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Illustration: Christine Wang.

Why stereotypes prevent the people who “have it all” from accessing treatment

Wake up. School. Extracurriculars. Work. Study. Party. Sleep. Sounds like a familiar routine for many of us, doesn’t it? Balancing all of this can often seem like an impossible task, especially while trying to eat right, maintain our relationships with family and friends, and keep our health in check.

But trying to excel in all areas of your life, or at least perform somewhat successfully, can often be impacted by a mental illness, and maintaining some semblance of stability as a high-functioning student can indeed have negative impacts on your own mental health.

As someone who has worked part-time for three out of four years of my undergrad, taken full-time classes, been involved in a variety of campus clubs and extracurriculars, all while trying to stay healthy and have good interpersonal relationships, I can definitely attest to the effects that all of this can have on a person’s mental health. There are days when you look at your to-do list and wish you could just go back to bed, but you know that you have to power through because you have a duty to yourself and to others to get the work done.

To some, a “high-functioning mental illness” can sound strange. We’ve all heard the stereotypes, that people with mental illnesses are lazy and thus can’t possibly succeed in school or other areas of their lives. How can someone with mental health issues be high-functioning?

These misconceptions make high-functioning people less willing to reach out for help—the stereotypes surrounding mental illnesses tell us that we’re weak if we speak openly about our struggles. That we’ll wreck the image that people have of us as accomplished and, pardon my French, that we have our shit together.

But high-functioning mental illnesses are more common than you may think, and the reality is that the girl who’s president of her club and acing six classes, or the guy working two jobs and on his school’s dance team could very well have struggles of their own.

“One could liken it to a mask”

For Joseph Senaratne, a second-year finance student at Ryerson University, his struggles with mental illness began when he started feeling like he had lost his sense of home and belonging while growing up.

This confusion brought upon a horrible sense of despair and developed into anxiety, which prevented me from doing things that before could have been done with ease,” he says.

Coming from a South Asian background, Senaratne highlights the cultural expectations of his family, specifically his father, and that it was almost impossible to discuss his mental health, which only made things worse.

“I am the son of the only son on my father’s side … I am expected by my father, my grandfather, and everyone around me to be the same. From a young age my father has drilled into me that I must be big and strong, and he forced me to play sports and work out.”

This expectation to be strong resulted in his father dismissing what he was going through, and being seen as “weak and needy” and not wanting to work hard.

“I grew hopeless, and the inability to treat my anxiety caused depression,” he explains.

Thankfully, his mother was more receptive to what he was going through and helped him get treatment, which is the reason why he is able to lead a high-functioning life today.

Senaratne notes a complex balance between working in a senior-level retail position and living with anxiety and depression, which he describes as a “disassociation.”

“One could liken it to a mask, where while I’m at work I have a separate retail personality which aids in making sales and ignoring emotionally taxing customers and tasks. This in itself is emotional labour.”

When it comes to school, Senaratne shares that his mental health can negatively impact his performance, which results in losing sleep to catch up on coursework. While he admits this might be toxic and unhealthy behaviour, he says that “slipping away from my emotions and having to focus on something … is an escape in itself.”

Senaratne shares the negative stereotypes regarding his mental health in relation to his work, namely the idea that “people with mental illnesses are flight risks to employers and are often unable to pull their weight in groups.”

“I’ve found the best way to deal with the stereotypes was by proving them wrong as best as I could,” he says. “By effectively holding out on the fact that I am living with a mental illness and simply working well, the stereotype of being lazy or a flight risk is dissipated upon me revealing the reality of my mental state to those I’m working with.”

The struggle of taking a day

“I can’t remember what it is like to be in school and not have some sort of mental health issue occurring at the same time,” says Emma, a third-year conflict studies and human rights student at the University of Ottawa, who has dealt with an eating disorder, post-traumatic stress disorder (PTSD), and faces an ongoing battle with anxiety and depression. Emma has chosen to keep her last name private in this publication.

“In a way that has helped me develop into the student I am today, I am hyper aware of my own personal needs and I am not afraid to put school or my social life on the back burner to take care of myself, but it has been difficult to get to that point today.”

Emma found herself able to balance school, a part-time job, and being a competitive swimmer in high school while dealing with an eating disorder, which she attributes to the support of her family and friends, but acknowledges that this wasn’t the case in her second year at the U of O when she developed PTSD.

The disorder manifested itself after a boy drowned while Emma was working as a lifeguard at a beach during that summer.

