Episode 29 - No One Signs Your Cast
Treatment for mental health issues rarely receives the same level of community support that a more visible struggle, like major surgery, does. But our friend, Shay, is out to change that.
A straight male who received treatment for anorexia, Shay experienced push back from some of his closest friends when he made the choice to seek professional help. Yet, his friends were eager to lend sympathy when he fractured an ankle... What gives!?
We are all about shifting this conversation along with Shay and cannot wait for you to hear more of his story.
Ellie Pike: Treatment for mental health issues rarely receives the same level of community support that a more visible struggle like major surgery does. Just think of it, chances are you've taken part in meal trains or financial pools for friends and family in chemotherapy, or for new parents, freshly home from the hospital with an infant, but have you ever whipped up your best casserole for a friend newly discharged from [00:00:30] mental health treatment? It's a rare thing. Today's storyteller is on a one-man mission to change that. Meet Shay.
Shay Chris: Just a little bit about me. I have four kids, two cats, and one dog. I live in Colorado, and I work in IT.
Ellie: When a life-threatening disorder forced him to face his fears of being seen as weak or feminine, he discovered that the only way to fully live was to embrace radical vulnerability and a more gender-fluid identity. [00:01:00]
You're listening to Mental Note podcast. I'm Ellie Pike. Shay's journey into advocacy all began with a blog post entitled No one Signs Your Cast. One reason that we wanted to invite you onto this podcast was this blog that you wrote that went pretty viral and popular. [00:01:30] It's called No one Signs Your Cast. You talk about your story of getting lots of attention for having a physical injury, but not getting that same attention when you have mental illness. Jumping in, what's the quick story of how your ankle became injured? Tell us a little bit about the outpouring of support that you received.
Shay: Oh, that is a long and complicated story, but basically, the short version is that I ended up just [00:02:00] breaking my foot. It was a simple fracture. It's called a Jones fracture. That just happens. A lot of dancers get it a lot. I have no idea how that happened. It just broke one day, and then two months later, it was really hurting. I went to the emergency room, and there was a clear fracture. Since then, I've had five surgeries on both my foot and my ankle, due to having to remove the tendons and having to remove the broken pieces that never actually healed, and all these [00:02:30] different things that needed to be done. It's just been a saga really.
Ellie: It sure has. I've known you through a couple of those surgeries. I even find myself paying a lot of attention to it, and saying, "Gosh, how are you doing? What do you need?" I know that that's been your experience with other people as well because there it's this noticeable issue that you have. Can you talk a little bit about what you wrote in that blog about the difference in how people support you for your physical injury versus [00:03:00] mental illness?
Shay: For the physical injury, it's really interesting to see how people, they want to ask questions, they want to know more about it. When I have surgery, people are bringing food over. We don't even have to ask for support at all, it just happens. Then contrast that to mental health, when I went off to treatment, it was this thing of "Hey, Chris, you really need to get your stuff together. [00:03:30] You've got a family. You need to be responsible. You need to suck it up, man up." All these sorts of things.
Ellie: For Shay, his mental health odyssey was deeply tied to messages he internalized about what it meant to be a man. Can you tell us a little bit about some of your earlier memories that showcase mental health struggles, and what the messages were to your being a male, being a boy?
Shay: The earlier messages [00:04:00] that I received as a kid were, "You're really, really sick. You're this violent person. You are evil. You're just a bad person." It just made things worse. A lot of my mental health struggles, at that point, were around post-traumatic stress as a kid. That was basically it, maybe throw in some depression just because the environment I grew up in. I grew up in such a [00:04:30] depraved and abusive environment. Yes, that was the message. It was just, "Do that. You need to just behave yourself. You need to be seen and not heard." Those sorts of things.
Then, it was definitely, "You have to be very manly. Don't wear nail polish, that's bad. Don't do anything like that." [chuckles]
Ellie: What were some of the other messages about what being a man meant?
