Anxiety & Depression

Trouble Coping

LGBTQ+ folks often have to cope with stigma, discrimination, and violence. When also dealing with a mental health condition, these difficulties are often amplified; for instance, an LGBTQ+ individual might feel stigmatized twice: once for their mental health issues and also for their sexual orientation or gender identity. Add to this to their experience of discrimination and the possibility of violence, and it can all become incredibly overwhelming.

Isolation & Loneliness

It’s normal for LGBTQ+ individuals to feel isolated or lonely. Depending on how “out” you are, you might not feel comfortable being yourself in public areas, and thus choose to spend more time alone. Some LGBTQ+ individuals feel that they must hide their sexual orientation or gender identity due to past experiences or potential fears of violence. Painful experiences of rejection by others in the past may also affect the way you operate in future relationships.

Negative Feelings

Unfortunately, LGBTQ+ individuals tend to have negative feelings about themselves because of their sexual orientation or gender identity. While it may not be something easily described, often LGBTQ+ individuals grow up with the sense that they are “different” and therefore “wrong”. The homophobia or transphobia they experience can often be internalized, and negative feelings can quickly become self-hatred. 

Anxiety

As a vital member of our emotional messaging system, anxiety exists to protect us. It warns us that something potentially harmful exists, either in our immediate surroundings or in the future, and is a rallying cry to “pay attention!” To help us respond to this perceived threat, chemicals increase our heart rate and breathing, preparing our body to fight or escape. However, these chemicals can misfire or get caught in a loop, causing anxiety that is either too frequent or disproportionately high for the circumstances, interfering with daily life. 

Anxiety can be generalized or can appear in social settings. It can also manifest as phobias, panic attacks, or obsessive-compulsive behaviors.

As a member of the  LGBTQ+ community, anxiety about how others perceive us, as well as legitimate fears about safety are commonplace. Often we internalize fear, self-hatred, and worries related to our sexual orientation or gender identity that otherwise don’t affect heterosexual and cisgender individuals.

Symptoms

• Feelings of danger, panic, or dread

• Nervousness, restlessness, or being tense

• Rapid heart rate

• Weakness and lethargy

• Rapid breathing, or hyperventilation

• Increased or heavy sweating

• Trembling or muscle twitching

• Digestive or gastrointestinal problems, such as gas, constipation, or diarrhea

• Difficulty focusing or thinking clearly about anything other than the thing you’re worried about

• Insomnia

• A strong desire to avoid the things that trigger your anxiety

• Anxiety surrounding a particular life event or experience that has occurred in the past, especially indicative of post-traumatic stress disorder (PTSD)

• Obsessions about certain ideas, or performing certain behaviors over and over again, a sign of obsessive-compulsive disorder (OCD)

Depression

Depression is characterized by a loss of motivation and energy and a surge in feelings of sadness or hopelessness. Feeling down from time to time is a normal part of life, but when emotions such as hopelessness, overwhelm, despair, or grief take hold and just won’t go away, you may have depression. Depression changes how you think, feel, and function and can interfere with your ability to eat, sleep, have sex, work, study, and engage in physical activities.

For LGBTQ+ folks who may already be struggling with loneliness and isolation due to their potential fears of discrimination and violence, depression occurs at higher rates and can manifest itself more quickly. As discussed above, internalizing negative rhetoric regarding LGBTQ+ people can make one come to view themselves as deeply flawed, unlovable, unworthy, and hopeless. 

LGBTQ+ individuals may struggle more with maintaining familial relationships, feeling culturally accepted, and establishing romantic partnerships. Remember, social support is incredibly important for everyone. LGBTQ+ people often have less social support from family and society at large, and therefore can be much more likely to see symptoms of depression throughout their lives. 

Symptoms

• Feelings of sadness, tearfulness, emptiness or hopelessness

• Loss of interest or pleasure in most or all normal activities, such as sex, hobbies or sports

• Sleep disturbances, including insomnia or sleeping too much

• Angry outbursts, irritability or frustration, even over small matters

• Tiredness and lack of energy, so even small tasks take extra effort

• Unexplained physical problems, such as back pain or headaches

• Reduced appetite and weight loss or increased cravings for food and weight gain

• Anxiety, agitation or restlessness

• Slowed thinking, speaking or body movements

• Feelings of worthlessness or guilt, fixating on past failures or self-blame

• Trouble thinking, concentrating, making decisions and remembering things

• Frequent or recurrent thoughts of death, suicidal thoughts, suicide attempts or suicide

Coping Skills

For anyone struggling with anxiety or depression, there are several coping skills or healthy habits that, if successfully included in your daily life, can help ease the symptoms of your mental illness. A healthy diet, adequate sleep, and regular exercise are the big three. They help you generate the chemicals your brain and body need to stay healthy.

On top of those habits, some psychological skills can also help. Making sure you are expressing your feelings appropriately is incredibly important for your mental health. When you feel anxiety or depression symptoms acting up, there are cognitive self-help skills you can learn to manage your feelings and thoughts. Mindfulness can also be a positive addition to your mental toolkit. 

More specific to LGBTQ+ individuals, it’s important to learn how to recognize experiences of bias and discrimination, and to have strategies to handle those experiences. For instance, when is it appropriate to confront those moments? Learning when you feel safe enough to speak up can empower you to accept who you are more fully and learn to rid yourself of any internalized negative feelings about who you are.

Social Support

Most LGBTQ+ individuals aren’t taught how to deal with discrimination. Take the example of African Americans in the US. There’s pretty good evidence that African American families teach their children to cope with discrimination and bias because they’ve lived with that experience; they talk to their children about how to handle it, and children learn by seeing their parents cope with discrimination. 

On the other hand, most LGBTQ+ individuals come from heterosexual families who have not faced anti-gay or anti-trans bias, so it really takes some effort on the part of the individual and the community to work with each other and learn how to manage discrimination.  Research shows LGBTQ+ people get less social support from families than heterosexual or cisgender people.

Social support is crucial to protect us from anxiety and depression. For this reason, many queer individuals make the choice to move to areas that are more accepting of people with varied sexual orientation and gender identity. If moving is not possible, then consider finding LGBTQ+ friendly organizations in your area like bookstores, community centers, etc.

Experienced Therapist

If you are part of the queer community and you suffer from anxiety, depression, or any other mental health concerns, finding the right therapist is paramount to improving your mental health. LGBTQ+ folks need mental health providers who have good multicultural competencies around LGBTQ+ concerns. Your therapist should be adept at distinguishing emotional responses that are distorted vs. realistic perceptions. They must know the laws and the community.

Pretend for a moment you go see a therapist who has little experience speaking with LGBTQ+ individuals. You tell them you are afraid of being fired because of your sexual identity, and they immediately assume your worry is a distorted perception or reality. They don’t know enough about the LGBTQ+ experience to recognize that this might be a realistic concern.

It takes lived experience and/or extensive cultural competence training to truly understand the concerns of an LGBTQ+ individual. I have the personal experience and the training. I also have years of professional practice helping members of the queer community address their worries in order to thrive and enjoy a happier life.