There is substantial evidence indicating that LGBTQIA+ individuals may face a higher susceptibility to certain mental health challenges compared to the general population. This vulnerability stems from the discrimination, homophobia, stigmas, and other stressors that arise due to our sexual and gender identities.
These stressors significantly impact our mental health and overall well-being, increasing the likelihood of encountering various problems.
It’s important to note that our sexual and gender identities themselves are not the causes of mental health issues such as anxiety, depression, or panic. Rather, it is the experiences, environments, relationships, and violence within our homophobic, prejudiced, and discriminatory society that contribute to these challenges.
Although there have been notable advancements in recent years, particularly in major cities, being LGBTQIA+ today is still not as difficult as it was, for instance, a decade ago.
However, the rise of conservatism witnessed in the past six or seven years has created highly stressful situations for all individuals who deviate from the “norm,” not limited to LGBTQIA+ individuals but also encompassing people of color, individuals with disabilities, and others.
While it may be tempting to rationalize that there is nothing wrong with us, that being LGBTQIA+ is neither an illness nor a problem, it is neither simple nor easy to cope with the consequences of a lifetime spent in a world that has consistently told us our way of being, desiring, and loving is wrong.
In other words, our increased risk of developing mental health problems stems not from being LGBTQIA+, but rather from living in a society that is predominantly male-dominated, homophobic, and oppressive. This society has shaped and continues to shape deeply rooted beliefs and fears about our identities, causing us to live in fear even today.
In this text, I aim to specifically focus on strategies that can help improve your relationship with anxiety symptoms.
From my professional perspective, many conditions commonly referred to as anxiety disorders are not necessarily mental disorders in themselves. In my work with LGBTQIA+ individuals, I witness daily how these anxious symptoms have become an integral part of our perception of life and how we have learned to navigate difficulties.
Addressing these symptoms may or may not involve a diagnosis. Many diagnoses can do more harm than good, as patients often begin to define themselves solely through the diagnosis, rather than viewing it as a tool for treatment and understanding.
If there’s one thing to take away from this text, it’s this: you are not defined by your symptoms. You are not merely a diagnosis or a disorder. You are a multifaceted and incredibly complex individual with a history that is difficult to explain and understand.
You are a long story.
And while it’s necessary to revisit many episodes of this narrative, the primary work always needs to be done in the present moment and how you cope with it. It involves changing the ways you approach your current challenges, which may be causing you distress.
Although I am not a staunch advocate for diagnoses (although I recognize their importance in various contexts) or for the definitions provided in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), I find the explanation it offers for anxiety disorders to be informative and helpful in understanding what might be happening with you. Here’s an excerpt:
“Anxiety disorders include disorders that share characteristics of excessive or irrational fear and related behavioral disturbances. Fear is the emotional response to a real or perceived imminent threat, whereas anxiety is the anticipation of a future threat. While these two states overlap, they also differ. Fear is often associated with heightened autonomic arousal, necessary for fight or flight, immediate thoughts of danger, and escape behaviors. Anxiety, on the other hand, is more commonly linked to muscle tension, vigilance in preparation for future danger, and cautious or avoidant behaviors. Sometimes, consistent avoidance behaviors can reduce the level of fear or anxiety. Panic attacks stand out within anxiety disorders as a particular type of fear response. They are not limited to anxiety disorders and can also occur in other mental disorders.
Anxiety disorders vary in terms of the objects or situations that induce fear, anxiety, or avoidance behavior, as well as the associated cognitive ideation. While anxiety disorders often coexist with each other, they can be differentiated by examining the specific types of situations that are feared or avoided, as well as the content of associated thoughts or beliefs.
Anxiety disorders differ from adaptive fear or anxiety by being excessive or persisting beyond appropriate developmental periods. They also differ from transient fear or anxiety, often stress-induced, by being persistent (usually lasting six months or more), although the duration criterion is considered a general guide with some flexibility, particularly in children (e.g., separation anxiety disorder and selective mutism).