“I found it too triggering to return to my job at the university pool, so I quit, and I also left my swim team. I struggled to focus enough to study or to sit down and write my papers, all I wanted to do was keep busy so I didn’t have to deal with my trauma. School was challenging and I missed a lot of class that year.”

Eventually, with therapy, the right support system, and understanding professors, Emma found herself able to get back into swimming. She credits her ability to maintain a healthy social life, good grades, and fitness routine to plenty of self-care, such as journaling and meditation.

But achieving this balance and performing well doesn’t always mean pushing yourself to your limits. Emma shares that she has to be patient with herself, and taking the time to find the right path to recovery was crucial to getting to the point she’s at today.

Her process of healing is ongoing, but she notes one major barrier standing in the way of this, which are the stereotypes about people with mental illnesses.

“I think one of the hardest misconceptions I’ve faced with all of my mental health struggles is that everyone assumes I am doing great and I don’t have very real needs that I am working hard to address,” she says. “I have managed to stay full-time in school, keep up my regular fitness, and socialize with my friends, but I don’t like to reach out to my peers when I am struggling and sometimes that gives the impression that everything is going well in my life.”

For Emma, stereotypical beliefs that people with mental illnesses are lazy or low-functioning lead to her facing judgment when she needs to take a day off to prioritize her mental health.

“I know that I’m lucky to be able to maintain the lifestyle that I have, but it has taken years of therapy and self-reflection and patience to be able to function the way that I do, and it takes work every day to keep making progress and not letting mental health struggles overcome my life.”

These stereotypes are found across our society when it comes to mental illness, though we often tend to hear more stories about issues such as eating disorders, depression, and anxiety. To better combat these stereotypes, we need to hear from high-functioning people with mental disorders that we tend to avoid discussing, or simply don’t know much about.

Making room in the conversation for high-functioning folks

Matthew Garber, a third-year psychology student at the U of O, was diagnosed with autism spectrum disorder (ASD) in the eighth grade, and falls on the high-functioning end of the spectrum.

I can still function in social settings, I am verbal, and I’ve learned to mask my behavioural signs well enough that if I didn’t tell you I had ASD you probably wouldn’t know,” he explains. Some of these behavioural signs include difficulties in social settings and following regimented routines and patterns in daily life.

He notes that there are plenty of stereotypes facing those in the autism spectrum community. “Spend half an hour in any chatroom online and you’ll find someone referring to someone else as autistic or retarded. They seem to believe that it’s funny to denigrate others who may be acting childish or stupidly by calling them developmentally disabled.”

“Luckily that tends to die out pretty quickly when people are better educated, so I don’t really face that here on campus. Whenever someone does call something or someone retarded or autistic or whatever else it’s always important to let them know that it’s wrong to associate such negativity and hate to people who really haven’t done anything to them.”

Both Emma and Garber believe that awareness is key to combating these stereotypes, and Garber suggests that the best way to start is to get to know someone with a mental illness.

Unfortunately, despite our efforts to dispel these myths, they still have a way of seeping into even our positive conversations surrounding mental health, and the ways we try to raise awareness.

“When I think about posters that I see outlining the signs and symptoms of mental health issues, sometimes I find myself second-guessing my own issues because they don’t always fit the norm,” says Emma.

“We need to talk about the other end of the spectrumthe people who throw themselves into school or work or sports as a way of coping with their anxiety or depression or to fend off panic attacks or flashbacks.”

“As one of those people, it’s hard to feel validated in my experience of PTSD, depression, eating disorders, or anxiety because it doesn’t always fit the ‘poster image’ of mental health issues. There is no right way to be depressed, just as there is no right way to get better. If you need more sleep and more therapy to recover than someone else, that’s okayjust as it’s okay if instead of finding yoga relaxing you find lifting heavy at the gym or running sprints to be the thing that keeps everything in check.”

As Senaratne puts it, “I wish people understood that mental illness does not dictate someone’s entire ethic and personality, it’s simply a part of it. It’s impossible to segment someone’s entire being into labelsit’s like building a brick house without mortar to hold them together. I am not my mental illness but more importantly, I am not just a person living with mental illness, I am a person.”

Changing our conversations around mental health is essential if we want to be more inclusive and supportive of those who don’t fit the stereotype. Not everyone with a mental illness spends all day in bed, and recognizing this is key to making high-functioning people with mental illnesses more willing to speak out about their struggles. Sometimes all it takes is reaching out to the person who seems to have everything together, and letting them know that they aren’t alone in what they’re going through.