We're Not in on the Joke

    I'm sure we've all seen the crime and arrest reports in our local newspaper like, "Man Flees Imaginary Pursuer on College Campus," or something like "Naked Man Arrested for Hiding in Stranger's Car". I'm sure we've also all heard people laugh at those reports and maybe even share them on social media for a laugh. We've probably all also seen the local homeless man talking to himself like he's having a conversation of which we can only hear one side, and I'm sure we've all had someone in the car that cracked some jokes or poked fun at that homeless man. In the celebrity realm, we've probably all seen and heard the jokes made at Britney Spears' and Amanda Bynes' expense after their mental health struggles. Just the other day on Twitter, I saw people retweeting Kanye West as he appeared to be in the middle of a mental health struggle and making jokes at his expense.

    I get it. Bizarre behavior can be funny.  I also know that people have a morbid interest in the "fall" of celebrities, and the more heartbreaking the "fall" is, the funnier it seems to be to those kinds of people.

    As I've seen the way people tend to make jokes and poke fun about "those stupid druggies" from the newspaper arrest reports with titles like the ones I mentioned above, I've wondered if those unkind people are aware that an untreated and/or severe mental health condition usually lurks behind those arrest reports, and drugs may not even be a factor. (Even if it is "just drugs", an addiction is still considered a mental health and public health condition that requires treatment.) When people rejoice in the mental health struggle of "those poor (snickers) celebrities", I wonder if they're aware that mental health conditions don't discriminate based on celebrity status, and that all the money, fame, and general "cool stuff" in the world doesn't make them immune to an imbalance of brain chemicals, just like it doesn't make them immune to cancer. I also wonder if they've forgotten that celebrities are humans with feelings.

    To the people that laugh at and make jokes at the expense of someone who struggles with their mental health...Do you realize that you know someone with a mental health condition? One in five people in the US lives with a mental health condition, so you're probably often in close contact with someone who has a mental health condition. Do you know that publicly laughing at someone who is struggling with mental health and making jokes about it is a big reason that so many people don't go and get the help they need to manage their mental health condition? 

    According to the American Foundation for Suicide Prevention, an average of 132 people commit suicide every day, which is around 48,180 people each year. According to the National Alliance on Mental Health, around 46% of the people who die by suicide each year have a known and treatable mental health condition. (That means those deaths could possibly have been prevented with treatment.) Maybe the way people in our society like to point and laugh at the mentally ill has something to do with why those people felt they couldn't ask for the help they needed and instead lost the battle with their mental health condition. Those crime reports and celebrity downfalls don't seem so funny now, do they?

    Laughing at mental illness is just another way that society has taught us to belittle those that are suffering and tell them that they don't actually matter. It sends the message to those of us with mental health conditions that the thing that literally tries to take our lives still isn't taken seriously. If you wouldn't laugh at or poke fun at someone with cancer, why are you doing it with mental health conditions? Both are deadly. Both cause suffering. So, what's the difference? How is one type of suffering allowed to be funny but laughing at the other type of suffering is forbidden?

    As someone with OCD, I've been in situations where my mental health condition has been made into a joke. I've been in a situation when I was crying because of my anxiety, and someone laughed because the thing I was crying about didn't make sense to them. Like everyone else with a mental health condition that gets turned into a laugh, I was not in on the joke, and I most definitely didn't find anything about the situation funny. 

    I'll end with this: Laughing at or making fun of someone as they struggle with a mental health issue, whether they're a celebrity or not, is never okay. Joking at our expense is yet another way that the mental health stigma keeps people from seeking help. All it takes is a moment to think. Think about how you might feel in a similar situation or how you'd feel if it was a parent or sibling in that situation before you share the "funny" crime report, before you share the "news" article, before you make that "joke" on social media. 

Ideas of Mental Illness

    I still have to have "the talk" with people from time to time. (You know...the conversation about the fact that I have panic disorder and primarily obsessional obsessive-compulsive disorder and what that actually means.) When I tell people that I have clinically diagnosed mental health conditions, their response is usually something along the lines of, "I never would have known if you hadn't told me. You just seem so...normal." (They also usually have the same response when I tell them that I have cerebral palsy.)

