When many people hear the term “mental illness” they picture someone on the extreme end of the mental health continuum. For example, they imagine a schizophrenic male off his meds, walking around talking to people who aren’t there; or a woman with severe OCD, who’s hoarding behaviors and obsessions with germs make it impossible to function normally. What they don’t realize is that the vast majority of individuals with a diagnosable mental health disorder – which, by the way, includes a rather significant portion of the population – often don’t look ill – at least not at first glance. They may also not look ill because they’re in treatment and it’s working well. Others may not look ill because they have the ability to “keep it together” for short periods of time, so only those closest to them have a clue as to what’s really brewing just below their façade of normalcy. Following are just a few examples of the less obvious faces of mental illness – the ones that few ever recognize or even suspect.
The highly functional alcoholic
Alcohol addiction falls under the mental health category of “substance dependence”. While some alcoholics do fit in the “falling down drunk” group, many fly beneath the radar. They successfully hide their addiction from all but those in their close inner circle, which typically includes their spouse, one or two other close family members, and their closest friends. Sometimes even those closest to them are unaware of – or in denial about – the severity of the problem.
Eric is a perfect example of a highly functional alcoholic. In his mid-40s, Eric is tall, fit, and very attractive. Boasting an MBA and strong leadership skills, along with a charismatic personality, Eric is the CEO of a Fortune 500 company. Devoted to his work, he puts in long hours, often in his office by 7 a.m. and out the door after 6 p.m. His workaholic tendencies have caused a lot of conflict in his 15-year marriage, but his stay-at-home wife enjoys the perks of his mid-six-figure income too much to rock the boat.
Eric’s wife also turns a blind high to his heavy drinking, which occurs on an almost daily basis. Plagued with insomnia, Eric is often up late. It’s not uncommon for him to consume several glasses of wine before he finally goes to bed – in addition to the expensive Scotch and other hard liquor he typically consumes when meeting with clients after work or when he first gets home. Yet, despite all the alcohol, Eric is up before dawn and performs his demanding executive duties amazingly well. Few would ever even suspect that he has a serious alcohol addiction. Sadly, like many high-functioning and successful alcoholics, he is far too proud to admit that he has a problem – let alone ever seek help for it.
The anxiety-ridden mom
Anxiety disorders are far more common than most people realize. While some people are disabled by anxiety, particularly when it comes in the form of severe panic disorder or PTSD, others suffer silently as they strive to keep their life together with sheer determination. Jennifer falls in the latter category.
Jennifer was in her mid-30s when she started a family with her husband of 5 years. Happily married and well-liked by her many friends, Jennifer found motherhood much more difficult than she ever imagined. Now 40 with 2 rambunctious boys at home, she often found herself struggling with significant anxiety. Although she didn’t have panic attacks, phobias, or obsessive thoughts, she worried constantly – one of the most prominent symptoms of generalized anxiety disorder (GAD).
If you were to meet Jennifer, you’d never guess that she struggles with GAD. She’s witty and outgoing, appears confident and “together”, and takes great care of her two young boys. Fortunately, her husband is also very supportive and understanding. Aware that anxiety disorders run in her family, she finally sought help from a therapist. In addition to therapy – which she didn’t find particularly helpful and eventually stopped – she also started taking an SSRI. Although medication provided some symptom relief, she eventually discontinued it. She didn’t like the side effects and had never been a fan of taking medication; she preferred more natural approaches. A former runner, Jennifer found that getting back into running and taking yoga classes regularly helped keep her anxiety symptoms at a tolerable level. After talking to a friend who had found therapy helpful or her depression, Jennifer decided to try a new therapist. She realized that her last therapist just wasn’t a good fit for her, and that working with someone different would be worth a try. Fortunately, she clicked with her new therapist and is now learning effective ways to reduce and manage her anxiety.
The successful narcissist
While many people use the term “narcissistic” to describe someone who’s merely arrogant or conceited, few outside of the mental health profession understand this complex personality disorder. It can be especially difficult for those in a close relationship with a narcissist. It’s not uncommon for these individuals to be described as “emotional vampires”, as they slowly but surely drain the emotional life out of those around them. Relationships with narcissists are truly “crazy-making”. They cause unsuspecting partners and family members to doubt or blame themselves for problems that inevitably occur in those relationships. Controlling and selfish, they leave a path of destruction in their wake. The successful narcissists can be particularly hard to recognize. Highly socialized, they are master manipulators. Like Sean.
