On bisexuality and mental health

CW: sexuality, self-harm, suicide, mental health

This may be new information to some people, or something they already know, but first off I just wanted to say: I identify as bisexual. For me, this means attraction to two or more genders.

I am also currently in a monogamous marriage with a cisgendered (“cisgender” is defined as when a person’s gender corresponds with their given sex at birth), heterosexual man. And here are some things I want you to know about bisexuality and mental health.

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Research has shown that bisexual individuals are at greater risk of having depression, anxiety, self-harming behaviours and suicidality than individuals who identify as straight, gay or lesbian (see here). Recent findings from one Australian study (https://www.latrobe.edu.au/news/articles/2019/release/study-looks-at-bisexual-mental-health) suggest that one in four bisexuals have attempted suicide; close to 80% of bisexual individuals have considered self-harm or suicide; and over 60% of bisexuals rated their psychological distress as “high” or “very high”. So, why are bisexuals suffering with poor mental health?

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For one, biphobia exists, and it takes many forms. There are harmful myths about people who identify as bisexual. Some of the most common “beliefs” include:

  • Bisexuals should are “greedy” and should instead just “pick a side”
  • Bisexuals are “just going through a phase”
  • Bisexuals are “confused”
  • Bisexuals are claiming to be bisexual just for attention
  • Bisexuals always cheat on their partners
  • Bisexuals exist purely for threesomes
  • The term bisexual excludes transgender, non-binary and gender non-conforming individuals, therefore bisexual people are transphobic (because “bi” means “two”)

All of these statements can cause damage and perpetuate stigma. These statements paint an inaccurate picture of what it means to be bisexual. In turn, this has a negative effect on the mental health of those who identify as such. The unnecessary perceived “shame” of being bisexual prevents many people from coming out to their closest family members and friends; research suggests that bisexual people are far less likely to be open about their sexual identity than those who identify as homosexual. 

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The identities of bisexual, pansexual, and non-monosexual individuals are often erased; for example, people may assert that I’m a heterosexual woman because of the current relationship that I am in. If I were instead in a relationship with another woman, people may assume that I was homosexual. These assumptions can often be frustrating, as it feels like we effectively have to “come out” over and over again. It also feels that we have to constantly “prove” our sexuality is real and valid, which again has a detrimental impact on mental health and our perceptions of identity.

For those of us in mixed-gender relationships, we may be told that we have the privilege of being in “straight-passing” relationships. In one sense, I agree with this; it is true that heterosexual relationships historically, and often presently, are seen as “the norm”, and therefore more “acceptable” than other types of relationships. We also know that people in same-gender relationships experience more hatred than people in mixed-gender relationships. On the other hand, this narrative of being “straight-passing” again erases bisexual and other non-monosexual identities, and can make us feel like we are not valid or welcome in the LGBTQ+ community. Again, we feel that we have to “prove” that our sexual orientation is legitimate.

It can be very tiring, stressful and harmful to our mental health when it feels that our identities are not respected or believed by other people. So please, educate yourselves, and #DoBetterBiUs

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This is only a very short piece on what it means to be bisexual, and how it affects mental health – there is so much more that could be said here. I encourage everyone to do some more reading around the subject, for example:

Busting harmful myths about bisexuality

Bisexual women at a higher risk for violence

My sexuality is not just about sex

Bisexuality and mental health

The mental health repercussions of identifying as a bisexual woman

What it’s like to be out but not out-out as a bisexual

Isn’t it easier, being bisexual?

