Every once in a while I’ll come across a Facebook status that reminds people to reach out if they are struggling. These “get help” posts frustrate me sometimes even when I know they come from a well-intentioned place. I don’t like that the burden gets put on the person struggling. It’s often hard to reach out to others when you’re in a state of depression or severe anxiety. Sometimes, we fear inevitable judgment. My frustration comes from knowing how difficult it is to find and receive the right help and that sometimes the “I’m always there for you” words are more of a gesture than a promise. We need more resources for mental health care in several important areas. We need more education and compassion.
A major criticism people have had about the show 13 Reasons Why is that they think it’s dangerous to make it seem as though help isn’t available. These critics claim the help is there if people just ask and that the show is sending the wrong message. I would have to disagree with these critics because I’ve been in Hannah’s position where I’m standing there begging for help and receive judgment instead. Hannah’s counselor telling her to “get over it” does happen in real life. Not all therapists are created equal.
I struggle with severe generalized anxiety disorder, depression, panic disorder, PTSD, and agoraphobia. My anxiety peaked when I was working in the financial industry as a proposal writer after spending years as a childcare provider. Not only was I unable to release my nervous energy while sitting still at a desk for hours every day but I was suddenly sucked into a toxic and competitive world after years of walking into work every day to little hugs and laughter. I was still struggling with a traumatic breakup and didn’t know yet that I had PTSD from the abuse. I thought I was going crazy. I drove into work every day feeling like I couldn’t breathe.
The insurance I had through my job offered six free therapy sessions with a provider under their network. I called the Employee Assistance Program and was set up with a therapist close to my apartment. The first session was an intake. The second session I sat on the couch and cried for the entire hour. The third session she told me she couldn’t see me anymore because my mental health issues were too severe for free sessions. She gave me the number of another therapist but I didn’t bother trying again. The idea of having to pour my heart out all over again was too much. She had introduced herself as having worked with pedophiles and inmates in jail but I, an abuse survivor, was too much. I felt even crazier.
One year later I was having hour long panic attacks several times a day after being emotionally and psychologically abused by another guy. These were full-blown panic attacks that felt like a heart attack. After a week of this happening daily, I decided to give therapy one more try. I wasn’t sleeping and was desperate for something to make them stop. I went on Psychology Today and searched for therapists local to me.
I ended up with a social worker just a couple of minutes away from me. The first few sessions went pretty well but our relationship went downhill pretty fast. She was late constantly, slept through one appointment, and was argumentative. When we discussed my abusive relationship she told me I allowed the abuse to happen, effectively victim-blaming me. Every day I dreaded going to therapy because I felt like I was being judged. I also felt like her lab rat more than a patient as she used an experimental treatment on my PTSD and pressured me into saying it worked even though it didn’t. It cost $100 to meet with her every week and I did this for several months before finally having the guts to break up with her.
I tried calling other therapists but they either didn’t have availability or were too expensive. One guy charged $26,000 for a series of sessions that were supposed to completely cure you. I ran into that a lot- therapists who claimed to have “the cure” if you coughed up several hundred dollars or if they were able to get to you on after going through their waiting list. When it comes to insurance, the coverage is usually minimal if the therapist accepts your insurance at all. Therapists can typically charge whatever they want and you’re lucky to find someone good who charges less than $150 per hour. I saw one new therapist who ended up spending an entire session talking about politics and her children, interrupting me to go on a rant about CNN anytime I tried to redirect the conversation.
The only person who was available to help me was my general practitioner who prescribed me Ativan. I had a bad reaction to the medication so I can no longer take it for panic attacks but it still makes me so upset that the only affordable and available help I could get was from a bottle of pills handed to me after a five minute appointment. It made me realize why it’s so easy for people to become addicted. Sometimes people like me are desperate for something to make them feel better and while it’s best practice to also be seeking therapy while using psychiatric drugs, the psychiatric drugs are more accessible and affordable for people with insurance than a therapist.
Thankfully, I finally found a therapist who I mesh well with but it took four tries and three years to make it here. People who are actively suicidal might not be able to wait that long. There are mental health organizations that are supposed to be there as a resource but I have called and been denied for not being “needy” enough. They wanted to work with people they considered to be severely mentally ill and the homeless. People like me, 20-something who look healthy and go to school full-time aren’t considered in need of their services.
