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PLOS BLOGS Speaking of Medicine and Health

Journeys in Mental Health

This is the first of a new series of blogs in which PLOS Mental Health explores personal mental health journeys globally.  A central aim of PLOS Mental Health is to provide a platform for lived experience voices. Although society is becoming more supportive and discussions are more open, many would still be more comfortable sharing their experiences anonymously due to different types of stigma. At PLOS Mental Health we want to help empower those with lived experiences but we also understand that true freedom is having a choice about how your story is shared. This blog series will therefore consist of accounts from anonymous contributors and will initially reflect the experiences of those working within the mental health profession.

Do they know you or the mask you put on every day?

I have long accepted that my mental health journey will be a continuous one. The beginning is not very clear and there certainly won’t be an end. There are OK times and there are bad times and there are times when I wonder how I keep going. Mostly, through all of this, I am acutely aware that I can transition regularly between these different phases and nobody around me is any the wiser.

I have a lot of skills. But by far, my most accomplished one is masking. If you detect a hint of pride in the language that I choose, you would be right. I am fully aware that masking is not the healthiest behaviour and I would like to be very clear that the way I express my experience of masking is entirely personal and by no means a form of advice for others. I share with the hope that this resonates and reiterates that with mental health, nothing can be one size fits all. But what makes me view masking in a favourable light sometimes is the fact that it is something I am in complete control of. I choose what people see and when. This is important to me when my daily life is dictated by many thoughts and feelings that I can’t always control. I have a prior diagnosis of Bipolar Disorder. Is that an accurate diagnosis? Maybe, maybe not…probably not. But that is an entirely separate topic for discussion.

I mask in all aspects of my life, both personal and professional. The continuous strain of masking played a key role in my decision to change careers. I didn’t feel like removing my mask, even a little, was an option for me. Instead I transitioned into a fully remote role, which allowed me to adapt my working pattern as needed and provided some much-needed masking respite between meetings. I feel privileged that I was in a position to make this change. This fully remote role also happened to be in the mental health field. To my surprise however, despite regularly interacting with mental health professionals, I still feel a constant need to protect who I am.

I don’t think anybody can mask all the time without some consequences. The cognitive load of constant filtering can be unbearable and is the main reason why, in an ideal world, nobody should have to mask. I am incredibly fortunate that I have an incredibly special and inspirational psychotherapist who has, without doubt, changed my life and shown me the true value of talking therapy. They are the first and only person for whom I do not wear any kind of mask.

So, what has this made me realise? That masking, both consciously and unconsciously, for all of my life, left me not knowing who I truly was. I started to believe the mask that I wore and as it started to slip, I was faced with a flood of confusion. But here is the caveat – my very special psychotherapist is a psychotherapist. Someone who can provide a completely safe environment for me that could not possibly be reliably replicated outside of my relationship with them. So, outside of the safety of their office, my mask must always be on hand. I am also very mindful of how lucky I am to even have my psychotherapist and the safety that they so beautifully create. There are too many people in too many parts of the world for which such a relationship and any kind of safe space is out of reach. Again, an entirely separate, but imperative discussion to be had.

In all honesty, I don’t know if masking is my downfall or my saviour. Or indeed both. It has hidden my real self even from me. But it has also protected me and given me control. Although there is a lot of discussion about why we should not mask (rightly so), I am leaning towards the notion that there is always a time and a place for it and perhaps the way we frame the use of masking can make the difference between isolation and empowerment.

I guess what I am saying is that everyone should have the option to share as much or as little as they like about themselves, and true freedom is all about that choice. The mental health field is constantly changing, and society is becoming more open and supportive – albeit more rapidly in some parts of the world than others.

There should not be a stigma surrounding someone being their complete and authentic self, just as much as there should not be a stigma for those who choose what to portray and reserve their authentic self for the privacy of their own company. I think that is just as sacred as being able to openly share. To mask or not to mask? The choice should always be flexible and always be yours. And you are always allowed to change your mind…

*The contents of this blog reflect only the personal experience and opinion of the author. This does not represent any kind of professional advice or the opinions of PLOS or PLOS Mental Health

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