Terms and Conditions Apply

I was talking about mental illness with someone the other day. We were talking about some things I had seen in online forums in which people were saying that they wouldn't want to date someone with disabilities and/or mental illness. Naturally, the conversation turned to whether or not you should tell a potential partner that you have a disability and/or mental illness. 

I know why many of us that live with a disability and/or mental illness are reluctant to disclose that to potential partners. As someone who lives with cerebral palsy as well as OCD and panic disorder, I'm extremely familiar with rejection and the fear of rejection because of those things about myself. There is still a stigma around both disability and mental illness that quietly says we're too much work, and that stigma can make disability and mental illness a deal breaker for some potential partners. However, even knowing that disability and mental illness might be deal breakers for a potential partner, I would still disclose those things about myself as early as possible. 

Sure, it can be scary to tell a potential partner these things because they might decide they no longer want to pursue a relationship with us. But, let's be honest, someone choosing up front not to pursue a relationship with us because of those things is going to be better for us because they obviously wouldn't be able to be as kind and patient as we needed them to be on the bad days, which would have negatively affected our mental health anyway. It's better to let the people that aren't good for us weed themselves out before we're emotionally invested. 

Also, just from a practical point, by keeping our disability and/or mental illness from a potential partner and entering into a relationship with them, we've basically ensured that we're going to have an unpleasant time in that relationship. A partner can't help us or accommodate us if we don't let them know that we need that from them. This is going to possibly put us in danger of ending up in situations that we shouldn't be in or literally can't be in without unpleasant consequences related to our disability or mental health because our partner didn't know about our mental health or disability limitations.

For our partner, when they find out that we live with a disability and/or mental illness that we didn't tell them before they agreed to be in a relationship with us, it could damage the relationship. Finding out that we kept such important information from them like some dirty little secret is likely going to make our partner feel hurt, lied to, and even betrayed and that big secret will more than likely break the trust we've worked to build in the relationship. It may even leave them wondering what other important things we've kept from them.

Each partner needs to be able to give consent to enter into a relationship, like informed consent is required before any procedure or research. A relationship is basically a contract between two people that has terms and conditions that apply (usually called their deal breakers and boundaries). Just like with any contract, people have to know ALL the terms, conditions, and risks of that contract before they enter into it, or the contract is no good. Mental health and disability are part of the terms and conditions that a potential partner needs to know about before they can give the required informed consent to enter into the relationship contract.

I'll end with this: Finding good, healthy relationships can be difficult for everyone, but it can be especially difficult for those of us that live with disability and/or mental illness, which can often make us want to hide those details about ourselves from our potential partners. We really shouldn't hide those things from our potential partners. Giving them all the "terms and conditions" is so important because this allows our partner to give actual informed consent to try out the relationship with us, and it allows us to select a partner who is willing to make the necessary room in the relationship to accommodate our disability and/or our bad mental health days to (hopefully) ensure the relationship is fun and healthy for everyone involved.

It's a Full-Time Job

Most people tend not to think about their mental health until they go through a period of poor mental health. Most people think of mental health as something you only really need to devote any time to managing if something goes wrong. They view mental illness in the same way, meaning that they think you don't really have to devote time to actually managing mental illness unless you're struggling with that mental illness. This isn't really an accurate way to think about managing mental illness or mental health in general.

Managing my mental illness is a full-time job, at least for me. I have to do things every day to manage the symptoms of my OCD and panic disorder. The list of things that I have to do includes making sure I'm getting enough rest, making sure I'm eating the right foods, making sure I'm exercising, making sure I have enough "wiggle room" in my schedule to deal with a sudden unexpected spike in anxiety or a full-on panic attack, and making sure I'm using the healthy management strategies and coping techniques that I've learned in therapy. In addition to that, I also have to keep up with my therapy appointments and make sure I'm working on the things my therapist and I talk about in therapy while I'm between sessions. 

In addition to all the things I mentioned in the previous paragraph, I always have to take my mental illness into account for every decision I make. I have to ask myself, "Will doing X negatively or positively affect my mental health, or is this something I won't know until I try it?" If the answer is that something will negatively affect my mental health, then I can't do that thing no matter how much I want to. If the answer is that I don't know if something will negatively affect my mental health until I try it, I have to ask myself, "Do I currently have the internal resources to be able to safely manage any possible negative mental health consequences if I try this thing?" (Because it's never a good idea to forge ahead with something when you don't have the internal resources to manage the possible negative effects.)

