I’m struggling today. Whereas most people come back from a retreat or conference inspired, I come back with my head full of self-doubt and discouragement. I’m not as business savvy as other authors, I’m not as connected, I’m not as successful, I’m not as productive, I’m not as organized, I’ll never be as good as, etcetera, etcetera.
I guarantee that if I texted the above to my friends, they would immediately remind me of all I’ve accomplished. My inbox would be full of reminders about how everyone has their own path to success and their own strengths. I know that I’ve been successful, and I know better than to compare myself to others. Knowing, however, doesn’t change the negative thoughts from pushing their way in.
My struggle isn’t the point of this blog, however. Instead, it’s a reference point. A conversation starter, if you will, to talk about mental illness.
Covid has made people more aware of mental health than ever. Two years of extreme isolation and anxiety have taken their toll on people. While it’s great to see people paying more attention to their well-being, the sad truth is that for millions of people, the struggle to maintain mental wellness has been going on for a lot longer than the pandemic, maybe even since birth.
The scariest part of mental illness is that for many people, their struggles are hidden. We tend to think of mental illness as something you can spot. The schizophrenic rambling with paranoia, the friend who calls in the middle of the night because they can’t handle life anymore, the alcoholic who hates himself, or the depressed mother who can’t get out of bed in the morning. Those are all very real examples, but for all the people we see struggling, there are just as many who keep their issues hidden behind a phony exterior.
I am one of those people. It’s called High Functioning or Smiling Depression. To the outside world, I am confident and goal oriented, a high achiever who always looks put together and tries very hard to be a positive person. Only my therapist, my husband and my closest of friends know that without psychiatric medication, I would be a quivering mess of low self-esteem who spent way too many days battling imposter syndrome. (As it is, even with medication, I struggle.) For people with smiling depression, success and accolades are validation that they matter. Problem is that the validation high only lasts a short time before they are chasing it again. Moreover, no amount of outside validation, even endless validation, can fill the emptiness. True validation comes from within and that requires self-esteem and self-love, two qualities people with smiling depression are often missing. 
Again, I’m not telling you this to gain sympathy or validation. I’m telling you because I am one of millions waging a hidden battle. People are always shocked when someone like Kate Spade or Naomi Judd. It’s only after their deaths that we learn about their despair and pervasive sadness casting a shadow over their lives.
Now I’m lucky. Thanks to years of therapy, I have the tools to battle the down days, and keep the depression shadows at bay. I’m speaking up today because I want others to get the help they need. Our country does a piss-poor job of providing mental health benefits. Insurance companies do not provide adequate coverage for mental health treatment. Anyone who has done deep talk therapy will tell you that it often takes several visits before you discover the root issue. Yet visits are often capped at a specific number leading many patients to end treatment prematurely.
And that is if your therapist accepts insurance. Insurance companies have made it so difficult for therapists that many have stopped participating in insurance plans altogether. Patients are billed full-price and must apply for reimbursement. I ask you, how many people can afford to pay a therapist $150 or more per week long term?
May is Mental Health Awareness Month. Perhaps, if enough of us speak up, our government will realize just many people need help, and just how many are going without it.