Storm Clouds and Sour Air: A Gradual Understanding of Mental Wellness
“I took a deep breath and listened to the old brag of my heart. I am, I am, I am” (Plath).
***
It was a Monday afternoon midway through my first semester, and I was reading an article for the class I had on Tuesdays and Thursdays. I was trying to annotate a printout of the reading in Central Library. Trying, as in I got distracted scrolling through Instagram. Everyone looked so cool and happy, with amazing academics and extracurriculars and so many friends…unlike me.
Suddenly, all my insecurities from the semester shot to the forefront of my mind, taking shape with startling intensity. I felt like I was failing in every area of my life. I was really struggling to keep up with academics and extracurriculars, and I didn’t feel that close to anyone. Most daily interactions were brief, friendly greetings: “Hi! How are you?” Because I was so overwhelmed every day, I barely had time or energy to keep in touch with my friends from high school, so I was feeling withdrawn from them, too.
A tidal wave of negativity crashed over me. I couldn’t think of anything positive about myself. I couldn’t focus on my work, having read the same sentence 20 times without understanding it.
I had to leave. I rushed back to my room, shaking slightly. The walk was painful and passed by in a blur. I was freaking out inside, yet in a disconnected, numb way.
Luckily, my roommate was not around, so I had my room to myself. I could safely break down in tears for the first time since coming to Vandy.
What was wrong with me? I could barely breathe. I had to open my mouth to force air into my lungs.
Mental health, I thought, confused, desperate.
My mental health completely crashed.
I was not okay.
***
It starts early, doesn’t it?
I rarely heard about mental illness in my childhood, but when I did, it was in a negative light. “Mentally ill” was associated with dangerous criminals in media. My parents didn’t see much nuance in it. One time, I asked my mom about suicidality, and she dismissed suicide as insane, crazy, dumb. If you were in pain, you had to suck it up and deal with it, not do something as crazy as killing yourself. Even as someone who has not struggled with suicidality, I was horrified to hear that.
But it made sense, given sociocultural context. It reminded me how prevalent the stigma around mental health issues remains, how symptoms were dismissed for most of human history. Mental health, if at all acknowledged, was imbued with misogyny and colonialism: ‘hysteria’ was considered an exclusively female disease associated with sorcery and sexual activity until the early 20th century, during which studies claimed that hysteria declined among Western patients while increasing in non-Western countries (Tasca et al.).
I never forgot those microaggressions. I never wanted to be diagnosed with a mental health condition. I never wanted to need a therapist.
***
For the next few weeks, I felt adrift, a ghost haunting my former self as she walked around campus.
“I wasn’t steering anything, not even myself. I just bumped from my hotel to work and to parties…and back to work like a numb trolleybus…I felt very still and very empty” (Plath).
Like Esther in Sylvia Plath’s The Bell Jar, a novel I read in tenth grade, I felt numb about everything. I went to places, talked to people, and completed tasks mindlessly. On the outside, I didn’t look too different—I tried not to. But on the inside, I felt a sense of emptiness and wrongness everywhere I went, like there was always a storm cloud above me. I felt disconnected from my own body. I still struggled to physically breathe.
***
When I was 13, one of my school assemblies was about mental health stigma. It was the first time I heard those words together, and I didn’t even know what stigma meant, but we were getting a crash course.
I realized that contrary to what my parents or media seemed to believe, “mentally ill” people were not serial killers or stupid. One of the speakers shared how she struggled with depression and felt sad all the time even though she had no specific reason for it—had great family, friends, a boyfriend. She experienced no significant strife or trauma. She wasn’t particularly different from my classmates or I other than that depression label.
This assembly was integral to my understanding of mental health as something not to stigmatize. Like physical diseases, mental health issues can appear for seemingly no reason, and people with these conditions are still people. If anything, mental health should be treated as seriously as physical health. As the speaker said, you go to the doctor if you break your leg or your stomach hurts. Why shouldn’t you ask for help if your mind is unwell?
***
Where would I be now if I hadn’t asked for help?
I floated aimlessly around campus, but I was trying to make things better. The day I had my mental breakdown, I acknowledged how not okay I was. I texted my orientation mentor—VUceptor—that I needed help. She said she struggled with her mental health in her first semester, so I thought she might understand. I also emailed all my professors, apologizing that my finals might turn out horrible because I could barely focus. I felt guilty. I wrote “you may not believe me” because I was doubting myself. In retrospect, my uncertainty was unsurprising, since people are significantly more likely to under-report mental health conditions than other illnesses (Bharadwaj et al.). Ethnic minorities especially deal with complex barriers to appropriate mental health services (Hoberman). Thinking back on my childhood and family, stigma is alive and well in many cultures.