This is EVERY DAY, whether I'm in a period of good or poor mental health and whether or not I'm experiencing symptoms of my mental illness. (I do even more things to manage my mental health on the bad days.) This isn't something I can take a day off from or only do when I feel like it. (And, yes, managing my mental health and being a paralegal can feel like I have a full plate depending on how well I'm doing with my mental health. It's like having two jobs at the same time.)

When I don't treat managing my mental health like the full-time job that it is, I always regret it. When I don't do the things that I need to do every day to manage my mental health, I don't function at the level that I consider to be my normal. I experience more spikes in the symptoms of my mental illness, and I end up existing in survival mode. I can lose days and even weeks in a blur of anxiety, panic, and unhealthy spirals. I'm also unable to be fully present in my life and my relationships with other people because nobody can be fully present in the external world when they're literally fighting to survive their internal world.

I know it can sound daunting when I refer to managing my mental health as a full-time job. It may even seem tedious to have to think about this THING every day and do stuff so this THING doesn't severely impact your ability to thrive and fully experience life. But...we all deserve to live as fully and as happily as we can, and we deserve to be able to be fully present in our lives as often as we can instead of just surviving. 

I'll end with this: People tend to think about managing their mental health as more of an occasional hobby instead of a full-time pursuit. This isn't a good way to think about managing your mental health for anyone, but it's an especially bad way to think about managing your mental health when you live with mental illness. A mental illness that you don't work on or think about until it's interfering with your ability to function can derail your whole life for months or even years. Adequately managing mental illness so that you're not constantly fighting to survive it requires work EVERY DAY, like it's a full-time job.

If You Don't Love Yourself

I know we've probably all heard the saying, "Nobody will love you if you don't love yourself." It's been around for longer than I've been alive, I'm sure, and at this point, it's viewed as good advice to people who are having trouble finding love and/or maintaining healthy relationships. I've heard it in movies. I've seen it in books. I see it online a lot.

Those of us that live with mental illness, trauma, and who have survived abuse or bullying know how impossible it can feel for us to love ourselves. All of these kinds of things that we live through can make us hate ourselves because we feel that we're "broken" or we're "damaged" or we're "worthless." Mental illness can literally tell us we're so terrible that we SHOULD hate ourselves. 

As someone who has lived with a mental illness for my entire adult life, and as someone who has only recently gotten to a place where I can say that I LIKE myself and truly mean it, the above-mentioned statement has always felt more like a judgement than an actual useful piece of advice. It almost feels like the statement is telling me that because I'm unable to love myself, then that means that I don't deserve to be loved by anyone else either. When the reason someone is unable to love themselves is something outside of our control like a mental illness, trauma, or some kind of abuse, the idea that nobody will love us if we don't love ourselves can be particularly damaging. It can support the faulty belief that we're inherently unlovable and that, even if someone tries to love us, we don't deserve it.

It took me so many years to get to a place in my healing journey to be able to see that the above-mentioned statement isn't the useful piece of truthful advice that people think it is. What it actually is, is a myth that needs to be debunked. 

Family, friends, and romantic partners can and do love their loved ones that don't love themselves. They often love them in spite of the fact that they don't love themselves. They love them because they can see all the good bits that people who don't love themselves have been conditioned not to see. They love them because humans are inherently loveable. 

The above-mentioned statement gets something wrong about love, to me. What it gets wrong is the transformative, healing nature of (healthy) love. It's the love we receive from others, especially the love we receive when we feel broken, damaged, or worthless because of our mental illness, our trauma, or the past abuse that we survived, that can help us on our journey of healing. It's that love that isn't conditional on our (self-assessed) worthiness or wholeness that can help us see that we deserve to love ourselves as much as these other people are choosing to love us.

