I'm Still Here

    I remember when I first started my weekly sessions with my current therapist. I remember how terrified I was, how hard life felt, and how hard it felt like I was fighting just to be functional ALL THE TIME. I would go to my appointment some days and cry through the entire session. I would tell her how weak I thought I was, how I wished I could be stronger, and express my worries about whether or not I'd be able to survive my OCD. Her response was always the same, "You've done a great job surviving so far. You're still here. So, that tells me that you can survive this time, too."

    At the time, I always felt like my therapist had more faith in me than I had in myself. I was so sure that she thought I was stronger than I actually was. I didn't understand how she could be so sure of my survival when I couldn't be sure. She was also so sure that I could get back to a higher level of functioning and be "better", even when I doubted that I'd ever get there. (That didn't mean I wouldn't work really hard. It just meant that I had my doubts, but that I'd do my best anyway in the hope that she was right.)

    A realization hit me the other night as I was trying to fall asleep. I'm still here, and my therapist was right. Another year is coming to an end, and I'm still here. Right now, I'm in the place in my life that my therapist repeatedly assured me that I could get to. I've made it to the place in my life that I doubted I'd ever see, the place I hoped for. I remember the times I prayed to reach this point, the point where I was no longer fighting so hard all the time just to be functional, the point where I no longer questioned my ability to survive against my own mind, where I felt like myself again. I'm there, right now. Realizing that feels weird in a good way. (Sure, I still have rough patches, but I no longer doubt my ability to survive them.) I just...needed to take a moment to acknowledge that progress and the hard work that went into it. 

    I'm not even just surviving anymore. I feel like I'm thriving more often than not. I feel like an actual person instead of a pit of darkness, anxiety, and despair clothed in human skin. I have sessions with my therapist every two weeks now instead of every week, and I feel good with that. (As in I don't feel like I NEED to talk to her every week to be okay.) I have friends, and I actually feel like I deserve them. I also don't feel like I need to keep people at a distance anymore to protect them, which is nice. (It's nice to let people in sometimes.) I got to experience having my dream job. I've reached "okay", and then I moseyed on past it to something more than just being okay. I feel...grateful to have made it this far, especially when I doubted that I could make it this far in the first place.

    I'll end with this: It's so easy when we live with mental illness to feel like we'll never get better, never be okay, and that we'll never feel like ourselves again. It's so easy to listen to our mental illness and start to believe that we're actually too weak and afraid to "win" against our own minds. It's easy to just want to give up. I've been there. Before anything could improve, I had to find the right therapist with the right therapeutic approach, and then I had to give it time to work. I had to trust my therapist. As much as I hate clichés, it actually does get better, I promise. You just have to still be here to give it a chance to get better. You're stronger than you think you are, I promise.

The Monster in My Head

     Most of my life has been controlled by my mental health conditions. Before my diagnosis, my OCD made me believe that only certain things were safe and okay. After my diagnosis, I found myself walking on eggshells most of the time because I didn't want to upset the delicate balance I had achieved with my mental health conditions. I was overly cautious to the point of being avoidant because I was afraid that something, anything or everything might cause a panic attack or an OCD spiral, even when something hadn't been a trigger for either of my conditions before. In other words, I treated my mental health conditions like the big, scary monsters under the bed that might jump out and grab me at any time if I stepped even one toe out of my carefully defined safety area.

    Until about 3 years ago, I was afraid to think about my mental health conditions. I was afraid to talk about my mental health conditions a lot. I was even afraid to read past journal entries in which I wrote about my mental health struggles. I was terrified that doing any of those things would bring forth my symptoms. I had worked (and was still working) so hard to be "okay" that I didn't want to do anything that might be considered angering the beast, so to speak.

    Checking in with your mental health, making sure that you're aware of how things are affecting your mental health, and being mindful of your triggers are all great things to do. Those things are crucial to having a good co-existence with your mental health condition(s) and having a self-care routine that actually helps. 