Shay: Growing up, my mom, she [00:05:00] wanted me to be a girl. That's complicated, but basically, it was, men are supposed to be strong. They're supposed to be rather stoic, and they're not supposed to cry. Crying is bad. Those are the kinds of things that I got.
Ellie: Bucking up and posturing was what men should do. How did that play out for you, specifically?
Shay: One of the things it did is I tended to wear hyper-masculine clothing. I [00:05:30] would look at these nail sets, and I would love them, and not lay a finger on them. That was in my later pre-teen years that that would happen, between 10 and 12. You could say I felt really empty inside, and I felt I was confused. I didn't know what to do with it.
Ellie: [00:06:00] For you, I'm curious, if you didn't "man up", what were you afraid people would see?
Shay: [chuckles] It's funny because I think, at that time, I didn't understand what I was hiding, I just knew it wasn't manly. At the time, I was trying to hide the fact that I liked nail sets, or that I wanted to wear makeup. At the time, I was dealing [00:06:30] with a lot of acne, so I had a very valid male reason to wear makeup at that time. Nonetheless, I was just afraid of what people would think if I wasn't this really tough stereotypical male archetype, I guess you could say.
Ellie: At this time, Chris, you were a teenager, and you're bucking up, showing yourself as very manly. At the same time, your mental health issues are just growing, and underneath the surface, but they started to [00:07:00] bubble up at some point, where you started to see them as a bigger issue. Can you describe what was happening mentally at that time?
Shay: Let me back up actually to my pre-teen years because this is really when it changed from just depression and PTSD that I was dealing with, and it really changed over to some eating disorder behavior. The other day, I got very curious about ARFID which is Avoidant Restrictive Food Intake Disorder. [00:07:30] I did some research, and this wasn't diagnosed or anything, but I realized that I more than likely had it as a kid. I started having that issue as a child, and then in addition to just the depression PTSD that I was coping with at the time.
Then as my teen years went on, I think that continued because I wasn't full-blown anorexic at that point. That happened in college, but definitely, I was [00:08:00] underweight, of course, through my whole teen years. I was still dealing with depression and PTSD. That's how things shifted for me as a teenager. I started weightlifting as well, to really try to look like some of the jocks that I really was not because I was in the Chess Club. I lettered in chess. [laughs]
Ellie: During this time, in your teen years, your eating disorder, how is it related to the depression and PTSD?
Shay: It helped me numb [00:08:30] out, for sure, but I didn't really have a ton of awareness around my eating disorder, at that point, because guys just didn't get eating disorders, that was a woman's problem. This is back in the '90s, so that's how it was portrayed. That's the way I was looking at it is, I'm just a little skinny runt, and I need to bulk up. [chuckles]
Ellie: You bring up a really good point though, the way that it played out for you was less about, "Let me get skinny," [00:09:00] but more so, "Let me bulk up."
Shay: It's interesting because when I went to college, it switched from bulk up to being skinny. Basically, once I moved out of the house, what I ended up realizing was how feminine I really am. I think it was a function of getting distance from my abusers. At that point, I just switched off of ARFID into basically full-blown anorexia nervosa. [00:09:30] I was all about trying to be as thin as possible, trying to basically disappear, you can say. I was trying to make the perfect body. I think it was driven to wanting to be impervious, but also wanting to be very, very thin, and feminine maybe.
I was trying to change my body to really just be different.
Ellie: Changing his body meant drastic consequences for Shay's well-being. [00:10:00] As time progressed, it became evident that he needed to seek treatment for anorexia. When you entered in, I remember you telling me you came, and you're all black, in your combat boots, you were postured up. Can you tell me a little bit about that?
Shay: The day I walked in the door at ERC? Yes, I came up with my duffel bag, which had all my clothes in it, things that I knew I was allowed to bring. I read the thing, and I did exactly what it said, the little letter we get. [00:10:30] I was just stoic. I was not in a position where I was going to show emotion, I was going to show up. I definitely felt extremely threatened. I was very aware of everybody that was around me, and it was definitely one of those back-to-the-wall days that I was having.