I'll end with this: We should all be able to love ourselves, but, boy, do I know how hard that is to actually do, especially if we live with mental illness, have been through trauma, or have been abused or bullied. When we don't love ourselves, it can be hard to believe that someone else might love us, especially with the statement, "Nobody will love you if you don't love yourself," weaved into society like a mantra. But...that statement is a myth. People can and do love us (in a healthy way), often in spite of the fact that we don't love ourselves, and it's that love that isn't conditional on our (self-assessed) worthiness and wholeness that can help us heal so we can grow into loving ourselves. And remember, even when you don't love yourself, you still deserve love from yourself and from other people, no matter what your mentally ill, traumatized, or abused brain tells you.

I'm Not Qualified for That

 I have an undergraduate psychology degree AND I live with clinically diagnosed OCD and panic disorder. When people find out these facts about me, many of them will ask some variation of the question, "Can you diagnose someone for me?" Sometimes it's asked in the way people often ask someone who is fluent in another language to say something on the spot, like asking a person to showcase an interesting talent just for fun. Other times, it comes from a place of legitimate concern for the person they're asking me to diagnose. Sometimes, they're asking for themselves, to figure out if they have one of the mental illnesses that I have.

I'm not qualified to diagnose anyone with mental illness just because I have an undergraduate degree in psychology. In order to diagnose someone with mental illness, I would need to have an advanced degree like a master's degree, Ph.D. or even a Psy.D. in clinical social work, clinical psychology, or mental health counseling with a certain (VERY LARGE) number of hours practicing clinical mental health counseling under the supervision of a licensed mental health professional to obtain a license to practice. It would be unethical for me to diagnose anyone without having the required experience and credentials. 

Living with mental illness also doesn't give me the required expertise to diagnose anyone. I only have knowledge of what mental illness is like FOR ME. Other people with the same mental illness will have a different experience. Additionally, some people don't fit with the traditional symptom outline of a condition, which only a mental health professional would be able to figure out. Saying whether or not someone has a mental illness just based on my personal experience with that mental illness would be wildly inaccurate and unethical at best and disastrously alienating to someone at worst.

Another reason I wouldn't diagnose someone else with a mental illness is because, for the person on the receiving end of the observation and diagnosis, it can be breach of trust and a boundary violation for them if they weren't the one asking for the diagnosis. Nobody should be discussing anybody else's mental health without their consent. Nobody should be observing someone else without their knowledge and consent so they can then discuss whether or not the person in question has a mental illness with that person's friends or family. 

Diagnosing someone with a mental illness is a serious thing. It's not a party trick, a nice bit of gossip, or something people should be speculating about. Speculating about the PRIVATE matter of someone's mental health and whether or not they have a mental illness can have a profound effect on the person's self-esteem, their self-worth, and their ability to trust other with sensitive information. It can also affect a person's relationships, employment, and quality of life if the speculations make their way around someone's work or social circle as fact.

I'll end with this: Just because I have an undergraduate degree in psychology and live with clinically diagnosed mental illness does not mean that I am qualified to observe and diagnose other people's mental health conditions. Only an actual mental health professional with an advanced degree, a set number of supervised counseling hours, and a license to practice mental health counseling should be diagnosing mental illness. It's also a breach of trust and a boundary violation to discuss someone's mental health and/or attempt to diagnose someone with a mental illness without their knowledge and consent, even if you mean well.

The Other Part of Prevention

*TRIGGER WARNING: Mentions of suicidal ideation and suicide.*

When society as whole focuses its attention on suicide prevention, like right now, for Suicide Prevention Awareness Month, it tends to focus on only one part of suicide prevention. Society likes to treat suicide like some tragic, unexpected event that's pretty much only associated with mental illness. Treating suicide this way makes society as a whole tend to only focus on the human connection and emotional support aspect of suicide prevention. Society stresses that we should all check in with our loved ones, that we should make sure people know they aren't alone, that we should make sure everyone knows that they matter, and to make sure we destigmatize mental illness so that everyone knows it's okay to "get help." (The definition of "help" meant by society in this instance is only mental health treatment.)

These things are great, and they DO help some people who are struggling with suicidal ideation and who are fully suicidal, but just doing those things isn't going to prevent every suicidal person from following through. In order to truly prevent suicide, we, as a society need to do a better job at fixing the underlying issue that is causing someone to be suicidal in the first place, because people can be suicidal for a reason that doesn't have anything to do with mental illness.

