Carlo* began noticing how deeply sad he felt long before he came out as a transman. He noticed that, in addition to gender dysphoria, he experienced periods of time when the weight of life just felt too heavy to carry. Periodically, he would withdraw from others and was immobilized at the thought of reaching out to friends and family. When the periods of low mood continued long after he came out and after he fully transitioned, Carlo began to recognize his life-long struggle with depression.
Similarly, August* struggled with periods of depression that often included intense irritability and bouts of anger. In addition to symptoms of depression, he also noticed that he worried intensely about many different parts of his life. August would lay in bed for hours at night worrying about his relationship with his boyfriend, about seeing his parents over the holidays, about making enough money to pay for another semester of college, and about his health. He often suffered from stomach upset, tension headaches, racing heart rate, and dizziness.
Both Carlo and August are among the many members of our community who experience depression and anxiety. The National Alliance on Mental Illness (NAMI) estimates that one in four Americans experience some form of mental illness in a given year. Depression, one of the leading causes of disability in the U.S., impacts 14.8 million U.S. adults directly. Anxiety disorders (Generalized Anxiety Disorder, OCD, Posttraumatic Stress Disorder, Phobias) impact 40 million people and often co-occur with depression. Research focusing on anxiety and depression in the LGBTQ community has shown significantly higher occurrence rates when compared to rates of heterosexual individuals.
“Our community, and the quality of life for individuals and families, is greatly impacted by the high rates of anxiety and depression that we experience,” said Heather Wilder, Psy.D., Co-owner of Wilder Therapy and Wellness in Cranston. “We are at higher risk not because we identify as lesbian, gay, bisexual, queer or transgender. What the research shows is the rates are higher because we live in a culture in which we are constantly bombarded with overt forms of oppression like bullying and inequality in legal protections. IN addition, we experience daily slights, called microaggressions, like hearing the phrase ‘That’s so gay’ used in conversations in our work and social environment.”
The stress related to being member of a minority group in an oppressive dominant culture combines with a complex mix of other factors that lead to anxiety and depression. A family history of mental illness, other biological factors, experiences of traumatic events, and inadequate family and social support can all contribute to symptoms.
Symptoms of Depression
“When you are depressed, everything can feel like it takes tremendous effort,” Wilder said. “Little things, like remembering to call someone or making dinner, feel like you are trying to run in deep water. People around you may be telling you things like ‘Cheer up,’ ‘Look on the bright side,’ or ‘You just need to get up and go outside.’ What they don’t understand is you can’t; you just can’t do it. ”
Symptoms of depression include:
- Depressed/intense low mood for most of the day, nearly every day
- Los of interest in activities, including ones that were once pleasurable
- Significant weight loss or gain
- Changes in sleeping patterns
- Feeling slowed down and loss of energy
- Feelings of worthlessness
- Difficulty concentrating or thinking
- Recurrent thoughts of death
- Increased use of alcohol or other drugs may occur
- Suicidal thoughts may be present
Symptoms of Anxiety
“Anxiety within normal limits can be a good thing,” Wilder said. “It’s what helps us complete tasks and get moving. When we feel it in excess or we are prone to experience it more intensely, it can be a big problem. In general, anxiety felt in an intense way can make you feel like you are on high-alert all the time. It feels like constant tension and stress that won’t ease. ”
Symptoms of anxiety include:
- Restlessness or feeling “keyed up” or “on edge”
- Easily fatigued
- Difficulty concentrating
- Muscle tension
- Sleep disturbances (difficulty falling or staying asleep, unsatisfying sleep)
- Physical complaints like nausea, headaches, racing heart, shortness of breath
- Panic symptoms or panic attacks
- Fear and worry about specific things or about many different things
“People who experience the symptoms of depression and/or anxiety do many things to survive them on their own. They may not be completely aware that the symptoms are treatable and can be overcome,” Wilder said. “In my experience, people live with depression and anxiety for quite a while before they get help. Often, they are doing so in isolation, which can make it harder for those things that once worked to continue to do so. That’s when it can be helpful to seek help from a therapist. When you’ve been carrying the heaviness by yourself for a while, having someone who can offer support can be the key to easing the burden.”
*Not actual names