Ellie: How old were you at this time when you decided to enter treatment?
Shay: I believe I was 29.
Ellie: This [00:11:00] eating disorder and mental health issues, they'd been going on for quite a while?
Shay: Oh, yes.
Ellie: Did you have the support you needed to enter treatment?
Shay: I had my wife's support. She was very, very, very supportive of me going to treatment. I did not necessarily have the support of other people. There were a few people that were very familiar with mental health issues, that were supportive, but for the most part, it was this silence. Every now and then, because I was in treatment for about [00:11:30] three months, I would hear from somebody that would tell me, "Man up. Do what you need to do. Get your butt home, and be a man." Those sorts of things.
Ellie: You were having the opposite experience of when you've had ankle surgery. People are not really jumping in, they're not asking about your treatment, they're not asking what's next and how they can support you, and they're not bringing casseroles to your house. What did that feel like to you, to have that lack of support, besides having your wife's support?
Shay: [00:12:00] I began to question. I certainly began to wonder if I was an irresponsible bum and if I really needed to analyze my life and take stock of my manliness. Basically, "Am I just an irresponsible idiot, or am I worthy of even being here?" I began to wonder if I should walk out of ERC's treatment center and come home. I was really embarrassed. [chuckles] The reason I was embarrassed [00:12:30] is because my whole life was about achieving great things and being there for my family, and doing these things, so I thought, "If I'm not doing that, this is back to your childhood. You are so broken, you are so messed up, your mom was right."
I was desperately trying to see if that was really true. If it was, I was going to deal with it, but that was where I was at. I was too embarrassed and ashamed to talk about it. [00:13:00]
Ellie: I think you hit the nail on the head there, it was beyond embarrassment. When you used the word ashamed, to me, that's expressing the internal feelings about yourself, "I am flawed. I am not enough. Something is wrong with me, innately, that I have to be here right now." That's certainly not motivating towards change, and growth, and health. I'm wondering how you did find that turnaround for you, where you were able to seek recovery [00:13:30] and join into the process.
Shay: It was basically a session that I had with my primary therapist in treatment. I think I sat there for five minutes, and she finally said, "I'm going to count to five, and you're going to say it, or the session is going to be over." [chuckles] Then, when she said five, it came out. I was basically just talking about how I really liked nail sets, and how I was just feminine, and all these things that I [00:14:00] never talked about. Once I did that, that changed the game. I basically brought up one of the most shameful things ever and talked about it. Then, on top of that, of course, moving along, we were doing a bunch of PTSD work, which addressed some of those shame topics.
Really just allowing a part of me to be seen and heard, seemed to be a game-changer, is what I would say.
Ellie: [00:14:30] This breakthrough for Shay is sadly rare in our society. Most men don't even make it through the door of the therapist's office to begin the process. Here to talk about the unique struggles of treating men is Dr. Tyler Wooten. A psychiatrist with over 20 years' experience and the Medical Director of Eating Recovery Center in Dallas.
Dr. Tyler Wooten: The boys and young men really struggle with a lot of the stigma of having an eating disorder, experiencing themselves [00:15:00] as having an eating disorder, they typically come in with more resistance to what they think of as a label of having an eating disorder because society equates eating disorders as a feminine disorder, and they really struggle much more so than girls and young women. Entering into eating disorder treatment sometimes, they get stuck in their own views of themselves. What's even more interesting is, [00:15:30] especially young men, as they lose weight, their testosterone starts to plummet.
Even in their own internal sense of masculinity that is helped by having normal testosterone levels, their testosterone levels are dropping, and so they start to feel themselves almost as-they use the term often as asexual, "My sexual drive doesn't seem to be there." Then, they start wondering about their [00:16:00] own identity as a male, and they start to question their sexuality because of it.
