Members of the LGBTQ+ community are at a high risk of developing clinical depression. Many transgender and gender-diverse individuals have attempted suicide. Why do these disparities exist, and how can you find supportive, equitable health?
Knowing the symptoms of depression can help you or someone you know get the treatment they need.
Risk of LGBTQ+ Depression
It’s estimated that between 3 and 6 of every 10 people who identify as LGBTQ+ experience depression or anxiety at some point in their lives. The risk of depression is twice as high for those who are lesbian, gay, and bisexual as it is for the rest of the population. For those who are trans, the risk is almost 4 times higher.
One reason members of the LGBTQ+ community face higher rates of depression is discrimination and prejudice. More than half of the LGBTQ+ community has reported experiencing threats, harassment, violence, and hurtful comments about their sexual orientation or gender identity. Social isolation can also increase the risk of depression, and people who are LGBTQ+ may feel more alone and isolated in their community. Geographic isolation can also contribute to this. An estimated 2.9 million people who are LGBTQ+ live in a rural county. Smaller communities can make differences more visible and offer fewer support and service options.
Members of the LGBTQ+ community can also have difficulty finding access to health care because of negative beliefs and actions. Not having good access to health care, especially gender-affirming care for trans and gender-diverse individuals, can increase the risk of depression.
It’s not just that people who identify as part of the LGBTQ+ community are more at risk of depression. People who are LGBTQ+ also have a much higher risk of suicide. And they’re more likely to have depression that interferes with their everyday activities.
One study found that 13% of people who are LGBTQ+ experienced mental health symptoms that were severe enough to interfere with their everyday activities. That is compared to 4% of those who were not members of the LGBTQ+ community.
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Symptoms of Depression
Not everyone has the same symptoms of depression. Some people might have only a few symptoms, while others may have several. If you are experiencing depression, talk to a doctor or nurse for help, especially if your symptoms prevent you from fully functioning in your daily life,
Common symptoms of depression include:
- Feeling hopeless, worthless, helpless, or guilty.
- Feeling sad or anxious all the time, or feeling “empty.”
- Feeling irritable or having a short temper.
- Not enjoying activities that normally make you happy.
- Not having a lot of energy or feeling fatigue frequently.
- Feeling restless or having trouble sitting still.
- Having trouble remembering things, concentrating, or making decisions.
- Having trouble sleeping or sleeping much more than usual.
- Changes in your appetite or weight.
- Having thoughts about death or suicide or wanting to hurt or kill yourself.
- Having aches, pains, headaches, cramps, or stomach problems that don’t have another explanation.
- Moving or talking more slowly than usual.
Treatment for Depression
The two main types of treatment for depression include therapy and medicine. Most often, using both of these treatments together has the most success.
Talk therapy, or psychotherapy, helps people see the way they deal with emotions. It also helps people change their reactions to their emotions, thoughts, and behaviors. Therapy involves talking to a licensed mental health provider, such as a counselor or psychologist.
Therapy can be between one patient and their mental health professional, or it can take place in a group setting. Some people do well in either setting, while others do better in one or the other.
Talk therapy can take time to help you feel better. It’s important to find a counselor who is right for you and continue seeing them to give therapy a chance to work.
Antidepressant medicines can treat depression. These mediciness work by changing the way your brain uses chemicals that affect your mood or stress.
There are many different kinds of antidepressants, and different drugs and dosages work better for some people than others. The side effects of different antidepressants also vary from one person to another. It can take time to find out which antidepressant and which dose will work best for you.
Most antidepressants take 4 to 6 weeks to begin fully working. It’s important to take them for that many weeks before deciding if they work for you. During this time, you might experience changes in your mood, sleep, appetite, and ability to think clearly.
If you start to feel better, you should not stop taking the medicine without talking to your doctor. Stopping an antidepressant abruptly can lead to withdrawal symptoms, your depression returning, or other effects.
Whether you are experiencing a crisis or not, special support resources for the LGBTQ+ community are available 24/7.
- The Trevor Project Lifeline is a service for youth who are LGBTQ+. Call 1-866-488-7386, text START to 678-678, or chat online.
- Trans Lifeline is run by the trans community and for the trans community. For peer support for yourself or someone you know, call 877-565-8860.
- The National Suicide Prevention Lifeline provides free and confidential services, including special support for the LGBTQ+ community. Call 1-800-273-TALK (8255).
For more information about mental health services at UPMC Western Psychiatric Hospital, call 1-877-624-4100 or 412-624-1000.
resolve Crisis Services at UPMC Western Behavioral Health provides 24/7 counseling and support to all Allegheny County residents. Call 1-888-796-8226 or visit our walk-in center at 333 North Braddock Ave., Pittsburgh, PA 15208.
Depression. National Institute of Mental Health. Link
Discrimination in America: Experiences and Views of LGBTQ Americans. Robert Wood Johnson Foundation. November 2017. Link
Grace Medley, Rachel N. Lipari, Jonaki Bose, Devon S. Cribb, Larry A. Kroutil, Gretchen McHenry. Sexual Orientation and Estimates of Adult Substance Use and Mental Health: Results from the 2015 National Survey on Drug Use and Health. October 2016. Link
Ilan H. Meyer. Prejudice, Social Stress, and Mental Health in Lesbian, Gay, and Bisexual Populations: Conceptual Issues and Research Evidence. Psychological Bulletin. September 2003. Link
Jonathon W. Wanta, Joshua D. Niforatos, Emily Durbak, Adele Viguera, Murat Altinay. Mental Health Diagnoses Among Transgender Patients in the Clinical Setting: An All-Payer Electronic Health Record Study. Transgender Health. Link
Joshua D. Safer, Eli Coleman, Jamie Feldman, Robert Garofalo, Wylie Hembree, Asa Radix, Jae Sevelius. Barriers to Health Care for Transgender Individuals. Current Opinion in Endocrinology, Diabetes and Obesity. April 2016. Link
Kassie R Terrell, Robert J Zeglin, Reagan E Palmer, Danielle R M Niemela, Nathan Quinn. The Tsunamic Model of LGBTQ+ Deaths of Despair: A Systemic Review to Identify Risk Factors for Deaths of Despair among LGBTQ+ People. Journal of Homosexuality. June 4, 2020. Link
Lesley Steinman, Amanda Parrish, Caitlin Mayotte, Perla Bravo Acevedo, Eva Torres, Mariana Markova, Margaret Boddie, Sue Lachenmayr, Carol Nohelia Montoya, Libby Parker, Edrei Conton-Pelaez, Joscelyn Silsby, Mark Snowden. Increasing Social Connectedness for Underserved Older Adults Living With Depression: A Pre-Post Evaluation of PEARLS. The American Journal of Geriatric Psychiatry. October 16, 2020. Link
LGBTQI. National Alliance on Mental Illness. Link
Mental Health and the LGBTQ Community. Human Rights Campaign Foundation. Link
Understanding Anxiety and Depression for LGBTQ People. Anxiety and Depression Association of America. Link
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UPMC Western Psychiatric Hospital is a nationally recognized leader in mental health clinical care, research, and education. It is one of the nation’s foremost university-based psychiatric care facilities through its integration with the Department of Psychiatry of the University of Pittsburgh School of Medicine. UPMC Western Psychiatric is the hub of UPMC Western Behavioral Health, a network of nearly 60 community-based programs providing specialized mental health and addiction care for children, adolescents, adults, and seniors throughout western Pennsylvania.