During one of his first few sessions of counseling, Jim LaPierre’s therapist asked him to describe his son, who was 9 at the time.
“I listed out a million things about my son, how wonderful and perfect he is, and she let me go on and on, and when I finally exhausted everything I could say about him, she asked me, ‘Isn’t that how you’ve always wanted somebody to feel about you?’ And I cried throughout the rest of the session,” he said.
LaPierre, 47, is a clinical therapist who owns Higher Ground Services, a mental health clinic in Brewer. He has studied depression and mental illness, and also experienced it firsthand.
“I was absolutely depressed by age 12, and I simply blocked awareness of this,” said LaPierre, who is also a BDN blogger. “I went to therapy [at age 30] because I was terrified that I would unwittingly harm those I was preparing to serve as I worked toward becoming a therapist. I knew I felt broken and ‘not good enough,’ but I was keeping myself so overly busy as a means to avoid my feelings.”
What was it like to finally talk to someone after 18 years of silently suffering from depression?
“I felt lighter. I felt more free. I progressively became more of who I wanted to be,” he said.
Research shows the stigma associated with having depression — including “internalized stigma,” which refers to the beliefs people with depression have about themselves — can keep some people back from seeking mental health counseling.
“The profound reluctance to be a ‘mental health patient’ means people will put off seeing a doctor for months, years, or even at all, which in turn delays their recovery,” said Dr. Graham Thornicroft at the Institute of Psychiatry of King’s College London.
In a 2012 report, “Attitudes Towards Mental Illness,” the Center for Disease Control found that stigma can lead lawmakers to allocate less money to mental health services and medical personnel to provide poorer quality of care.
It took LaPierre many years before he sought counseling.
After being bullied, “my attempt to get out of depression in my teenage years was experimenting with drugs and alcohol, and trying to work was a way to try and escape my reality. The more I focused on work, the more I did drugs, the more I was able to escape the perpetual feeling of sadness. [Drugs] allowed me to hide and to fit in. I hid my true self from everyone — not just my depression,” he said.
Having grown up in a household where he “experienced predominantly neglect,” LaPierre remembered what it was like to suppress his emotions and push the symptoms of mental illness aside.
“When you grow up in an unhealthy family, whether the family has neglect present [or] abuse present, you learn not to trust,” he said. “You learn not to have needs, and you learn how to hide your true self and your true feelings. You get too good at hiding.”
But even teenage boys who become counselors need help.
“I think everyone who enters social work believes that if you help enough people, you’ll end up healing yourself,” he said. “[But] it doesn’t work that way. It can’t work that way. You have to help yourself.”
If you talk to one of the 350 million people around the world living with depression, you might hear how difficult it is to be open about a malady just as debilitating as the flu or a broken bone.
“I always felt different,” said Joyce, a 57 year-old resident of Farmingdale. “I felt like I was hiding something.”
Joyce — who asked not to have her last name published — currently works as a peer support specialist at Kennebec Behavioral Health in Waterville, where she helps patients who need someone to talk to in a crisis situation.
She’s also suffered from depression for most of her life. She was officially diagnosed in her early 20s. But that pain made it easier for her to accept and help others.
For years, Joyce said she hid her depression from employers and fellow employees.
“In jobs, you can’t display [depression], and I didn’t want to feel different from other people,” she said. “I wanted to be accepted, so people didn’t know I had depression.”
Before becoming a peer support specialist, Joyce worked at several jobs, the first of which was an at-home daycare she opened and ran after she gave birth to her daughter at the age of 25. She ran that for the next 20 years, while her daughter — and later, her son — grew up.
“Life is difficult when you have kids and have depression and don’t want to be involved in life,” Joyce said. “[But] I don’t think I ever got to that point where I couldn’t do it anymore when I was younger. I was just on automatic pilot. I have a strong sense of responsibility anyway, so I did what I had to.”
Following her kids’ move out of the house, Joyce worked at a couple organizations that care for children.