Ellie: That is a really important point. Relating this back to Chris, when his anorexia began, it started as bulking up, and it started as building muscle mass. Later it turned into diminishing his body size, and actually embracing a different kind of feminine look. Can you describe the presentation of anorexia, and how it plays out for men versus women? [00:16:30]
Dr. Wooten: Young boys are really subjected to a lot of abuse and bullying, even more than the female population. 1 in 3 boys are bullied, but only about 30% report. Over half of young boys are physically abused. One in six are sexually abused. A lot of times, the young man, if they've been through [00:17:00] traumatic and difficult experiences in their life, their desire at strength and protection may become something that is very triggering and overwhelming for them. They don't really know how to process the information. They may not have ever talked about it or had any therapy.
The young man, typically, what I see even clinically over and over again, is that the boy who presents with anorexia nervosa [00:17:30] had no original intent in becoming thin, but then the thinness of the boy can sometimes become a triggering tractor, and what they need to do is bulk up. A lot of times, the underlying foundation of that is self-preservation and protection, that they need to be strong. They get triggered by the desire to have big arms, big legs, big abs, like a six-pack abdomen. [00:18:00] They're very, very, very motivated by that.
They start working out because they want to be bigger and stronger, but then what happens is they start looking into food, and diet, and what they need to do to cut down on their body fat because they want to look more and more ripped. The boys, as they start to lose weight because they're doing some sort of restricting dieting, begin to see more and more [00:18:30] muscle tone, and then, their mind, in their body distortions, in a sense, do start to see themselves as bigger, and so they think, "If that's working, I need to do more of it."
Then, it triggers more and more of the eating disorder pathology in their brain. As they lose weight, their obsessive-compulsive tendencies begin to increase, their anxiety begins to increase, they stop being able to make good, clear, logical, [00:19:00] concise sorts of decisions, and then, by that time, they're off to the races.
Ellie: I'm curious, now that you are in recovery, and you have a family of four, you're active in the community, how do you talk about your journey outwardly, and how are other people perceiving that experience now?
Shay: [00:19:30] Now that I have both sides, I really work on just having balance between the two. Basically, being feminine, if I want to do my toes, I can do my toes. If I want to hang out with my female friends and just chat about girly things, I can do that. If I want to hang out with my male friends and chat about hunting and fishing, I can do that. I allow both pieces to live, and I don't allow shame [00:20:00] for either piece.
Ellie: It sounds like that's become such a freeing part of your story. I am really grateful that you're willing to share that because whether or not other people say that outwardly, that they can relate. I think a lot of people can relate, even females identifying with those "masculine parts" of themselves, and knowing that there can be freedom in holding both sides and that we're all a little bit of all of it. Most of us are not 100% feminine or 100% masculine. [00:20:30] Those are social constructs anyways. Thank you so much for sharing your piece of that.
I'm curious how your relationships, especially your relationship with your wife, shifted as you were able to embrace your masculinity and femininity together.
Shay: I feel like it's grown stronger really. She's embraced that piece of me, certainly. In fact, she always knew it was there. That's the funny thing. [chuckles] It was really just me that was trying to deny it. She [00:21:00] always saw it. I've changed, certainly, from this mysterious person with long hair to this very open, and loving, and fun-loving person who's able to be whole. I think that has benefited her as she goes through her own journey. We've been able to talk about that piece and just grow closer as a couple.
Ellie: I appreciate you sharing about that, and I appreciate the word that you're using to describe yourself as whole. To me, that's the opposite of shame-filled. [00:21:30] It is very fun-loving. It is very joyful. Who you are is totally different than who you were when you were in the depths of your mental illness. I'm curious, how would you describe what healthy is for you overall now, in regards to depression, PTSD, and the eating disorder that you used to battle?
Shay: Basically, now, being whole, it was interesting because when you said I'm a completely different [00:22:00] person, the interesting thing is, is I always was this person. This person was just deep down inside and just hadn't come out yet. We're dealing with just all the joy that comes from being whole and not denying who you really are, which I would argue, you have a limited amount of control over. That's basically it. Now, I talk about my feelings. If there's something going on, I just talk about it with my wife. [00:22:30] Life is really-it's more authentic, I think is the word I'm going to use. Then, in regards to PTSD and stuff like that, when I start to see my PTSD come into play, I just take more self-care. It's a sign that I need to go to the spa or just chill out, find time talking about non-kid-related things with the wifey, or hang out with friends, that sort of thing.