Since individuals with anxiety disorders often overestimate the danger in the situations they fear or avoid, determining the level of excessive or disproportionate fear or anxiety is primarily done by the clinician, taking into account contextual cultural factors.”
One major issue with diagnoses, especially regarding anxiety, is that the majority of people experience anxious symptoms regularly, leading to the perception of an “anxiety epidemic.” In my view, we are living in an era that induces anxiety, and escaping it completely is challenging. However, we can challenge the notion of disorder and learn to coexist with our unique ways of expressing these symptoms. This involves creating new meanings, paths, and strategies to lead a better life.
Shall we discuss some strategies?
Physical activity
There is compelling scientific evidence that regular physical activity has a profoundly positive impact on symptoms of anxiety. It’s not necessary to exercise every day or engage in a specific type of exercise, but incorporating movement into your routine can greatly enhance your overall well-being. While it may seem obvious that our physical state affects how we feel and think, many people don’t live in a way that reflects this understanding. When you feel physically better, with improved fitness and overall well-being, your mental health also benefits proportionally. Exercise doesn’t eliminate anxiety entirely, but individuals with better physical fitness are better equipped to manage their anxious symptoms. Even a few 20-minute walks per week can make a significant difference. The key is to keep moving and stay active.
Diet
Recent studies have revealed a connection between gut health and brain health. The microorganisms residing in our digestive system play a crucial role in our mental well-being, and diets high in sodium and processed foods (such as frozen or packaged foods, processed meats like ham, sausage, etc.) may contribute to the decline of these microorganism populations. Research suggests that these populations have a complex relationship with our emotional states. It’s a wise idea to reevaluate your eating habits, not by following an idealized diet, but by striking a balance between processed foods and incorporating more natural foods, probiotics (like yogurt), and foods that promote gut and overall physical health. Learning more about nutrition and consulting a nutritionist can be beneficial, not just for weight loss but also for improving your relationship with food.
Alcohol and other substances
Approaches centered around condemnation and prohibition of both legal and illegal drugs have proven highly ineffective and come with significant social costs. Today, there is a harm reduction perspective that seeks to find ways of using these substances that are less harmful to the users. It’s not necessary to completely abstain from recreational substance use if that doesn’t appeal to you. However, it’s essential to evaluate whether the way you consume these substances negatively impacts your life. For example, alcohol is a depressant of the nervous system, and it’s common to experience feelings of sadness, low energy, or reduced motivation in the days following its use, even without a hangover. Similar effects can be observed with substances like cocaine and various strains of marijuana, including the popular “pressed” form, which is the most common way of consuming the herb. Does this mean that abstinence is the only solution? Not necessarily, especially if it’s not a desirable option for you. However, reducing or modifying your consumption can lead to significant improvements in your quality of life. If you find it challenging to make these changes on your own, seeking professional help is advisable. Harm reduction policies are already being implemented, including within public healthcare systems.
Sleep
The quality of your sleep, even more than the number of hours you sleep, is instrumental in managing anxious symptoms. Not everyone can or needs to sleep exactly eight hours per night, but the relationship between sleep problems like nightmares, insomnia, restlessness, and anxiety is well-documented. It’s important for you and the professionals assisting you to take your sleep into consideration and seek ways to improve its quality. Good sleep hygiene can make a significant difference. For example, taking a relaxing bath, preparing your bed before lying down, changing the lighting in your room, aromatizing the environment, avoiding cellphone use at least 30 minutes before bedtime, engaging in relaxing activities like reading a book or listening to soothing music, practicing breathing exercises… the possibilities are endless. Interestingly, although these interventions are widely publicized, it’s remarkable how many patients I encounter who have never considered trying any of these methods and immediately think of taking sleeping pills. I have nothing against medication, but it’s important to try other approaches first and even while using them. Discuss alternative ideas with your doctor and psychologist.
