October 24, 2022

Lonely at the Top: The Toll of “High Functioning” Depression and Our Pandemic Mental Health Crisis

Stacy Torres author photoBy Stacy Torres

From the vantage of midlife, I’ve pondered social mobility’s toll on myself and others who’ve climbed from the poor or working-class into the professional class. I’ve spent my entire life developing a titanium outer shell, making myself strong and tough as poverty conspired to knock me off track. Skilled at powering through, I’ve worn my resilience like a Purple Heart. I had to fight. And fight. And fight.

But I’m tired of running to stay in place. At 42, I still spend considerable time quieting the inner monologue that says I’m not good enough. In my current position as an assistant professor of sociology, work and productivity remain intertwined with my identity and self-worth. Rejections can feel personally crushing. I’ve often dwelled on my failures, feeling like an imposter. Being hard on myself served me in the climb, but harmful perfectionism now yields diminishing returns.

The higher I’ve ascended, the greater pressure I’ve felt to mask vulnerability. Many who’ve been one of few or the only—woman, racial or ethnic minority, immigrant, poor person, or any number of underrepresented identities—in our classes, workplaces, and communities had no choice but to go it alone. But surviving as a lone wolf can be damaging. Exceptionalism complicates seeking help when you most need it.

Many of us don’t advertise our suffering. Given my educational and career credentials, it may appear to others as if nothing’s amiss. Some call this kind of depression “high functioning” (though experts debate the utility of such labels). I call it hanging by a thread.

My recent depression snuck up with the accumulation of pandemic fatigue, grief for my father’s death, and work and caregiver burnout. I’m not alone in my mental health struggles. According to the World Health Organization, depression and anxiety have increased 25 percent globally during the pandemic,

In different depressed periods, I’ve had suicidal ideation, gained and lost weight, and drank too much. But I’ve always showered, combed my hair, and gotten out of bed. Even as a suicidal college student, I maintained straight-As. Minuscule tasks require loads of energy and courage. I push through fatigue, tears, apathy, self-doubt, distraction, and despair, willing myself to work, exercise, and eat my broccoli. The worst feels over now, but I’m not “fine.” Keeping myself from plunging back into the lowest lows requires daily vigilance.

To safeguard my mental health, I don’t have a smartphone or use social media. I stopped perusing academic Twitter ten months ago, staunching the constant news feed of others’ accomplishments that stoke my insecurities. I attend a university-based bereavement group, where we cry about our dead parents and lately about work burnout. Music lifts me from the darkest places. It’s hard not to feel like a failure on days when I try everything, and the dark cloud doesn’t lift. But I push those painful thoughts to the edge of my cognitive plate, like some rancid vegetable, and recognize the small triumphs: answering email, taking a walk, sleeping through the night.

The last few years have me reassessing every aspect of life, especially work. With rising dissatisfaction and resignations now the norm in higher education, I’m in good company.

As I recently updated my curriculum vitae for my upcoming “appraisal,” a term which makes me feel like a piece of furniture, my publication gaps revealed the pandemic’s toll on my productivity. These “deficiencies” are evidence of my toiling to keep vulnerable family members alive and healthy, especially in the pandemic’s earliest waves. My sister’s declines led to repeat hospitalizations and a nursing home admission in 2020. Six months later, my father’s lung cancer returned. He died in 2021.

It’s difficult to admit to other accomplished people that you’re quietly breaking down, but I’m getting comfortable revealing my cracks. And I feel a growing responsibility to share my vulnerabilities with those who might benefit, perhaps a struggling student or colleague who needs to know they’re not suffering alone. In my classes I make space for us to express grief, anxiety, depression, with the weary world churning as it does.

It’s hard to claim ownership of any illness, especially one that hasn’t achieved pink ribbon status. My mother, sister, and I have all had psychiatric hospitalizations. Whenever I’m tempted to remain quiet about my depression, I recall the iconic AIDS advocacy poster Silence = Death. Divulging my family’s mental illness always prompts relieved confessions from others.

Breaking the silence is an important step, but unless the United States commits to a major investment in chronically underfunded mental health services, we won’t save lives. As the pandemic has exacerbated the nation’s mental health crisis, a shortage of mental health providers, especially those of color, and growing demand have strained access to treatment. One of the consolation prizes from this bleak year has been receiving a year of free grief counseling through my father’s Medicare hospice benefits. His hospice agency handed me a weekly counselor, sparing me the soul-sucking agony of searching directories, making calls and getting turned away.

We must also address different structural barriers limiting trust and access to mental health care, especially for racial and ethnic minorities who carry the grief of racism and have suffered the pandemic’s disproportionate death and economic fallout. Ensuring sufficient mental health funding would support communities of color with reduced access to care due to affordability, stigma, distrust in the medical system, and a dearth of culturally competent services.

Beyond increasing access to resources, the government should ensure coverage parity for mental health care and raising insurance reimbursement rates for behavioral health services. Workplaces must also realize that providing access to short-term counseling, which I’ve received through my employer, supports workers and companies — and consider making those services permanent, even if the urgency inspired by the pandemic has ebbed.

As I sift through the pandemic’s personal wreckage, I don’t expect to glue the pieces back in the same way. I’ve thought of these ruptured years as kintsugi, the Japanese art of repairing cracked pottery with gold enamel. The beauty lies in its history, its breakage. If only dust remains, we have nothing to repair. I’m grateful for the shards I still have and the hope I keep alive, with a constellation of support, that I can make them into something whole and beautiful again.

If you are having thoughts of suicide, call or text 988 to reach the National Suicide Prevention Lifeline or go to SpeakingOfSuicide.com/resources for a list of additional resources.

Comments

Thanks for sharing. I will save it in my dashboard for the next chance.

"I’m grateful for the shards I still have and the hope I keep alive, with a constellation of support, that I can make them into something whole and beautiful again."

These words touched me. I can't keep silent about how much I'm involved in reading
Thank you for what you do keep up the good work!

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