatly increase the days where I feel like I’ve done something other than sleep, and it’s given me a support system of people who value me.

I may not be there yet, but I feel as though I’m slowly getting closer to being happy.

Reminder to Enter Our Mental Health Book Giveaway!

Posted in Shattering Stigmas

Q&A with Akemi Dawn Bowman

15068129Hello everyone! I am so pleased and excited to have Akemi Dawn Bowman, the debut author of Starfish, to talk about her book and mental health representation in YA! Starfish is a contemporary YA novel about Kiko, a half-Japanese girl whose rejection from her top art school sends her on an unexpected journey to come to terms with herself, her history and her family. The novel features on-the-page representation of anxiety in various forms. You can find Akemi on Twitter and her website.

So Akemi, my first question is where did this story about a girl struggling with abuse and anxiety come from? Did you know going into the writing of it that you would be tackling these topics or did they emerge as you were writing?

I guess the simple answer is that Starfish is the book I needed most as a teen. I wrote it knowing exactly what topics it would tackle and how it would end. A lot of writers say they pour their heart into their work, but I think I might’ve left a few pieces of mine on the pages. My biggest hope is that Starfish will reach the people who need it most, and that they’ll read Kiko’s story and find a mirror. And I hope that mirror will help them feel not so alone.

29456598The representation of mental health and illness in Starfish deals with the intersection of mental health with other parts of Kiko’s identity and her experiences, from her Japanese heritage to her family to abuse. How did you go about crafting this intersectionality and how important was it for you to show the intersectionality of mental health in the book?

Very important! Similar to Kiko, I am biracial and have social anxiety, so crafting her identity and experiences felt very natural to me in some ways. Creating a story that pulls from lived experiences is very different than writing something completely from a person’s imagination. Because there are nuances that aren’t easily picked up on by people who’ve never lived that experience. And also, these experiences can vary so much when you take into account the other parts of a person’s identity. Kiko, for example, is a survivor of abuse, lives with social anxiety, and is half-Japanese/half-white, but raised by her white mother in a predominantly white town. Her anxiety is a part of her, but it’s also hugely shaped by her environment and the many layers that make up her identity. All of these different parts of Kiko overlap and intertwine—they affect one another. Being biracial alters how connected she feels to her Japanese identity. Having anxiety changes her perception of her emotionally abusive mother. Being a biracial teen girl with social anxiety in a white town gives her a different experience to someone who might’ve lived in LA, for example. I tried to show the complexity of these layers while also making sure it felt organic to the story.

You mentioned on Twitter that you edited out instances of the words “crazy” and “insane” from the book in between the printings of the arcs and the final copies. Thank you so much for doing that and being so candid about it. What led you to that decision and what has the reaction to that decision been like?

All the credit goes to my amazing editor, Jen. She’s the absolute best, and I’m lucky to be on the same team as her. She pointed the words out to me during a round of edits because she wanted Starfish to be as inclusive as possible. I hadn’t known those words were offensive, and I immediately panicked and deleted every single one of them. I have a very deep fear of upsetting people, so I spent a few months being really embarrassed and terrified I was going to unintentionally hurt someone. Eventually I came to the conclusion that it would be better to just admit my mistake and put it out in the world, because maybe the admission would prevent someone from being hurt. I haven’t really noticed a reaction to it, really, but it honestly wasn’t about getting a reaction. I don’t need a cookie or anything like that—I just wanted to prevent readers from getting hurt, and tell the ones who were hurt that I’m sorry and that the words had been removed from the final copy.

One of the goals of Shattering Stigmas is to dismantle the stigma against mental illness by creating a safe space for people to discuss these issues and raise awareness about mental health via their favorite mental health reads and personal experiences. How important is mental health awareness to you and has writing Starfish impacted that in any way?

I LOVE that this is one of your goals! It’s so important and something near and dear to my heart. People shouldn’t be afraid, embarrassed, or ashamed to talk about their mental health. It’s so important to speak up if you’re not feeling okay, and to seek help or medication if you need it. It took me years until I finally sought help because I thought what I was feeling made me weak. I worried people would think I was complaining or exaggerating, because I’d never had the support of people who were very knowledgeable or understanding about mental health.

When I was a teen and in my early twenties, I was horribly afraid to leave my house. I was fine going to and from work, because that felt like someone else was depending on me and I hated letting people down. But if it was just me, I didn’t like to go anywhere. I always thought everyone was staring at me, even if I was just driving around in my car. Sometimes I’d have to loop around a parking lot several times, and then sit in the car for an hour before I could manage to walk inside the grocery store. And there were other things too, like how I’d only take the trash cans down to the curb once the sun went down, because I didn’t want anyone to see me. It would take hours (sometimes days) to make a phone call because I was terrified of having to speak to anyone. And if someone knocked on the door without calling or giving me at least a few hours to prepare, I’d freeze up and not answer. And then I’d end up sitting at home having an anxiety attack because I was so afraid they were going to come back.

But then I sought out a therapist, and that’s how I learned what social anxiety was, and how it was affecting me. Therapy wasn’t a cure, but having a term for what I was feeling has helped me to cope so much better. And I live with it now, in a way that isn’t quite as restrictive as it used to be.

So yes, mental health awareness is very important to me, and Starfish was therapeutic in a lot of ways. I was able to channel my anxiety into another character, and then give her a hopeful, triumphant story to show how anxiety can be dealt with in a healthy way (especially when you have supportive friends and/or family!).

What are some of your recommendations for great mental health representation in YA? 

History Is All You Left Me by Adam Silvera does a wonderful job of portraying OCD. And I’ve heard incredible things about Little & Lion by Brandy Colbert, which deals with bipolar disorder, and Eliza and Her Monsters by Francesca Zappia, which has anxiety and depression rep.

Are there any mental health issues you wish were more widely represented in YA?

I wish there were more books with characters who have depression but don’t also have suicidal thoughts. Because the two don’t always go together. And it would be great to see books with characters who deal with mental health issues, but where the main plot doesn’t revolve around this. For example, Kaz Brekker in Six of Crows by Leigh Bardugo has PTSD, but it wasn’t a book about PTSD. It was a fantasy world, but the rep felt realistic, because that’s how real life is. Many of us have mental health issues, but they don’t necessarily define us, and they certainly aren’t all that we are.

