Mental Illness: The Lies We Tell and the Secrets We Don’t

Woman's face shown without a mouth
Image by Ivan Pretorius from Pixabay

As a mental health nurse, I always hoped that my clients would feel comfortable and safe enough to be open and honest with me. As someone with depression, though, being open and honest is likely to go straight out the window if it appears to conflict with whatever goal or need feels most pressing at the time. While this may sound manipulative, it’s something I’ve learned to do for the purpose of self-protection and self-preservation. It’s part of the armour that I put on when my illness leaves me feeling weak and defenceless. Recognizing the lies we tell is important in understanding what their purpose is.

I don’t think this is uncommon, either; the lies we’ve told can continue to echo through our minds, even when we’re sure we had to tell them. Lies by omission don’t go away simply because we choose to skip over them.

Medication adherence

Medication adherence is a common thing to lie about, often motivated by concern about some form of negative reaction or consequences. Often it means the prescriber isn’t in as good a position to adjust treatment appropriately, but that may pale in comparison to the potential consequences of being open.

After my first hospitalization, conditions were put on my nursing license that I had to see my psychiatrist regularly and take medications. Between my hospitalization and my eventual return to work, I had a suicide attempt that I didn’t tell anyone about. After that, I figured what’s the point of taking medications if I feel like crap anyway, so I stopped them. Luckily, the meds gave me enough of a start that I was able to achieve full remission anyway. For more than a year while the conditions were on my license, I lied about taking my meds. I even picked them up regularly from the pharmacy to keep up the lie. Unfortunately, it came back to bite me in the ass when my then-boyfriend overdosed on my large stash.

Suicidal ideation

The topic I lie the most about is suicidal thinking. My past experiences in hospital were quite negative, and I never want to be hospitalized again. Being held involuntarily was particularly difficult. Disclosing suicidal ideation is 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 weighing of pros and cons, there’s little that would win out against my desire to avoid hospitalization.

Selective disclosure

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 drugs were a necessity. At the same time, I didn’t want to risk talking about my depression and getting the same unhelpful response. The mental compromise that I was prepared to make was to only admit to being unable to sleep.  In doing so, I could get my mirtazapine and quetiapine back on board and get some sleep. After a little while longer, I felt safe enough to disclose the rest of what was going on.

In the end, we can just try to do the best we can with the situation we’re faced with. The more that health care providers understand that, the easier it might be for us to remove some of that armour. It’s not realistic to think that the lies we tell and the secrets we keep will ever disappear entirely, but it’s worth reflecting on what underlies them so they don’t end up coming back to bite us in the butt.

Have there been lies you’ve told, either outright or by omission, to your treatment team?

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54 thoughts on “Mental Illness: The Lies We Tell and the Secrets We Don’t”

  1. I, too, have been on the receiving end of forced hospitalization and as a result i am very careful about disclosing the truth.With my current T, i prefix “concerning” info with ” now don’t take this the wrong way–” i think this has saved me a couple of times. Doc

  2. Fortunately, I’ve never been admitted to hospital. But of course, like you Ashley, and many others, I’ve lied about symptoms. There’s no way I’d admit to suicide attempts, I’d just say suicidal ideation – which is there more than I’d ever tell. And for that reason, I do take prescribed meds; Paroxetine and Amitriptyline.

    Of course, I’d lie again if I had to 🙁 There’s no way I’d want to be detained in our mental health hospitals as they currently are 🙁

  3. Many years back, when I finally took the courage to reveal my life-long medication plan to my best friends. They were in disbelief and assured me to stop taking my medication because they thought I was mentally healthy enough to cut off my dependence on pills. I was wondering and did some internet search and was exposed to some unverified information about psychiatric drugs. I stealthily stopped my Olanzapine intake for at least three months during my undergraduate internship. I never told my treatment team. Since then, from a pretty, optimistic and active girl, I slowly turned into a ragged, depressed, demotivated lady. After that, I continued to take my medication due to sleepless months and a few trips to a hypnosis therapist. However, it has been hard to recover to be like that bright girl during my undergraduate life. Maybe coupled with my career-related confusion right after my internship, my mental health had turned under control yet I could never recover to be the same bright girl again. Slowly, I ended up in an unhealthy two-week romantic relationship out of irrationality. And later, I had a few years of serious, crippling relationship delusions with another guy at work. And my life has not been easy as there have been deep, dark valleys from time to time. I wonder if those few months of being off my medication have turned my life path so much. Till now, I cannot gained back that feeling of life momentum during undergraduate years. Even when I am around my then-best friends of undergraduate years, I feel like shit because maybe I have changed due to poor mental health and this has changed the ways they relate to me.

    1. It’s hard to look back and wonder what would have happened if certain things had been different. We can guess, but there’s really no way to know.

      1. Yes, you are right. Life always comes with unanswered questions. Certain things are always unknowable. We just need to continue to live well with all the unknowable things. It is hard if we keep holding on.

  4. Great post! I love your insight. It it tough being hospitalized and being essentially ordered to take medication. I’ve been there, several times. Thanks for your honesty!

    Yes, there were things I did not tell my care team for a long while. I have always been a mistrusting kind of a person, and I was afraid to tell people about my psychotic symptoms as well as my exact history with said symptoms. I didn’t want to be looked at, or thought of, as completely off my rocker or as someone who was “difficult to treat”. It has been 15 years since my psychotic symptoms became almost unbearable at times. I finally talked to my doc about it, just last week. It was hard, but I’m glad I did it. My doctor finally has a better idea of what is going on with me, and, for the first time, I feel good about that.

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