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

Dr. Ahuja is a board-certified psychiatrist and a leading voice for the LGBTQ community. As Director of Psychiatry at the Los Angeles LGBT Center, the largest LGBT center in the world, he leads a team that cares for more than 2,500 patients.

Major depressive disorder (MDD) is one of the most common mental illnesses in the United States, affecting more than 21 million adults in the United States.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 US population identifies as LGBTQ+, 39% of the LGBTQ+ community have reported experiencing a mental illness in the past year.³ In fact, LGBTQ+ adults are 2.5 times more likely to use mental health services compared to cisgender heterosexual adults.³ This can be compounded by the unique challenges the LGBTQ+ community faces, such as discrimination or rejection from loved ones and society, or a lack of trust in the healthcare system.

Here, Dr. Amir Ahuja, MD, board-certified psychiatrist, shares his personal insights into the challenges members of the LGBTQ+ community can face when it comes to experiencing and managing depression, as well as some coping strategies.

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

Depression is anything but simple. It is a disease like no 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 Director of Psychiatry at the Los Angeles LGBT Center. I also have extensive 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 appropriate doses and duration) in the current depressive episode, which is why many of those 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 of the LGBTQ+ community tend to feel more isolated than their cisgender and heterosexual counterparts. Many have been rejected by their families and ostracized by society. I also think this is compounded by the fact that many gay men were lost to the AIDS epidemic, and surviving gay men of a certain age have lost many partners and friends.

Additionally, I believe there are disparities in the trauma that LGBTQ+ people experience, such as intimate partner violence, harassment, and discrimination. There are also disparities in terms of physical health, where LGBTQ+ people in certain subsets have higher rates of heart disease, cancer, and shorter life expectancy.⁵

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

I believe culturally competent resources are vital for the LGBTQ+ community to get the health care they need. Many LGBTQ+ people, especially transgender people, have had terrible experiences with healthcare and are reluctant to go to the doctor because of it. A welcoming environment goes a long way toward bringing about change and rebuilding trust. Additionally, research repeatedly shows that all LGBTQ+ communities feel more comfortable with culturally competent providers and facilities.

I work at the LA LGBT Center, which is the largest LGBT center in the world. The Los Angeles 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 many online resources available such as DepressionLooksLikeMe.comwhich houses mental health resources tailored to the LGBTQ+ community. This includes healthcare directories that make it easy to find a provider, including the nearest LGBTQ+-friendly healthcare professionals or community centers, as well as live, ongoing support that can connect people with trained counselors.

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

In my practice, I approach these discussions with my LGBTQ+ patients just as I would with any patient. I start by talking about what depression can feel like, as there are many misconceptions. Depression is not a state of mind or a choice, nor something someone can get out of. It is a serious mental illness that can occur to anyone of any age and to people of any gender, sexuality, race, ethnicity, socioeconomic status, or religious background. Many people think it is simply about 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 out of nowhere. I believe that normalizing the conversation around mental health and erasing the stigma that is often associated with it can help people feel less alone in their struggle.

When discussing treatment options for my patients living with depression, I like to understand their goals so I can help them achieve them while managing their depression.

5. What advice would you give to LGBTQ+ people 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 text away. Many people, including me, 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 you if you don’t reach out. Therefore, it is very important to take the first step to ask for help.

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

This post was sponsored by Johnson & Johnson.

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. American mental health. Depression. Accessed November 1, 2024. https://www.mhanational.org/conditions/depression
3. American mental health. LGBTQ+ communities and mental health. Accessed November 1, 2024. https://www.mhanational.org/issues/lgbtq-communities-and-mental-health
4. Health Research and Quality Agency. Definition of treatment-resistant depression in the Medicare population. https://www.cms.gov/Medicare/Coverage/DeterminationProcess/downlo ads/id105TA.pdf. Published on 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%20%20mental%20health%20disorders