Do you have any self-care tips, tricks or secrets you’d like to share?

I wish I had more, to be honest! I used to draw a lot, and I found that relaxing. My three-year-old has one of those watercolor books where the paint is already in the page so you just have to add water. It’s so therapeutic. For me, it’s finding distractions to keep my mind and hands busy at the same time. And a lot of deep breaths and imagining all of my bad thoughts are literally drifting away from me. Sometimes it helps!

Thank you so much for answering my questions, Akemi! It has been such a joy to host you on my blog for Shattering Stigmas.  

Thank you so much for having me!

Reminder to Enter Our Mental Health Book Giveaway!

Posted in Shattering Stigmas

Eternity by Aurora McNally

Today I have a friend I’ve known since high school on the blog to talk about intergenerational relationships of transgender women and the ivtersectionalities between mental health and transgender identity. I hope you will all enjoy this thought provoking post. Take it away, Aurora!

CW: Transmisia, racial slurs, occasional misgendering.

PART ONE: THE FIRST THURSDAY OF APRIL, 2014

I stood outside the building for at least 10 minutes, before I turned around and walked back towards home.

I meant to go to the New York City LGBT Community Center for a support group for transgender people. I’d never been there before; in fact, I’d never actually met an openly-transgender person before. But I didn’t make it inside that day.

I don’t know exactly what I was afraid of. But I just wasn’t ready that month. At the next month’s meeting, I took a deep breath, and walked in the front door and spoke to the man at the front desk. It was five minutes after the group was supposed to start.

Me: “Hi, um. I’m, um, I’m looking for the, uh, the transgender support group.”

Him: “Sure! The one for trans men, right?”

Three years later, I’m still not sure whether or not this should have upset me. I lean towards no.

Me: “N-no.”

He gave me some complicated directions, and I wandered through the building, through the courtyard, and then into another building.

This was my first time meeting any other actual transgender people in person, as far as I knew. I’m sure I’d met a few before; there’s a lot of us. But this was my first time meeting any other actual openly-transgender people before.

I found myself in a room where I didn’t quite feel like I belonged, through no fault of anyone there. I was by far the youngest person in the meeting of about 30 people; the second-youngest was at least a decade older than me. Most of them were between 40-60, with a solid chunk of them well into their 70s.

I was also the shortest one, by at least four or five inches. I was always on the short side, and always self-conscious about it; this room confirmed it. I felt like a child, only partly because of the height difference, but mainly because of the age difference.

Most of these women had transitioned very late in life; some started at triple my age. They faced a great consequence for that: the older transitioners did not look like women. It was heartbreaking, not because I feared the same fate for me–I’d done the research, and I knew that transitioning in my early 20s would be more than young enough. Some didn’t even know it was possible to transition until they were triple my age. They were victims of aging, with bodies that had grown more and more masculine throughout their adulthoods.

The older ones wore baseball caps to cover up their receding hairlines, if they still had any hair at all. A few had grown out their natural hair, which, in many of them, had grown back with the help of hormone replacement therapy. Most wore a wig. On some, a five o’clock shadow crept its way into each crevice on their face. Some had deep, booming voices that ricocheted off the brick walls of the little room when they spoke. On the inside, they felt the same way about their gender as I felt about mine. On the outside, I was nothing like them.

The two women running the meeting made a few failed attempts to keep it organized. They had a set topic that they kept trying to come back to, but the group itself kept discussing mental illness. Most of them had been openly transgender since back when being transgender was a mental illness, described in the DSM-III and IV as “gender identity disorder.” “They only put us in the DSM to try to re-stigmatize homosexuality!” one of them yelled; others nodded in agreement (GID was added to the DSM seven years after homosexuality was removed. GID was removed from the DSM in 2013.)*

The conversations of mental illness grew. “They just wanted an excuse to institutionalize us! Throw us into asylums! ‘Let’s take these trannies and throw them in here! Keep them away from the rest of us!’” she said in a mocking voice. I shuddered a little bit when she used that word. So did a woman sitting near me, a thin black woman who piped up for the first time that night to explain that the word in question, she felt, was no different from another heinous word used to describe black people. I wasn’t sure whether or not it was appropriate for me to indicate my agreement.

The discussion of mental illness ebbed and flowed throughout the night. Some mentioned having other mental illnesses, and some were extremely vehement about how hard they’d worked to earn the right to call themselves “not mentally ill” because they were transgender. One said she’d actively tried to hide her obvious symptoms of Bipolar Disorder, because she didn’t want medical professionals to develop a stereotype about all transgender people having Bipolar Disorder. They lived in a world surrounded by stigma attached to mental illness, and they wanted no part of that for themselves or their community.

After the meeting ended, several of the group’s members and I visited a diner nearby. I made new friends there. The age difference didn’t seem to impede my friendships with them initially. If anything, they were only more eager to help. “Oh, you’ll be totally fine,” one of them said in her booming voice, smelling my nervousness radiating off of me. “You transition this young? Christ, you’ll be cute as hell.”

The comments about my appearance made me uncomfortable, even if they were made with good intentions. But these comments were coming from people who’d craved received similar compliments. I couldn’t blame them for making them.

They saw me as an innocent young transgender girl, starved for their wisdom, which they happily regaled upon me without my prompting. My view of them was not exactly the inverse. I didn’t need their wisdom at much as they needed to share it with me. To me, they felt more like equals. After all, we were all transgender women, and we all looked equally like women at this time. By which I mean, none of us really did.

Walking back from the diner to the subway, one of the women — a woman in her 60s or 70s named Katherine (who’d only transitioned a couple of years prior) — caught up with me as we walked down 14th Street, towards the subway. “You know, a lot of these young girls, like you… They come here, to this group, they come to us, they’re nervous, they’re scared, they don’t know what to do, and then we teach them everything. We show them where to get hormones, and where the best support groups are, and we tell them all about the right doctors and the right surgeons,” (surgery was an idea that I’d barely considered at the time). “They come to these meetings for a year or two, and learn everything they need to know.”

“And then they transition,” Katherine said, before letting out a long sigh. “And then they disappear.”

“What do you mean?” I asked her.