    What people always mean by saying that I seem "so normal" is that I don't fit the idea that most people have of a mentally ill person. In my experience, a lot of people tend to only have an idea of the low-functioning side of mental illness. Others have this idea that people that have mental health conditions are generally "eccentric" or "weird", thanks to the portrayal of mental illness in a lot of pop culture. You know, the Johnny Depp level of eccentricity. (I'm not at all saying that Johnny Depp has any mental health conditions, just that he's generally considered to be a bit strange by most people.) Or, the beautifully chaotic and beautifully broken, romanticized version of bipolar disorder that TV shows and movies like to portray that's all intrigue and mystery and quirky and strange in a fun-cool kind of way while the mania is present and then in black and white, and lifeless when the depression is present.

    Sure, there are some people with mental health conditions that do fit those ideas, but a great many people don't realize that those low-functioning and eccentric ideas aren't the whole picture of "mentally ill people". (Side note: a lot of those people also don't really get that eccentricity DOES NOT ALWAYS EQUAL mental illness.) A large number of people that live with mental health conditions are "normal" and high-functioning, meaning that they have jobs and interests and social skills and otherwise healthy, well-adjusted lives.

    According to the National Institute of Mental Health, 1 out of 5 adults in the US lives with a mental health condition. That's around 47 million people! Some of those 47 million are low-functioning because of their mental health condition, and some of them also exhibit eccentric behaviors because of their mental health condition. But...can you see how it's impossible for ALL 47 million of us to fit into just those two categories? So, the whole picture of "mentally ill people" is incomplete without also including the idea that some people are pretty similar to everyone else even though they have a clinical mental health condition. Odds are that if you don't have a mental health condition yourself, you're probably close to someone that does at any given time in your life. Odds are also that you couldn't point that person out (unless they've had "the talk" with you) because they appear to be "so normal". 

    Now, why is that important? Because, many times, people that don't fit into the low-functioning or "weird" categories have a harder time getting people to take their mental health conditions seriously, and that may be a barrier to treatment. It's also important to those of us diagnosed with a mental health condition that society has a broader idea of what mental illness looks like so that once someone is diagnosed, it might make the diagnosis feel less terrifying if we can see a possibility for something more than being permanently low-functioning or the resident (and usually avoided) neighborhood weirdo.

    I'll end with this: You never know who lives with a mental health condition, but odds are, we all probably know someone with a clinical mental health condition. Not everyone with a mental health condition is going to be low-functioning, at least not all the time. Not everyone with a mental health condition will be weird or eccentric. So many of us that live with mental health conditions are pretty much like everyone else, with jobs and healthy relationships and other "normal" things like non-mental health-related hobbies we just also have a chronic health condition that needs monitoring. 

Healing is Active

    I was discussing mental health and therapy with a friend recently. (I know, I talk a lot about mental health with my friends, but we talk about lighter stuff, too, I swear.) They asked me if I thought true healing was actually possible. Of course, my answer was, "Yes, healing is definitely possible..."

    Could you sense the "but" that comes next? Here it is: "Yes, healing is definitely possible, BUT it doesn't just happen." What I mean by that is that healing is not a thing that happens TO you. Healing is a thing that happens BECAUSE of you.

    There seems to be this common misconception about the healing process. Many people think that healing sort of just magically happens after you've been in therapy for so long. People tend to think all you have to do is go to therapy, and then you'll wake up one morning and miraculously be healed from past traumas and unhealthy coping mechanisms. I can see why people think that. Thanks to jump cuts in movies and TV shows, healing looks a bit like a new and improved phase of life that someone just sort of falls into with the passage of time.

    Healing is actually nothing like that. Healing is not a journey in which a person can just sit back and enjoy the ride. Healing is a journey that requires active participation. You have to choose to start that journey and then carefully choose every step you take in order to heal. Like I said, healing doesn't happen TO you as a result of therapy; healing happens BECAUSE of you, BECAUSE of the things you learn and the steps you decide to take.

    Healing takes effort. Your therapist can talk to you about it for years, give you information, give you tools, and do everything that a therapist possibly can to help you, but it won't actually help you heal if you don't take the information to heart, believe it, and then use it. The actual sessions are only part of healing. The other part comes after the hour-long sessions end. That's when you have to choose to use the information and the tools to help yourself. 

   I'm not at all saying that healing will always happen, and it's our own fault when it doesn't happen. I completely understand that there are periods when survival will be the only option, and healing will have to take a backseat. I get that. I still have those periods, and I probably will always have them. During those times, my only priority is making it through that day. It could be DAYS or WEEKS before I can shift out of survival mode and back into a more even state of existence. That's okay. Having those hard times does not mean that all the healing we've worked toward has been undone. 