    However, being so cautious that you become avoidant because you're AFRAID of your mental health condition and its symptoms, like I was, is not checking in and being mindful. Tiptoeing around your mental health condition because you're afraid of causing symptoms to occur is actually a thing that creates MORE space in your mind for your mental health condition to run amuck, because in tiptoeing around it, you spend a lot more time thinking and worrying about it than you would if you weren't being so careful of it. So, the more time you spend fearfully thinking about it and worrying about it, the more space you create in your mind for the things you're afraid of to happen. By being afraid of my OCD and panic disorder I was actually making them worse.

   Instead of greeting my symptoms with fear and trying to fight them off like a wild animal fighting to escape a predator, I had to learn to just say, "Okay, this is happening. I don't like that it's happening, but I'm still going to be okay. I know how this is going to go, and I don't need to be afraid." (I worked on this as part of regular cognitive-behavioral therapy practice and with ERP. Yes, it was unpleasant, but it was so worth it.) Over time, the fear I associated with my mental health conditions and what they were "going to do to me" lessened until I noticed I was no longer actually living in fear of my own mind. When I stopped being afraid of my mental health conditions, that's when I could fully engage in the self-care and healing part of my wellness journey.

     It's impossible to make peace with something and to non-judgmentally allow it to be present when you're afraid of it. I had to stop viewing my mental health conditions as the terrifying monsters that lived in my head, and I had to learn to view them for what they actually were: chronic health conditions. Since there isn't a cure (in the truest sense of the word) for mental health conditions, I'll be living with mine as peacefully as possible or as miserably as possible for the rest of my life, depending on the way I interact with them.

    I'll end with this: Having a mental health condition and experiencing symptoms is scary, but that doesn't mean that tiptoeing around it and being afraid to "anger the beast" inside your mind is the answer. That also doesn't mean that your mental illness is a monster that lives in your brain that you have to pretend isn't there to keep it from jumping out at you. You'll never have peace that way. I had to learn, with the help of my therapist, to stop fearing my symptoms and to view them non-judgmentally as a thing that happens when I live life with a chronic health condition before I could make peace with my funky brain.

The Other Half of Forgiveness

    It seems like people are always urging forgiveness, doesn't it? Forgive anybody who may have hurt you or done you any kind of wrong. Forgive them even if they don't ask for it or deserve it. Forgive them because they may not even know or understand that they have hurt you. Forgive because holding onto grudges, anger, and other negative feelings only actually hurts you in the long run. 

    People love the idea of forgiveness, but they only ever really talk about half of it. Half of forgiveness is forgiving other people, and, yes, that's really important. Forgiving yourself is the other half of forgiveness that gets ignored a lot, but it's just as important, if not slightly more important, especially for those of us that live with a mental health condition or have endured some kind of trauma.

    If there is one thing that I've learned about life with a mental illness it's that it involves a lot of forgiveness. This is a point that my therapist really emphasized with me in the early days of my time with her. I would be guilt-riddled over something, usually my intrusive thoughts, some perceived moral shortcoming, or some incident in which I wasn't as kind or selfless as I thought I should have been (as is often the case when you're dealing with something like OCD), and I would tell her how awful I was still feeling despite the fact that I had prayed about it. She would always say something like, "So, you prayed about it, and asked for forgiveness, but...have you forgiven yourself for it yet?" I used to HATE that question, because forgiving yourself is HARD, friends. Saying to yourself, "I forgive myself for my past mistakes," and actually MEANING IT, and then actually working to change your faulty thinking patterns so that you can let go of the things you forgave yourself for is HARD.

    Learning to forgive yourself is hard for people with healthy brains, and it's even harder for those of us with mental health conditions because, a lot of the time, our mental health condition can make us believe that we don't really deserve forgiveness from anyone, let alone ourselves (which is a lie). Learning to forgive yourself is a crucial part of the healing process, though. How can you heal from your past if you can't forgive yourself for the things for which you are carrying the blame? How can you move past an issue if you can't forgive yourself for the role you think you played in it? The answer: You can't. So, you have to first extend the same forgiveness to yourself that you extend to everyone else so you can leave the past where it belongs: in the past.

