"I never wanted to be a distraction and I accept that my timing was not ideal and my message could have been clearer. More importantly, I would never trivialize mental health or use the term lightly."
These two lines in the statement Naomi Osaka wrote to announce she'd be withdrawing from the French Open, and to share her experience with depression and anxiety, actually broke my heart a little as a psychiatrist.
When I read them, I see someone who is struggling, and at the same time, having to apologize and defend the fact that she was "sick enough" to use the term mental health to describe her symptoms and situation in the first place. I also see a 23-year-old, biracial female telling the world that her problems were real, no matter what her critics wrote or tweeted about her being a "diva" or "arrogant spoiled brat" for announcing she'd skip press conferences while in Paris in order to preserve her mental health.
This is not a statement by someone who is 100% sure that her decision was OK. And it should have been.
These are the words of someone who internalized much of the predictably stigmatizing backlash she received by speaking out and simply having the gall to ask for what she needed mentally to do her job. Veteran athletes, like 18-time Grand-Slam winner Martina Navratilova, told Osaka to 'woman up' and follow the 'rules' of the job, tennis officials called her decision 'unacceptable' and a 'phenomenal error', and journalists, like British right-wing television personality Piers Morgan, said that Osaka was "narcissistic" and "world sport's most petulant little madam."
Most of the initial criticism boiled down to: It was the wrong time, she did it the wrong way, and she was even the wrong person (with the wrong kinds of problems). And it's those responses that could not be more wrong or more dangerous myths to perpetuate.
Osaka shared that she has both social anxiety and depression that have interfered with her day-to-day life long before this tournament. Social anxiety can make it hard for anyone to be in a group, let alone a group of professional journalists you don't know asking you intimate questions that are often intended to elicit anger or tears. And, depression can make it hard to even get out of bed. But apparently, that wasn't good enough, or sick enough to "qualify" as a real mental health issue, according to some critics.
Believing there is a bar that needs to be met symptomatically to qualify as someone allowed to ask for help means that many people are suffering in silence along the way. In my experience, this mindset delays people getting help (or prevents them from getting help at all) because when they assess their own symptoms, they think someone is always worse off than them, and that they are "weak" or need to "suck it up and deal with it." I can only imagine how many times Osaka wanted to bring this up and didn't, or worse, tried, and was told it didn't matter or she couldn't because of what people would think before she said enough was enough. I can only imagine how close to a crisis she actually was before she finally decided to speak up anyway. We might not all relate to press conferences and tennis matches, but we can all relate to not knowing if we deserve to put ourselves first.
That's because we exist in a culture, especially as women, that prizes putting other people's needs before our own. The U.S. is the only industrialized nation without paid parental leave, which means many women work literally up until the time they give birth. We don't have enough time allotted for bereavement or caregiving, which has only become more obvious during the pandemic. And, on the whole, we don't provide the mental health support we need to in our workplaces. I've had patients who do meet the standards to take short or long term disability leave by law, but won't speak up for fear of how their manager might react to an 'invisible' illness. But even though we are expected to work through emotional and physical illnesses until they reach crises, it does not mean it is acceptable. In other words, just because we can do it and survive it, does not mean we do so without scars, and does not mean we should do it that way. Just because that is how it is, or how it has always been, does not mean that it is right.
As we return to our offices, so many of us need to be evaluating what makes us happy and what work environments fit our values and make us feel safe. (For some that may mean not returning in person at all, or even quitting instead). When we see the predictable reaction to Naomi's request for boundaries — the dismissal of her problems — we may question if our own mental health problems are enough. If a professional athlete competing in one of the most high-stakes tournaments in the world doesn't have an "excuse" to tend to their mental health, then who does?
The truth is there is no "right time" to talk about your mental health. If something affects your daily life and how you function, it matters. The time to talk about it is when you want to talk about it and the time to get help is when you want to or are ready to. The cool thing about boundaries is they are yours and they can change. You have the right to assess how you feel and make your own choices. We aren't used to living that way or considering ourselves as part of the equation — and that needs to change.
Ultimately, when you are struggling with something people cannot see, in this case, depression instead of a shoulder injury, some people might assume the worst — that you are faking it or using it as an excuse to get out of something you don't want to be doing. But, just because others can't see it, doesn't mean it isn't real.
The real person who trivialized mental health isn't Osaka, but the people who questioned her in the first place.
Jessi Gold, M.D., M.S., is an assistant professor in the department of psychiatry at Washington University in St. Louis.