    Healing does not happen in a linear progression. (My therapist says it's more like a spiral. Which means the bad times and times of healing can and will circle back around time and again.) Healing also is not a phase of life that can be ended for us or a destination from which we can be kicked out. Healing is an active state of existence that we can create around ourselves over and over again.

    I'll end with this: Many people think that healing is a thing that happens TO someone, but healing is actually an active process that happens BECAUSE of someone, BECAUSE of the steps they choose to take on their mental health journey. Mental health management functions in a spiral of bad and good days, which means that those of us with mental health conditions will have times when healing can take place and times when survival mode is activated and healing is paused. That is okay. Don't give up on the hope that you can heal because you continue to have bad days. The bad days don't undo the healing that has already happened.

Reframing Brokenness

    I recently had a friend that also lives with a mental health condition ask me if I thought we (those of us with mental health conditions) were doomed to be broken forever. I haven't stopped thinking about her question ever since she asked. 

    Feeling like you're permanently broken is, quite possibly, one of the worst feelings in the world. I vividly remember what it was like when I felt like I was irreparably broken. I remember being so sure that no one would ever be able to "fix" me. I remember feeling more alone than I've ever felt in my entire life. That was a time in my life when I thought it would be a divine act of mercy if I didn't wake up the next morning. It honestly breaks my heart to think that other people feel the way that I felt a few years ago.

    I even told my therapist that I was "too broken". She was quick to ask me something along the lines of, "If a friend told you they had OCD, depression, anxiety, PTSD, or any other kind of mental health condition, would you think they were broken?" I answered that, of course, I would never think that about them. Then she asked me, "What makes you different? Why do you think you're broken if they aren't?" I sat there in silence because I didn't have an answer. The real answer is this: Unwell brains lie, my friends. 

    I understand that it might be hard to believe me or anybody else when they tell you that you aren't broken. On my worst days I still fight with that lie. On my worst days, in the middle of a panic attack or an OCD obsessive loop, it's so easy to believe the lie and just accept my fate to be permanently broken and to get lost in the darkness and the hopelessness that belief brings. I understand that just accepting the lie as truth is a whole lot easier than the work it takes to haul ourselves back from the edge. I understand that it's easier to let yourself feel broken than to have hope (and then face the possibility of that hope being snatched away) that you might not actually be broken. It's also hard to let go of the idea that you're broken when you've lived with that belief as a piece of who you are for too long, as we often see with those of us that live with an undiagnosed and/or untreated mental health condition. 

    Mental illness does not equal brokenness, no matter what our unwell brains tell us. Having a mental health condition just means that I have a chronic health condition that affects the chemicals in my brain. Like all other chronic health conditions like diabetes and autoimmune disorders, my chronic health condition (AKA my mental health conditions) need assessment, proper treatment, and symptom management. It's a lot easier, in my mind, to live with my mental  health condition and to show myself compassion since I've stopped viewing it as the thing that makes me broken because viewing my mental health condition as the thing that makes me broken has the potential to make me hate my mental health condition and myself. Instead I view it for what it actually is...a chronic health condition that affects my brain.

    I'll end with this: If you're brain is telling you that you're broken it's lying, I promise. There is actually hope with proper treatment and a whole lot of compassion for yourself. Your mental health condition isn't some defect that makes you broken, it's a chronic health condition that affects your brain chemicals just like other "invisible" chronic health conditions affect other areas of the body.

It's Not an Either/Or Situation

    Lately, I've been seeing some things online that tell people with mental health conditions that if they just eat the right foods and make the right lifestyle changes, they won't have to take their psychotropic medications anymore. I've seen things that suggest anxiety can be cured using only meditation. I've seen things on social media that tell people on antidepressants that the only antidepressant they really need is to spend some time outdoors and get some exercise. I find this attitude more than a little troubling. 

   I know there is a stigma associated with mental health in general, and that their is a particular piece of that stigma that tells people they should feel embarrassed or ashamed if they have to take medications to help balance out their brain chemicals. I know, especially recently, with the rise of the "back to the earth" movement among younger generations, natural remedies for ailments are pushed pretty heavily. That's fine. Natural remedies can work for SOME things. What isn't fine is that society treats medication, especially for "invisible" conditions like mental health conditions, and natural remedies as sort of an either/or situation. As in you're either doing things the "wrong" way and taking the medications, or you're doing things the "right" way and stopping the medication for the old-fashioned natural approach.

