Trans issues with associated mental/emotional issues

[amandam]

I want to start this thread based on my own experience and how often others mention their mental and emotional issues, especially anxiety and depression. Perhaps we can help each other know better how to decipher things?

For myself, I have anxiety and depression and I am on the trans spectrum. At times, it's hard to tell if the issues I deal with are because of the trans identity or something else. Sometimes, it is hard to decouple which is which. Y'know, does my trans issues blow up the anxiety, or does the anxiety blow up the transness.

I think this might be more of an issue in detransitioners, but I'm not sure. For detransitioners, in the beginning they are absolutely convinced they are the opposite sex, then they further realize they were mistaken. I definitely wouldn't want to go that far to find out I was wrong.

Any tips or experiences on how you got through your emotional/mental issues to find the truth of your situation?

[annaleaver]

Find help through your GP or Gender Specialist, they will help you establish a line between your mental health issues and being transgender.

Being transgender is not a mental health disease, and hence can't be treated with anti-depressants, anti-psychotics etc. I hope this helps.

Anastasia x   

[amandam]

I know all of that and have a therapist, just looking for examples of people who thought things were one way and then later determined they were another. It could be either way. What they thought was trans, was not, or, what they thought was stress, etc. was really trans showing through.

[Dena]

I am aware of some people who detransitioned and for most of them, they were transgender however life was very difficult because of job or family issues so they decided to step back for a while. Of the few that were left who detransitioned because they decided it was a mistake, they choose not to deal with their issues in therapy. They either bypassed therapy or didn't discuss everything they knew. The therapist is there to determine if you have any condition that would prevent you from making an informed decision on your issues and there are issues that can interfere with your judgement. Failure to discuss these issues with your therapist means you may be unable to make an informed decision.

I know there are people out there who don't really need therapy and could probably transition without difficulty or regret however I still feel it's a good insurance policy to have enough therapy to verify any issues you might have are addressed. How much would depend on the individual and how honest they were in therapy.

[Virginia]

I am a survivor of childhood psychological and sexual abuse and developed a female alter to cope with the trauma. When my female alter became self aware my doctors misdiagnosed me as a late onset transsexual in denial. Three years of therapy later when the flashbacks, nightmares and time loss began I was correctly diagnosed with Dissociative Identity Disorder/Multiple Personality Disorder.

You can read more in my post, "Childhood Trauma Survivor Misdiagnosed as Transsexual with Gender Dysphoria" at https://www.susans.org/forums/index.php/topic,176195.msg1548804.html#msg1548804 .

[Kylo]

I thought my anxiety and depression (and antisocial tendencies) had little to do with being trans from the start, and that it was some indelible part of my personality. I seemed to have been proved totally wrong in that almost as soon as I started HRT, my anxiety all but vanished and I find it quite difficult to stay depressed now, even though I still live in a rather depressing situation. Rather than it being down to transition or gender itself, I think it was largely down to estrogen in a brain not meant for it. I've also noticed since HRT that I've become far less antisocial and actually crave wanting to socialize.

While all this is good, it does present me with the issue of not knowing myself as well as I thought I did, and having to discover what kind of personality I really have.

[Allison S]

I feel like mental health care can be very vague in certain ways. There's no way to prevent slip ups with people eventually detransitioning. What's great about informed consent is that usually a lot more trans people are being helped in a timely manner.

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[pamelatransuk]

Hello again Amanda

As you know we have corresponded previously on your other thread "Dealing with a Suppressed Life" and I have followed your story there.

First of all I agree completely with Anastasia that being transgender is not a mental health disease.

In answer to your question concerning correlation between being trans and being depressed and/or anxious, I discussed this last year with my gender therapist and we both agreed that being trans was likely causing the major part of my depression but not the whole of it.

In simple terms for most of my life I had suppressed my gender identity as I did not wish to deal with it out of fear and embarrassment and for family and social reasons such that I was just existing rather than living; sometimes mildly depressed and sometimes more depressed; wishing my life away really. However from start of 2017, my trans feelings became so prominent such that BOTH the trans feelings AND the depression became unbearable such that I had to take action by therapy and then subsequently we both agreed HRT appropriate for me. I have been on HRT 5 months and I know for certain not only that I feel better emotionally and peaceful but also that a good chunk of the depression has lifted. I remain somewhat depressed but nothing like as bad as late 2016 and significantly less than I have felt for decades.

