Weathering The Storm

​In doing my clinical work, I spend much time supporting and processing the reactions of vulnerable clients from marginalized populations to the current and recent political climate in the United States which has included the Supreme Court ruling that took away federal abortion protections.  For myself and among clients I see, many of whom are not female assigned or identified, a fear nonetheless set in that many of the freedoms, values, and protections that came about as the result of tireless fighting and advocacy for workers, women, people of color, and LGBTQIA+ people, and others could/will be on the chopping block. 
 
Doing the clinical work that I do, I especially found many of my transgender and/or Queer clients fearing for the state of their marriages, their employment, their right to a safe abortion and also for their physical safety in ways that they had not since before the Obama administration.  In many cases, this very real fear has led to an exacerbation of mental health symptoms already present or created symptoms of a severity and duration necessary to warrant an Adjustment Disorder Diagnosis or a diagnosis of Major Depressive Disorder.  To look at how some of the composite reactions I've seen have led to symptom creation and exacerbation, let's take a look at the criteria for Major Depressive Disorder as it relates to the experiences of clients and others as reported and observed and discuss how we as clinicians in this practice approach supporting clients with these symptoms and societal concerns.
 
The symptoms that are potentially part of a depressive episode include: depressed mood, loss of interest/pleasure, weight gain or loss, thoughts of death or suicide, feelings of worthlessness/guilt, fatigue, insomnia/hypersomnia, decreased concentration.  These symptoms need to exist in an episode which lasts 2 weeks or more.  I have seen symptoms such as these arise for the first time or be exacerbated by the current circumstances.  In my clinical work, most notably, I have seen these symptoms arise in clients pertaining to both the recent Supreme Court ruling coupled with comments made by a justice that he might be inclined to vote to overturn the past Marriage Equality ruling that federally legalized marriage for Queer-Identified Individuals.  These federal events coupled with Missouri taking steps to orchestrate one of the most rigid statewide abortion bans in the country, led many of my clients to contemplate leaving the state or residing in a more progressive country.
 
In terms of how I’ve seen symptom creation, depressed mood was most frequently caused by negative and invalidating reactions to the local political situation by clients’ loved ones.  The disillusionment caused by this disconnect often leaves Queer and Trans people wondering how their family and purported friends can support politicians, institutions, and businesses that have agendas and take measures that treat marginalized people in invalidating, harmful, personal safety-jeopardizing ways.  Loss of interest/pleasure in activities often relates to limits in the ability to comfortably engage in hobbies.  Clients often have feelings of worthlessness related to feeling as though their safety and value as a person are being undermined when things like so called “bathroom bills” are being voted upon to not allow transgender people to use the bathroom that corresponds with their identified gender or when Queer and Trans client see reproductive rights for women being rolled back and understandably worry that their much more recent/tenuous rights will be next on the chopping block.  All of these concerns can and have disturbed my clients’ sleep, appetite, and made them feel drained and exhausted.  As such, some, in addition to considering relocation are considering trying psych meds for the first time.  We have been processing the resulting elevated symptomology with our clients and, when needed, referring them for additional services like psychiatric care, support groups such as those at MTUG, 12-Step meetings at place such as the Alano Club, and normalizing our client’s fears and concerns related to the ways in which they are understandably symptomatic/experiencing elevated levels of symptoms due to the fear of losing the already unacceptable level of rights and benefits that were fought for during Stonewall and for decades since, and generally assisting in the formulation of “created family” for our clients who are often being harmed by their biological families and systems of power.
 
If you are someone who is hurting or feeling isolated or in-danger as a result of the current political environment, please know that you are not alone and that others are also struggling markedly with their mental health.  Please know also that even though it can be especially scary for people who have been let down and marginalized by people who should have helped and cared about them, there are service providers some of whom are in the community who are open, affirming, and are advocating both in the field and in their personal lives for LGBTQIA+ people, their marriages, their personal safety, their need for safe spaces including bathrooms, and the need for greater awareness of the needs of this community for the competence of service providers.  While many of us feel that these are dark, scary political times and will be for some time, we at Healing Reflections Therapy are dedicated to affirming and defending the rights of the Queer and Trans communities as well as cisgender women and communities of color. 

​~Chris Scarberry, LPC