    Forgive yourself for all the situations you handled the wrong way in the past in regard to your mental health before you learned the right way. Forgive yourself for all the times you let your mental illness make you believe you were unworthy or undeserving of forgiveness or anything else for that matter. Forgive yourself for all the time and opportunities you feel like you let your mental illness steal from you. Forgive yourself for all the times you felt like your mental health condition ruined something. Forgive yourself for everything you didn't become that you thought you should have. Forgive yourself for all the time you wasted avoiding getting the help you needed. Forgive yourself so you can start to heal. Forgive yourself because you don't deserve to carry the extra weight of the guilt, shame, and anger over things you can't go back and change. Forgive yourself so you can learn to live completely in the present.

    I'll end with this: Yes, forgiving other people is important to your overall well-being, but that's only half of forgiveness. The other half, forgiving yourself, is just as important, if not more important to your mental health. Learning to forgive yourself is difficult (possibly one of the most difficult things I've had to learn), but it is crucial to the healing process. You have to forgive yourself for your past before you can work through it and move on from it. And, remember, if your mental illness makes you think that you don't deserve or are unworthy of forgiveness, it's lying to you.

Checking In

     When people talk about mental health, they often emphasis the importance of checking in on your loved ones. We all see the posts on social media reminding us to check on our strong friend, our distant friends, our goofy friends because they might not actually be as "okay" as they seem. Those same people that remind everyone else to check in with others often forget about the other check-in that's just as important: checking in with yourself.

    It's easy to remember to check in with other people most of the time because we can more easily see changes (like a drop in functioning, a change in our interactions, and emotional changes) in other people. American society has taught us to not recognize those changes as easily in ourselves, though, and so instead we prioritize "powering through" or "dealing with it later" when we might notice something feels off. So, of course, we don't think about ourselves a lot of the time past a surface-level, like whether or not we've eaten that day, or whether we're sleepy enough to go to bed at night.

    Checking in with yourself is so important even when you don't have a mental health condition, and especially during times of high stress (like a pandemic and the holidays happening at the same time). Checking in with yourself is a vital part of self-care. It's actually how you figure our what kind of self-care you need at any given time. But, to actually do it properly, you've got to go deeper than the usual surface-level concerns. Example: Instead of just asking if you've eaten today, it's a good idea to ask, "HOW have I been eating lately? Do I need to change any of my eating habits to improve how I'm feeling? How can I change them within my (dietary/budget/time) restrictions?"

    Don't forget about checking in with your mental health, too, even if you don't live with a mental health condition. To check in with myself, I regularly ask, "How am I ACTUALLY feeling overall lately? Am I honestly okay, or am I trying harder than usual to be okay these days? Have I been feeling 'not like myself' in any way?" Then I have to go a little deeper and ask myself, "In what ways do I feel 'not okay' or 'not like myself'?" 

    Once I do the "system scan" I have to ACTUALLY implement or change my self-care routine to reflect my current needs. The same self-care routine won't be helpful for every issue. If I've slipped back into an unhealthy thinking pattern, or if I need to get more sleep, then a face mask and meditation aren't going to be the self-care things that make me feel the most "okay". Checking in with yourself is the only way to really become self-aware enough to realize that how you care for yourself needs to change from time to time. 

    A note for those of us with mental health conditions: Don't confuse checking in with monitoring. Monitoring is more specific than checking in, and monitoring generally makes us feel worse, not better. Monitoring is when we notice we're experiencing symptoms of our mental health conditions, and then we keep going back and asking, "Am I still anxious/depressed/having intrusive thoughts?" And then we just keep going back and doing that over and over again. By doing that, we've just added to our symptoms and exacerbated them by worrying about them. The goal of monitoring is to make sure we stop having symptoms of our mental health condition. That is not the goal of checking in with yourself.

    Checking in with yourself is an overarching assessment of "Am I okay or not okay, even if I'm dealing with symptoms of my mental health condition? If not, what can I change to work toward being more okay?" The goal of checking in with yourself isn't to stop your mental health symptoms but to help you tweak/shift/change all the areas of your life that you can to get into a space where things generally feel more okay than not okay. However, reaching a feeling of being okay may actually help your mental health symptoms even out since some of the previous stress and worry have been lifted.

