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Coming Out about Depression

Mental health issues can continue to impact openly LGBTQ people.

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October 11 marks the celebration of National Coming Out Day, when LGBTQ people across the country pause to reflect on the significance of openly identifying as a member of their community. It’s a time to think about how personally meaningful it can be to step more fully into authenticity, and also acknowledge the cultural and political importance of this brave act.

October also marks the observance of World Mental Health Day, which brings awareness to the global impact of mental-health conditions, and aims to encourage nonjudgmental conversations about the importance of diagnosis, treatment, and access to care.

While thinking about these two October observances, it might be easy to imagine that coming out will quickly remove the psychological distress of being in the closet. That’s certainly the case for many, but not all coming-out stories have happy endings. In fact, many LGBTQ people continue to struggle with illnesses like depression even after coming out.

When we hear the word “depression,” we might think of a person with overwhelming sadness or uncontrollable crying spells. But the effects of depression can vary quite a bit from person to person. Someone you know could be showing much more subtle signs of depression, and they might well benefit from additional support or mental-health assessment and treatment.

Having Feelings Is Okay

We all experience a variety of emotions in response to past and present life events. Happiness, frustration, surprise, and even sadness are all a part of the range of feelings that human beings have. Emotional ups and downs occur so many times throughout the day that we barely even recognize it. Having a wide range of emotions (including experiences of sadness) doesn’t mean you are depressed. It means you are human. It may help to remember that this year has tested our emotional resilience in unprecedented ways as we cope with social unrest and a deadly pandemic.

It’s Not Just ‘Sadness’

While people commonly equate depression with simply “feeling sad,” the psychiatric condition Major Depressive Disorder or MDD (sometimes referred to as “clinical depression”) refers to a specific collection of physical and psychological symptoms that accompany a significant and persistent decline in mood. This dip in a person’s mood can be experienced as simply feeling “down,” or it might also manifest as being easily irritated, bothered by small things, snapping at people, or becoming impatient.

Although sadness or a change in mood is the primary symptom, it is the associated physical and mental symptoms that lead to a diagnosis of Major Depressive Disorder. In MDD, sadness occurs alongside changes in sleep or appetite, diminished ability to concentrate and focus on tasks, low energy, or feeling physically sluggish, run down, or perhaps agitated. Feelings of guilt, worthlessness, hopelessness, or helplessness can overtake the emotional experience and become overwhelming. Hobbies and activities that were once enjoyable may no longer be of interest or as fun as they once were.

For some, feelings of apathy may predominate. In those cases, people may describe their mood as persistently “blah.” Although not always seen in MDD, some people experience persistent thoughts about self-harm or even suicide.

Am I Depressed?

Everyone experiences one or more of the symptoms listed above from time to time. Who hasn’t had a bad night’s sleep or eaten too much or too little in response to stress? Some days we just have more energy or focus than others. Guilt is also a natural feeling, and while it may be uncomfortable, it can prompt us to apologize to friends or family we have wronged. Expecting to be happy every moment of every day is not realistic, and can set us up for feelings of disappointment over not being as cheery as the smiling people we see in the media.

All the same, the mood changes that mental-health providers become most concerned about are those that  last over extended periods of time. In the case of MDD, that would be at least two weeks. Do your symptoms negatively impact the way you feel about yourself or your ability to function in relationships, at work, or at home? Experiencing these chronic physical and mental symptoms may signal a need to talk with a physician or therapist.

LGBTQ Depression Issues

LGBTQ people are especially at risk for experiencing MDD. In fact, studies suggest that adults with same-sex attractions are more than twice as likely to have experienced psychological distress in the past year, when compared to their heterosexual counterparts, and transgender individuals are over three times as likely to experience psychological distress.

There are several reasons for this distress and depression among LGBTQ people, despite the greater visibility and acceptance experienced by many members of the community. Exposure to homophobia and transphobia can lead to internalizing negative cultural attitudes about LGBTQ identity. Many struggle with persistent feelings of guilt and shame regarding sexual orientation and gender identity. Social stigma, discrimination, and the fear of harassment and violence are everyday occurrences that contribute to stress and trauma.

Where Can I Go for Help?

If you suspect that you may be suffering from depression, the first thing is to recognize that you are not alone. There is no shame in struggling with this illness or seeking treatment, and the good news is that treatment works. Many people have found that psychotherapy and/or antidepressant medications can help tremendously in lifting their mood and reducing their symptoms of depression.

There are many local and national resources available, both in-person or online. These organizations provide services ranging from a listening ear to extended treatments. Seeking out these services, which can sometimes be done anonymously, can be a sign of strength and commitment to your personal growth. It may well be one of the most important things you ever do. There’s no need to wait until a crisis happens. You can begin engaging in mental-health and wellness support today.

Finally, if you have struggled with or are currently experiencing suicidal thoughts, consider texting or calling one of the mental-health hotlines for a referral to one of the local resources listed below.


Suicide-Prevention Hotlines

LGBT Switchboard Houston: (713) 529-2311

National Suicide Prevention Lifeline: 1-800-273-TALK (1-800-273-8255)

Crisis Text Line: Text “HOME” to 741741

Veterans Crisis Line: Confidential crisis chat at VeteransCrisisLine.net, or send a text to 838255

Local Mental-Health Resources

Montrose Center
401 Branard St., Houston. 713-529-0037 or montrosecenter.org

Legacy Community Health
832-548-5000 or legacycommunityhealth.org

This article appears in the October 2020 edition of OutSmart magazine.

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Daryl Shorter, MD

Daryl Shorter, MD, is a Diplomate of the American Board of Psychiatry and Neurology and is board certified in both general and addiction psychiatry. His clinical practice focuses on veteran care, and he lectures widely on LGBTQ mental health. Dr. Shorter can be reached at [email protected]

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