LGBT people seek mental health care at higher rates

I recently heard someone say that there were no recorded mental illnesses in his family since the beginning of time. I had to remind him that many people are too embarrassed by the stigma of mental illnesses to reach out for help they need.

Mental illness are extremely common – the National Institutes of Mental Health report that more than a quarter of Americans have a diagnosable condition in a given year – and do not make you “crazy.” What does make you crazy is stewing in your own negative thought process for hours, upon days, upon weeks, upon months, upon years. People who do this often end up in a worse state than they originally were, far removed from reality.

Ignoring symptoms can be dangerous, and often, mental health issues can be easily dealt with at first, but continue to rapidly grow into a much larger problem. Mayo Clinic describes generalized anxiety disorder to be one such illness in its summary of the condition: “Your worries are unlikely to simply go away on their own, and they may actually get worse over time. Try to seek professional help before your anxiety becomes severe – it may be easier to treat early on.”

Because of the way LBGT identities are still treated by society, we are no strangers to mental illness – nor to stigma. Being in the closet, feeling forced to lie to everyone (including yourself), can be one of the most damaging things that we do to ourselves, and sometime leaves scars.

According to a 2007 study by Dr. Wendy B. Bostwick at the National Alliance on Mental Illness, LGBT community members are at the highest risk for depression, anxiety, and substance use disorders. We are 1.5 times more likely than heterosexuals to be diagnosed with a mental health disorder, and lesbian and bisexual women are 3 times as likely to experience generalized anxiety disorder.

Does this indicate causation – the stress of living as a minority exacerbating common minor tendencies towards depression or anxiety into full–blown conditions requiring treatment? Or is it simply correlation – perhaps LGBT people are more willing to speak to mental health professionals in the first place?

Statistically, LGBT people seek out mental health services more often than straight people do, but this raises further speculations. Does this indicate a higher prevalence of mental health issues, or are we just more likely to ask for help when we need it? Perhaps adding another stigma like mental illness feels minor compared to the stigma we already try to overcome as LGBT people?

I have neither the resources nor the will to answer that. What I do feel free enough to speculate wildly on is how our community responds to the mental health community – LGBT people and mental health institutions have not had a great relationship in the past.

In 1952, the American Psychological Association listed homosexuality in the Diagnostic Statistical Manual (DSM), which practitioners use to guide their diagnoses and track statistics about mental health, as a “sociopathic personality disturbance.” Treatments were often cruel and unusual – the most infamous intervention was electroconvulsive therapy.

But the APA has changed – since 1973, same-sex attraction is no longer classified as a mental illness, and in fact the APA chastises those who hold prejudice towards LBGT individuals. An APA task forced released a 2009 report called “Appropriate Therapeutic Responses to Sexual Orientation” finding that “research and clinical literature demonstrate that same-sex sexual and romantic attractions, feelings, and behaviors are normal and positive variations of human sexuality.” More recently in May 2013, the release of the DSM-5 addressed a long–standing struggle within the LGBT community by removing “Gender Identity Disorder” from the manual and instead relying on a more neutral term, “Gender Dysphoria.”

Perhaps the evolution of positions of the APA and DSM toward LGBT realities, combined with changing attitudes towards mental health, is leading us closer to becoming the best versions of ourselves. I cannot encourage mental health awareness more. Stay healthy out there, team.