Why My ‘Disguise’ Is an Important Part of My Job in Mental Health

Every day, I put on my costume — my disguise, I suppose you could call it. I put on a happy face, I straighten up my clothes and I go to work.

Now, most people do this anyways, but it feels somewhat different when you work in the mental health field. You see, I work with teenagers with behavioral issues linked to their past trauma, as well as their intellectual and psychiatric disabilities. I also do per diem work with adults who also have psychiatric illnesses, and I am also a graduate student studying to become a school counselor.

I am also diagnosed with borderline personality disorder (BPD) and bipolar disorder type 2. My residents, my clients — they don’t know this.

With the adult population, I do openly talk to them about my experiences when it feels important to self-disclose. They do not know of my diagnoses, but they do know I see a therapist and a psychiatrist. When they ask me a question about whether or not I have been to a mental health facility such as a Personalized Recovery Oriented Services (PROS), I answer as honestly as I can without disclosing too much. When it comes to my teenage residents, I am less open. They know I take medication, but they don’t know what for. When we do our daily check-ins and I’m feeling depressed, I usually tell them I am tired and I am not feeling well. They need me to be a strong role model for them, and unfortunately, I feel like disclosing my mental health to them would be frowned upon by my agency.

Last night, I found myself sitting in the emergency room with one of my teenage clients. This client has been having increased impulsive behaviors and needs care beyond what we can give him right now. It was suggested he go to the local hospital and because I was his staff member, I was to transport him with another staff member. Funnily enough, we were to go to the same hospital I found myself in only a few weeks prior for mental health-related care.

Because of this, I knew exactly what to expect — the long wait times in the emergency room followed by another long wait time in the crisis unit. My co-worker, on the other hand, had never been to this hospital before and who knows what his mental health status is like — it’s not something we discuss at my job.

My resident would ask me questions about the unit he would possibly be moved to and I would have to answer with borderline honesty while acting like I wasn’t sure. It was so difficult, but I kept my head. I wanted so badly to disclose to this resident that I had been in his shoes only weeks prior — that I had been stripped of my street clothes and forced into a hospital gown. That I had sat in a chair in the hallway and he was lucky to have a room with privacy. That I knew what he was feeling, to a certain extent. That a year before I had been admitted to the same unit he would be admitted to. However, I kept my mouth shut because self-disclosure with clients and residents can only go so far. I also knew, knowing my borderline side, that my self-disclosure would spill over and would go beyond what he needed. I would have made this trip more about me than it was about him so I really had to self-regulate.

It can be exhausting, holding in these secrets. I want to be open with them so they know they have someone who they can come to with their problems and will get an honest answer based on experience. But I also know that being in school to become a counselor, there is only so much you can disclose before you infringe on the client’s rights. So I put on my happy face, slap on my disguise, and do my best to help them from my experience without them knowing too much about my own.