Some people are suicidal because they don't have access to housing. Some people are suicidal because they don't have access to adequate food for themselves and their family. Some people are suicidal because they don't have access to a certain type of healthcare (including gender-affirming treatments, abortions, and substance abuse treatment) and/or medications that they need. Some people are suicidal because they don't have access to services to help them with a school-related issue. Some people are suicidal because they can't find work. Some people are suicidal because they're trapped in an abusive relationship with no way out without some kind of assistance. Some people are suicidal because they're trapped in poverty.

The other part of suicide prevention that society leaves out (probably so nobody has to acknowledge that suicide isn't just a tragic event that only affects the mentally ill and is often related to lack of access to resources and society/government shortcomings when it comes to helping people meet even their basic needs), is that IN  ADDITION TO emotional support, people often need some type of tangible support or help from a service like social services or government programs in order to fix the underlying issue that makes life unlivable. At the very least, people need someone (friends/family/volunteer community workers/social workers) to help facilitate access to the things that would fix the reason life felt unlivable for them. If people are treated in in-patient facilities and improve there, but then they're just plopped back out into the same situation with the same underlying issue that made them suicidal with no access to the thing that fixes the underlying issue, then, society hasn't done all it needs to in order to prevent that person's suicide. 

When I was struggling with suicidal ideation, everyone did everything that the pamphlets and websites told them they were supposed to do to help someone in my situation. I went to the ER and was evaluated by a crisis counselor. People were extra kind to me, and they made sure I knew they loved me. My mom took FMLA leave from work when I needed her. Then when she had to go back to work, she had other people come and sit with me so that I was never alone at home. Yes, I'm grateful for these things, and they made me feel safe at a time when I was terrified...but these things aren't what actually saved my life. 

What actually saved my life was a phone call. My mom talked to a family friend about what was going on with me. This friend had a good professional relationship with some mental health professionals that I had tried and failed to gain access to on my own. This friend made one phone call, and I had an appointment the very next week with that therapist that I hadn't previously had access to. (Thank you for helping save my life, Candice.) If my friend hadn't made that phone call and connected me to someone that helped the actual reason that I was dealing with suicidal ideation, I probably wouldn't be here today, even though, according to society, my support system was doing everything "right" to make sure I remained alive. 

There was a reason that life felt unlivable for me. I was in therapy, but the kind of therapy I was in was not working for me, but it was all I had access to. I needed access to a different kind of mental health treatment that I had tried and failed to gain access to. All of the kindness, check ins, and the emotional support weren't going to fix the reason I was dealing with suicidal ideation, because the only thing that could fix that was access to the treatment I needed. 

I know I was one of the lucky ones because all it took was a phone call from a friend to help me access what I needed to survive. This is actually how all of society should function when it comes to suicide prevention, though. Nobody should have to be lucky to have what they need to no longer be suicidal.

I'll end with this: Suicide prevention is more than just making sure someone has human connection, knows they're loved, and has emotional support. Suicide prevention is access to resources and services that actually treat or fix the reason someone feels like life is unlivable. Sometimes that reason is mental illness, but a lot of other times that reason is related to reality-based problems like lack of access to housing, healthcare, food, education, and other societal issues.

Make it Funny

I use humor as a way to cope with my mental illness. What I mean when I say I use humor to cope with my mental illness is that I make jokes about what my life with mental illness is like. I make jokes about using the CBD products to manage my symptoms. I make jokes about the other management strategies and coping techniques that I pull out of my Mary Poppins-style bag of tools. I also make jokes about the emotions that often come with trying to live my best life in spite of the mental illness like the anger, the frustration, and the impatience. Sometimes, I even try my best to make my intrusive thoughts seem as ridiculous as possible so I can really play up the fact that they aren't based in reality so I can file them away more easily.

It's okay that I am the one making jokes about my life with mental illness. It's not okay when other people make jokes about my life or anyone else's life with mental illness. For me, it's not even really okay when other people repeat my own joke about my mental illness to someone else. It's also not okay for me to make jokes about anyone else's life with mental illness even if they're doing it, but I can laugh with them.