    I'll end with this: People are generally quick to remind everyone to check in with their loved ones to make sure they're okay, but they often forget to extend the same level of attention and care to themselves. This is your reminder: check in with yourself regularly. Make sure you're closer to okay than not okay in every way that you can. Also, it's completely normal to need to change up your self-care routine because your needs aren't always going to be the same. 

I'll Deal with that Later

     When it comes to health concerns, especially those "invisible" health concerns like high blood pressure, signs of autoimmune conditions, and especially mental health conditions, for many people the default thought pattern is, "I'll deal with that later". And by "deal with it later" they usually mean that they'll deal with the issue when they're forced to deal with it by something external, like an ER doctor, an extremely distressed loved one, or, occasionally in cases of severe mental illness or substance abuse, the court system. I was a "deal with it later" person when it came to my mental health, and, to this day, that is something I regret.

    It's so easy to have that "I'll deal with that later" attitude, particularly when it comes to mental health. It's so easy to make excuses for why you can put your mental health on the backburner. The whole, "I don't have time to go to therapy." Or, "This isn't bad all the time, so I don't need therapy." Or, "I'm only having panic attacks because I'm stressed. They'll stop soon enough." Or, "I'm only depressed because X,Y, or Z. It's only been a few months. I'm sure I'll feel better soon." Then before you're even sure what happened, your life isn't so much a life as it is an existence of dread and darkness punctuated by sleep because the issue actually didn't go away like you thought it would.

    The thing that doesn't seem to register with mental health conditions is that, like all other conditions, like high blood pressure and autoimmune conditions, the longer the condition goes untreated because it doesn't seem that serious, the more serious it's going to get over time until something disastrous happens. No health condition, including mental illness, is going to just disappear or spontaneously resolve itself if you put it off for long enough. As with all health issues, if you don't see to the issue as soon as it arises because you think you don't have time or it isn't bothering you all the time, then your health will force you to take the time to deal with it at some point. Believe me when I tell you that it will be extremely unpleasant when it reaches the point when you find yourself forced to deal with it.

    By the time I was forced to deal with my mental health conditions, I had reached the point that I was barely functioning. I could barely manage to eat anything. I had lost weight. I was having panic attacks daily. I was crying myself to sleep and crying when my mom had to leave to go to work and crying at random times throughout the day. (Yeah, I cried A LOT.) I felt like I was a terrible person, and I hated myself all the time. I was in my second spiral that felt and looked like some kind of nervous breakdown. I was terrified. I ended up at the hospital. 

    Don't do what I did, friends. Don't put your mental health off and promise to deal with it later. Don't think that an issue isn't important if you don't experience it ALL THE TIME. Don't ignore it because you're afraid of what the symptoms might mean. Don't tell yourself that whatever issue it is will just sort itself out. It'll be much better and easier to manage if you deal with an issue or set of symptoms as soon as they start happening.

    At the first sign something isn't quite right, at the first panic attack, first intrusive thoughts, the first time you even think you might be depressed, seek help. Talk to your doctor and see if they can refer you to a therapist. Call your insurance provider and ask about in-network mental health services. Drop into your local community mental health agency to schedule an appointment if you don't have insurance. Don't wait until it reaches the critical point and something external forces you to seek help. (Reminder: most community mental health agencies charge on a sliding scale for mental health services and even some medications, and the service might be free or nearly free depending on your income level.)

    I'll end with this: Your mental health is too important to ignore or put off taking care of. An untreated mental health condition can steal your life away just as quickly as a physical health condition. So, please, at the first sign that something feels even the slightest bit "off" or different, seek help. Don't wait until it's so bad that something forces you to seek treatment, because, I can tell you from experience, you don't deserve to feel as miserable as you'll more than likely be feeling by that point. You deserve more out of your life than just an existence of pain and misery paused by a few hours of sleep.