Stress management
This is the most challenging of all because it naturally lies at the core of what causes anxiety. In my professional experience, the first step is to understand the reasons behind our stress. It’s easy to say that you’re stressed because you have less money than you would like, but could the underlying reason be even deeper? It’s possible that money concerns echo old problems and fears related to instability, insecurities, and changes, for example. You might feel that your self-worth is tied to how much money you make, triggering your anxiety. And so, it goes. Understanding the root causes of your stress is crucial for developing effective strategies to face it. By doing so, we can act on the problem’s source rather than merely addressing the symptom.
Pleasure
In my experience as a clinical psychologist, it’s evident how LGBTQIA+ individuals believe they understand pleasure but actually experience so little genuine pleasure. Our notion of pleasure is often linked to having an incredibly stressful and anxiety-inducing week, followed by indulging in excessive weekend activities like drinking, partying, and sex. Or even binge-watching series for 10 to 12 hours a day. Are any of these activities wrong? Not at all. But it’s important for our experience of pleasure not to be limited to the weekends. We need to develop the ability to experience pleasure in our daily lives. This can be achieved by reeducating our perception of reality, our capacity to marvel at the ordinary, the simple, the routine. By developing diverse hobbies or interests, appreciating or creating art, engaging in activities that relax us while also developing our subjectivity (how often do you choose to watch that show or movie that doesn’t make you think?). Even in your sex life, how often do you find yourself masturbating or having sex in the same way you know will make you climax quickly? How often do you live your sexuality by going straight to what you already know brings you pleasure, without exploring new possibilities? Exploring pleasure doesn’t always have to involve trying a new fetish, fantasy, or sex toy. It can simply mean paying more attention to touch, caresses, kisses. Looking at the person in front of you differently and asking yourself: what else is possible? And then test it out. Exploring pleasure in all the senses and aspects of your life is one of the most powerful ways to combat anxiety.
Relationships
Based on my experience, a significant portion of anxiety symptoms among LGBTQIA+ individuals, stem from social interactions and interpersonal relationships. From the socially absorbed pressure to perform certain behaviors to the impacts of homophobia, including family relationships, toxic work environments, and the feeling of unsatisfactory connections. It is crucial that you honestly examine your relationships and seek to understand which ones are contributing to your distress. Once you identify those that are harmful, start thinking about strategies to modify the dynamics or situations or even seek out different relationships. It’s understandable that achieving this isn’t easy, and you may need to seek help, but it is essential to understand the source of the problem.
Self-care
For most LGBTQIA+ individuals I know, self-care is often equated to skincare, dieting, and weightlifting. However, true self-care is about looking at your life with honesty and kindness, and committing to do what is possible, realistic, and sustainable to make positive changes. It is rarely necessary to make drastic and sweeping changes. Often, it is the small changes that are the most sustainable and have the most long-term impact.
Strive for realism
Many anxious symptoms arise from fears, pressures, and expectations that are completely unrealistic or impossible. It can be challenging to determine this on your own, but it is a constant exercise to challenge our own thoughts and beliefs and bring them back to what I like to call the “realm of possibility”: what can be done, here and now, with who we are, with what we have, without waiting for anything new to happen to take action (or bring an action to a close).
Engaging in therapy with a psychologist
Contrary to the increasingly common belief, “having therapy in order” is not a cure-all remedy. However, having the guidance of a well-prepared psychologist who can address your issues, with whom you have a trusting relationship, and who employs up-to-date and tailored interventions based on your reality, makes all the difference in the world. I work with LGBTQIA+ individuals dealing with various anxiety symptoms every day, and together we find paths specifically designed for each person’s reality, with beautiful results to witness.
These 10 possibilities for addressing your anxiety symptoms are far from being the only ones. I intentionally omitted, for example, the use of medications, not because I am against them. I believe that the responsible use of medications under the guidance of a competent psychiatrist can be very beneficial. However, I also believe that the decision to start medication doesn’t need to be the first choice. Based on my personal and professional experience, along with ample scientific evidence available, I believe that you can indeed initiate many of these changes on your own with highly positive results. Of course, it is unvaluable to have the support of a qualified mental health professional, such as a psychologist, to assist you in this process.