But I remembered what I learned from high school about how mental health discussion should be normalized. I remembered the advice I’d heard at Vanderbilt itself about the importance of self-care and mental health. That gave me the courage to admit I was not okay, even to my professors.
These people helped me. My VUceptor replied almost immediately and was super concerned and supportive, writing detailed messages. I felt reassured—her kind words were slowly breaking through the bell jar of negativity enshrouding me. Each of my professors replied to my email with condolences and compassion. No one doubted me; they believed me more than I did. Several offered me extensions on final projects. I could hardly believe it. These kind sentiments helped me survive the next morning, when I felt like a new person, excruciatingly aware of a mental ache that permeated my thoughts and actions. I felt like I would never be the same again.
***
My tenth-grade English class was one of my most stressful experiences, but it made me more aware of mental health issues.
In our first major assignment, we had to write mini-essays about a book from a list of “fine literature.” I chose Cut by Patricia McCormick, and I was stunned. It was the first time I read about mental health in literature, the first time I read about cutting from a first-person perspective.
Although the descriptions of blood and physical cutting disturbed me, I could relate to the feelings of insecurity, self-doubt, and self-blame expressed in the book. For instance, the narrator, Callie, admits that she was afraid “people would get mad at [her]” when she spoke up in group therapy (McCormick 123). Although I usually didn’t expect teachers or classmates to get angry at me, I felt very self-conscious whenever I spoke up and rarely raised my hand in class, so I could understand that kind of fear. Callie, and the people she represents, wasn’t bewilderingly different from me. As someone who has been privileged enough to never undertake self-harm, Cut helped me feel empathy towards people struggling with mental health issues.
***
“Wherever I sat…I would be sitting under the same glass bell jar, stewing in my own sour air” (Plath).
I never wanted to relate to The Bell Jar, but I was starting to feel what Esther, the narrator, was going through. I really did feel like I was stewing in my own sour air, floundering under the weight of my inescapable inability to breathe or find fresh air.
I didn’t know what was wrong with me. Was it depression? Anxiety? I sat on my bed almost every night, searching up “symptoms of mental illness” on my phone. I had some symptoms of depression, but not all of them; and some symptoms of anxiety, but not all of them. Something was off about my center of balance, but I couldn’t name what it was.
And I tried to know. At my VUceptor’s suggestion, I visited the University Counseling Center (UCC) for the first time. I could barely process that I was seeking therapy. I never wanted to—and I’m not the only one. Only about 20% of children and adolescents with depressive or anxiety disorders use mental health services, and since I had been an adolescent just a couple months before college, that statistic pretty much applied to me (Essau). Stigma is still a major barrier to seeking mental health treatment (Sickel et al.).
But I’m glad I sought professional help, even if it didn’t solve all my problems.
My counselor asked me vague questions about what I was feeling, why I had come. It was like a dam burst. I rambled on about my life and broke down in tears. She handed me tissues and did not interrupt me. I was embarrassed because I’d never cried like that before a stranger, but it was helpful to let myself feel my emotions. It was another step in acknowledging that something was wrong and being okay with that.
I just wished the therapist gave me concrete advice. She was just supporting me, suggesting regular appointments and habits for the long-term. I wanted a quick solution, something to make me okay again, but she didn’t have any. As it turns out, mental health treatment is largely palliative rather than curative, helping with symptom management and quality of life rather than providing some magic solution (Drake et al.). I really wanted to get back to my usual self right away, but there was no rushing something that had been months, even years in the making.
I wanted what Callie criticized in Cut: “I imagine [my therapist] working on me as an algebra problem…until there’s nothing left on the page but a line that says x = whatever it is that is wrong with me” (McCormick). I wanted to solve for x = whatever was wrong with me; otherwise, I felt more lost.
After that UCC appointment, I wasn’t any closer to a diagnosis. I blindly wandered on with no word for what I was feeling and no end in sight. I wasn’t even sure I could say I had a mental illness. Unlike the worst symptoms of depression, which Esther experienced in The Bell Jar, I was technically getting up in the mornings and attending classes.
I felt a lingering sense of wrongness and emptiness in everything I did, and I was extremely distracted and unmotivated, but I wasn’t completely debilitated. Shockingly, I still participated in class discussions. I was having imposter syndrome around mental health, like I wasn’t mentally ‘wrong’ enough to have an issue that needed help. I wasn’t exactly Esther or Callie. I wasn’t suicidal or suffering from an eating disorder.
But I wasn’t who I usually was. I wasn’t as resilient as I was a couple months before this ordeal; I could usually console myself and move forward with anything, but now disappointments and negative thoughts hit me so hard I could barely breathe. I wasn’t as motivated as I was the week before my mental breakdown. I was struggling, no matter what the DSM-5 said.
