My Smile Hides the Fact That I'm Constantly Thinking About Suicide

I’ve had many psychologists not believe me when I talk about my mental health because I smile through it, I maintain good eye contact and I make sure I present well to whoever I’m seeing. In terms of a mental state exam, I’m perfectly fine — just going through a rough patch. Who would think the girl who is easily able to connect with people is also the girl who is constantly considering suicide?

Masking is a concept I’m sure many other people have names for, but for me, it works best. It’s almost like being a chameleon — you change colors to suit your environment.

As someone who experienced mental illness from the onset of puberty and possibly even before that, I was dismissed and told it was “normal teenage mood swings,” when in fact I was attempting to take my life every other night. The days and moments I wasn’t thinking about my death, I was drowning on the inside. I hated making eye contact and I never wanted to smile.

But, being a human, and more importantly, a woman, I was constantly told by my peers the same thing.

Smile.

“Smile, it could be worse.”

“Smile, you should be happy about this.”

“Smile, you are so lucky with what you have.”

“Smile, you have nothing to be sad about.”

Smile.

I was often told off my peers and family members for not making eye contact, for not smiling, for not having energy, for not being clean or presenting well, for being “selfish.” Being shamed, in my opinion, is the best weapon humans have to make people conform to a certain standard. We constantly fear the “not quite normal” and we, from childhood, try to get people to act in the “normal” way.

So, I started to smile. I make excessive eye contact. I make sure I have energy and am upbeat around others. I never ever go to an appointment without clean clothes, showering, brushing my hair and teeth. I put others first to the point that I begin to neglect myself. I know I’m strange, but I hide most of the strangeness and I definitely am not as open as I could be about my health.

Because of this, whenever I talked about suicide or self-harm, I was ignored because I was smiling. I was 18 when I was believed, and it took until I was 21 to find someone who believed me completely. My new psychologist knows that when I smile, I’m masking. I’m pretending to be OK, because that’s what I was raised to do. If I saw I haven’t showered for a week or haven’t eaten in days, she believes me and helps me find a way to cope.

Presentation is everything in society. It’s the way we hide, say where we are from, what class, what profession. However, it’s a double-edged sword. People present themselves to be mentally healthy. Even with chronic illness, if it’s invisible and you present well, people don’t believe you when you say you actually do have an illness. And in an area where appearance plays a major part in assessment of mental illness, there needs to be some changes.

Mental state exams or evaluations focus on the now. There has been some speculation about the effectiveness of the exam, but it is still widely used as an assessment tool. While the now is important, so is the history. We focus on the serious things like energy levels and suicidal and homicidal thoughts, but we also need to focus on some of the smaller things.

When was the last time you bathed before today?

When was your last meal?

Things that indicate how they are at home and over the long-term rather than the presentation or mask they may be wearing now. Presentation is a major part of the way we interact with people, and who we interact with. And those who are seriously ill but manage to mask in order not to be isolated need to feel comfortable telling mental health professionals they aren’t OK, and they present themselves this way for a reason. They need to be believed because if we are going to exist in a society that promotes people pretending to be something they are not, there needs to be a way to get people to safely say “I’m not OK” and be believed and not dismissed simply because they are really good at looking “normal.”