Coming Out of the Mental Health Closet

Series: Evaluating Reality Using Science

Written by Dr. Gleb Tsipursky, Intentional Insights Co-Founder and President.

Graphics by Cerina Gillilan

My hand jerked back, as if the computer mouse had turned into a real mouse. Would they think I am crazy? Would they whisper behind my back? Would they never trust me again? These anxious thoughts ran through my head as I was about to make a post revealing my mental illness to my Facebook friends.

Whenever the thought of telling others about my mental illness entered my mind, I felt a wave of anxiety pass through me. My head began to pound, my heart sped up, my breathing became fast and shallow, almost like I was suffocating. If I didn’t catch it in time, the anxiety could lead to a full-blown panic attack, or sudden and extreme fatigue, with my body collapsing in place. Not a pretty picture.

For 6 months, I had been suffering from a mood disorder characterized by high anxiety, sudden and extreme fatigue, and panic attacks. I really wanted to share much earlier. It would have felt great to be genuinely authentic with people in my life, and not hide who I am. Plus, I would have been proud to contribute to overcoming the stigma against mental illness in our society, especially since this stigma impacts me on such a personal level.

Ironically, the very stigma against mental illness, combined with my own excessive anxiety response, made it very hard for me to share. I was really anxious about whether friends and acquaintances would turn away from me. I was also very concerned about the impact on my professional career of sharing publicly, due to the stigma in academia against mental illness, including at my workplace, Ohio State University, as my colleague and fellow professor described in his article.

Still, I did eventually start discussing my mental illness with some very close friends who I was very confident would support me. And one conversation really challenged my mental map, in other words how I perceive reality, about sharing my story of mental illness.

My friend told me something that really struck me, namely his perspective about how great would it be if all people who needed professional help with their mental health actually went to get such help. One of the main obstacles, as research shows, is the stigma against mental health. We discussed how one of the best ways to deal with such stigma is for well-functioning people with mental illness to come out of the closet about their condition.

Well, I am one of these well-functioning people. I have a great job and do it well, have wonderful relationships, and participate in all sorts of civic activities. The vast majority of people who know me don’t realize I suffer from a mental illness.

That conversation motivated me to think seriously through the roadblocks thrown up by the emotional part of my brain. Previously, I never sat down for a few minutes and forced myself to think what good things might happen if I pushed past all the anxiety and stress of telling people in my life about my mental illness.

I realized that my mind was just flinching away, scared of the short-term pain of experiencing anxiety and stress of sharing about my condition. This flinching away prevented me from really thinking clearly about the long-term benefits to me and to others of sharing my story of making the kind of difference I wanted to make in the world and being authentic with people in my life. I recognized that I might be falling for a thinking error that scientists call hyperbolic discounting, a reluctance to make short-term sacrifices for much higher long-term rewards.

To combat this problem, I imagined what world I wanted to live in a year from now – one where I shared about this situation now on my Facebook profile, or one where I did not. This approach is based on research showing that future-oriented thinking is very helpful for dealing with thinking errors associated with focusing on the present.

In the world where I would share right now about my condition, I would in the short term be anxious about what people think of me after they find out. Anytime I saw someone who found out for the first time, I would be afraid about the impact on that person’s opinion of me. I would be watching her or his behavior closely for signs of distancing from me. And this would not only be my anxiety: I was quite confident that some people would not want to associate with me due to my mental illness. However, over time, this close watching and anxious thinking would diminish. All the people who knew me previously would find out. All new people who met me would learn about my condition, since I would not keep it a secret. I would make the kind of difference I wanted to make in the world by fighting mental stigma in our society. Just as important, it would be a huge burden off my back to not hide myself and be authentic with people in my life. This would be a great benefit to me in the long term.

I imagined a second world. I would continue to hide my mental health condition from everyone but a few close friends. I would not be making the kind of impact on our society that I knew I would be able to make. I would always have to keep this secret under wraps, and worry about people finding out about it. I would always be stressed about hiding my true self, always worried about people somehow finding out, always and feeling like a hypocrite. Always regretting the chance to make the kind of impact I knew I could make. Moreover, likely people would find out about it anyway, whether if I chose to share about it or some other way, and I would get all the negative consequences later.

I shuddered when I imagined that kind of life. With that shudder, I knew that the first world was much more attractive to me. So I decided to take the plunge, and made a plan to share about the situation publicly. As part of doing so, I made that Facebook post. I had such a good reaction from my Facebook friends that I decided to make the post publicly available on my Facebook to all, not only my friends. Moreover, I decided to become an activist in talking about my mental condition publicly, as in this essay that you are reading. I also published articles about my condition in prominent academic media channels (Inside Higher Ed and Diverse: Issues In Higher Education) to challenge the stigma against mental illness in academia. I also shared my story with a local newspaper, to raise awareness of mental health and deal with stigma against mental illness.

What can you do?

So how can you apply this story to your life? Whether you want to come out of the closet to people in your life about some unpleasant news, or more broadly overcome the short-term emotional pain of taking an action that would help you achieve your long-term goals, here are some strategies.

  1. Consider the world where you want to live a year from now. What would the world look like if you take the action? What would it look like if you did not take the action?
  2. Evaluate all the important costs and benefits of each world. What world looks the most attractive a year from now?
  3. Decide on the actions needed to get to that world, make a plan, and take the plunge. Be flexible about revising your plan based on new information such as reactions from others, as I did regarding sharing about my own condition.

What do you think?

  • Do you ever experience a reluctance to tell others about something important to you because of your concern about their response? How have you dealt with this problem yourself?
  • Is there any area of your life where an orientation to the short term undermines much higher long-term rewards? Do you have any effective strategies for addressing this challenge?
  • Do you think the strategy of imagining the world you want to live in a year from now can be helpful in any area of your life? If so, where and how?



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