“They just stop coming back,” she replied, stone-cold. “We give them everything they need and then they stop coming back to the group. We give them so much help, and then they blend into the woodwork, while the rest of us stand out like a sore thumb.”

I rode the train home in silence, reflecting on everything I’d seen and heard. I mostly thought about what Katherine had said. ‘I would never do that’, I thought to myself. ‘No, not me. If these good women teach me what I need, I would never take their wisdom and then abandon them like that’.

‘That’, I decided, ‘would be a cruel, ungrateful thing to do.’

* * *

PART TWO: SOMETIME IN APRIL OF 2015

I spent a while unsure about whether or not to transition. For some transgender people, the consequences of transitioning are greater than the pain of staying your assigned sex. Some know that they will be disowned by their loved ones, kicked out of homes, written out of wills. Some will lose their careers, their friends, their relatives, even custody of their children. I didn’t need to fear these losses the way many other transgender people do, but I still considered not transitioning. I knew that transitioning would be difficult, and I knew I could still lose — at most — a handful of friends, and maybe some relatives.

Whether or not I was transgender was not a question; I was, of that much I was certain. But whether or not I should transition was a much more complicated decision.

I mentioned this to a few of the women at the group, when we met at in the back of the diner on 14th Street after the group in April. Some of them attempted to posit advice to me: “What things and people do you fear you could lose if you transitioned?” “How much happier do you think you would be if you transitioned?” “Are you concerned about blowback in your career?”

Katherine — the woman who warned me about the younger transitioners from the group a year earlier — framed the question much more simply. “When you die, what do you want your gravestone to say? Should it say a male name? Should it say ‘Loving father and husband’? Is that what you want to be buried under?”

“Or should it say something else?” She paused. “Should it say something male or something female? Loving husband or loving wife? Caring father or caring mother? Do you want an accurate gravestone or not?” Then Katherine’s voice became quieter, as though she didn’t want the other tables to hear.

“What your gravestone says is how you’ll be remembered for the rest of eternity.”

Her voice dropped to a whisper. “How do you want to be remembered?”

Two things struck me about what she said. The first was the word “eternity”. ‘What a bizarrely biblical word for her to use,’ I thought. ‘What a strange way to describe forever.

It-ter-nuh-tee, I would slowly whisper to myself on the train that night, feeling my tongue flick around just a little bit between my lips as the word softly passed through them. Ee-ter-nih-tee.

But it was another term that stuck with me more. What stood out most was the particular terminology that she used: “accurate gravestone”. An idea so foreign to the rest of the world — “How could a gravestone not be accurate?” — mattered so much to everyone at this table, including me.

I couldn’t bear the thought of being known — not just in life, but in death as well — as the wrong kind of person. I couldn’t bear the thought of not having an “accurate gravestone”.

I came out to my parents the next day.

* * *

PART THREE: A COLD AFTERNOON IN MID-JANUARY OF 2016

In the winter of 2016, I began taking an American Sign Language class in New York City.

At this point, I’d been on hormone replacement therapy for about five months. My body looked only a little bit different. I had made slight but measurable progress. I wasn’t out of the closet to most people yet. I still used my old name. I showed up to the first day of class expecting to be seen the way I always was: as male. That’s just how I was living at the time. I wasn’t yet ready to live the way I live now.

That being said, I was not pushing myself to present as either a man or a woman. I had no facial hair. I showed up to the meeting with my hair down, just grazing slightly past my shoulders. I wore a puffy purple coat, which most people would’ve categorized as “unisex,” and a matching purple scarf.

My ASL teacher, a Deaf mean in his 30s with a thick black beard, opened up the first lesson by teaching us two simple signs: “same” and “different”. He gestured to three women sitting next to each other. “Same!” he signed at them for the whole class to see. Then, he pointed to a man and a woman sitting next to each other. “Different!”

He kept this up. People sitting next to someone of the same gender had “same” signed at them. But a man and a woman sitting next to each other had “different” pointed at them.

And then he reached me, sitting with two women to my left and two women to my right. “Same, same, same, same, same,” he signed.

* * *

PART FOUR: A FEW WEEKS LATER, ON AN EVENING IN LATE-JANUARY OF 2016

To call myself “elated” after the encounter with the ASL teacher would be an understatement. I’d told nearly every friend I was out to at the time. My friends from home had all reacted happily. “Congratulations! That’s wonderful!” one friend said. Younger trans friends were congratulatory. “It sounds like it’s going well!” Even my parents, who were still getting used to these changes, were excited for me. I was excited to see the older women at the group a few days later, so that I could tell them all about it!

At the diner, I shared a corner of a table with some of the older transitioners, including Katherine, and told them the very same story.

“…and then he signed ‘same’ at me and the women I was sitting between! Isn’t that exciting? He just… He just *saw* me as a woman! I wasn’t even trying!”

Their reaction was nothing. There were no cheers. There was no joy. Their faces fell just slightly.

What had happened completely accidentally to me in my ASL class was something that would never happen to them. They would never been seen on the outside as who they are on the inside. They would never be automatically grouped in with all the other women, let alone so effortlessly. Certainly not without trying really really hard to present themselves just the right way.

Certainly not accidentally.

I had intended to share a happy little story about my progress with them, but all I did was brag about something that they would never have. I’d waved money in a homeless man’s face; I’d shown pictures of my enormous Thanksgiving dinners to a starving woman.

Their experience as a transgender person was one blanketed in the stigma of a mental illness they’d never had. For most of their life, they’d been considered worthy of institutionalization in a mental hospital, not just in the eyes of the general public, but even in the eyes of doctors and mental health experts. They’d been spit on in the street, from the stigma of a mental illness that they didn’t have and that didn’t exist.

But here I was, bragging about my success. Thoughtlessly, carelessly bragging.

I’d made each and every one of the women in that conversation uncomfortable. They didn’t know how to speak up for themselves and say “We will never understand how that feels, and all that we want is to feel it.”

Instead, they sat silently for a few seconds until someone changed the subject. I traveled home that evening with a stomachache.

* * *

PART FIVE: THE NEXT COUPLE OF DAYS

I realized that Katherine was right all along. Her premonition–that I would learn what I’d needed to learn from this group and then abandon them–was true. But I’m not sure if I abandoned them, or if they abandoned me. Maybe we both abandoned each other. Maybe nobody abandoned anyone.

