5 Private Battles of People With Mental Health Conditions

On some of the darkest nights of my mental health condition, it felt like my mind had turned against me. Loud, voice-like thoughts tore into me. "No one likes you." "You think you're a good person, but you're not." At times, I'd shout back. I felt incredibly low. It took time to build my strength to address myself in the midst of these storms. I would say out loud, "I am a kind person." I would guide myself through the tasks of the day. I got help. Those times are more than 10 years behind me now and I'm thankful for it.

Today, as a therapist, I often help individuals through battles they do not openly share. It's a privilege to witness their strength and recovery.

On Internal Battles

Battles within ourselves are common both for people with and without mental health conditions. At some point, almost all of us will struggle with grief, anger, realities we are not OK with, regret, and more. This is life.

Still, for individuals living with mental illness, the wars inside us can at times intensify. It takes strength. What follows are five common internal battles faced.

1. Intense fear

I have treated at least 100 people living with anxiety disorders like panic disorder and generalized anxiety. Often, these fear-based states create invisible barriers. Morning anxiety magnifies the difficulty of leaving home for work or school. Similarly, riding through social anxiety often means facing discomfort. The treatment for anxiety disorders often involves a level of exposure to one's fears. This in and of itself can be a fight. Yet, it is one worth taking on. Through psychotherapy, it is possible to overcome the fences anxiety places on our lives so that we can move toward what matters to us.

2. Obsession-based rabbit holes

Psychological conditions that have elements of overthinking such as obsessive-compulsive disorder (OCD) can lead a person into an anxious rabbit hole of obsession. This might look, for example, like a fear that one could have hit someone with their car. For someone with a particular obsession, the simple reassurance of not having seen/heard the clear impact that would be there if we hit someone with a vehicle might not be enough. There is something known in inference-based cognitive behavioral therapy (I-CBT) as inferential confusion. The OCD might try to guide someone through an unending series of rabbit holes—checking one's car for marks, driving back by the scene, researching online whether it is possible to hit someone without knowing it, or asking for reassurance. As one tries to distance themselves from these obsessions and compulsions, they are likely to experience a level of anxiety. The difficult work of psychotherapy for OCD such as exposure and response prevention therapy (ERPT) or I-CBT involves changing one's response to these rabbit holes to eventually hop out.

3. Unkind voices and thoughts

Hearing voices is a common experience among a variety of mental health conditions, including those involving psychosis. In addition, loud negative thoughts are also common in depression. One of the most common manifestations of hearing voices is a critical voice commenting on one's actions or giving someone unkind instructions. When someone hears this kind of voice, they often need help, ideally with a team-based approach. For some, medication alleviates some symptoms; however, many people continue to hear voices even when taking medication. Psychotherapy that involves building one's compassion toward oneself such as compassion-focused therapy can help people who have a critical voice whether it is part of a psychotic disorder or not. Working through one's blocks to give oneself compassion is a journey that involves great strength.

4. Missing one's highs

Bipolar disorder involves massive highs (mania/hypomania) and lows (depression). For most, the majority of time is spent in depression. One of the difficulties that is common in bipolar is not knowing if one can trust one's happiness. Is a good day just a good day, or a signal of an upcoming mania? While mania often involves a sense of euphoria, increased productivity, and decreased inhibitions, it can be destructive. Yet, once a person has experienced that kind of high, they often miss it. Particularly when in the middle of a depressive episode. Discovering joy and meaning within a range of healthy moods is key for recovery in bipolar disorder.

5. The will to live

Tragically, suicide is a real risk for many individuals living with mental health conditions. For someone experiencing suicidal thoughts, this internal struggle can be a fight for one's life. Reaching out for support which may include crisis resources such as the 9-8-8 lifeline is vital in these times. No matter how dark it gets, it is possible to feel better. Yet, we have to be alive to make it to that point.

If you or someone you love is contemplating suicide, seek help immediately. For help 24/7, dial 988 for the 988 Suicide & Crisis Lifeline, or reach out to the Crisis Text Line by texting TALK to 741741. To find a therapist near you, visit the Psychology Today Therapy Directory.

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