Accountability

     Accountability AKA taking responsibility for one's actions. Humans are taught to be accountable by good parents as soon as they're old enough to play with other children. This idea of being responsible for one's actions is one of the big life lessons educators hope their students learn, that ministers hope their parishioners can take to heart, that bosses hope their workers come equipped with, and that mental health professionals hope their clients can grow into. In other words, having accountability is extremely important on a personal and societal level.

    Having accountability is so important, yet, people with mental health conditions aren't always held accountable for their actions, particularly by their loved ones. I get it. It can be difficult for loved ones to navigate the changes that come with the sudden onset of symptoms, the diagnosis, and the subsequent trial and error process of finding the right therapeutic approach and the right medications. So, many times our loved ones will be more lenient with problematic behaviors in an attempt to be understanding while they're waiting to figure out what's going to be most helpful. That can be a good thing as we all need extra compassion, understanding, and leniency from time to time.

    Many times, though, the need to be seen as understanding can go too far. Sometimes, loved ones will make excuses for problematic behaviors and use the mental health condition as the excuse, even after a treatment plan is in place and the adjustment period has long gone. As in, "He hit you because he has bipolar disorder, and he just can't control himself sometimes." Or, "She yelled at you because you touched X, and you know that triggers her OCD." Or, "They only have a substance abuse problem because they have depression, and that's the only way they can cope." I personally know someone who says things like, "Well, you trigger my anxiety and depression, and then I turn into an asshole. That's just the way my symptoms present themselves," because other people let them be this way, and now their mental health condition has become an excuse for poor relationship skills.

    That's...not actually how it works.

    Living with a mental illness IS NOT an excuse to treat people poorly. If someone is treating you poorly and blaming it on a mental health condition, please note that the Diagnostic and Statistical Manual (AKA the DSM) doesn't list "being a jerk" as a symptom of any mental health condition. I had a professor at university say something along the lines of, "You can't always control how you think or feel in a situation, but you can ALWAYS control your behavior." So, stop making excuses for them, especially if the excuse is their mental health condition. People always have the choice between treating people respectfully or treating people poorly. Accountability isn't supposed to fly out the window in the name of being understanding.

    If someone is having problems in their relationships or problems functioning in society, that person has the option to take responsibility for their actions and address the issue in treatment with their therapist. If they do not address these problem behaviors and work to correct them across all of their relationships, that is a choice, and they chose not be accountable. That person is then choosing to willfully continue that harmful pattern of behavior. That choice had nothing to do with their mental health condition and everything to do with their lack of accountability and lack of care for the people their behavior is hurting.  

    Also, that whole pattern of, "I have a mental illness which basically means that I can be a jerk and pretend that I can't help it," hurts more than just the people in that one person's life. It hurts EVERY SINGLE PERSON in the world that lives with a mental health condition. The mental health stigma already tells society that mentally ill people can't have normal relationships, and so by choosing to treat people poorly and then blaming it on a mental health condition, the person is just allowing that piece of the stigma to become more widely believed and more deeply ingrained in society.

    I'll end with this: Having a mental health condition isn't a free pass to treat people in an unkind way. Yes, trying to be understanding, sympathetic, and lenient when someone is learning how to live with a mental health condition can be a good thing, but when that leniency turns into making excuses for problematic, hurtful, or abusive behavior "because they have a mental illness" that is no longer good. That is enabling, and it helps the other person avoid taking responsibility for their actions. How someone treats other people is always a choice, whether they have a mental health condition or not.

Christian Faith and Therapy

     I've been feeling a bit more reflective this past week. In particular, I've found myself reflecting on my faith journey and my mental health wellness journey, and how those two things work with and inform each other. I've been thinking about what it has been like for me to be a Christian with a mental health condition, mental health treatment, and how many Christian faith communities deal with mental illness. 