    Natural remedies, as I said before, can work for SOME things for SOME people. The lifestyle changes and natural remedies can be good for helping manage the day-to-day symptoms of some conditions like anxiety and depression, but they don't treat the underlying issue of the imbalanced brain chemicals. Only medication and therapy can work to treat the underlying issues of imbalanced chemicals and faulty thought patterns that come with the out-of-balance brain chemicals. It isn't an either/or situation. At best it's an AND situation between medication and lifestyle and/or diet changes that a person can afford or is able to make.

    I get it. Many people don't like taking medication every day, especially not if it's something they may have to take for the rest of their life. Psychotropic medications, like all medications, can come with nasty side effects. The trial and error process of finding the most helpful medication in the correct dosage can be tedious and discouraging, especially when someone is in emotional distress or is otherwise significantly impaired by the mental health condition. I also get that medications are expensive. So of course, a great many people will be grasping at whatever could work to get off the medication in favor of something "easier" and less expensive. Of course, if some change or natural remedy worked for you, you might be tempted to push your friends to go off meds and try the thing that worked for you instead.

    But...let me explain why that's not a great idea. Many people need their medications to be functional and to stay alive. No amount of exercise, diet changes, lifestyle changes, or supplements in the world can replace the medication. That is okay. Also, those people, no matter how much they love you and want to make you happy, are not obligated to risk their jobs, mental stability, and lives to try the remedy that worked for you. I know it can be tempting to look for an "easier" (as in easier to access or tolerate or talk about) way to help your brain, but nobody should ever go off their medication unless their psychiatrist tells them it's time to stop the medication. 

    I'll end with this: I know I talk a lot about the lifestyle and diet changes I made to help improve my life with OCD and panic disorder and that I also talk a lot about taking L-theanine and CBD products instead of taking medication. That doesn't make me anti-medication. It should never be medication OR natural remedies, lifestyle changes, and diet changes. It should be medication AND natural remedies, lifestyle changes, and/or diet changes depending on the changes someone is able to make. Lastly, and I can't emphasize this enough, if you are taking medication, PLEASE DO NOT stop your medication in favor of a "more natural approach to treatment" because someone who is not on your mental health team wants you to/because it worked for them/because it's "better"/because it works faster, or any other reason.

The Bad Days

    Often, unless I've been full-on panicking, when my therapist asks me how I am at the beginning of a session, I'll say, "Eh. I'm fine." Then she'll reply, "Like actually fine, or the kind of fine where you're about to tell me all the reasons you're not actually fine?" (A lot of the time it's the second "fine".) 

    I don't like talking about my bad mental health days. Even after four years and eleven months in therapy, my knee-jerk reaction to a bad day is to act like it's a dirty little secret. Part of it is because I'm naturally a very private person. Part of it is because I have a hard time trusting other people with such "valuable ammunition" like information about my bad mental health days. Part of it is still the mental health stigma that is woven into our society, like the unwritten rule in our (American) society that tells us that people aren't going to want to "put up with us" if we show symptoms of a mental health condition. It actually took me a couple of YEARS to be able to tell my best friend when I was having a bad day with my OCD despite the fact that we talk almost every day, because I was afraid she wouldn't want to deal with all my nonsense. (She doesn't think it's nonsense, and she's a good member of my support system.)

    I also had this idea, at the start of my journey with mental health counseling, that once I had spent enough time in therapy that I wouldn't experience bad days any more. I thought I'd go in, work on my OCD, and then my brain would be "fixed" enough so that I wouldn't have any more really bad days. So, you can imagine my frustration when the bad days were still (less frequently) happening one year into therapy, two years in, three years in...I thought I'd be "better" after all that time. I thought healing meant that the bad days would magically disappear. That idea made it feel like I was failing every time I had a bad day, so of course I treated the "failures" like a dirty little secret.

    I have since learned that bad days are a permanent part of living with a chronic health condition, like mental health condition. They may happen less frequently, but at some point, a bad day will happen, and that's okay. A bad mental health day isn't a failure. It's just a bad day, like the days you wake up and the knee you sprained six years ago is aching for some unknown reason, and so you manage the pain as best you can and be extra careful with your knee that day. It doesn't mean you aren't healing properly, it just means that day is one in which you need extra care.