***
In eleventh grade, I took a psychology class for the first time. The teacher was strict, and the course was textbook-boring, but it reinforced the significance of mental health issues. I learned about the DSM and different types of disorders. I learned that there are medical elements to psychiatry and biological elements to psychology.
I later wrote a research paper about caregiver burden in schizophrenia care, so mental illness became something I studied academically. I treated it just as seriously as a physical condition. It was becoming normalized in my mind—just another affliction that people can suffer from.
But I didn’t think it could happen to me.
***
Ultimately, I made it through thanks to new habits and community support. I tried to build in helpful habits, including meditation, eating breakfast even when I was stressed, listening to music more, unplugging from social media, and being honest about not feeling okay. Support from other students I opened up to helped me. I continued visiting the UCC and reminded myself that others were struggling, too.
I don’t mean to say that it was a neat ending or ‘fix.’ Even now, there are times when I feel that cloud of negativity again. There are times when I feel viscerally lonely in a sea of people. It comes at me like a wave, stealing my breath. But I ultimately manage to get on with my day or night and breathe again. I feel the resilience that characterized most of my high school experience.
I tell you this not to praise Vanderbilt as an institution, but to share what I’ve learned. I don’t know how you’re feeling, but I want to say that your mental health doesn’t need to look like anyone else’s for you to take care of it. To this day, I don’t know what I was dealing with, but I can put that dark period behind me because I asked for help. Mental health isn’t a monolith; there are stages and layers. It’s not “mental health issue” or nothing. Being mentally healthy is normal, but so is feeling not okay with things. Even if you aren’t actively struggling, it’s best to build in healthy practices so your mental health doesn’t get worse. I would be thrilled if you never experience a fraction of what I did.
Your help doesn’t need to look like mine. Meditation helps me, but maybe you feel more lost in your thoughts. Therapy is an important service, but it might not be most beneficial to you. The UCC’s lack of availability and the lack of mental health resources globally is a huge issue (Butryn et al.). However, even though we can’t be blamed for the existence of stigma or the shortage of mental health services, I hope you can take measures to improve your well-being however you can. I am all for therapy becoming more available and less expensive, but you don’t need to use a specific type of service. I just hope you can always prioritize your mental health when things are getting stressful, or you feel behind on everything. I’m not going to put a label on what it means to not be okay.
Bibliography
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Butryn, Tracy, Bryant, Leah, Marchionni, Christine, and Sholevar, Farhad. “The shortage of psychiatrists and other mental health providers: Causes, current state, and potential solutions.” International Journal of Academic Medicine, 2017, 3: 5-9. https://www.ijam- web.org/text.asp?2017/3/1/5/209851. Accessed 1 May 2022.
Drake, Robert E., Green, Alan I., Mueser, Kim T., Goldman, Howard H. “The History of Community Mental Health Treatment and Rehabilitation for Persons with Severe Mental Illness.” Community Mental Health Journal, 2003, 39(5): 427-440. https://link.springer.com/content/pdf/10.1023/A:1025860919277.pdf. Accessed 1 May 2022.
Essau, Cecilia A. “Frequency and Patterns of Mental Health Services Utilization Among Adolescents With Anxiety and Depressive Disorders.” Depression and Anxiety, 2005, 22: 130-137. Accessed 1 May 2022.
Hoberman, Harry M. “Ethnic Minority Status and Adolescent Mental Health Services Utilization.” The Journal of Mental Health Administration, 1992, 19(3): 246-267. https://link.springer.com/content/pdf/10.1007/BF02518990.pdf. Accessed 1 May 2022.
McCormick, Patricia. Cut, Scholastic, 2000.
Plath, Sylvia. The Bell Jar, Heinemann, 1963.
Sickel, Amy E., Seacat, Jason D., and Nabors, Nina A. “Mental health stigma update: A review of consequences.” Advances in Mental Health, 2014, 12(3): 202-215. Accessed 1 May 2022.
Tasca, Cecilia, Rapetti, Mariangela, Carta, Mauro G., and Fadda, Bianca. “Women And Hysteria In The History Of Mental Health.” Clinical Practice and Epidemiology in Mental Health, 2012, 8: 110-119. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3480686/. Accessed 1 May 2022.
Teresa Xu (she/her) is a student at Vanderbilt University studying English literature, Sociology, and an interdisciplinary major called Medicine, Health & Society. In addition to reading and writing, she enjoys going on walks and hikes, learning different cultural dances, singing, and simply exploring the diversity of life. She is especially interested in capturing the beauty of nature, the complexity of mental health, and the power of storytelling in her poetry.