I know that there was nothing left to fuel a friendship. We had one very important thing in common–we were all transgender–, but what good could that be when such a vast sea of differences stood between us? Their average age was older than my parents, old enough to be my grandparents. I was still a college student, and these women were old enough to collect Social Security. Several of these women had already easily outlived three of my grandparents. They exchanged stories of the Vietnam draft and watching the Watergate scandal unfold.

How in the world could I relate?

A friend of mine — a friend unrelated to this story — immigrated to the United States from Poland in 2005, when she was about 25. Her new next-door neighbor in America — an elderly American-born man in his 70s — immediately introduced her to a friend of his: a 70-year-old woman, who, like her, had immigrated to the United States from Poland at about 25. “The two of you can speak Polish to each other and talk about Poland!” her new neighbor explained excitedly. “I’m sure you’ll have so much to talk about!”

They didn’t. A 45-year age difference, and no interests or hobbies in common, did not a friendship make. They met once briefly, had nothing to talk about, and never spoke again. If a common language and home country couldn’t fuel their friendship, then how could these women and I — people united only by one singular trait — possibly be friends?

By this point, I stood to gain almost nothing from their friendship, and they stood to gain even less from mine. I was a bit heartbroken, but I couldn’t find any reason to keep coming back to that group. I didn’t feel like it would be right to them to share my successes with them. In the end, I got a few of their numbers to text them occasionally, and our contact fizzled.

Katherine’s premonition came true. I never returned to that group.

I left the group with a handful of knowledge, and with the priceless idea of accurate gravestones that had convinced me to transition in the first place. But I left feeling icky about leaving, taking all that knowledge and wisdom and then disappearing, especially so abruptly.

I wonder what Katherine thinks of when she thinks about me, if she even does think about me. I wonder what she thinks of me: a person who got to do something she dreamt of her whole life, something she didn’t even know was possible, a whole 45 years younger than she did. If I didn’t get to transition until my 60s, if I didn’t get to be comfortable in my own body until I was more than triple my age, I would have frustrating feelings about those who transition in their early 20s like me. I wonder if she holds jealousy, anger, bitterness.

Or maybe it’s narcissistic of me to assume that she thinks about me.

Maybe she doesn’t even think about me at all.

* * *

PART SIX: SOMETIME IN DECEMBER OF 2016

I visited the NYC LGBT Community Center for a meditation class one evening, in the same building as the group I’d met Katherine at, nearly three years before. Before the class, I stopped at the coffee shop in the lobby. While watching the slow barista at work, I noticed Katherine in the corner of the lobby, sitting in silence, reading a book. I’m terrible at recognizing faces, but I know it was her: the distinctive wrinkles that wove along her chin and forehead, and her signature wavy/messy hair, growing grayer each day, clinging onto what little brown pigment was left. Most notably, the large scar along the side of her neck that she got in Vietnam.

She looked so content, so peaceful. She was somewhere else, somewhere far away, distracted, lost in her book. I sat at the table at the coffee kiosk for about 15 minutes, peering over my phone at her while I nursed my shitty coffee and pretended to read before my meeting started. She didn’t look up from the book once.

I left her alone. She was busy, and our time together had passed.

* * *

PART SEVEN: JANUARY 11, 2017, AND THE DAYS THAT FOLLOWED

Sometimes my coming out feels a little bit fraudulent. It was, at minimum, less eventful than it should have been.

Coming out is supposed to be difficult. I have friends who came out as gay and who lost friends and family for it. One friend’s aunt and uncle sat shiva for her when she told them that she was a lesbian. A friend of mine who lived with her parents was handed a garbage bag and told to “pack her shit and get the fuck out” when she told her dad she was transgender. Katherine’s children didn’t speak to her for a decade, and they are still on difficult terms.

But I faced no backlash. No distant relatives writing me out of their will; no people unfriending me, neither in real life nor on Facebook. One post on Facebook quietly pushed a slightly-refreshed identity to the acquaintances I’d picked up along the way to that moment.

For Katherine, and for most people who transition at her age, such a thing is not possible. I faced essentially no difficulty in coming out publicly. The worst response we received came from one distant relative who told my parents that she would pray for me; she did not make clear whether she meant “I will pray for God to protect your daughter” or “I will pray that God will fix your deranged son”.

That the worst response I received was a “we’re not sure whether this was well-intentioned and just poorly-worded or if she actually hates us” type of response should show the success that I had. Older transitioners are rarely so lucky. Many of their transitions end in bitter divorces and ruined friendships.

Katherine lost her best friend of over 60 years over it. My best friend picked out my name for me. The difficulties that she and I face as transgender people are not equal.

Where would I be if I’d been born in 1950? Where would I be if I had to come out to my grown children, or potentially even to my grandchildren? Would my spouse stand by my side? Would I have to throw away a career? Would I have a best friend who happily suggests a new name for me, or a best friend who cuts off all contact?

The months that followed my own coming out came with many tears: happy tears for me, and very happy tears for the younger transitioners I’ve come to know, who will know even less of adult gender dysphoria than I have. Sad tears–sometimes, very sad tears–for the transgender people I knew who transitioned so late in life, partly because, for many of them, their appearance will never fit their identity, and partly because, as one of them once said, they’ve “wasted the first 55 years of their lives,” living as someone else. Living as someone they never were.

Living as someone they could hardly survive being.

I did that too, but not nearly as long. I think that that kind of anguish, much like interest, compounds over time.

* * *

PART EIGHT: TWO WEEKS AGO (SAMMY)

My part-time job as a babysitter for a few local families finally intersected with this story when I babysit for a family with three children; two boys, 10 and eight, and a two-year-old girl. Or that’s at least what this mom — who needs me to babysit because she has the flu — says when she describes her kids to me over text message. When I meet her in person, I’m informed that her middle child, eight-year-old Sammy, is gender non-conforming, and sometimes likes to dress up as a girl. She asks if I’m comfortable with this, and I say that I am.

Less than an hour after I’ve met the children, Sammy has asked me if I’m a boy or a girl. I say I’m a girl, with an obvious hint of surprise; I’m rarely asked this question. He asks if I was born a girl or if I became one. While shuffling and handing out a new round of Uno cards, I say that I became one (ignoring the incredibly problematic terminology behind the idea of a transgender woman “becoming a girl”). I don’t make eye contact with anyone as I say it.