On the connection between physical health and mental health

CW/TW: depression, suicide, cancer, long term illness

I was inspired to write this blog after having a tough time with both my physical and mental health recently. A few months ago I had a flu-type virus which meant I was unable to work for two weeks. Because of this, not only did I suffer physical effects such as tiredness and low energy, but I felt even more useless than usual; “if I’m not well enough to work, what’s the point? I’m no good to anyone.” I admit that I struggled with not only the usual negative thoughts that come with depression, but at some points I felt lower than I have done in a long while. It also happened to come at a time where I was struggling with work; stress and my ongoing depression was having an impact on my ability to focus, and I felt very stuck on a particular piece of work I had to complete. All these issues were piling on top of one another, and I began to question if I should be continuing… With work, with life… It was a scary time. I can confidently say I’m out of the worst of it, and although it may seem like a sad and negative situation, it has given me something to write about with passion.

“Physical health” and “mental health”… What do these phrases have in common? Perhaps the most obvious commonality is that they are both concerned with health, which has an impact on our overall sense of well-being. With this in mind, should we treat them separately? Should we prioritise one over the other? You may already have answers to these questions, but please read on for my opinion and some facts about how physical and mental health and intrinsically linked.

Now, in terms of definitions: physical health is about your body and how well it is functioning; similarly, mental health refers to how your mind functions. This does not necessarily mean that they should be thought of as separate entities; instead, they should be viewed as aspects of the human being that exist and work alongside each other – or sometimes against each other.

Previously, physical healthcare has remained very separate from mental health services. It has also been the case that physical health conditions are more commonly and openly treated than mental health conditions. This is perhaps due to the unnecessary stigma around mental health conditions (Mental Health Foundation); although these days, it is encouraging to see that mental health is being more openly talked about, particularly in the online world (in my experience, anyway). Despite this, there is more funding for research on physical health conditions than mental health conditions (MQ). In their report, mental health organisation MQ state that:

“…just over £9 [is] spent on research per year, for each person affected by mental illness. By comparison, £612 million is spent on cancer research each year, which translates to £228 per person affected – or 25 times more per person.”

This is a worrying finding, and shows the inequality between physical and mental health research. We can, of course, acknowledge that cancer is an understandable cause for concern amongst the public, given the diagnosis and mortality rates reported by Cancer Research UK and the Office for National Statistics (ONS). However, mental illness should also be a huge cause for concern – in 2017, suicide was confirmed as the cause of 5,821 deaths in the UK (ONS); perhaps this number is not as high as those reported for deaths caused by cancer, but it is a huge number nonetheless, and one we should seriously be working on reducing.

And so, on to the connection between physical and mental health…

Physical health may affect mental health, and mental health may affect physical health. For example, experiencing a long term physical illness such as diabetes may lead to developing symptoms such as low mood and fatigue, due to the chronic and relentless nature of the physical condition. It has been reported that two-thirds of people with a long term physical health condition will also have a mental health condition, such as depression or anxiety (NHS England). Even less “serious” physical health conditions, such as the common cold (or the flu, as mentioned in my introduction), can make us feel a bit rubbish about ourselves.

Similarly, people with mental health conditions such as depression may struggle with finding the motivation to exercise, for example, which can have a detrimental impact on their physical health (this is something I know very well from experience). In terms of research evidence, some studies report that serious mental health conditions may reduce life expectancy by between 10-20 years (Oxford University) – which is a truly shocking finding.

The connection between physical and mental health is strong, and there is an increasing demand for physical healthcare to incorporate psychological treatment, and vice versa. Organisations that are part of the Improving Access to Psychological Therapy (IAPT) programme in England are increasingly expanding their services to provide support to people who live with long term physical health conditions.

Integrating physical health and mental health services is an excellent way of promoting overall well-being for people who use these services. Not only will this integration improve outcomes for service users, but it would also be financially beneficial for our strained healthcare providers (The King’s Fund).

The bottom line for me is that we should be looking at our health and treating illness in a holistic manner; we should be considering the whole person, rather than splitting health into strictly separate categories.

For more on this subject, I would recommend dipping into the following links:

Mental Health Foundation – Physical and Mental Health

MQ – How does mental illness impact our physical body?

