As a mental health nurse, I always hope that my clients will feel comfortable and safe enough to be open and honest with me.
As a person with depression, though, being open and honest is likely to go straight out the window if it appears to conflict with whatever goal feels most pressing to me at the time. While this may sound manipulative, it is something I do for the purpose of self-protection and self-preservation. It is part of the armor that I put on when my illness leaves me feeling weak and defenseless.
The topic I lie the most about is suicidal thinking. Based on past experiences, I never want to be hospitalized again. Disclosing thoughts of suicide is probably one of the quickest ways to get committed to hospital, so I keep my mouth shut. Is that a safe, healthy way to approach the issue? Of course not. But in the balance of pros and cons that goes on in my head, there is little that would win out against my desire to avoid hospitalization. I try to consider this in my professional life and be very mindful of how I’m reacting when clients disclose suicidal thoughts to me.
I also omit symptoms that I either do not want or do not feel ready to talk about. At one point I had gone off meds for a while after a 3-strikes-you’re-out series of negative experiences with doctors. After a couple of sleepless months I realized that I really needed to find someone to order some drugs for me. I didn’t want to talk about my depression for fear of getting a similar reaction to the last few doctors I’d seen, so I only admitted to being unable to sleep. In doing so I could get my mirtazapine and quetiapine back on board, and after a while I felt safe enough to disclose the rest of what was going on.
In the end, I can only conclude that we just try to do the best we can with the situation we’re faced with. And I think the more that health care providers understand that, the easier it might be for us to start to remove some of that armor. It’s not realistic to think that we will never feel the need to resort to lies and secrets, but it’s worth reflecting on what underlies them so they don’t end up coming back to bite us in the butt.