Making jokes about my life with mental illness is a coping strategy because mental illness is a dark, heavy thing to live with, and the moments when I can find something about it to laugh about make it a little lighter and take away a tiny bit of the power that it can feel like the mental illness has over my life. When other people make jokes about someone else's life with mental illness, it usually isn't to help that person cope. It's often at the expense of that person, in an attempt to belittle the fact that they're struggling with something the person making the joke doesn't believe is a real, life-threatening condition. That's why it's okay for mentally ill people to make jokes about their own life with mental illness but it's not okay for other people to do the same thing. 

When I'm making jokes about my mental illness and the way I live my life with it, my intent isn't to cause harm. My intent is to prove to myself that I can find a break in the suffering to laugh. If I can find that one break, then I know I can hang in there because, surely, there will be more breaks in the suffering in which I can find something to laugh about. If I can just survive, one bright moment of laughter at a time during the periods of struggling with my mental illness, then I know that the struggling will eventually end, and I'll be able to find my way back to a happier, healthier place again. 

I feel like I should make a distinction. While I use humor as a coping strategy, I'm not flippant about my mental illness. I still give it the proper seriousness, compassion, and treatment it deserves when required. Humor isn't a replacement for actual treatment, and "laughing off" signs or symptoms of a possible issue with your mental health is not the same thing as using humor to cope with a mental health condition. 

I'll end with this: Using humor is a pretty common way that humans cope with unpleasant things, and a mental health condition is no exception to that coping strategy. Laughing in the midst of the suffering is often the only way people can find the strength and the will to keep hanging in there until they can find their way back to a healthier place. It's okay if someone with mental illness makes jokes about their mental illness and the way they live with it. It's not okay if someone else makes jokes about someone else's mental illness or their life with said mental illness.

I Don't Have the Mental Space for This

Recently, I've had some extra things going on in my life in addition to work, the continued pandemic, and generally living with and managing my mental illness. As a result of those extra things, I've found myself blatantly refusing to take on more things. As an example, recently in a work-related situation, I had to tell someone, "I just can't do this for you. I don't have the mental space to be able to do this right now." I'm also feeling less social most days because I lack the mental space and energy to engage with more people than I'm required to for work. (And, yes, I feel guilty for having to tell people that I don't have the mental space to do what they're used to or what they want me to do even though my therapist is reminding me to make sure I'm being extra kind and compassionate with myself right now.)

A lot of the time, when we have to tell a loved one or anyone else, "I'm sorry, I just don't have the mental space for this right now," the other person feels stung. This is never our intention, but I get it. When we say we don't have the mental space for something it can feel like we're saying, "I don't feel like dealing with you right now." Or, "You're exhausting." Or, "I'm tired of hearing about X, Y, or Z." Or even, "I don't care about your problem."

Despite the fact that saying, "I don't have the mental space for this," is often negatively perceived, we don't mean it as a more polite way of saying any of the things in the previous paragraph. What the statement generally means is that we're feeling overwhelmed with some things that are happening internally, externally, or both at the same time. It can mean that we need to devote all our mental energy to making it to the end of a project for school or work. It can mean that we're using all of our available resources to survive a physical or mental health crisis (maybe ours or someone else's) or a mental health spiral if we have a mental health condition. It can mean that we're exhausted and need to recharge by engaging in extra self-care. Once we've survived what we need to survive or handled whatever it was that was taking up all of our extra mental space, then we'll come back around to help loved ones with the remaining things that we didn't have the space to help with before.

I also feel like I should make sure we all know that saying, "I don't have the mental space for this," doesn't mean we're lazy. It means we're recognizing our limit and doing what we need to do to care for ourselves. Realizing that you can't take something on and then giving yourself permission not to go ahead and pick it up anyway is a healthy response. (And, yes, this is a reminder for me as much as for everyone else.)

I'll end with this: Saying, "I don't have the mental space for this" isn't a more polite way to let someone know that you don't want to deal with them, find them exhausting, or don't care about their problems. Saying, "I don't have them mental space for this" actually means what it says. It means we're overwhelmed with things that are going on internally, externally, or both and we don't have any more room in our minds to pick up any new things that we have to think about or worry about. It's also healthy for everyone to recognize when they've reached their limit and to allow themselves to say, "I don't have the mental space for this right now."