Both Sammy and his older brother are shocked. The older brother lets out a “wait, really?” but then drops the topic after I answer in the affirmative. Sammy, however, fires off an entire line of questioning for me. He wants to know all about it. He asks if I’m transgender. He asks if my parents were okay with me transitioning. He asks if it was difficult. He asks if I’m happier. I answer all questions with a “Yes” and a small smile.

Three hours later, with his brother out of the house for a little while, his baby sister fast asleep in her crib, and his sick mom fast asleep in her own bed, he tells me that he likes to play dress-up.

“That’s nice,” I respond. I can’t act too excited; that could be seen as encouraging it, which some parents wouldn’t be okay with. But I can’t act uninterested, because, well, I’m definitely a little bit interested.

“Did… you ever play dress-up when you were a kid?” he mumbles.

I very softly nod, as though I don’t want anyone to hear me, even though we’re the only two people in earshot.

He lights up. “Do you want to see me play dress-up?”

He interprets my gentle nod as a wild enthusiastic “yes”, and bolts up the stairs. He returns five minutes later, out of breath, wearing an inexpensive wig with hair about as long as my natural hair, a small pink t-shirt, and a skirt with purple tights on underneath. “Ta-da!” he yells.

Only a minute later, as if nothing just happened, he returns to playing with the toys he was playing with before. There’s something different in the way he carries himself. There’s a small sliver of strength that wasn’t there before. There’s a slight feeling of confidence in the air. A child has gained a shitload of confidence, and she’s much happier now. Shit. I mean, he. He’s much happier. I’m still supposed to call her a “he”. Him, dammit. This is really difficult to do with a kid who looks like a girl.

I keep accidentally calling him “he”. I ask him if he prefers being called “he” or “she”; he says he’s fine with either one, but when his mom comes downstairs and I talk to her for a few minutes, it becomes clear that — although she is perfectly fine with the dress-up — she is certainly not okay with anything other than “he”. He wears the outfit for the rest of the evening, and when his mom comes downstairs to walk me out, I keep accidentally calling her son “she,” because this child that she calls her “son” just looks like a girl.

If he’s even transgender at all — he seems uninterested in actually transitioning for now — there’s plenty I could help him with. But we’re at different points in our lives. I’m much older, and we have very little in common.

If he is transgender, he’ll likely spend a lot less time being called mentally ill than I did, just like I spent less time being called mentally ill than my older peers. Similarly, he’ll likely want little of my help; if he’s anything like I was, he’ll likely want almost none of my help at all. He’ll get support from people his own age, and the Internet might fill in the gaps. Maybe I’ll abandon him by needing a transgender youngster to mentor, and maybe he’ll abandon me by not needing my help. For now, our only relationship is as a child who needs a caretaker, and a babysitter who needs some extra money. Nothing else brings us together, and it’s certainly possible that nothing ever will. But that’s okay.

I know the people that I first reached out to for guidance probably think that the younger transitioners come to them for help and then toss them aside when they’re finished with them. From their perspective, that’s a pretty understandable interpretation of the truth. If I hadn’t had to deal with them trying to show their support for me by giving me piles of advice I didn’t really need, I’d probably be far too eager to present Sammy with that very same thing.

* * *

PART NINE: THREE DAYS FROM NOW

I still have one good friend from that group: Danielle, a vibrant blonde woman of about 35, and undoubtedly the youngest person I met at the group who still frequently attends it. Danielle and I hang out from time to time and discuss what’s been happening at the group. It gives me a chance to observe the drama of the group from a careful distance. Today, she sent me a text updating me on some recent events.

Katherine passed away yesterday. Danielle was interested in whether I would be attending the funeral, three days from now.

I won’t be able to attend the funeral. I couldn’t make it if I wanted to; I’m currently volunteering as a camp counselor at a summer camp in New Hampshire, and I can’t sneak out to New York for a funeral, but I’ll spend some time thinking about her. I’ll be a bit distracted from what I’m supposed to be doing today, but I’ll mourn her as best as I can.

* * *

PART TEN: ETERNITY

When I met Katherine, I would have told you that we had only one important thing in common: that being transgender was the only trait we shared. But that would be incorrect.

Katherine and I will someday have another thing in common: we will both be buried beneath an accurate gravestone. We will each rest under a gravestone that says the right name and the right words, and we will rest there for eternity. Ee-ter-nih-tee.

She and I don’t have much in common. We both struggled for our whole lives with how we were born, and we both struggled with the stigma of a mental illness that no longer exists. But I believe the most important thing we have in common is that we both fought for our accurate gravestones, and that someday, she and I will both rest in peace forever beneath our accurate gravestones. This loss is sudden and sad, and I’m supposed to appear sad when I’m mourning the loss of a friend, but knowing that she’ll forever rest beneath a gravestone that describes her properly will keep a little smile on my face for today, and for tomorrow, and for eternity.

*Editor’s Note: Gender dysphoria remains an overarching diagnosis for trans individuals in the latest edition of the DSM and the language of the DSM still largely reinforces gender as a binary system. 

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I’m Scared from Anonymous

This poster prefers to remain anonymous. Still, I hope you will support them in the comments and read their lovely post. 

CW: Anxiety and suicide

I’m scared. I’m scared of everything. There isn’t much I can accomplish these days without a minor (and sometimes major) anxiety attack. There are things I can’t explain, just tightness in my chest and clouds behind my eyes. All I have are stories, not reasons. The what, not the why. Here is some of the what, because maybe (or maybe not) I’m not alone in this world.

Right this very second. I’m scared. I’m scared the comments on my writing will be cruel. There is no way in hell I’m going to read them. I email this essay, and never look back. I’m going to see Jon Bellion, one of my favorites, on Oct 7, but I know my thoughts are going to be preoccupied with the knowledge that someone is going to be looking at my writing and making a judgement. I really am trying my best, but that doesn’t mean everyone is kind.

I went to church today, and I was scared. My friend was teaching, and she’s a good teacher. When she came over and whispered that she was running out of things to say and there were still 30 min left of the class, I was scared because I know I could never have filled the time. She did it perfectly.