I am not saying you should start HRT; that it a matter for you and your therapist. Essentially I am saying that HRT may be a useful "exploration mechanism". We start on low dose HRT and we are always free to stop. I feel it is the right fuel for me as a transwoman and it has the add-on of lowering my depression significantly.

I hope you discover the best course of action for yourself.

Wishing you well as always. Hugs

Pamela

[SadieBlake]

Amanda, suggest you read about co-morbidity, the clinical term for having multiple issues that may or may not interact.

For my part I analyzed the possibility that my motivation to transition stemmed more from reaction to awful family situation than from having a feminine brain (which I do consider a mental health issue, mostly because most of us are improved by medical intervention, be it HRT, counselling or gender confirming surgical procedures.

I can talk about this forever, however my work day is starting so another time perhaps.

[Charlie Nicki]

I've felt depressed a lot of times since starting transition. It's mostly being due to social pressure, fears, doubts and heart break. Every step of the way has been mentally challenging for me mostly because I'm defying the status quo each time. And I feel lonely since breaking up with my ex. I think estrogen has definitely enhanced all these negative feelings. So I wouldn't say being trans means you will be depressed, but going through everything we have to go through just to build and express our identity can definitely be depressing.

[Briah]

This is an excellent thread and is similar to one that goes on in the adoption world as well.

Disclaimer: I am identifying as a trans woman but not transitioning due to family.  I am also a psychotherapist (emphasis is not on the psycho.)

In the adoption world I would frequently see families that would blame all behavior and emotional problems on being adopted.  I remind people that adopted children are children first and adopted second.  Some get it. Others . . .

So, as I came to identify as a trans woman I realized that some of my depression, a lifelong challenge, was the result of an inner discontent and longing not recognized.  I didn't have the words to put to it at first and later I didn't make the connections.  What came first?  No idea.  I still get periods of depression and I recognize that some if it is that I want to transition and am not in a place that I can do it--now.  Some of it is that I am working in the child welfare field at the moment and struggle with the various "stories" that I am stepping into.  And some of it is the vicarious PTSD from working with so many people who have been traumatized. 

I feel the dysphoria strongly some days.  Some days it is depressing for me to know that I can't transition right now.  I also began to feel something new--body dysmorphia.  I am 6 feet tall and 200 pounds and somewhat chronologically endowed yet I see myself as slim, maybe 5'6" or a little more and much younger.  This is a cause for some frustration as I see outfits that I absolutely love and know that that inner girl could look really good in them but the "real" girl would look silly. 

I think that the dysmorphia is directly linked to identifying as female.  The depression mentioned above I think is a combination of who I am and "who I am", if that makes sense.

I have been spared the anxiety that some talk about.   I have worked with enough people with anxiety issues that I am thankful that I have not had to deal with it.  As has been said anti-anxiety meds and anti-depressants can help.  I think that working on it with a therapist makes a difference as well (ok that wasn't quite a self serving plug).  It can also help bring clarity as to what is a result of being trans and what is the result of being human living in an insecure world.

As I stop to think about being transgender and what it means in the sense of the "task" of being transgender it can get a little overwhelming.  There is so much to think about.  We need to confirm our identity, usually through multiple visits with a doctor and psychotherapist/psychologist to get the letter; we need to talk with the doctor about HRT and have the visits to monitor hormone levels; we need to look at major surgery or surgeries; we need to learn about makeup and hair, things cis women learn from birth; we need to learn how to dress so that we look good; we need to learn to walk; we need to learn to talk; we need to learn to be; and we need to earn enough to pay for it all.  As I write this it feels a little much to deal with, yet this is the reality of what trans persons live with every day.  Yes some of the items above are  specific for the trans woman yet trans men also have a variety of issues that they have to come to terms with as well.

Life presents challenges and can be a little much to deal with.  It doesn't matter if you are cis, trans, or an alien.  Being trans just adds a little spice to the mix. 

Now I am rambling so I will just quit.  But not before I wish you all well and wish you a good day today and better tomorrow.

[amandam]

I think sometimes it's hard to analyze a feeling to figure out whether it is a transgender feeling, or just a hope/wish fueled by emotion. I think in order to transition you have to be confident enough that the feeling is not fueled by your depression, etc. and can stand alone as a transgender feeling.

