We're out. We're proud. We're on Prozac?
It's been nearly 30 years since the American Psychiatric Association ceased listing homosexuality as a mental disorder in the Diagnostic and Statistical Manual of Mental Disorders--saying that gay people are not mentally ill and are not more likely to have mental health problems.
Now part of that long-held position is being called into question. As a panel of researchers reported at the APA's annual meeting in San Francisco in May, the latest studies suggest that lesbian, gay, and bisexual adults appear to be more likely than heterosexual adults to experience depression and anxiety.
These studies, which are based on analyses of large national surveys, contradict years of previous research, which most often focused on subjects culled from gay pride events and through advertisements in the gay press.
The discrepancy stems, in part, from the different methodologies--both of which have their pluses and minuses, researchers say. The latest studies, analyzing the national health surveys, best represent the whole population. Still, the percentage of respondents who identify as gay or lesbian is relatively small. In one study, for example, only 74 of the 2,917 adults questioned identified as gay, lesbian, or bisexual.
In contrast, the earlier studies, which focused specifically on gay people, naturally have larger percentages of gay-identified participants. But because the subjects were recruited from gay pride events and through the gay media, they are less likely to represent the gay and lesbian population as a whole.
To be sure, not all gay people who are depressed say it's linked to their sexual orientation. In some instances depression can be biological. In other instances it can be situational--due to a breakup, an HIV diagnosis, or the unexpected pink slip. But researchers say it is also possible that these factors only compound the stress that gay people experience as members of a minority group.
"Minority stress is socially based and stems from an environment characterized by prejudice," says Ilan Meyer, an assistant professor of clinical sociomedical sciences at Columbia University. "It is experienced on top of the other stressors people have in their lives, and it can affect a person's mental health"--including their risk for depression.
The theory of minority stress could explain why recent studies have found higher rates of depression in bisexual men and women, who often feel isolated from both gay and straight populations. In addition, it underscores how being part of a supportive community can be critical for your mental health.
"Being part of an LGBT community may be protective against depression," says Esther Rothblum, a University of Vermont psychology professor. This might be one reason the studies conducted on people at pride parades--traditionally supportive events--did not find higher depression rates, she says.
Of course, even people who completely out can experience homophobia. And, according to Queer Blues: The Lesbian & Gay Guide to to overcoming Depression, up to 1.7 million gay men and lesbians suffer from depression. "I was running a support group for gay men with depression," say Braden Berkey, director of behavioral health services at Chicago's Howard Brown Boystown and worked in professions that were accepting of who they were. So in terms of minority stress, you wouldn't expect it to be there." But as the group continued to meet, he says, the conversations turned to the anger the participants had because of the restraints they felt as a result of their sexual oreintation.
Although antidepressants do help many people suffering from depression, some psychoteraphists are concerned that these new studies will cause some doctors to simply encourage their gay patients to "take a pill" rather than push for public policies targeted at reducing discrimination and minority stress. …