My brother tried to commit suicide last week. I was scared. I was scared for him, I was scared for my parents. My brother is okay, no liver transplant was needed, and he’s in a safe place. I was scared for the younger brother. Would he get ideas? What if he got home form the hospital and tried to hurt someone other than him? Did I need to drop out of college 87 days before I graduate to protect the ones left at home? (I in fact did not drop out of college)

I left my friend’s house at 1:00 last night. I got scared. Was there someone else in the car with me while I was driving home? Sure there was a box of silverware I am supposed to deliver to my aunt in the trunk, but maybe someone else knew that and decided to sneak in there and catch me unaware? What if they popped out and I got scared, swerved, and hit a child? Who’s fault would that be? I would be driving, but they would be the ones scaring me.

Yesterday, my best friend invited me to make lunch at his house before we went and saw a play that I was very excited to see. We saw the play, came home, and I got scared. He has this friend that seems to think I’m a threat, and she’s trying to come between us. What if he had made plans with her, and there I was looking so stupid asking what we were going to do that night? He told me that she had invited him to the movies, but he said no because he’d rather hang out with me. I was scared that she was going to know it was me with him. He said we could make dinner together. I was scared.

Today I’m scared because I have to turn in a research proposal. It’s an incredible piece of work, and I’m actually proud of it. But what if the professor doesn’t like it? What if the email doesn’t send and it’s late and I lose half credit? I can’t focus on this lecture because I have to obsessively check my email to make sure it sent. Logging out and back in is more important than whatever is being said to me.

I’m not sure I have a point, but all I have to say is believe someone when they say they have anxiety. Anxiety isn’t anything logical. There isn’t any basis for me to be scared, but here I am. I understand that I shouldn’t be nervous of the things I am, but that doesn’t change the tightness in my chest, or the racing of my heart. Maybe medication is the answer, or maybe it’s to surround myself with people that believe me.

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Getting Help During My Worst Panic Attack by Shalena Mathews

Hi everyone! Here on the blog today is Shalena to candidly talk about one of her experiences having a panic attack. I hope you will all enjoy this honest post. 

CW: detailed discussion of mental illness including depression, panic attacks, and suicidal ideation; use of drowning metaphors; detailed description of a panic attack, asthma attack, nose bleed, calling and interacting with emergency services, and going to the hospital

Over the last ten years I’ve had a handful of panic attacks. Most were mild, and when they weren’t, regaining stability usually involved curling up into a blanket burrito in my safe place until the panic passed. Sometimes I reached out to loved ones and they gave me additional support and security that helped me through.

Nothing beyond my general depression and anxiety seem to trigger my panic attacks; they just happen. Luckily, they are few and far between and while sometimes painful and inconvenient, not too difficult to manage.

Except for once, when I had the granddaddy of panic attacks on October 16, 2016.

The day started out a little stressful. I woke up later than I had intended, so I dressed and ran out the door to make it on time to the Southern Festival of Books in Nashville, Tennessee. Thankfully I made it with a little time to spare and had a great day listening to and meeting authors (and buying books, of course).

I was done at the event around 4:00pm, and I was tired and hot from all the walking, but happy. As I walked back to my car at a nearby parking garage, I answered a phone call from a loved one and we got into an argument. I got upset, and my body’s natural response to this is to start crying.

Even after the call was done and with the car’s A/C blowing in my face, I couldn’t get a handle on my feelings or my body’s reaction to them. It was about that point I realized I hadn’t taken any of my daily medications because I’d rushed out of the house that morning. This meant I was fighting to control conditions – depression, anxiety, and asthma – which I always need medication to alleviate.

I tried a few different methods of calming down, but nothing worked. My brain and body fixated on every bad thing, creating an ocean of every terrible thought and feeling I’ve ever had about myself; an ocean I was lost in. Wave after wave of panic tossed me about. Whenever I thought I’d gotten my head above water, another rolled over me and down I sank again.

My sobs turned to wails then to howls. Drowning in my own brain and howling with anguish made it difficult to breathe. That ocean of terrible thoughts pressed against me. Every muscle in my chest ached, and with every tiny inhale, my chest caved, like my sternum was trying to meet my spine.

The mental and physical pain were severe and I couldn’t stop them. Then it happened. I thought about killing myself. I visualized ramming my running car into the nearest wall of the parking garage, could feel the gas pedal inches from my foot, waiting to be smashed down. Thankfully, some small part of my brain had separated itself from the panic and pain.

It’s a strange thing to have two brains at once: the one that has been taken over by something you can hardly name, and the other, the true you, clinging to sanity. That part of me stood on the shore, screaming, “We survived this before! Keep fighting!”

That part of me made me turn off the car and take the keys out of the ignition.

While this was safer, it also turned off the car’s A/C, which didn’t help my physical condition at all. But I wasn’t about to roll the windows down for some air. I didn’t want anyone to see me like this. Just the thought of some well-intentioned stranger coming up to my car worsened my panic because of the potential embarrassment. I say this as someone who never gets embarrassed by anything; that’s how bad it was.

Amid the gasping for air and trying to stay sane, I had to keep blowing my nose and wiping my face because of all the snot and tears rolling out of me. But then I missed a big droplet of snot that hit my t-shirt. I looked at my shirt and noticed it had changed color. It wasn’t snot.

My nose poured blood. I hadn’t had a nose bleed in well over a decade and this was no simple bleed; it was a gush, strong and constant. I was freaked. On top of the panic, all I could think was that my brain is drowning, I can’t breathe, and now I’m bleeding. And none of this was about to stop anytime soon.

I had to get help.

I couldn’t get out of my car. Because I was so crumpled by the panic and lack of oxygen, it was difficult to move anything but my arms. But I had my phone. I was in Nashville, not my home, and I didn’t know anyone in the city well-enough to call on them.

I only had one real option. It took me a few minutes to finally do it, but with whatever little courage I could dredge up, I dialed 911.

I’ve never called 911 in my life before this. But I did it.

The voice on the other end of the phone was friendly but to the point, “911, what’s your emergency?”

