Disclaimer: The following article may contain sensitive topics.
In April of 2019, I was officially diagnosed with general anxiety disorder. This was a pretty big thing for me, partly due to the challenge of navigating a new diagnosis, as well as medication and cognitive behavioural therapy. But also because I’d been struggling with my mental health for about a year and a half leading up to my diagnosis.
Rewind to the fall semester of 2017, I began experiencing extreme stress and anxiety related to my academics which impacted my ability to sleep, focus in class and retain information I’d spent hours drilling into my brain. When things didn’t start to improve after taking time to de-stress over Christmas break, I started seeking help with the hope of resolving my troubles with sleeping. My doctor suggested that I may have a general anxiety disorder, but I wasn’t officially diagnosed at the time because I seemed to function well in other aspects of my life. It was assumed that my lack of sleep was plausibly connected to high stress levels. Instead, I was given a one-time prescription for a sleeping pill that I was told to take only under extreme circumstances, such as the night before an exam. I was also referred to an occupational therapist to equip me with better tools to manage my stress and fall asleep at night. This solution ended up being more of a temporary fix, and although it helped me manage some of my symptoms more efficiently, it didn’t end up being enough in the long run.
In March of 2019, I finally hit my breaking point. I had managed my symptoms for too long and my mental health began to completely deteriorate. With the support of some short-term accommodations provided by my university, I barely managed to complete the semester. This time around, I was officially diagnosed with a general anxiety disorder and began medication two months later in May. It didn’t take me long to feel the full effects of my medication and truly realize the toll my anxiety took on my daily life, including academics. I learned that although the medication helped, I still experienced periods of time where managing my disorder was extremely difficult. It didn’t always seem like I was struggling on the outside, which made it harder for others to understand me, but I still was. This brings me to my main point: mental health affects everyone differently. When I started cognitive behavioural therapy, it was suggested that I’d been dealing with a general anxiety disorder for the majority of my life, but because I’m what they call ‘high-functioning’, it was tricky to diagnose. ‘High-functioning’ is a term commonly used to describe those diagnosed with mental disorders who, despite their disorder, function relatively normally. Although this term can undermine the struggles high-functioning people face, I unfortunately don’t have a better one. Overall, having a mental disorder that’s perceived as high-functioning can make it harder to get an official diagnosis.
In my case, my anxiety appears as high levels of stress, but in the case of my friend, Asia (Sotera) Mader, her attention deficit hyperactivity disorder (ADHD) appears as laziness. Sotera finds herself hyperfocused on certain tasks which she completes extremely well, but then has issues focusing on other tasks. She feels like her behaviour is commonly written off as laziness because people just assume that she should apply that focus and motivation to all aspects of her life. Sotera was not diagnosed with ADHD until January of 2020, but had she been diagnosed earlier, some aspects of her life may have played out differently. For instance, she also suffers from depression, anxiety, rejection sensitivity dysphoria, disordered eating and post-traumatic stress (PTS). Although not all of her disorders directly stem from undiagnosed ADHD, some are ADHD specific.
Sotera has spent years trying to navigate the world without understanding why she is the way that she is, and why she couldn’t function the way everyone else seemed to. This led to anxiety about doing what others would perceive as wrong and accidentally annoying those around her, causing her to feel self-hatred and extremely low self-esteem. She became frustrated with constantly being told to try harder in school and extracurricular activities despite already doing her personal best, which was a huge blow to her already low self-esteem. Over time, this may have led her into an abusive relationship that resulted in her PTS. In both of our cases, being labelled as high-functioning not only delayed a diagnosis of a mental disorder but inhibited others from taking our mental health seriously. There are times where we may appear to be functioning normally in certain facets of our life, such as work or school, but barely manage to function in others. I’ve also had experiences where I’ve found it challenging to complete more than the bare minimum of what I needed to get done. This can entail finishing pressing assignments or tests yet being unable to attend class, or fulfilling my academic obligations yet withdrawing from my social circle. Especially when interacting with others, the challenges I’m currently facing with my disorder are not easily seen, and it’s been assumed that I’m not going to class or hanging out with friends because I don’t want to or feel like it. Having my issues dismissed by those around me not only makes me feel like I’m over-exaggerating my condition, but makes me more concerned with how I’m perceived by others and even doubt my diagnosis.
Sotera has had similar experiences to mine. She has always had good grades in school and was tested as a child for being academically gifted in language and literature. Not being properly challenged in school, combined with her ADHD, meant she could coast on her intelligence with little effort and was often perceived as lazy. Even after navigating her many diagnoses, there are times where she feels that those around her don’t take her mental health seriously. When discussing symptoms of her disorders, Sotera sometimes faces issues with people claiming that everyone feels those same emotions. Although she knows that most people try to be comforting, their words feel dismissive. The best analogy she’d heard is, “Everyone goes pee but if you’re peeing 50 times a day, it’s a medical issue and you need to see a doctor.”
Although not everyone who is high-functioning experiences delayed diagnoses or dismissive behaviour, it’s still an issue. Stigma surrounding mental health is fading, but this doesn’t always apply to those who don’t appear to be constantly struggling.