Ellie: [00:23:00] Do you mind going into that a little bit? What are some warning signs for you when you know that PTSD is affecting you and that you need to step away?
Shay: It's an increase in hypervigilance. Another thing is if I start to have flashbacks, which these days I don't have. I used to deal with flashbacks multiple times a day, every day. Now, I do not deal with flashbacks multiple times a day. I don't even deal with them every week. When I start to see flashbacks coming into play, I go, [00:23:30] "Oh, what's going on? I'm hypervigilant. I'm having flashbacks. I really need to go to bed on time tonight. I really need to take a bath, or I need to go do my nails, or just whatever it is, and just go chill.”
Ellie: That's a really good example. What about depressive symptoms? Do you ever find yourself noticing that you're going in that direction again? What do you do, if so?
Shay: Suicidal ideation was a big part of something I dealt with [00:24:00] on a daily basis when I was in my illness. That and sadness expressed itself as anger for me. When I would notice anger, I would stuff that deep. Now, if I start to have some of those depressive thoughts, like, "I'm not good enough, I'm not worthy," those sorts of things, the first thing, and this is really a general statement for mental health, but whenever any of this stuff comes up, my first thought is, “Am I getting enough rest?
How [00:24:30] do I make sure that I get to bed early tonight?" Sleep is so important to recovery, a good solid eight hours." That's always my first thing with depression is, “Are you sleeping?” That's really it. I just make sure that that self-care game, it's the same thing with PTSD, I just really engage the self-care game.
Ellie: I imagine part of self-care is making sure you're eating well, especially considering you're in recovery from an eating disorder as well. How do you do that, and [00:25:00] add that to your self-care game?
Shay: With eating, a lot of times, anorexia gets compared to recovering from drug addiction. The thing that we can't do with an eating disorder, that you can do with a drug addiction is, abstain. You can’t abstain from food; you need food to live. What I had to do was really work with my relationship with food. I had to work on fear of foods. That was early [00:25:30] recovery, and I had to eat via a meal plan. Eventually, in later recovery, what I was able to do is develop more intuitive eating habits. I was able to see food as something that could nourish me, and energize me towards my goals, and something that I could really enjoy.
I've always loved Mediterranean food. I've always loved Greek food, Italian food, all that sort of stuff. I got a Mediterranean cookbook, not on the Mediterranean diet. [00:26:00] I don't believe in diets. On the Mediterranean cookbook, I just started cooking food that I loved, and that tasted great. It had tons of colors in it. It had tons of vegetables, it had chicken, it had beef, lamb, take your pick. It had all these things that were just tasty, and that I just loved. I started to learn to eat food that nourished my body, and that I absolutely loved cooking and eating. Changing that [00:26:30] relationship with food has been really key to recovery.
Ellie: I'm curious, what you would like our listeners to really gather from your story, and what do you hope that they take home from your experience?
Shay: I think it's really important for people to understand that, and especially men, but I think women can really benefit [00:27:00] from this as well, and that is that vulnerability is strength. When you have the courage to be vulnerable-- I will not mince words here. Do not mistake this, vulnerability takes a ton of courage and vulnerability in front of a group of people takes even more. When you are vulnerable, you are authentic. When you are authentic, you are able to be your true self. Doing that enables you to really get joy [00:27:30] in your life because you can't be joyful unless you're authentic. You can only be a second class, somebody else.
For me, I had to first accept that. Accept both the masculine and the feminine, be okay with the feminine, and then from there, love the feminine. Once I did that, it really, really was that game-changer. I just want people to really get back to being vulnerable, and being courageous, and being who they really are, because we don't need a second class somebody else, we need you. [00:28:00] When I was me, that's when my career took off. That's when my personal relationships took off, my friendships. That's when my marriage got better and better. I was in recovery that always helps. It was just all of it, across the board; vulnerability and authenticity.
