Writer/comedian Sara Benincasa: ‘My aim is singular: to dispel stigma around mental healthcare’

At 7 p.m. on Tuesday, Sept. 19th, author and comedian Sara Benincasa will deliver the keynote address at the Iowa State University Mental Health Expo. Benincasa will discuss her experiences dealing with a major mental health crisis she faced as college student and the ways in which it impacted her life.

Known for her candor, self-deprecating humor and thoughtful analysis, Benincasa is a vocal proponent of accessible, affordable mental healthcare. Little Village recently spoke with Benincasa about her ISU lecture and how she manages to maintain her own mental health while leading such a creative and productive life.

I was trying to come up with a title for what it is you do, specifically, but your interests and skills are so broad-based that it was a challenge. What title(s) do you prefer?

I’m a writer, first and foremost. I’ve written jokes, books, scripts, articles, opinion essays, (bad) poetry, marketing copy and more. I did stand-up for years, and I still do storytelling from time to time. I speak at colleges and universities, and I love that. But I started as a writer.

Your style of comedy is very open, self-deprecating and honest. You’re willing to expose a lot about yourself in order to connect with your audience in a meaningful way. What are the pros and cons of this kind of blurred performer-audience relationship?

To me it’s not a blurred relationship at all. I share some things others might not and hope my voice comes across as warm and personable, but it’s all an effort to make people feel less alone as I entertain them. That doesn’t mean anyone is invited to be my friend or to truly get to know me unless I specifically extend a private, personal invitation. I get annoyed some people don’t respect boundaries, but a long time ago I came to understand that I’m not a real human to some of them.

It’s on me to engage as I wish and to set appropriate boundaries where necessary. It’s important to recognize that one can’t be “nice” all the time. Women are typically encouraged to always be sweet and smile. Wisdom comes when you start saying “no” and occasionally employ more colorful language to put up a bright red stop sign.

You talk very openly about your struggle with agoraphobia. On a number of occasions you’ve mentioned that the literal definition of agoraphobia is: “fear of the mall.” That line always makes me laugh as it reminds me of Dawn of the Dead. In all seriousness, can you briefly define what agoraphobia is and how it manifested in your life?

“Agora” means marketplace and “phobia” means fear, hence the genesis of that joke. Typically agoraphobia has to do with a fear of a loss of control, so one restricts one’s daily movements. At its most severe, one may refuse to leave a room. But along that spectrum you have people who won’t leave their house, yard, neighborhood, city, etc. I’ve been everywhere on that spectrum. Some people benefit from cognitive behavioral therapy (CBT). Others use medication or other methods. For me it’s been a combination of CBT, meditation, medication, proper sleep and nutrition. Over time you find “your recipe” as my mom calls it.

When did you start giving mental health lectures? What does a typical Sara Benincasa lecture consist of?

I’ve been doing this since 2009. I’d compare it to a TED talk — informative but entertaining. My aim is singular: to dispel stigma around mental healthcare. I want students to walk away feeling less afraid to ask for help and to feel less judgmental if their friends or family members see a therapist or enter a recovery program. It’s definitely more serious than my comedy, but there will be some laughs in there too.

I never mock anyone’s condition, but I sometimes make fun of myself for my ridiculous choices in life. I talk about stresses they may encounter in college. Then I share my own story, which involves dropping out due to mental illness and learning how to ask for help. I talk about the fact that help is available and that you’re not weak or a loser for asking for help. I talk about how we are responsible for our own choices, and we can’t cure a friend. A shoulder to lean on is fine; your whole body is not. Conversely, your friends can’t “fix” you. In fact, you don’t need to be fixed. It is on you to ask for help, to advocate for yourself as best you can, and to not give up when you don’t get the answers you want immediately. That’s very tough.

Can you talk about the importance of friends and family as they relate to mental health? Do you have any advice for those who might not have a strong support system? What does one need to do in order to accept help/treatment for mental health issues?

I was and am enormously fortunate to have a support system and to have money to pay for professionals. When I had a nervous breakdown and needed a lot of care in my early twenties, my parents had money to cover it and they didn’t need a break on cost. I’ve benefited from a sliding scale as an adult at times when my income was low. Doctors, counselors and social workers deserve to make a good living and it seems to me quite fair to offer a sliding scale to those who can prove their income is lower.