The rational part of my brain had figured out what to say, so between heaving breaths I said, “I am in extreme emotional distress and need help.” That was all it took. The operator seemed to understand what that meant and started getting details from me about where I was. Luckily, I was in the parking garage connected to the Nashville Public Library and could see the level number on the wall in front of me. I described my car and answered questions as best I could. She spoke in a calm voice and tried to soothe me and had me stay on the phone until help arrived.

The first people to arrive at my car were police. I remember three or four officers being around, but two mainly spoke to me. One was on my side of the car, shining a flashlight around the interior and relaying my condition to the other officers which were radioing whoever they radio. This officer immediately noticed the blood on my shirt and I told him about my nose bleed. One of them asked if I was suicidal and I explained why I’d taken the keys out of the ignition. They seemed to understand that while I’d had a suicidal thought, I wasn’t in immediate danger of self-harm.

The officer on the other side of my car asked if I had any weapons and it was then I remembered a box cutter in the glove compartment. He removed it. They complimented me on doing the right things and calling for help.

All the while I was still in panic mode, crying and struggling to breathe. They had the security guard drive one of those ATV vehicles up to my car and helped me into it. They drove me down to the main level, but some issue was keeping the ambulance away and another officer gave me a paper bag to breathe into and tried soothing me. All of the officers treated me with care and didn’t make my situation worse, something I was extremely grateful for.

I finally made it into the ambulance and the EMTs were also nice and helpful. They had to ask me a bunch of questions, which they apologized for, but they talked to me like I was a normal human being, even when I had trouble focusing and talking. We got to the hospital and the EMTs explained my situation to the ER nurses and then left, wishing me luck.

At this point, I was so exhausted that I’d stopped gasping for breath, but I was still intermittently crying and my chest felt like I’d been run over multiple times.

Finally I was in a hospital bed in the emergency room. I’m not sure who I saw first, a nurse probably, and I had to go over everything that happened again. Then a doctor came and I had to repeat a lot of what I’d just told the nurse. An administrative person came in and had me go over and sign some forms.

The doctor returned and gave me some medication that helped calm me down. I actually chuckled when she told me what it was called because one of my characters in the novel I’m working on takes it. That’s really the only time anyone looked at me funny during this whole ordeal.

Then another nurse or tech came in and administered a breathing treatment. What I hadn’t realized was that the reason I’d had such trouble breathing and why it hurt so badly was that the panic attack had triggered an asthma attack. The nose bleed they chalked up to my blood pressure skyrocketing from the panic and asthma attacks.

I continued to lie in the hospital bed, letting the medicines take affect. Everyone was efficient and to the point, but no one seemed to judge me. After I was better an hour or so later, though weak and in need of food and rest, I left the hospital and took my first ever Uber ride back to my car.

I’d survived.

It’s been almost a year since that panic attack, but looking back on it is still a little difficult. It was a harrowing experience that I don’t wish on anyone. However, if I am glad of one thing, it is that I can share this experience with others. Not the panic attack; I know many people go through those every day, but the experience of calling emergency services to get help.

It was scary but absolutely worth it. I’d had no occasion to know how the Nashville police, EMTs, or hospital staff would react to someone having emotional or mental suffering, but they all surpassed my expectations. It felt like they’d all been trained in how to handle someone like me, someone who was in distress and needed medical attention but couldn’t get it on her own. They were all calm and reassuring and I couldn’t have asked for better treatment.

I don’t know how other places handle emergency calls for mentally distressed people, but I imagine calls like mine are common. I hope my experience is standard for this type of situation, but I realize that people of color, queer people, or other marginalized groups may have different and worse experiences with emergency services. I wanted to share my experience because it gave me hope: hope that the people who are supposed to care for us in times of need know what they are doing and are willing to help however they can.

It also gave me hope for myself, that I was able to reach out for help when I needed it. If you find yourself in a similar situation, reach out, however you can to whoever you feel safe reaching out to. It will be difficult and it will definitely feel scary, but it will be worth the effort because you are worth it and you deserve to survive.

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My Friend Has Anxiety. What Can I Do? A Guest Post by Paula Stokes

Y’all. I am so, so thrilled to host YA Author Paula Stokes on my blog today to talk about mental health. She is one of my favorite authors and I admire all she has to say about mental health issues. Without further ado, I’ll let Paula take it away:

When Taylor offered me a chance to write a post for her Shattering Stigmas blog feature, I was all over it because I love thinking about (and talking about!) mental health. But I’ve already written posts about mental illness myths, the PTSD and therapy portrayals in Girl Against the Universe, and my own struggles with anxiety.

So for this I decided to do something different and write a sort of “advice column” for people who have friends with anxiety disorders and want to know if there are ways they can be more supportive. I have an undergraduate degree in psychology, a master’s degree in nursing, and experience working at a psychiatric hospital, but I’m not claiming to have the expertise of a licensed therapist and this is not meant to be medical advice. Also, people with anxiety disorders are not a monolith any more than people of a certain race or sexual orientation are. No strategies will work for everyone, but I can give you some tips that might help a lot of people 🙂

First, you should know that the umbrella term “anxiety disorder” includes several different types of afflictions, including OCD, PTSD, phobias, panic disorder, social anxiety, generalized anxiety disorder, and more. I’m going to mostly use my own anxiety as a reference and you can sound off in the comments if your experiences are different. Let’s make this post + the comments a source of information for our well-meaning non-anxious peers 🙂

I have a phobia of public speaking that overlaps with more mild social and general anxiety, so basically the idea of having to do a book event is enough to send me into a panic attack complete with chest pain, shortness of breath, sweating, etc., but I also worry sort of relentlessly about other stuff to a degree that it negatively impacts my personal and professional life.

The difference between a non-anxious person worrying and someone with anxiety worrying is that the non-anxious person feels stress or uncertainty, but then goes on to have a normal day at work or school. The anxious person might sit for hours fixating on the worst-case-scenario. If a friend doesn’t respond to your text, you might think they’re busy or that their phone battery died or something. An anxious person might think they’ve somehow offended that friend and that friend is mad at them and might hate them forever. If you make a mistake at work, you might worry about your boss yelling at you or it affecting your end-of-year review. Anxious people make mistakes at work and worry about getting fired and never getting another job and ending up homeless and their kids starving because they can’t feed them. This is called catastrophizing and if it sounds exaggerated I can tell you from personal experience that it isn’t. I catch myself engaging in these kinds of destructive thought processes all the time.

