A primer on how to talk about anxiety and depression, two of the most prevalent mental illnesses facing college students and Americans in general.
My balance was off kilter. My vision blurred. My breathing was shallow and quick, like I’d run a marathon without rest. But my legs wobbled to the point that I could hardly walk. I felt like vomiting. I stumbled from the shower without completely washing and collapsed on my bed. I had no idea what was happening. All I knew was that I didn’t want to play the baseball game that I was supposed to play later.
This was me, nine years ago, having my first, but not last, panic attack. It was sparked by a baseball tournament that I had woken up at 4:45 AM to prepare to play. It was not my first bout of anxiety, but it was the moment that made me aware of how much anxiety could paralyze my actions.
To me, the above photo is a fair representation of how anxiety, as well as depression, can present themselves internally. You feel trapped behind glass, capable of witnessing sunshine, but not necessarily feeling its glow and warmth for yourself. The glass makes the photo blurry because anxiety and depression are often blurry, with undefined borders and boundaries, appearing at moments where you least expect and in ways you least expect.
The National Alliance on Mental Illness (NAMI) estimates that “1 in 5 U.S. adults experience mental illness each year” and that 1 in 25 experience serious mental illness. At a time of intense stress and worry in this very unequal country of over 300 million people, I’d lay a comfortable bet down that these numbers are only going up.
But anxiety, depression, and other mental illnesses are often subjects that go unremarked upon. They remain undisclosed, personal problems, rather than acknowledged predicaments affecting millions. Claudia Vernon, Coastline College’s Mental Health Therapist, has been practicing for longer than I’ve been alive (Claudia has 24 years of therapising under her belt to my 22 of plain existence). She’s worked as a Licensed Clinical Social Worker (LCSW) for nineteen years. And she told me that it’s time to de-stigmatize and change the way we talk about these issues, particularly anxiety and depression, both of which “are common in the 18-25 year age range.” So let’s talk about it.
An Overview of Anxiety and Depression
Anxiety and depression are two of the most prevalent mental illnesses. According to NAMI, over 40 million U.S. adults have an anxiety disorder and over 17 million U.S. adults have had a major depressive episode in the last year.
Multiple factors, including lifestyle, genetics, physiochemical, cultural, traumas, etc., have all been linked to partially causing or contributing to anxiety and depression. The reason behind how or why someone, or many people, has/have anxiety and depression can help unpack these illnesses in the long run, but in the meantime we have an epidemic (let’s face the facts that the world has many epidemics going on right now) of untreated anxiety and depression. First and foremost we need to de-stigmatize.
The Embarrassment or Shame Factor
People hesitate to seek help, not just when it comes to their mental health, but when it comes to everything. More specifically, we let our anxieties, fears, pains, basically a ton of feelings, build and fester.
“You’re not lacking just because you felt like you need someone,” says Claudia. Our American culture likes to present an independent, rugged, tough image. Claudia put it as the “pulling ourselves up by our bootstraps” approach. And that image bleeds into our daily lives, how we treat others and how we treat ourselves. Claudia thinks the hesitation to seek help is at least partially cultural, remarking that when she sees clients from different backgrounds she likes to frame her job not as a “therapist,” but as a “feelings teacher.”
“Feelings are overlooked,” Claudia continues, “and can be overwhelming and unmanageable.” A mental health professional is there to help parse our feelings. They provide support as we sort through our daily tumult in the same way we sort through our dirty laundry for a shirt to wear one more time before the wash (I can’t be the only one doing that).
If you or peers have found yourselves shutting down feelings or disregarding them, take a moment to acknowledge simply that it’s okay to have feelings. Then, consider telling someone about those feelings, opening up. If you don’t have someone at hand you’re comfortable talking to, consider finding a professional. There are a number of online therapy services and apps that have launched in the last few years, offering affordability and convenience.
Education Isn’t Enough
Claudia made a point that took me down a peg as a writer and pseudo-educator: “The reality is there isn’t execution with education.” A.K.A. it’s not simply enough to read the articles and know the terms (though we’ll return to language later). We’ve seen hundreds of magazines and newspapers cover these topics in article after article. I know what you’re thinking, ‘isn’t this the exact de-stigmatization you were talking about?’ And yet record numbers of Americans still feel the tug of anxiety in their stomach and the weight of depression across their shoulders.