    I don't usually get personal in this way, but for today's topic I feel like maybe I should. So...just some background information: I have always been a religious person, and I will probably always be a religious person. I spent a lot of my early adult years searching for the place that felt like it "fit" me. I was raised in a pretty conservative Baptist family. (Seriously, I come from a family with what feels like (to me), a LARGE number of Gospel singers and preachers.) I converted to Catholicism in college. Then, in my mid-twenties I found my true "fit" in the Episcopal Church. Although I haven't felt up for going in a while, it's still the first place I want to go when I'm stressed for too long or things feel like too much because I feel at peace there.

    There still seems to be this idea in many Christian faith communities that people have to choose between their faith and getting treatment for their mental illness. I haven't heard this idea spoken out loud by any modern pastor or priest, but it still pervades the American culture of Christianity, especially in rural places and fundamentalist-leaning churches. It's an idea that whispers, "Oh, you're going to therapy INSTEAD of just talking to the pastor? Oh, you're taking MEDICATION?  Oh, you're choosing to believe in SCIENCE instead of having faith in GOD?" WHAT KIND OF CHRISTIAN ARE YOU?" (The implied answer here is: "not a good one.") It feels a little bit like the Evolutionist vs. Creationist debate all over again, except this time, the stakes are people's mental health and their actual lives instead of what somebody can teach in the classroom. 

    It doesn't have to be like this, though. In fact, it shouldn't be like this. Your priest or pastor isn't a therapist. He/She/They are a religious leader. They aren't qualified to be a therapist (unless they have a dual degree and a dual career as a mental health professional and a pastor), and expecting them to have more than a passing knowledge of how to manage mental health topics isn't fair to them. That's too much weight to expect someone without the right training to carry. Your religious leader CAN definitely be part of your support system, though. That's what they're there for. Not to treat, but to support. (I do wish I saw something mental health-related in church bulletins or bulletin boards like a crisis center number or the number for local community mental health organizations listed for anyone that needs them.)

    It also shouldn't feel like faith and science are mutually exclusive ideas because they aren't. I mean, you go to the doctor for heart problems, and you still have faith and are still a Christian. So, you can go to a mental health professional for brain chemical problems and still have faith and be a Christian. Also, God can lead you to a mental health professional just like God can lead you to any other right choice that you pray about. You can also still pray about your mental health while undergoing treatment with a mental health professional. (I pray all the time that God helps me figure out how to help myself and that God helps me find the strength to hang in there when it gets tough.) Just because I pray doesn't mean that I don't believe in or trust the therapeutic process. You can trust in both, at the same time, without lessening the "effectiveness" of either of them.

    I'll end with this: Even today, many Christian faith communities have a hard time recognizing mental health conditions as actual health conditions that need specialized treatment instead of some moral or faith crisis that can be solved by a heart-to-heart with the pastor or priest. In some areas, seeking mental health treatment can be seen as a rejection of one's Christian faith, but that isn't the case. You can still keep your faith and get treatment because science and faith actually aren't mutually exclusive ideas. God can lead you to a therapist just like God can lead you to the right job, spouse, or any other decision you pray about.

Just Chillin' in the Freezer

     Panic attacks are weird and traumatic and unpredictable, aren't they? I used to have them almost daily, and I still have them occasionally, even after my time in therapy. It seems like, even today after a lifelong battle with them, that I still sort of scramble to remember coping techniques sometimes, particularly if a panic attack just comes on quickly, with no warning, like the times I've been woken up by a panic attack at night from a sound sleep.

    As someone who lives with panic disorder, I've spent plenty of time trying to avoid having a panic attack in the first place or trying to stop a panic attack before it spirals out of control. In the early days, I did everything from standing on one foot to watch TV to practicing a British accent just so the space where the panic lived in my mind might be filled up enough with other things that I wouldn't have room left for the panic to occur. Then once I started therapy, I would do meditation and relaxation breathing, yoga, and other helpful things. Since panic disorder is so unpredictable, sometimes those coping techniques work, but sometimes they don't. I'm sure all of us living with panic disorder have been there, right? We do everything we can think of, but the panic attack still comes barreling at us like a train at full speed.

