Harry says he has not always managed his bipolar disorder effectively.
Back when his problems began, a half century ago, treatment of serious psychiatric
disorders seemed much less scientific. Sometimes they also seemed more punishing
"It took years of me struggling with myself
and the system before things started to get better," he remembers. Growing
up gay in the 1930s was another part of the struggle. He has vivid, painful recollections.
"Back then, there wasn't really even a word for what we were," he mused,
"and we sure as hell didn't talk about it with our families."
prefers not to chronicle his struggles in detail. "Let's just say that it
wasn't all that much fun." He does admit that early on, he spent a good deal
of time in psychiatric facilities, trying the "treatment du jour"-everything
from cold water baths to insulin injections and major tranquilizers. It wasn't
until 1975 that he was even finally diagnosed with bipolar disorder. Before that,
he says, he had collected diagnoses that ranged from schizophrenia to psychotic
depression. These labels were "semi-educated guesses" that, he believes,
prevented him from getting effective treatment. Though his episodes of mania only
occurred once or twice a year, they were severe enough to disrupt his life. He
would be hospitalized for weeks, even months. Finally the mania would subside
and he would start picking up the pieces of his life.
His doctors subscribed
to the theory, prevalent at the time, that his mood swings were caused by "homosexual
"Not all of my life was horrible," he says. The
"smooth sailing" times included peaceful intervals with "the love
of my life." Harry met Alan, an actor, at a party in 1953. Alan was both
"worldly and charming." And when he called Harry "sweet and handsome
... well that was it. My heart just melted."
course of their forty-three years together, they had almost as many "ups
and downs" as Harry had mood swings. But the up times were enough to carry
them through the bad ones. Harry credits Alan's unwavering support with getting
him through the hospitalizations and the bouts of despair, guilt, and suicidal
thinking. They were both relieved when a combination of new medications, individual
psychotherapy, and a support group for people living with bipolar disorder kept
Harry out of the hospital for longer periods. He eventually managed his condition
so successfully that he has now gone over fifteen years without a single inpatient
Worse than the most horrible treatment back
in the "old days," Harry says, was the day that he lost Alan to emphysema
in 1996. The heartache is completely different from the depression he has experienced
for so long. Losing Alan was like losing his lover, his father, and his soul mate
all at once, he says somberly. Tears well up in his eyes. He clears his throat
and turns his head. "The last few years have been especially hard."
a year after Alan's death, Harry fell and broke his hip. After surgery to correct
the fracture, Harry spent a few weeks in a skilled nursing facility. While he
was there, learning to walk again, his friends suggested that he consider more
supportive living arrangements.
At the continued urging of
his friends, Harry sold the home that he and Alan had shared and moved into an
assisted living facility. While he finds the center clean and the staff nice,
he bemoans the fact that "they don't know squat about gay people." He
misses his friends and thinks about Alan every day. When he feels particularly
isolated and alone, he questions whether "life is worth it."
In fifth grade, Kris's Catholic school changed their policy. They
split the playground into two parts. Thereafter, the nun who supervised recess
announced that the boys would play on the right side and the girls would play
on the left. The boys' new space was twice as big as that of the girls. It was
also level. The newly designated female zone, as well as sloping, was pitted at
its lowest end with mud puddles. Kris knew where she belonged, and she refused
to budge. She was sent to the principal's office.
Word of the
episode spread like wild fire among her classmates. Soon they began to taunt her.
"You think you're a boy. Eewww, gross. You are so ugly. You are just like
a boy. You must be a boy." When the taunts became unbearable, Kris would
grab or punch whichever tormentor was close at hand. Back to the office she would
go, for a time-out and another lecture and a warning. The worst incident occurred
right before summer break. Egged on by his pals, a sixth-grader grabbed her breast
and crowed, "Hey, she's a girl! She's got titties." Then in a singsong
voice: "I felt your titties. I fit your titties." Before he could dodge
her, she got him in a hammerlock. She half-choked, half-dragged him to a giant
puddle on the girls' side of the playground, and heaved him in. By then a crowd
of other kids had gathered. When she saw the supervising nun striding in her direction,
Kris fled into the principal's office. There, defiant and ashamed simultaneously,
she blurted out her "crime."
The nuns called her
parents in and told them it would be better if she stayed home for the few
weeks remaining in the school year. They also told them that she would not be
welcomed back the following year. During the summer, Kris didn't go outside very
often. Her brain felt fuzzy. She had trouble sitting in one place for very long.
Whenever she ate, she felt sick. Often, after meals, she would lock herself in
the bathroom, and stick her finger down her throat until she threw up. When she
was sure she would be alone in the house, she used her Swiss Army knife to scratch
her chest and her thighs. Watching the blood ooze out of the cuts gave her some
momentary clarity and relief from the other, awful feelings. She made sure her
clothes always covered the scabs.
Queer children's gender nonconformity
makes them easy targets. Lonely, often desperate for attention, their depressions
can easily be misconstrued as acting out. The problematic behavior further marks
them as "different." Ever more alienated, they become more seriously
depressed. Most ominous is that the depression, because it remains invisible,
is never treated... Gay/lesbian/bisexual students with depression often go undiagnosed, because they are already seen as "different", their depressions can easily be misconstrued as acting out.
- Hardin, Kimeron and Marny Hall, Queer Blues, New Harbinger
Publications, Inc.: California, 2001.
Boundaries and Dangers in the Supervisory Relationship
- Budd, Phillip, Boundaries and Dangers in the Supervisory Relationship , Saint Anthony Hospital Family Medicine Residency Program, 2018.
Reflection Exercise #6
The preceding section contained information
about counseling clients with alternative sexual or gender identities. Write three
case study examples regarding how you might use the content of this section in
Peer-Reviewed Journal Article References:
Aarts, H. (2019). Goal setting theory and the mystery of setting goals.Motivation Science, 5(2), 106–107.
Amaro, C. M., Mitchell, T. B., Cordts, K. M. P., Borner, K. B., Frazer, A. L., Garcia, A. M., & Roberts, M. C. (2020). Clarifying supervision expectations: Construction of a clinical supervision contract as a didactic exercise for advanced graduate students.Training and Education in Professional Psychology, 14(3), 235–241.
Borgogna, N. C., McDermott, R. C., Aita, S. L., & Kridel, M. M. (2019). Anxiety and depression across gender and sexual minorities: Implications for transgender, gender nonconforming, pansexual, demisexual, asexual, queer, and questioning individuals. Psychology of Sexual Orientation and Gender Diversity, 6(1), 54–63.
Ellis, A. E. (2020). Providing trauma-informed affirmative care: Introduction to special issue on evidence-based relationship variables in working with affectional and gender minorities. Practice Innovations, 5(3), 179–188.
Graham, K. A., Dust, S. B., & Ziegert, J. C. (2018). Supervisor-employee power distance incompatibility, gender similarity, and relationship conflict: A test of interpersonal interaction theory. Journal of Applied Psychology, 103(3), 334–346.
QUESTION 9 Why do gay/lesbian/bisexual students with depression often go undiagnosed?
Record the letter of the correct answer the Test