I’ve been thinking a lot about appearances (thank you Miss Allie Burke!) and how it relates to mental illness. I’ve been thinking about how we look can often give people an impression about our health. When you think of someone who has a mental illness what comes to mind? Is she well groomed and stylish or is she disheveled and dirty? There is a common misconception that to have a mental illness one must be unkempt.

I remember my first time visiting a counselor. I was in second-year university and I had just been caught by my best friend  with cuts all along my arms. My friend was scared for me after I admitted to having suicidal thoughts. I didn’t know at the time, but I was in the throes of a major depressive episode. At the time I didn’t even know what depression was. I was 18, living away from home at a university that had once been fun, in a program that I enjoyed, but all of that had fallen away. I hated everyone there. I didn’t understand how everyone could party so much. I didn’t get how my roommates were so messy. I couldn’t keep up with the demanding reading schedule of my classes and I was struggling with a long distance relationship. No wonder I was feeling depressed. Now some people could have dealt with the pressure of that life. Some people could have adapted. But what I have learned, after 10 years of dealing with my mental illness, is that I don’t handle stress well. Stress aggravates my condition, which interferes with my sleep and as soon as I’m not sleeping I know my mental health will quickly move down hill.

So, my friend being the smart cookie that she is forced me into university counselling services the very next day for an emergency appointment. The appointment had been made a few hours before I had to go to class and I hadn’t given any real thought to what I was wearing. Oddly, I remember exactly what I wore that day. I paired my jeans with a fuchsia pink lace cardigan (that covered the cuts) with a matching fuchsia camisole underneath. I had never seen a counselor before in my life, but I was struck when she pointed out my outfit.

“Well you’re dressed nicely today, you don’t look like you’re struggling.”

How was I supposed to look? Should I have shown up in her office in pajamas with greasy hair and body odor? Is that what we think a person struggling with mental illness looks like?

And this wouldn’t be the only time this happened to me.

Many years later, after I was well schooled in the mental health system and seen various psychiatrists and psychologists. I had already been diagnosed with bipolar disorder and was in the throes of another depressive episode, but also dealing with extreme panic attacks. I melted down in a grocery store on an errand to buy napkins for my mother. There were simply too many choices and my heart started racing, I couldn’t breathe, and the aisles were closing in on me. The cacophony of the store was overwhelming and the I lights were too bright. I don’t even remember if I bought napkins in the end or if I just ran out of the store. At this time I had also lost the ability to order food in a restaurant. Whenever I went out for dinner with my then boyfriend (now husband) I would just order whatever he was eating.

I was incapacitated by anxiety. Coupled with the crippling depression and suicidal thoughts, the only thing I could think to do was to be admitted into the hospital. I was speaking with the admitting psychiatrist who had been dealing with my case who said: “You don’t look like you have anxiety.”

How was I supposed to look in that moment? The anxiety had passed. Should I be crying? Panting? Suffocating like I had been in the grocery store? I was severely depressed, but I wasn’t in the middle of a panic attack. In a few words, this doctor had dismissed me based on how I was presenting to him in that moment. He made me feel like shit. He made me feel like I was pretending to have severe anxiety (because being admitted into the hospital was something someone did for fun!)

Over the years I have realized that I use clothes and make up as an armor to protect myself from the assuming eyes of doctors and society. When I’m in the depths of depression or dealing with severe anxiety, I ensure that I am well put together with a face full of make up so that no one knows how I’m struggling. Except that this has worked so well that even doctors don’t believe me when I’m asking for help. It’s like they’re expecting a neon sign, blinking above my head, saying: “She is experiencing bipolar depression. She is having extreme panic attacks.” Or they are expecting me to show up unshowered, in sweats, and matted hair. That’s just not me.

Every day we make assumptions about people based on what they’re wearing. But people, and especially doctors, need to remember that there’s no “look” to mental illness. Anyone can have depression, anxiety, post-traumatic stress disorder, borderline personal disorder or whatever else. Just because I don’t look sick, doesn’t mean that I’m not suffering.