    Instead of going straight for a hard brain reset (if I'm not sobbing yet), I can do one more thing that always seems to work. I go stick my face in my freezer for a couple of minutes, and then I do some relaxation breathing while I've got my head stuck in there. If it doesn't drop my anxiety to a completely manageable level, it at least stops the panic attack. I know that sounds weird, but it works. (I also read online about someone who would hold an ice cube in their mouth to stop a panic attack, too. Holding an ice cube in your hand is supposed to work as well, but I find that putting my face in my freezer works best for me.)

    Here's why something like this tends to work: When you have a panic attack, all of your focus is turned inward. You're only aware of your mind racing and your heart racing and how you might feel like you can't breathe. You're also probably monitoring for any other symptoms associated with a panic attack. When you go stick your face in your freezer, you're shifting your focus from internal (where the panic attack symptoms are) to external (where you're suddenly feeling the cold air on your face and breathing it in). Shifting your focus from internal to external like this is a way to bring yourself out of the panic apace and back into the current reality. Also, the relaxation breathing is a way to trick your brain into thinking things are calm instead of in overdrive and out of whack. 

    I'll end with this: Life with panic disorder can be unpredictable, to say the least. Sometimes the usual coping techniques don't work, or if the panic attack comes on quickly, we can be left scrambling to remember anything we learned about how to manage moments like these. Something that shifts your focus from internal to external is ideal, like (for me) sticking your face in your freezer for just a couple of minutes, to stop a panic attack. 

Your Therapist is Not Your Friend

     I recently had someone tell me that they think of their therapist as their friend. This person told me that they felt like their weekly therapy appointments were just two friends hanging out and chatting about stuff. This person also thought the therapy they received from this therapist wasn't helping them, but, since they thought of the therapist as their friend, they didn't want to find a new, more helpful therapist. This situation is not a good one, my friends. This is not how a client-therapist relationship should look or feel.

    Your therapist is not your friend. Your therapist is not supposed to be your friend. Forgive me if that sounds harsh. A client-therapist relationship is like a business partnership. The client and the therapist are the business partners, with the therapist as the "senior partner", there to guide the newer, more inexperienced business partner (AKA the client) through the business venture of rewiring their brain and healing their trauma. Like with most business partners, there are certain boundaries that are defined from the beginning by the client and the therapist when they agree to work together. (A therapist usually defines the parameters of the client-therapist relationship and the expectations for the process during the in-take appointment.) If you ever feel like your therapist is your friend more than you feel like your therapist is a mental health professional providing a needed service, the boundaries have become blurred or weren't enforced properly, and this is not good for the therapeutic process.

    When your therapist becomes your friend instead of your mental health counselor, the whole therapeutic process can fall apart. Think about how you interact with your friends. You might hide things from them or lie to them to avoid having them think or feel differently about you. You're also likely to ignore help your friends try to give you, or if they tell you that certain behaviors are becoming a problem. You can't do those things with your therapist. You have to tell your therapist everything, and you have to put in the work outside the sessions that they expect of you or therapy won't work.

    Your therapist also has a duty to remain objective when it comes to treatment. If your client-therapist relationship has turned into more of a friend-friend relationship, it can become difficult for the therapist to remain objective and for the client to place their trust in the therapist's ability to treat them adequately. (Note: if a therapist has lost the ability to be objective with their client, it's unethical for them to treat that client any longer.)

    I hold my therapist in high regard, and I trust her with my life. I enjoy the way she has worked with me for the past five years. However, I know she isn't my friend. She is a professional, much like my primary care physician, that I am paying to provide a service that contributes to my overall well-being. We have boundaries. My therapist is a warm and caring individual, and I truly believe that she cares about me as a person. However, my appointments never feel like we're just two gals chillin' over a nice cup of tea. My appointments feel more like business meetings. I'm not making idle chit-chat or asking her about her life during my hour session, and she doesn't share details about her life with me. We work during my appointment to change the way I function and interact with my mental health condition. We meet with a thing to accomplish and an end-result visible on the horizon.

    I'll end with this: It might seem weird to think of the person you share your most troubling experiences with as "not your friend", but your mental health counselor is not your friend. It should never feel like your therapist is your friend, or like your counseling appointments are just two friends hanging out. If that happens you need to address the issue and possibly find a new therapist that can provide objective and professional treatment.

