People in the LGBT community suffering from any kind of mental illness have another element to consider: the pathologizing of their sexuality by the mental health community.

“My being a lesbian was the one thing in my life that I had no problem with at the time I was depressed,” she said. “I had so many other things that were causing me to be depressed. I told the therapist that. She just looked at me like I didn’t know what I was talking about. That just made me feel like I had nowhere to turn.”

Compton found another therapist who put her on anti-depressants and made a contract with her to call if she was feeling suicidal. Compton recovered from her depression and never attempted suicide.
“It took months, but gradually I was able to come out of it. I feel grateful that I didn’t end up dead. But I still resent that other shrink. She could have killed me.”

The issue of how to treat LGBT people with depression or other forms of mental illness has not been sufficiently addressed by the mental health system. Outdated perspectives on the relationship between queer sexuality and mental illness still obtains among many in the mental health system.

Goldenberg agrees that this is an area that has yet to be addressed to the extent it needs to be studied. “Being gay or lesbian or transgendered basically puts the LGBT person in a situation where they are facing chronic trauma in the macro environment: homophobia. It’s a chronic relentless trauma–dealing with constant homophobia. Even if you aren’t aware of it, it’s always there. You have to fight the world in addition to dealing with whatever stresses you have in your daily life that we all have–family, relationships, work. The effort of dealing with all of this wears you down. It primes you for depression.”

Berg, like Manning’s other friends and family, wanted to know why Manning killed herself. The shock of the violence of Manning’s suicide hung over everyone who had known her. Many were more angry than sad. Said one woman who knew her well, “I cannot think of a more selfish and self-absorbed act than what she did. She left everyone with life-long guilt that we didn’t save her.”

Passing judgment on suicides is common, says Goldenberg, but also unfair.

“It’s natural to blame the suicide for doing such a terrible thing to family and friends,” she explains. “But the reality is, empathy doesn’t enter into it. This isn’t a considered choice, it’s a combination of factors leading to a release from pain. The depressed person doesn’t feel anything is worthwhile.

“So to the survivors, it seems like a really selfish act, but I don’t think most people can think about the pain they are causing other people. They are so entrenched in their depression, they just want to end the pain. The main thing is to seek help immediately as soon as depression starts. Don’t think you can snap yourself out of it or that getting help is somehow giving in or failing. Getting help is saving your life.”

LGBT people may be the most averse to seeking help for mental illness while also–ironically–being most in need of it.

The extra stresses that Goldenberg and the AFSP outline suggest that even the slightest depression should be a warning signal for LGBT people to seek help, because depression takes hold so quickly and once it is entrenched, seeking help may no longer seem possible to the depressed person.

“Medication *is* an answer,” asserts Goldenberg. “It alleviates the pain and the emotional disruption that leads to suicidal thoughts. People need to think of mental illness the way they think of other illnesses. You wouldn’t think you could just snap yourself out of appendicitis–you’d go to a hospital and have it treated. Depression is no different. It needs to be treated and if it isn’t, it can kill you.”

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