Recognizing and Treating Depression in the LGBT Community

by Katharine Swan

with clinical consultation by Cherie Verber, MA, MFT

Like any other medical condition, depression needs to be diagnosed before it can be treated. Unfortunately, depression can be difficult to nail down, as the same symptoms that affect a depressed person often prevent him or her from recognizing the problem and seeking help, as well. As difficult a challenge as it is to recognize and treat depression in mainstream society, it can be an even bigger problem in the LGBT community: studies have shown that gays and lesbians are more likely to experience depression than their straight counterparts.

What is Depression?

Depression is more than simply having a bad day – it is a serious disorder that permeates all parts of a person’s life. Symptoms may include:

• Extremely depressed mood
• Self-loathing
• Anxiety
• Irritability
• Inability to concentrate
• Tiredness
• Increase or decrease in appetite
• Weight change
• Sleeping too much or too little
• Headaches and other pains
• Substance abuse

As you can see, depression is nothing to sneeze at. Feeling down for a day or two is not usually a problem, because you can shake it off after a little while. Clinical depression, on the other hand, is like drowning in quicksand – no matter how much you want to get out, every move you make simply drags you in deeper.

Depression and the Gay Community

It is probably quite obvious why members of the LGBT community are more susceptible to depression. Whether or not you are open about it, simply being gay creates an additional stress factor that straight people don’t have. If you hide your LGBT identity, you most likely experience a great deal of anxiety about being found out; even if you are open about it, homophobia can make your life less than peaceful. Gays and lesbians who struggle with their identities have additional anxieties about not fitting in with either mainstream society or the LGBT community.

Unfortunately, one of ways that depression among the LGBT population manifests itself is increased drug and alcohol use and abuse. Internalized homophobia might be a primary cause. Gay children often grow up in a society that says that they should not exist and certainly should not act on their feelings. These societal feelings can be internalized. The conflict between what they feel and what they believe they should feel can cause psychological stress, and in an attempt to not “feel” some LGBT people turn to self medication with drugs and alcohol.

Additionally, many gay and lesbian people have their first sexual experiences under the influence of alcohol. This might be a way to overcome the internal fear, denial, and anxiety about gay sex. Alcohol use and sexual behavior can be conditioned together so that the pattern continues, and the depression can intensify.

What Causes Depression?

The causes of depression can be hard to pinpoint, but we do know that environmental factors can act as “triggers,” sending a person into a downward spiral. As we discussed in the previous section, stress and anxiety are often associated with depression. Other factors that may act as instigators include the sudden death of a loved one, a difficult physical illness, hormonal changes, medications, or substance abuse. People with a personal or family history of depression may be more likely to become depressed.

Although the causes of depression are sometimes unclear, we do know that clinical depression is accompanied by a chemical imbalance in the brain. The brain uses chemicals, known as neurotransmitters, to relay messages. Neurotransmitters are fairly specialized, with each one controlling a different type of message. For example, a lack of serotonin – the “happy chemical” – is believed to be linked with the irritation, anxiety, and difficulty sleeping associated with depression. Shortages of norepinephrine, a neurotransmitter than controls alertness and arousal, may be related to tiredness and depressed mood. However, it is not known whether the chemical imbalance causes depression, or vice versa.

Treating LGBT Depression

When you are depressed, you feel helpless and alone, like nothing – or no one – will ever be able to help you feel better. Fortunately, nothing could be further from the truth. Antidepressants help someone who is clinically depressed by simulating the chemical that is lacking in his or her brain, thereby correcting the imbalance. Of course, this is only a temporary solution – a band-aid, if you will. When the person stops taking the antidepressants, the factors that triggered the depression will still be there – particularly for gays and lesbians. The real cure will come when scientists come up with a pill to treat homophobia – but until that day, we need to find ways to deal with the stress and anxiety on our own.

This is where therapy comes in. Since a pill can only correct the brain’s chemical imbalance, we need to be able to cope with events in our lives that could trigger depression. This is particularly true in the case of gays and lesbians, who often deal with homophobia on a daily basis. Even in small doses, homophobic treatment can be difficult to deal with; it is no wonder that daily encounters have the power to send someone into a tailspin. An experienced LGBT counselor teaches you to deal with stress, anxiety, and loss, so that in future encounters you may pass through unscathed.

Self-acceptance of homosexuality may also be important in the treatment of LGBT persons who have problems with substance abuse and/or depression. One study found that self-acceptance was a key variable in the recovery of gay men.

Protecting the LGBT Community

Depression is not the only mental disorder that affects gays and lesbians. The LGBT community is also more susceptible to anxiety and mood disorders than mainstream society. Although certain people would have us believe that these are signs that gays and lesbians are all mentally ill, nothing could be further from the truth: in actuality, psychosis is no more common in gays and lesbians than it is in their straight counterparts. In fact, the only disorders that show a higher incidence in the LGBT community are the ones that are exacerbated by dealing with something unusually stressful – such as enduring homophobic treatment on a daily basis.

Gay and lesbian sexual orientation is frequently cited as a risk factor for suicide. Because no official suicide statistics include information on sexual orientation, however, firm data are lacking on whether suicide rates are higher among gay, lesbian, bisexual and transgendered people than in the general population.

Regardless of its causes, depression is a serious condition. Living with depression is only half a life – or no life at all, in cases of suicide. Depressed gays and lesbians may also neglect those who are counting on them: their children, their partners, their friends. To protect us from the impact of depression, the LGBT community as a whole needs to maintain an awareness of the disorder – helping each other to recognize the signs and seek treatment for ourselves and our loved ones.

For local referrals to gay positive therapists, please contact your local gay and lesbian service center. You will also be able to find listings of gay-friendly AA or NA meetings, rap groups, and other support services to assist you in navigating your way out of depression.

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