My general recommendations begin with the dire emergencies. If you fear you will hurt yourself or someone else, call 911. Check out the National Suicide Prevention Lifeline or the Rape Abuse and Incest National Network (RAINN). If you are fortunate enough to attend a school with counseling resources, seek them out. If you work at a company that provides confidential employee counseling, seek it out. You can’t pray away mental illness. You can’t think it away, meditate it away, or wish it away. Prayer, positive affirmations and meditation can be extraordinarily helpful but they do not substitute for the actual medical care you need.

Are you at a point where mental health care is just routine maintenance for you or do you still feel like it’s a battle? Do you ever worry your agoraphobia might return? Is it necessary to have a plan in place for such a possibility?

Routine maintenance, but I have bouts with really dark depression at times. I did earlier this year. But I’m so used to it that I was able to ask for help promptly and begin seeing a talk therapist without missing work. This time, I also saw a nutritionist who helped me lower my caffeine and sugar intake and raise my intake of fresh fruits and vegetables. With her help, I tracked what I ate and came to see how certain foods affected me negatively and made it tougher for me to sleep. Sleep is so important for those with mental illness, so this was revelatory. Eventually I decided to go back on a small dose of Prozac after about a year off it. I began a meditation practice too. So yes, it helps a lot to have a plan in place.

How do you ground yourself both personally and professionally?

I make sure to see people at least once a day, because it is very easy for me to fall into my old habits of staying at home and inside my own head. Being out and around people is very important for me because the lure of self-isolation is strong. Obviously a day alone here or there is wonderful but I’ve got to incorporate communication with others. I know this sounds quite obvious, but when you live in a brain that sometimes tells you just to stay alone, it can be quite addictive. I work from home right now so that makes it even more important for me to get myself out to a public space and write.

At one point in your 2012 book Agorafabulous you mention being “too busy to panic.” What role does being active in one’s professional, academic and personal life play in mental health? Conversely, are there traps that can exacerbate mental health struggles?

I think overwork is a problem, as is stuffing one’s day full of activities simply to avoid hearing one’s own thoughts. However, being idle and just contemplating one’s troubles all day long is not good either. For me, a routine is very helpful. If I’ve got this unruly brain, I may as well give it some structured activity. So ideally, I get out of bed at 6:30 a.m., I sit and meditate for ten minutes using a guided meditation app, I get up and brush my teeth and take my Prozac and drink water, I go about my work. I text friends, try to see a person I enjoy, and get a walk in. I do one thing just for fun having nothing to do with work. I put away my electronics a half hour before I get into bed. I sleep seven-to-nine hours. Not all of this happens every day. But if I do some of it every day, I usually feel pretty good.

How have your mental health issues impacted your social and dating life? Do you forewarn friends or romantic partners about your struggles? Do you have any advice for people who are currently struggling with mental health concerns on how to manage social and dating situations?

I am very Googleable so there’s a lot out of there. Some of it pleases me, some of it doesn’t. If somebody wants to get to know me, they’ve got plenty of info at their disposal. If they’re still interested, cool. If not, we aren’t supposed to be together. I’d be upfront when it feels appropriate. You don’t have to spill it all on the first date.

If somebody does not wish to date you because of your [mental health] history or anything else, well, that’s their deal. Move along. Plenty of folks I know who struggle with these things find someone to love and be loved by in return.

In Agorafabulous you mention having extreme anxiety from a very young age. What age is it appropriate to begin mental health treatment? In hindsight, do you wish you’d been able to see a therapist when you were a child?

I’d say early good intervention is great but there are those who abuse children with mental illness, so just any intervention is not right. People who push medication are jerks to be avoided. A complementary approach is a fine one, combining conventional therapies with those regarded as alternative. Ideally, every child deserves a complete evaluation incorporating multiple appropriate therapies by ethical providers. Most often kids get a piecemeal approach.

I wish I’d learned earlier that feelings are not facts and that they pass. I wish I’d learned self-soothing techniques like breathing rituals. Those things would’ve been very helpful. And I wish I’d incorporated exercise into my life earlier.

When was the last time you had a panic attack?

I honestly can’t remember. Isn’t that great? But I haven’t had my last one, I’m sure. They happen now and again. They could happen on the way to Iowa! Or in Iowa! Which would be hilarious in a sense, but I’d be able to talk about it to the students. Thankfully, I know a bunch of breathing and visualization techniques and I have Xanax if all else fails.

If you could directly communicate with readers currently suffering from untreated mental health issues, what would you say to them?

I’d say, “I believe in you. There is help out there. The first thing to do is ask for help. It might take a little while to find but you will find it and you will succeed in ways you’ve never imagined.”