Sean is a 36-year old, strikingly handsome plastic surgeon. He had married a fashion model in his late twenties. Their marriage ended in a bitter divorce 6 years later. Sean has no problem finding beautiful, successful women to date. Charming and seductive, those who date him often find themselves falling fast and hard. He excels at making a woman feel like she’s the most special, beautiful, amazing woman in the world – at least early in the relationship.
After a few weeks or months, he eventually gets bored with each woman. He starts finding fault with her appearance, her personality, her performance in the bedroom – everything. He also becomes increasingly controlling. When a woman dares to react or stand up for herself, he masterfully twists things around so the conflict is always her fault – never his. His angry responses are controlled, yet extremely hurtful. He knows exactly how to strike her Achilles’ heel. As each woman is discarded, Sean quickly moves on to his next unsuspecting victim. What’s especially interesting is that these are intelligent, highly educated women. Yet, once they become tangled in his narcissistic web, it’s extremely difficult to separate reality from the distorted spin he puts on everything in each relationship. His exes always end up hurt, angry, confused, and wondering what on earth went wrong. Several – including his ex-wife – have gone to therapy to gain perspective and understanding. Each woman had a powerful “ah-ha” moment when her therapist explained that she had been involved with a narcissist. Sadly, that didn’t take all the pain away.
The depressed musician
It’s not uncommon for artists – particularly musicians – to have serious battles with depression. In many cases, their psychological pain is often what allows them to feel the music so deeply and express it so beautifully. But it can also be their downfall if they’re not careful. As performers, however, they learn to put on a façade as they entertain others.
Patrick is a devout Christian, talented pianist, and prolific songwriter. After spending several years travelling and performing with a Christian band, he branched out on his own as a solo artist. Nothing gives him greater joy than expressing himself through music. He spends hours each day at the piano, perfecting the lyrics and melody to his latest song.
Everyone who knows Patrick loves him. He is very personable, giving to a fault, and has a playful sense of humor. When he’s around people or on stage, he portrays an infectious smile that lights up the room. But when he’s alone – which is often – the smile fades and the darkness of depression is apparent. He keeps it well hidden, however, and never confides in others – even those closest to him. He prays fervently, and finds some solace in his faith. Sadly, though, fleeting thoughts of suicide often cross his mind. He quickly dismisses them, as he firmly believes suicide is a sin. To this day, Patrick continues to write and perform his songs. If you listen very closely, his pain and despair occasionally come through in the deeply moving lyrics. But few, if any, will ever realize just how depressed he really is. He lives his life in quiet desperation, hiding behind the façade of “Christian joy.” Most people know an Eric, a Sean, a Jennifer, or a Patrick. But it never crosses their mind that these individuals are “mentally ill”. They are successful, charming, “together”, even happy or joyful – at least on the surface. They have friends, families, careers. They dress well, have good social skills, and appear to function as well as anyone – in fact, they may even excel in several areas of life. But that doesn’t change the fact that they struggle with mental illness. Sean, Eric, and Patrick – like so many with a psychiatric disorder of one form or another – never seek treatment for it. Eric is in denial and far too proud. Sean, as a typical narcissist, doesn’t even see himself as having a problem; rather, the problem is always with everyone else. Patrick, although aware of his emotional pain, regards it as God’s way of testing him and seeks comfort in his faith. Jennifer, on the other hand, is in therapy for the second time, and finally making good progress. The bottom line is that mental illness isn’t always obvious. In fact, it’s often hidden behind a façade of wellness prompted by shame, pride, lack of self-awareness, denial, or fear. It’s also often not obvious because, in many situations, it’s not a severe, debilitating condition. Like Jennifer, Patrick, Eric, and Sean, many people with mental illness function quite well in life, even though they may be suffering silently or negatively impacting others around them. Despite the stigma and disparaging connotation of the term “mental illness”, it impacts people from all walks of life and is far more pervasive than most people ever realize.