    As permanent events in life with a mental health condition, bad mental health days need to be acknowledged and accepted. Yes, it's unpleasant, but acknowledging that it's happening and that it'll happen again at some point takes away some of the power the bad day has to make you feel even worse about the fact that you're having a bad day. It's just a bad day, not a personal failure or a dirty little secret, and it's only temporary.

    I'll end with this: If you're a very private person, like me, it can be extremely difficult to let people in, especially to be able to talk about anything personal, like the details of a mental health condition. Bad mental health days aren't a dirty little secret or a personal failure. They're a permanent event in life with a mental health condition, and that's okay. Despite what the mental health stigma tells us, it's okay to have bad days and to show symptoms, and it's also okay to talk about it while it's happening or after it happens.

Anxiety Isn't a Code Word

    As someone with two diagnosed anxiety disorders, anxiety is pretty much my constant companion. I check in with my anxiety often so that I'm always mindful of how I'm feeling and treating myself, and I usually manage it pretty well. But, then, there are just some things that happen, or some places, or some people that can be a trigger for my OCD and/or Panic Disorder. 

    As someone with Panic Disorder, crowds, like those we usually find in stores before the holidays, or those generally swarming the streets of Gatlinburg can trigger a panic attack. Over-stimulating environments, like if the environment is really loud or there are a lot of flashing lights, or if people are yelling can trigger a panic attack. Wearing a mask when I go out is also a thing that can trigger a panic attack, as is having a stuffed up nose. (I still wear a mask.)

    As someone with OCD, change of any kind is a huge trigger for me. Any change in my daily routine, and especially bigger changes in my life like moving, cause a spike in anxiety that will then cause a spike in the occurrence and volume of my intrusive thoughts. Even happy changes, like unexpectedly being invited somewhere or unexpectedly having someone I like drop by for a visit is enough to cause a spike in my anxiety, because that is a deviation from the day's routine that I had planned out the day before.

    Here's the thing though: "This is messing with my anxiety," isn't code for, "I don't want to do this" or "I don't like this". Just because something makes me anxious doesn't mean that I don't WANT to do that thing. It doesn't mean that I don't LIKE doing that thing. Just because something could make me anxious doesn't mean that I won't TRY TO ENJOY the thing. Just because I'm anxious when someone drops by for a visit unexpectedly doesn't mean that I don't want to see them or that I don't want them to come over. Sure, I wish they had called or texted first, but, I'm still probably happy to see them. (I'm an introvert, so I'm not above just not opening the door and/or hiding until they leave if I REALLY didn't want to see them. I would also just decline an offer if I didn't want to do something.)

    Here's what that does mean: I may have to work a little bit harder to be able to do the thing. It may take me a little bit to work up to doing whatever the thing is, especially if I've already had a panic attack doing that thing or a similar thing before. (Example: I had a panic attack in the movie theater once, and it took me a couple of months to be able to go back to the movie theater.) I also probably need a small adjustment period to get used to the unexpected change even if it's a nice change. I mean, my brain is more than likely screaming at me, "This wasn't the plan. This feels different. DANGER! ABORT MISSION!" So, I'm going to have to work on quieting that anxious voice, which may take a few minutes. It also means that some days the trigger may feel too intense or my anxiety may already be too high, and I may have to leave or cancel doing whatever thing it was.

    I used to feel guilty, ashamed, or angry when I experienced an OCD spike or had a panic attack when I was TRYING to enjoy something. It almost felt like making excuses to admit that something was negatively affecting my anxiety disorder. I try not to be so unkind to myself these days. I had to stop and recognize that making my mental health a priority was actually listening to my body and acting accordingly. Sometimes, that just means talking to myself with extra compassion and patience while I still try to enjoy a place, event, or people; and sometimes that means recognizing that I need to step away to bring myself back to a better place before I can truly enjoy something or embrace a change in routine.

    I'll end with this: Experiencing mental health symptoms doesn't mean that someone doesn't want or like doing something or being somewhere. It may just mean that someone needs extra compassion and understanding to work through the symptoms or that they need to gracefully bow out this time. That is okay. Saying something is triggering a mental health condition also isn't a code for "I don't want to do/don't like this." No one should feel guilty, ashamed, embarrassed, or angry for prioritizing mental health in this way.