Whether an anxious person is suffering in the throes of a full-blown panic attack or silently stewing at home over a worst-case-scenario, prolonged stress has profound implications for both physical and mental health. Getting into that is beyond the scope of this post, but if you’re interested in reading more, Hans Selye’s General Adaptation Theory is a good place to start.

So how can people help? Let’s start with what not to do: 

 

Don’t treat anxious people like they’re drama queens or hypochondriacs.

“I feel like you’re being a brat just because you don’t want to do this thing,” someone once said to me when I was literally so terrified that I was thinking about getting into a car accident to avoid said thing. Not only does judging people with anxiety not help, it also reinforces the idea that “everyone else thinks mental illness isn’t real” in their brains, which will make them less likely to seek help when they desperately need it. Do you ever wonder why so many people commit suicide without ever asking for help? Maybe some of them do it because they’re already in such a dark place that they can’t bring themselves to risk being belittled or judged.

 

Don’t give false reassurances.

When a two-year-old goes to the dentist for the first time it’s helpful for a grownup to tell them everything will be fine because it’s a new experience in a scary place and as a parent or adult they respect you as an authority figure and can be soothed by your reassurances. When you tell an anxious person “Everything is going to be fine,” you are either telling them something they already know or you are making assurances you can’t guarantee. People love to tell me everything is going to be fine when I’m nervous before book events. Guess what? I know that. I’m know I’m not literally going to die. But anxiety isn’t rational. The “fight or flight” responses I have don’t magically switch off because I can acknowledge that my fear response is out of proportion to the actual risk.

On the other hand, if you’re at the hospital with your friend waiting for a biopsy result, you might be really tempted to bust out the “I’m sure things will be okay” line, but that’s you trying to reduce your own discomfort. What if you say that and it turns out your friend has cancer? There are some instances when things might not be okay, and even if someone is struggling with severe anxiety at those times, lying to them won’t help.

 

Don’t call attention to people’s anxiety.

Why are you so nervous??” my nursing instructor bellowed across the room as I was preparing to complete my skills check-off on IV insertions. “Your face is so red and you’re sweating!” Um, thanks. I was nervous because the school policy was actually to kick someone out of class and make them pay and start the course over the following semester if they failed a check-off twice. And after she announced my terror to everyone around me, I was even more nervous. I felt like all my classmates were staring at me. Mild nervousness is performance-enhancing for some people, but near-panic attack anxiety reduces cognitive-functioning and performance for almost everyone. If you highlight someone’s anxiety and make it worse, you are sabotaging their chances of success.

 

Don’t insist on “fixing the problem.”

Look, we anxious people appreciate the thought, but even if you’re a therapist or a doctor, you can’t magically fix things. When your friend or family member tells you “I am freaking out because…” they are looking for support. They are not looking for you to come up with a “solution.” When you insist upon going into fix-it mode, for example “Well I will talk to the teacher you’re having trouble with” or “Let me hear your speech right now and I’ll tell you if it needs work” you are making your friend’s suffering about you—doing what you need to do to make yourself feel better instead of focusing on their needs.

 

So if those are the things you shouldn’t do, are there any ways you can actually help a friend struggling with anxiety? Yes! And bonus, they’re actually pretty easy.

 

Listen.

Just listen. If I send someone a 3000-word email about why my job stresses me out, I don’t want a list of lower-stress job opportunities. If I thought I’d be happier in a different job and would also be able to survive, I would get a different job. What I want is just to be heard. For someone to say, “That sucks. I’m sorry you’re going through that. I hope things get better soon.” Bonus points if the person is able to remind me why my innate qualities might make things a little better for me or other people without veering into “Everything will be fine” territory.

 

Ask “What can I do for you?”

Sometimes it’s hard to ask for help. An open-ended offer can make someone struggling with anxiety feel more comfortable in verbalizing their needs. More often than not, the anxious person is going to say something like “Just your being here helps.” But maybe they’re so panicked they haven’t eaten all day. You might be able to make a huge difference just by ordering a pizza or going out to get some sandwiches. This might require acknowledging someone’s anxiety, but it’s okay to do that if you’re a close friend and you’re not announcing it in a judgmental tone in front of an audience, like my nursing instructor did.

 

Provide unconditional support.

“I’m afraid I’m going to fail this test and fail the class and fail out of school and waste all the money I spent on tuition and…” Don’t tell this person they’re being silly or ridiculous or that everything will be fine. Just tell them “Well I don’t think that’s going to happen, but I will love you even if it does. I will be there for you no matter what.” I will be there for you no matter what—I literally teared up typing that sentence because most of us don’t get to hear those words very often in our lives and they are so incredibly powerful. So much of anxiety stems from this paralyzing fear of failing at something and ending up all alone. If you can tell someone you’ll be there no matter what, and mean it, you’ve given them a support network and changed their life for the better, even if they don’t immediately recognize it.

 

Encourage people to get help.

If you think a friend might need help but you’re not sure, recommend they talk to a medical professional and let someone with training make that call. Getting help can be as simple as telling your internist you’re struggling with anxiety and asking if she can refer you to a therapist for an evaluation. It does not mean taking anxiety medication (though there’s nothing wrong with that if it’s what you and your healthcare provider decide to do) or entering into a once a week relationship with a therapist. Maybe your friend goes for an evaluation and the therapist just helps them find a free support group for people with similar struggles. Or if your friend isn’t comfortable going to a healthcare provider, you could recommend they reach out to a minister or priest or find a support group on their own.

 

Those are my thoughts on how you can help your friends and loved ones who are struggling with anxiety. What do you guys think? Share your thoughts and additional tips in the comments 🙂 Thank you to Taylor for including me in this awesome series.

 

unnamedBio:

Paula Stokes is an author, freelance editor, online instructor, and mental health nurse. Her writing has been translated into eleven foreign languages. Paula loves kayaking, hiking, reading, and seeking out new adventures in faraway lands. She also loves interacting with readers. Find her online or on Twitter.

Note: If y’all are looking for a great mental health read, one of my favorite mental health reads ever is Girl Against the Universe by Paula Stokes. I highly recommend this adorable rom-com with an anxious MC!

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