Unmasking Hidden Struggles

I was recently reading Kerry Washington’s memoir, where she shared a deeply personal account of her struggles with disordered eating during her college years. She explained that disordered eating was her way of masking emotional pain, comparing it to self-medicating with drugs or alcohol. For Kerry, maintaining the appearance of having it all together was paramount, and she found that while drugs or alcohol might reveal her struggles to the outside world, disordered eating allowed her to keep her secret hidden. She could binge in private and work out obsessively without anyone knowing.

The danger of hidden struggles is that they often go unrecognized and untreated for far too long. When someone appears to have it all together, friends, family, and colleagues might not suspect that anything is wrong. This lack of recognition can prevent individuals from receiving the support and intervention they need.

Furthermore, the isolation that comes with hidden struggles can exacerbate mental health issues. When people feel that they must hide their pain, they are less likely to seek help or confide in others. This isolation can lead to a worsening cycle of unhealthy behaviors and emotional distress.

Kerry’s story highlights a critical issue in mental health: the facade of solidity and control. Many people, like Kerry, feel immense pressure to appear perfect, competent, and untroubled. This societal expectation can drive individuals to develop harmful coping mechanisms that are easier to conceal.

This is most dangerous to our health because we silence ourselves and don’t allow ourselves to utilize resources of support. In an attempt to break the silence and disrupt the stigma surrounding mental health, I want to share my own struggle with mental health challenges.

A couple of weeks ago, I was at a gala and I complimented someone I knew on her dress. As I inquired about the designer (of the dress), I realized that we were wearing the same designer. I stopped what felt like a natural urge to say. “I’m wearing an Alexis dress too,” because I thought she would think I looked cheap and not believe it was the same designer.  

Sounds silly, right? It’s a cognitive distortion or thinking error called mind reading. My distorted thinking didn’t begin in that moment. I had been feeling anxious the week leading up to the event (my anxiety had nothing to do with the event), and my persistent anxiety over an extended period of time, in the absence of tending to my emotional needs, caused my distorted thinking.

I also recently experienced a social interaction where someone acted out towards me, but the root cause or underlying issue had nothing to do with me. I tortured myself…making it about me…perseverating over it for days after it occurred. This is also a thinking error, it’s called personalization.

I’ve suffered with depression and anxiety, since I was in the 4^th grade. Mental health data suggests that by the time an adolescent sees a mental health professional, they’ve been having symptoms for about 8-12 years.  I was nearly 16 years old the first time I saw a therapist. I had been suffering for 7-8 years before I talked to a professional.  I am committed to therapy for the rest of my life. It is an essential part of caring for myself.

My frequency of treatment is typically once every two weeks, but I adjust my frequency based on my emotional needs. I typically know it’s time to increase my frequency or go back to therapy (if I’ve gotten away from my routine) when my thinking becomes distorted. There are so many cognitive distortions/thinking errors. Practicing self-awareness and recognizing when my thinking is distorted has been my signal to revise my frequency of treatment.

My two most common thinking errors brought on by my anxiety and depression have been personalization and mind-reading.

• Personalization – taking responsibility for events or situations that are not entirely within one’s control, often leading to feelings of guilt, blame, or inadequacy. People who engage in personalization might interpret events as being directly related to themselves, even when this is not the case.
• Mind-Reading – assuming that you know what others are thinking, particularly when you believe they are thinking negatively about you. This can lead to misunderstandings and anxiety, as you might react to what you think others believe rather than what they actually think.

 When I recognize that I’m falling into the trap of distorted thinking, I have a few strategies that help to mitigate emotional distress and regain a sense of balance. Here are the steps I take:

1. Contact My Therapist: I revise the frequency of my therapy sessions. Regular check-ins with my therapist help me stay grounded and provide professional guidance on managing my thoughts and emotions.
2. Practice Guided Meditations Daily: I get really strict with myself about practicing guided meditations every day. This helps me center my mind, reduce stress, and cultivate a sense of inner peace.
3. Midday Treadmill Walks: I walk on the treadmill in the middle of the day. Physical activity boosts my mood and provides a break from negative thinking patterns.
4. Challenge Negative Thoughts: For every negative thought I experience, I come up with three alternatives. This practice helps me shift my perspective and break the cycle of distorted thinking.

While these protective factors are beneficial, they are not a cure-all. Just this week, I experienced an overwhelming wave of sadness in the middle of the day. I felt pressed for time and space to give in to my sadness, but I knew intellectually that avoiding negative emotions could lead to greater distress. So, I decided to embrace my feelings instead.

I took a break in the middle of the day—a rare occurrence for me. I put on comfy pajamas, wrapped myself in a blanket, and allowed myself to feel sad. This break lasted for two hours, and it was exactly what I needed. By giving myself permission to experience my emotions fully, I found that I felt much better afterward. When it was time to see patients that evening, I was able to show up effectively and with renewed energy.

I’m still healing and continuously practicing my techniques. I also accept my vulnerability to mental health challenges. It’s important to remember that self-silencing can increase the risk of cardiovascular disease and other health issues. Embracing our emotions and using them as signals to respond to our needs is essential to maintaining both mental and physical health. By acknowledging and addressing our emotions, we can better care for ourselves and create a more supportive environment for those around us.