The King’s Fund – The connection between mental and physical health

Science Daily – Body and mind need care in mental illness

Thanks so much for taking the time to read this post. Please feel free to leave a comment; let me know if there’s anything I haven’t made clear, or if you have any thoughts you want to add!

Personal experiences of anxiety: presentation edition

I, like so many other people, deal with anxiety on a daily basis. It creeps its way into so many aspects of my life. As I write this, anxiety is preventing me from calling my local medical centre to book an appointment. But the topic of this blog post isn’t about something I do on a daily basis, or even with some regularity; in fact, it’s about something that’s quite rare. It’s about the experience of anxiety that consumes me whenever I have to give a presentation.

I was inspired to write about this because a couple of days ago, I was talking to my husband about being invited to present at an event focused on making a positive difference, be that for patients, or for the workforce (I work in the NHS – see my introduction post for context). That doesn’t sound too bad, right? Someone wants me to present the work I’m doing that is having, or will have, a positive impact on others, to a room full of interested people. Well… I was taken aback by how strongly I reacted to this conversation, physically and mentally.

The simple thought of standing in front of a crowd of people made me feel sick – an intense, negative version of feeling “butterflies” in my stomach. The feeling where you are convinced that you might actually throw up. I became shaky, trembling, uneasy. Fear and dread began to take over my entire body, to the point where I felt frozen in my chair. I felt regret for bringing this topic to the conversation, as it made me feel so unwell. And all of this happened just because I thought about presenting; what would happen if I were to do this for real?

Well, I have recently had to give a presentation at work, on a much smaller scale, about a project I am working on which focuses on “evidence-based practice” (I will discuss this topic in a future blog post). Incidentally, this would likely be the topic of my presentation at the aforementioned event. But in this instance, I had to present some data to five other people, all of whom I work closely with for four days of the week, every week. The experience of presenting to this group actually went quite smoothly, as I felt I had a good grasp on the data and had prepared fairly well. Before the meeting, however, I was a bundle of nerves; I experienced sleeplessness the night before, and physical sickness on the morning of the presentation. I put myself under a great deal of stress, and worked overtime, to ensure I was prepared for this one-hour meeting. For one hour of my life that went quite well, I made myself physically and mentally ill in order to “prepare” myself for presenting. It doesn’t seem to add up.

Previous experiences have also resulted in me feeling unwell. I distinctly remember (and re-lived it on social media, thanks Timehop) the anxiety that accompanied preparing for and giving a presentation based on my undergraduate dissertation six years ago. Part of our dissertation grade was based on this presentation, and even though it was a small part, it still amped up the pressure on final year students at the time. I remember waiting in a corridor, outside the room I was going to present in to two people; my dissertation supervisor, and another colleague of his – both lovely people. And despite the pleasant nature of my small audience, I was absolutely overcome by fear. Once again, I felt physically sick, and was legitimately worried about needing to throw up before, during, and after my presentation. I felt faint, weak, as if I were fighting to survive. This time, these feelings didn’t stop while I was presenting, and were revealed in physical actions; I was audibly shaky, stumbling over my words, and became clumsy using technology which I was usually so familiar with. I left the presentation thinking, “was that even worth it?”

While I do acknowledge the benefits of presentations, and therefore practising the skills required to present successfully, in my experience the negatives outweigh the positives. As I was formulating my next sentence for this post, I thought to myself, “sure, but the negative consequences of presenting do not last forever”, but perhaps in my case they do. As I stated near the beginning of this article, even the thought of presenting causes me distress, and at this moment it feels like it’s something that I might never overcome. Only time will tell, but it is something that is likely to affect my career and future opportunities; presenting is a skill that often is highlighted as part of “essential” criteria on job applications, and will particularly impact me if I continue down my chosen pathway of research. On the plus side, there are always poster presentations…

What are your thoughts? Do you struggle with presentations, or find them a breeze? Have you found ways to cope with any anxiety brought on by presenting or the thought of presenting? Let me know!