Advice from a healthcare provider to members of the LBGTQ+ community living with depression

This post was sponsored by Johnson & Johnson.

Major depressive disorder (MDD) is one of the most common mental illnesses in America, affecting more than 21 million adults in the US.¹ Depression can happen to anyone, at any age, and to people of any race, ethnicity, socioeconomic status or religious background.² While only 4.5% of the U.S. population identifies as LGBTQ+, 39% of the LGBTQ+ community has reported experiencing a mental illness in the past year.³ In fact, LGBTQ+ adults are 2.5 times as likely to use mental health services compared to cisgender heterosexual adults.3 This can be heightened by the unique challenges that the LGBTQ+ community faces, like discrimination or rejection from loved ones and society, or not feeling confident in or trusting of the healthcare system.

Here, Dr. Amir Ahuja, MD, a Board-Certified Psychiatrist, shares his personal insights on the challenges that members of the LGBTQ+ community may struggle with when it comes to experiencing and managing depression—as well as some strategies for coping.

1. What is your background and experience treating patients living with depression?

Depression is anything but simple. It is an illness unlike any other, and some forms of depression can persist even after multiple treatments. I have helped thousands of people in the LGBTQ+ community manage their depression as the Director of Psychiatry at the Los Angeles LGBT Center. I also have a wealth of experience treating patients with all forms of depression, including those with treatment-resistant depression (TRD).

TRD is often defined as an inadequate response to two or more antidepressants (of adequate dose and duration) in the current depressive episode, which is why many who are diagnosed with this form of depression cycle through treatments without relief.⁴

2. What unique challenges do you find members of the LGBTQ+ community struggle with when it comes to experiencing and managing depression?

I find that members in the LGBTQ+ community tend to feel more isolated than their cisgender, heterosexual counterparts. Many have been rejected by family members and ostracized by society. I also believe that this is compounded by the fact that many gay men were lost in the AIDS epidemic, and the surviving gay men of a certain age have lost many partners and friends. 

Additionally, I believe that there are disparities in trauma that is experienced by LGBTQ+ people, like intimate partner violence, harassment and discrimination. There are also health disparities in terms of physical health where LGBTQ+ people in certain subsets have higher rates of heart disease, cancer, and shorter lifespans.⁵

3. What roles do community resources and support networks play in mental health of the LGBTQ+ community, and how can members talk with their doctors about finding resources?

I believe that culturally competent resources are vital for the LGBTQ+ community to get the healthcare they need. Many LGBTQ+ individuals, especially transgender individuals, have had terrible experiences with healthcare and resist going to the doctor because of it. A welcoming environment goes a long way towards making a change in this and rebuilding trust. Also, research repeatedly shows that all LGBTQ+ communities feel more comfortable with culturally competent providers and centers. 

I work at the LA LGBT Center, which is the largest LGBT center in the world. The LA LGBT Center offers LGBTQ+ patients the help and resources they need to manage their depression. While not everyone lives in a city where there are physical centers to go to, there are a lot of online resources available likeDepressionLooksLikeMe.com, which houses mental health resources tailored to the LGBTQ+ community. This includes healthcare directories that make it easy to find a provider, including the closest LGBTQ+ friendly healthcare professionals or community centers, as well as live and ongoing support that can connect people with trained counselors.

4. How do you approach discussions about mental health with LGBTQ+ patients?

In my practice, I approach these discussions with my LGBTQ+ patients just as I would with any patient. I start by discussing what depression can feel like, as there are many misconceptions. Depression is not a mood or a choice and not something someone can snap out of. It’s a serious mental illness that can happen to anyone at any age, and people of any gender, sexuality, race, ethnicity, socioeconomic status or religious background. Many people think it just consists of being “sad.” In reality, it can involve feelings of numbness and disconnection with lack of joy, fatigue and brain fog. It often affects appetite and sleep. It can be caused by life stressors or seemingly come from nowhere. I believe that normalizing the discussion around mental health and erasing the stigma often associated with it can help people feel less alone in their struggle. 

When I look at treatment options for my patients living with depression, I like to understand my patients’ goals, so I can help them accomplish them while managing their depression.

5. What advice would you give to LGBTQ+ individuals who are struggling with depression but may not feel comfortable seeking help?

You are seen, you are heard, you are not alone, and help is just a phone call or a text away. Many people, including myself, are here to help you overcome depression and live your best life. We care about you and want the best for you, but we can’t help if you don’t reach out. So, taking that first step in reaching out for help is so important. 

6. Where are some additional resources that people living with depression in the LGBTQ+ community can find care and help?

References

1. National Institute of Mental Health. Major depression. Accessed November 1, 2024. https://www.nimh.nih.gov/health/statistics/major-depression#part_2563
2. Mental Health America. Depression. Accessed November 1, 2024. https://www.mhanational.org/conditions/depression
3. Mental Health America. LGBTQ+ Communities and Mental Health. Accessed November 1, 2024. https://www.mhanational.org/issues/lgbtq-communities-and-mental-health
4. Agency for Healthcare Research and Quality. Definition of treatment-resistant depression in the Medicare population. https://www.cms.gov/Medicare/Coverage/DeterminationProcess/downlo ads/id105TA.pdf. Published February 9, 2018.
5. Health.com. 7 Major Health Disparities Affecting the LGBTQ+ Community. Accessed November 1, 2024. https://www.health.com/mind-body/lgbtq-health-disparities#:~:text=People%20in%20the%20LGBTQ%2B%20community%20face%20significant%20health%20disparities%20that,use%2C%20and%20mental%20health%20disorders