[pamelatransuk]

So, as I came to identify as a trans woman I realized that some of my depression, a lifelong challenge, was the result of an inner discontent and longing not recognized.  I didn't have the words to put to it at first and later I didn't make the connections.  What came first?  No idea.  I still get periods of depression and I recognize that some if it is that I want to transition and am not in a place that I can do it--now. 

Hello Briah

I agree with your entire post but just wish to highlight the above paragraph as that is how I have always felt. (I am now 5 months into HRT and hoping to publicly transition next year.) I have been long term depressed but which came first being trans or depression? Will being trans as that started before birth but only afterwards at puberty did I really appreciate the consequences.

And Oh Yes it always has been a longing, an unrequited yearning!

And a good day and better tomorrow to you also.

Pamela

[pamelatransuk]

I think in order to transition you have to be confident enough that the feeling is not fueled by your depression, etc. and can stand alone as a transgender feeling.

Precisely!

[Allison S]

It's a risk we take, like anything in life... That's how I see and rationalize my transition. Everyone is different... There's many physical features about me I can't change to match what I always "hoped" to be and look like... What I decide to do instead is change the things that I can. Maybe I'll learn to really like myself for once? I know I strongly disliked myself for a very long time and couldn't live like that anymore...

If someone can manage their dysphoria and live a full/healthy/succesful life- well I really envy that. But being transgender is life and world altering.

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[ErinWDK]

This thread connects to where I really am.  My gender therapist retired last year (personal issues, she wasn't even 70 -- so FAR too young to retire) so I have been working with a different therapist.  This therapy is based on Internal Family Systems Therapy developed by Richard C Schwartz.  The internal family system reflects the natural multiplicity of one's psyche.  Dissociative Identity Disorder is the far end of the continuum of this.  I am an adult survivor of prolonged, severe, child abuse.  This was mostly emotional abuse and neglect.  I am trying to put things together, but so far I do not think there was sexual abuse -- Thank God!  Using IFS I am going to speak of "Parts" -- this is rather different from Alters; but it seems to accurately reflect who I am and where I am.

There are seven main parts.  Some people want to think one or another of the three most important ones act a lot like Alters.  However, these are all at their best when they work together.  None of them really want to be in charge.  By IFS theory "Self" should be in charge, so that is sort of the way things should be.  As I am a survivor of prolonged abuse "Self" is a difficult entity to pin down, and has blended with the parts.  Sorting this is where I am in therapy.  It is deep.

Most of these main parts are female.  One pointedly has no gender.  One is male, but that is nominal only.  The one people think they see is the one that has presented male all these years -- and "he" is fully sick and tired of putting on the phony face.  So we have gender identity imposing itself on my issues.  I do not think the non-standard gender identity was the source of the abuse; but I will need to come to an effective peace over the abuse before I can devise a realistic strategy to deal with gender identity.

At this point attempting full transition would be running from my issues.  Not good...

[amandam]

Related to this is, I've heard, for some, that hrt can create a "placebo" effect. This can be dangerous. Let's say you're depressed and dysphoric to some degree. You do hrt and feel better. So you decide to go all the way. Yet, you may not really need to transition, you're just being fooled because you feel better. This worries me.

[Charlie Nicki]

Related to this is, I've heard, for some, that hrt can create a "placebo" effect. This can be dangerous. Let's say you're depressed and dysphoric to some degree. You do hrt and feel better. So you decide to go all the way. Yet, you may not really need to transition, you're just being fooled because you feel better. This worries me.

I don't think this is accurate. If anything, feeling really good on HRT can actually make people comfortable in that stage, without needing to do anything further. In my case, I felt good on HRT because I knew things were changing but socially I didn't like feeling in between the genders or not fully recognized as a female, and this feeling pushed me forward into the process.

[pamelatransuk]

Placebo effect is temporary and then reduces. You feel great at first but you come to a more rational decision later in the HRT period.

I agree with Charlie Nicki - afterwards it provides greater experience emotionally and it gives you more motivation to transition further.

Pamela

[SadieBlake]

Amanda I'm gonna agree with the other replies about placebo effects, and add that what you're describing isn't what I think of as placebo. I don't know if you have started HRT yet?