Let me, or rather let Claudia (who’s way smarter than me), put it this way: “I know how to eat right, but that doesn’t mean I’ll eat right…I know I should exercise. I know exactly why it’s good for me. But is there execution on that knowledge?” As I write this I’m wearing boxers and a t-shirt that hasn’t been washed in three days and sitting on the couch, so touché Claudia.
Her point is logical and extremely important to grasp. Education alone can’t get us there. It is only one aspect of de-stigmatizing this dialogue on anxiety and depression. Essentially, the conversation begins with education; it doesn’t end there. Be intentional about your mental health, the same way you would be intentional about what you eat, or how much you exercise. Put aside five-ten minutes (at least) every day to think about what you’re going through and how it makes you feel. Mindfulness meditation has done wonders for me personally, and I think it could help you too.
The “Well, I’m not that bad” Issue
In her 20+ years of therapising (patent pending), Claudia says there’s a series of common phrases she’s heard time and time again. I got the sense from our conversation that it wasn’t just her who’d been hearing them too; if I polled every social worker, therapist, counselor, or mental health professional in the U.S. (and probably many of our system’s informal mental health personnel—like teachers—too) they’d probably say the same thing. Phrases like: “well, I’m not that bad…” or “I’m not as crazy as…” or “Well I’m not there yet…”
Besides echoing the highly underrated Ice Cube flick of a similar name, “I’m not there yet” is the most absurd, but somehow the most common. Its very wording imagines that there’s a hypothetical extreme (a far off “there”) of anxiety and depression, a place that most Americans, including college students, think they’ll never hit. Per Claudia, “mental health is a continuum. You can come in at any point to seek professional help.”
Claudia points out that this issue is often even more insidious for younger people. Because they’ve been educated enough to know the basics about anxiety and depression, college and high school students believe that they don’t need to seek help.
We’re all capable of handling a different set of pressures. What’s bearable for me might cause a major depressive episode for someone else. What causes me anxious terror might be a walk in the park for you. For you college students in the room, let me put it in a way I know you’ll understand: there’s no grading scale, no A+ for mental health or D- on anxiety, to signal that it may be time for dialogue or action. And that’s good, in the sense that we can abolish the notion that “normal” exists. But it’s challenging in that it forces us to be more aware of our own limitations, and be comfortable acknowledging said limitations.
Be compassionate and understanding. When someone says they’re anxious or depressed, don’t dismiss their feelings out of hand. Be empathetic. We can’t control our feelings, but we can control, or understand, how we respond to them.
Language and How to Use It
Another issue with helping someone through anxiety and depression arises even after you’ve gotten them to open up, just a bit. Here’s where all those articles and mental health education efforts do pay off. According to Claudia, “kids nowadays have a better vocabulary than our older generation.” Perhaps they’ve literally been taught more words that can express their feelings beyond “bad” or “good” or “fine.”
Think about it this way. When you go to the doctor and want to describe a pain in your side, you have to use all the words at your disposal: is it a burning pain? Stinging? Sharp or more slow? Does it build over time? The exact same thing is needed for kids and adults because your counselor and therapist, just like your doctor, can’t literally enter your mind and body to see what’s up. A vocabulary is needed. If you’ve made an appointment with a counselor (good on you!) take a moment to search for words that can properly describe how you felt, with regard to a specific situation, or just throughout a day.
These are clearly not the final, final thoughts on this issue. This is a discussion that needs to kept being had, over and over again, until the resources exist for all people and people feel comfortable reaching out for those resources. Speaking with Claudia, I came to understand that mental illness in general, and anxiety and depression specifically here, are prevalent enough that no one should feel put-off either by having them, or by hearing that a peer or family member has them. They are just one more aspect of an already stressful existence, especially right now in the pandemic. Claudia talked about how, in order to effectively get rid of stigma, we must let open dialogue about these issues seep into culture, into conversation, into compassionate understanding. Don’t let this article be your only resource. Treat it as an introduction, a small primer, and then go and learn more. Just don’t forget to execute on that learning.