Ellie: Thank you so much for sharing that. I am just so glad [00:28:30] that you're willing to be vulnerable and authentic on this show because I think you're sharing the story that a lot of people don't know how to share yet, and that a lot of us can relate to. Thank you so, so much.
Shay: You're welcome.
Ellie: Chris, along the way, and through your recovery journey, you've really become an advocate, and you care a lot about de-stigmatizing mental health. One of the ways that you've done that is through writing, and through a blog. Can you tell us [00:29:00] a little bit about that and why it's important?
Shay: Really, I had not been heard for so long. One of the things that I worked on in treatment was finding my voice. A lot of people don't think a six-foot three man needs to find his voice, but it's true. I think, just with all of the stigmatization, both from my family of origin, and from people, and the environment we have today, where, unfortunately, we're dealing with all sorts of shootings, [00:29:30] if you have a mental health issue, people are all of a sudden wondering if you need your guns taken away, or if you are going to all of a sudden burst into violence and go stab 10 people outright.
Mental health is not that. People with mental health issues are not violent. Almost always, there's another component involved that triggers the violence. Shifting back into-- [00:30:00] me personally, it was just I want people to be able to heal. I want people to be able to support their friends and to be willing to do that. That's something I allude to in the last paragraphs of the blog is, one day, you may be battling mental illness, and you will need the support that you didn't give other people. I want people to view mental health as the same thing as physical health. There's really not a big difference or any real difference [00:30:30] except that one is in the brain, and another is in another system in the body. Treatment methodologies seem to be virtually the same in terms of diagnostics, and treatment plan development, and all that.
Ellie: Thank you so much for saying that. I think that that rings so true. I remember when I first had that realization when I was early in college and I went to a seminar, and they said, "If your friend had a broken leg or it was bleeding, you would rush them to the hospital. If someone's brain was bleeding, and you [00:31:00] can't see it, it's just as important. We just need to pay attention." You're exactly right; mental health and physical health are just as important as the other.
Shay: Yes, and there's no need to stigmatize it. That's why I talk so openly about it because I think it's just so important for people. Just like when people talk about their broken leg, or people ask me about my ankle, I want people to be able to ask me about my mental health or anybody really, and it just be a completely normal, not a big deal conversation. That's how it should [00:31:30] be. It shouldn't be something where people don't want to talk about it. I had a co-worker the other day that didn't want to talk about his son's autism.
He would talk about it with me because I have two autistic kids, but he wouldn't talk about it with anybody else. He didn't want me to share it with anybody else. That's the sort of stuff I want to make go away.
Ellie: Oh, thank you. I think that that just even feels freeing, hearing you say that. Thank you for sharing so openly. I think that that's going to do great service to destigmatizing mental health.
Shay: You're [00:32:00] welcome.
Ellie: I have three main takeaways from Shay's story. First, we have a long way to go in getting more comfortable with the fact that straight men face mental health obstacles. Second, seeking treatment and finding recovery is actually a sign of deep strength rather than weakness. Third, that through recovery, everyone gets to discover a part of themselves that they never knew existed. For Shay, it means embracing [00:32:30] his feminine side while also being married to a woman and having a family. For you, it might look totally different.
Personally, I would much rather live in a world where people feel supported in expressing themselves in a healthy way, rather than falling into negative coping patterns that ruin lives and families. That's where you come in. If you, or someone you know, needs professional help, on embracing yourself and living courageously, seek out help. There's no shame in asking for what you need. You [00:33:00] can reach a trained therapist to see if treatment is right for you, by calling 877-411-9578. Our show is brought to you by Eating Recovery Center and Insight Behavioral Health Centers.
You can learn more about the people we interview at mentalnotepodcast.com. We'd also love it if you left us a review on iTunes. It helps others find our podcast. Mental Note is produced and hosted by me, Ellie Pike, directed by Sam pike, and edited by Josh Wright. [00:33:30] Till next time.
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