Insurance isn’t always helpful even if you have it. I had a hard time finding a therapist who would accept my insurance because my insurance company has a poor reimbursement rate for therapists. My current therapist accepts my insurance but the co-pay is high and always rising. If you don’t have insurance because you can’t afford insurance, how are you supposed to afford between $200-$500 a month on therapy?
I applied for disability earlier this year when my depression became so bad that I stopped taking care of basic needs like showering and eating. I developed agoraphobia and having to drive even five minutes down the road caused me to have panic attacks. I knew I wasn’t capable of being a reliable employee and that I would likely get worse if forced to work full-time while still relearning how to care for myself. The process was more complicated than I thought it would be, especially for people who are chronically ill. I had to fill out packet after packet of forms and wait months to hear back. All of the letters I received gave me the contact information for a Social Security employee to get in touch with if I had any changes. I did have a change in my mental health care provider so I called and left a voicemail to inform her. Weeks later, I received a letter that since I had no mental health care provider I needed to be evaluated by a psychologist of their choosing. However, I did have a provider and gave the woman I called the information. She just chose to ignore my call. I realize they receive many calls a day but it is their job and the communications I received instructed me to contact her with any changes.
I went to the evaluation when none of the customer service representatives would help me with the miscommunication. One CSR even hung up on me after I asked her how to make an online account so I could keep up with the status of my application more easily. The website says to call a CSR for help on how to make an online account. The evaluation consisted of a series of the same questions they asked me in the packets they sent me. Did I feel hopeless? Do I have trouble with basic needs like cooking? At the end of the evaluation the psychologist told me that she’s not allowed to make the determination about whether I’m disabled. She can’t give any opinions. All she can do is report back what I say to her and the woman who ignores my phone calls gets to decide. Even my own doctor who sees me in person wasn’t allowed to say whether I’m disabled. Every single day people without any sort of medical degree are making the determination about whether someone is sick enough. It was determined that while I “claim to be suffering from anxiety, depression, PTSD, panic disorder, and agoraphobia,” there’s probably something I can do.
70% of people are denied disability the first time they apply. If denied, they may appeal the decision and wait another several months but a high percentage are still denied the second round. They may appeal a third time and this third appeal is when you go to court, preferably with a lawyer. This whole process can take years and many people have to go on welfare to be able to wait that long for benefits. Unfortunately, every state is different and not everyone is eligible for welfare.
When I was denied disability, I was told by everyone to seek out a disability lawyer. I called every disability lawyer in the state.
“What’s your birth date?”
“March 18th, 1991.”
“Oh, that’s why everyone’s rejecting you,” the last lawyer I called told me. “You’re too young to be sick.”
I was silent.
“Well, what does your PTSD stem from?”
“An abusive relationship.”
“Is he in jail?”
“Were there charges pressed?”
I was denied assistance. Without charges being pressed against my abuser, “there wasn’t enough evidence.” Disability lawyers typically only get paid if they win and so no matter what their website says about how they’ll help you win no matter what, it’s really all about the money. That’s how it is for Social Security too. They want to award as few people as little money as possible. When you go through the disability process, you’re no longer a human. You’re a number. Instead of looking for reasons to help you, they look for reasons why they shouldn’t help you. I’d never felt so pessimistic about the system before having to go through this process. I know people who are on disability and still have trouble making ends meet because of how low the monthly payments are if they do get approved.
Public Education and Compassion
When I was at my old job and had just gotten out of an abusive relationship, I dealt with my mental health issues by myself because my friends weren’t there for me. The same friends who called themselves mental health advocates and retweeted suicide hotline numbers were ignoring my texts, rescheduling our plans constantly, and telling me my panic attacks were me feeling sorry for myself. People tend to not know what to do when they’re actually faced with something heavy. “I’m here for you,” has kind of become like “We’ll get coffee soon,” when you run into an acquaintance you know you’ll never see again.
At work, the girl who sat next to me would send me emails making fun of my anxiety. For a few months I had thought I was having heart problems. I went to a cardiologist just to find that nothing was wrong with my heart. It was a developing panic disorder triggered by the PTSD. The girl next to me laughed when the cardiologist had me wear a holter monitor. She sent me memes making fun of hypochondriacs and accused me of being dramatic.
