Navigating the Mental Health Field as a Highly Sensitive Person (HSP)

some observations about the nature of depression as a TMS (transcranial magnetic stimulation) technician

I’ve recently discovered what it means to be a highly sensitive person. It is characterized as a personality trait that about 15-20% of the population possess. It can manifest in a multitude of physical ways such as being overwhelmed by bright lights or sounds and emotional ways such as feeling someone else’s grief as if it were your own. But in essence, HSPs tend to process external and internal stimuli more deeply than most people.

It takes a certain level of understanding to be able to work in mental health settings. If you take anything personally, you will not survive the pressure for very long. It is easy to say but emotional contagion is real and acts like airdropping a photo but instead it is an emotional state. For most sensitive people, this is inherent to their daily experience of life.

One of my newer patients came in the first day with a very flat affect. I noticed several cues off the bat. They would not reveal anything unless provoked. Their communication was very dry. I had to pry information about the pain they were experiencing from the stimulation intensity. Thankfully, I learned these things early which has helped me communicate with them in a specific way that meets their needs. My goal is to make sure the treatment is as comfortable as possible. After dealing with previous patients who were talkative and rather warm with me, speaking with this patient was a stark contrast. It was challenging at first because I couldn’t help but feel all of their energy in the room.

However one day, something shifted once they brought their significant other in to watch in on a session. I got to see a little more into their world. This individual was very emotionally intelligent and sweet. I knew instantly and without a doubt that their presence was a positive influence in the patient’s life. They communicated with me the whole treatment about the small things they noticed about the patient’s improvements. It’s a gift to have these sorts of people in your life who are looking out for your well being and pointing out the details that you may not register quite yet. Just because you don’t feel it yourself doesn’t mean progress isn’t always underway.

Then, they mentioned that after treatment one day the patient went to the store to pick up gardening supplies for their project that has been in the works for months. This was a big deal in their partner’s eyes because the patient hadn’t had the motivation for tasks like this. This is a prime example of the complexity of depression. Contrary to popular belief, it is not just a persistent low mood. Depression impairs many areas of our cognition. The prefrontal cortex is associated with planning, decision making and motivation. How can we make good decisions if we don’t physically have the capacity and resources to do so?

Their partner also noted that they had shown more emotions when they’ve both watched shows and movies lately. To the average person, this might not mean much. But to me, hearing about these small wins meant everything. I wasn’t able to get any information from the patient up until then and they even reinforced that there weren’t any changes to personally report. When I told their partner I was interested in gardening as well but was overwhelmed by the process, they gave me the best advice there is: start small.

As behavioral health technicians, we have to do a lot of troubleshooting on the job. Not everything is cut and dry. It is all revolved around getting better and seeing results--everything else is trivial. With my observations, I make suggestions to the psychiatrist on site and we work together to solve problems. In this case, he was having trouble with constant headaches and I hypothesized that it had to do with the way his neck was situated in the chair. So, we did a re-mapping and I made sure to work with him to find better chair settings even if that meant starting from scratch in terms of mapping the brain. Fortunately, that work paid off. His head pain has sinced decreased and is now non-existent.

When he came in the other day and I got him from the waiting room, I could tell from the first few seconds that there was a slight smile on his face. It wasn’t huge and you could miss it if you didn’t pay attention. But it was there. He always had a blank expression and I could tell he despised answering my routine question of, “How’s it going today?” Being sensitive, I feel I pick up on everything. And I was right! When screening him, he said, “I woke up in a good mood today.” I can’t tell you how stunned I was. That was incredible news.

With depression, day after day things can feel monotonous. Dreadful even. It feels never ending, until one day, it’s not. This anecdote alone is proof. Focus on the small wins. When everything is overwhelming, pick the smallest positive thing about your day and meditate on it as long as you can. Sometimes we take in so much information daily, take on so much negative energy from others that we are left on low battery, desperately needing a recharge. But we can’t even muster up the energy to help ourselves. But one thing that we can do is zoom in, not out. The big picture can be too overwhelming. Dwelling on the past and the future and how we can make meaning from everything that has been going on in our lives is too much to process when we are just trying to survive our fragile emotional states. Zoom in. Was it a stranger's smile that gave you a warm fuzzy feeling today? Was it a beautiful, rare flower on someone’s lawn? Was it the presence of a beloved animal? Ultimately, you get to choose what you notice. :)