She eventually lost her job — a position she’d held for five years — because she had an episode where she couldn’t get out of bed: an experience created by exhaustion from working 10-hour days, difficulty in her marriage to her husband of 30 years, and her depression.
After what she calls her “breakdown,” Joyce connected with Crisis and Counseling Centers, a mental health and substance abuse treatment facility in Augusta.
After eight days in a hospital, and a divorce, Joyce now holds a seat on the Crisis and Counseling Centers’ Community Advisory Committee. She said she feels as though she can “finally be myself and be more lively.”
Depression is something she will likely live with for the rest of her life, but Joyce’s experiences have taught her how important understanding and empathy are for recovery.
“I’m more compassionate, and I’m more forgiving and accepting,” Joyce said. “Just because somebody is different doesn’t make them wrong or bad. I’m more accepting of different lifestyles. Because of course I don’t want to be judged for mine or be thought of as less [than]. It makes the world a better place to have differences.”
“The two things that I’ve loved most in my life were my aunt who raised me and my cat that I had for 15 years,” said Joe, 60, of Augusta. “That’s kind of sad, when you think about it.”
Joe — who, like Joyce, asked not to have his last name published — has suffered from “borderline bipolar disorder, a mood disorder and ADD” for most of his life: illnesses he was never encouraged to talk about while growing up.
Bipolar disorder is characterized by drastic changes in normal moods and behaviors, where the person swings between manic highs and depressed lows.
“It was like voodoo back then. Nobody ever talked about mental illness” Joe said. “Because there was only one way you could go — to the ‘loony bin.’”
Having worked for 25 years doing “a little bit of everything,” from construction to shipping, receiving and factory working, Joe has experienced firsthand discrimination and societal isolation due to his mental illnesses.
He first remembered feeling different in school, when homework assignments were due.
“I was probably in the fourth grade. I would get cramps in my stomach,” Joe said. “We all had to bring a paper in, and I’d always put my paper under someone else’s paper so that the teacher wouldn’t see. I didn’t realize I had depression or anxiety. But now that I think about it, it was anxiety.”
He grew up with abuse and neglect, and was bullied in school.
“We smelled bad, having to wear dirty clothes,” Joe said. “We were picked apart. I didn’t do very well in high school, either. I think it was because of the ADD. I even had a teacher who told me ‘not to take math again, as long as you’re in high school, stay away from it.’”
Such an experience, like Joe’s, is doubly harmful: Public stigma can perpetuate an internalized “self-stigma” in people living with mental illness, making them feel even more pessimistic and hopeless.
What’s especially dangerous about this self-stigma that haunts those who live with mental illness is that it can prevent the person from finding the resources and care they may need.
Fortunately, for Joe, he’s now getting the help he needs and is doing his best to help others — specifically his younger siblings.
“I see a psychiatrist every three months now, and I’m on medication,” Joe said. “If you ever have bad [thoughts], you set up a counseling session. That’s what I tell my brothers and sisters. Don’t let it get so far that you break the law or hurt yourself.”
“It’s a neverending story — mental illness,” Joe said. “You’re constantly battling it. This is a crossroads for me now. Where do I go from here?”
And where do we go as a state?
Groups such as the National Alliance of Mental Illness have been working for years to reduce stigma surrounding mental illness. And the Affordable Care Act, which expanded the Mental Health Parity and Addiction Equity Act of 2008, prevents insurers from providing less favorable benefits for mental health services than for medical or surgical services.
But perhaps the greatest barrier is cultural.
“I often wonder if we’ll live to see the day when we can talk about issues like suicide or addiction in the aisles of the supermarket with concerned neighbors without speaking in hushed tones, as if we have something to be ashamed about,” Molly Knight Raskin, a freelance writer, told Psychology Today.
Just like those suffering from a mental illness, this shift in the way people talk about issues such as depression will take work.
“People try to do it alone,” LaPierre said, referring to those who experience mental illness. “And it’s simply not possible. You can’t think your way into a new way of living. You have to live your way into a new way of thinking.”
Michael J. Kennedy is an intern at BDN Maine. To find counseling services near you, call 211 or visit http://211maine.org/.