For the most part, I kept to myself at work and would eat lunch alone as my coworkers would sneak away from their desks quietly so I wouldn’t join them. During a one-on-one my manager told me that people come up to her and ask why I’m so sad. She said my work was fine but the fact that I looked upset and worried most of the time reflected poorly on the team. Anyone with a mental illness knows how exhausting it is to fake being happy especially for long periods of time. I wasn’t trying to look depressed but how down I was feeling and how little I was sleeping showed. But the concern wasn’t about me and how I was feeling. The concern wasn’t that my coworkers had intentionally excluded me. The concern was how I would make the team look. After many other unrelated events took place, I decided to quit.
I lost my best friend when I quit because she thought my PTSD made me crazy. I’ve lost a lot of my support system through the years. One of my best friends got engaged during the time my PTSD was at it’s worst. She decided I was too far behind her to be in her life and slowly drifted away. When I tried to talk to her about it, I was lashed out on and made to feel crazy and unlovable.
I recently started opening up about mental health on Instagram and through a blog. Ever since I started opening up about my story, I’ve noticed people straying from me. Behind my back I get called crazy. Some people seem embarrassed to associate with me now that I’ve publicly admitted to having a panic disorder. Some people mistake my advocacy for “oversharing” and act uncomfortable around me. It’s been upsetting for me to see people I’ve opened up to sharing memes that make fun of 13 Reasons Why and hear them say that they don’t care about suicide or that Hannah is dramatic. Just when I think I’m helping them start to get it I realize they haven’t been listening and I even worry that what they say about Hannah is what they’re secretly thinking about me.
The point of people discussing the show is to normalize talking about mental health and suicide, a topic people tend to avoid until they’re faced with it. Normalizing talking about it creates a safe space for people to open up and hopefully prevent suicide. The negative talk surrounding the show has showed that people lack the compassion for and understanding around mental health.
Another criticism of the show was that it makes it seem as though people only care when you die. I get why that concept upsets people because it is terrible but it’s also true. A couple of people I graduated from high school with tragically committed suicide awhile back. When these losses occurred so close together my Facebook feed was flooded with posts about telling someone if you’re struggling and getting help. Some of those same people have been the ones sharing insensitive 13 Reasons Why memes or making fun of my blog.
I’ve reached out to people many times throughout the past year asking to hang out so I could practice getting out more and work on my social anxiety. I always get hit with a “yeah, definitely. I’ll let you know,” and never hear anything back. I’ll see them posting pictures of being out with other people. They have the time, they just don’t want to spend it with someone who might have a panic attack. I tend to be the one to text first and if I don’t, I won’t hear from most of my friends with a couple of exceptions. My friends have made me feel like a misunderstood burden.
This isn’t meant to be a sad message that there’s no hope or help out there. There are good therapists out there even if it takes time and a lot of referrals to find one. Joining the mental health community introduced me to a wonderful support system of people who get it. I get that people say “get help” thinking that the help is readily available out there and they’re trying to help. You can’t fully understand how complex mental health care is until you’re thrown into it. I, myself, thought getting help was as easy as calling a therapist and getting treatment before I developed severe problems. I never expected to feel dehumanized or find no one on the other end when I reach out for help. I wish someone had prepared me for that.
All I ever read before decided to seek out help was To Write Love On Her Arms Facebook posts reminding me daily that people care and there’s help for me out there. These messages that are meant to be uplifting simplify what it means to get mental health care and they only talk to the receiving end. Who is out there telling the rest of the world to be more helpful? I fear we allow people to assume more help is out there than there is and they think it’s our fault if we don’t get the help we need, like how people are saying Hannah would have been okay if she had just reached out. She did. She was bullied and tossed to the side. This unfortunately happens all the time and it’s happened to me. We have to be honest about these things if we really want to prevent suicide and eliminate the stigma.
So if someone tells you that they’re going through a mental health crisis, be that helpful person. Be that person who doesn’t judge them and answers the phone. Put as much effort into advocating for better resources and reformed mental health care as you do into encouraging people to seek out help.