Should I Tell My Therapist?

     This is a question that I get asked quite often by my fellow therapy-seekers. They will usually tell me about their problems, stresses,  the new or most bothersome symptoms of their mental health condition, or a mistake or bad decision they may have recently made, as friends do. Then they'll ask me, "Do you think I should tell my therapist about this?" My answer is always, "YES. TELL THEM."

    I completely understand how this can be an uncomfortable thing, but if you're in therapy, you are ABSOLUTELY supposed to tell your therapist everything. If it's good, bad, ugly, embarrassing, shameful, scary to talk about, and everything in between, you're supposed to talk to your therapist about it. Even if you think they'll be mad at you, (spoiler: they won't be mad at you), tell them. Even if you think they won't like it or understand it, tell them anyway. Even if you're sure they won't able to help you, tell them everything anyway. If you're asking yourself or anyone else, "Should I tell my therapist about this?" the answer is yes, you definitely should. That's the only way therapy will actually be helpful.

      When I had my intake appointment with my first therapist, I almost didn't tell her about my intrusive thoughts. I was afraid that she would either think I needed to be institutionalized (they don't really even do that anymore) or that she'd confirm my worst fear, that I was actually possessed and she couldn't help me. Then I realized that if she didn't know, that I wouldn't even be in therapy for the one thing that was causing all of my other symptoms, so therapy wouldn't actually help me at all. So, I told her, and I was absolutely terrified as I told her. She said she could still help me, and because I was honest, I finally got the help that I so desperately needed. Because I had told her EVERYTHING, I had taken my first step in the healing process.

    Being completely open and completely honest with your therapist is the only way that the therapeutic process is going to work. If you keep anything hidden or don't talk about ALL of your feelings, then how are you going to process everything that you need to process in order to heal from it? You have to be willing to let your therapist see all the "broken" bits, all the bits that you don't like, everything that feels weird. You're therapist needs to see all of that so they can see the "whole picture" of you, your illness/trauma, your thoughts and beliefs, your feelings, and your life so they can see how best to help you figure out how to help yourself.

    I'll end with this: I know it can be terrifying to think about telling someone, even a therapist, all of the things you think are strange about your mind, all the things that you feel ashamed of, and/or all the things you think make you "broken". But...the only way that the therapeutic process works and helps you heal from your trauma is if you're completely open and honest. If you think for even one second, "Should I tell my therapist about this?" The answer is YES, TELL YOUR THERAPIST.

The Big Misconception

     I know, it seems like I'm always mentioning how the symptoms of mental illness come and go over time. That's one way in which mental illness is a little bit predictable, because we know that life with a mental health condition will require more effort on some days than on other days. One thing that I haven't talked about, though, is how those symptoms can change over time.

    One common misconception about mental illness is that people experience the same symptoms of their mental health condition over and over again. That's not usually the case. If it was, those of us with a mental health condition wouldn't really need ongoing therapy once we learned how to manage the symptoms for which we went to therapy in the first place.

    The reality of living with a mental illness is that symptoms change from time to time. Sure, some symptoms can go away or lessen to the point that we might barely notice them. But...new mental and physical symptoms can also occur at any time. New triggers can emerge. New intrusive thought can suddenly filter into or take the place of old intrusive thoughts. (So far, the content of my intrusive thoughts has changed four times during my wellness journey.) This can happen through no fault of our own. It just happens sometimes, and then we're left trying to figure out how to manage this new piece of the puzzle that appeared after we already thought our puzzle was put together.

    The other piece of that misconception is that everything will be fine as long as the person is on their medication, and their mental illness will continuously be "better" with the medication. Medications can stop working. Dosages need adjusting sometimes, or the medications may need to be taken at different times of the day or night if it's helping less than before. Sometimes the medication can cause a new set of symptoms (as it happened in my case), and then a new medication may need to be added to treat the new symptoms. Sometimes medications need to be changed altogether, and then the person experiences a spike in symptoms as they wait the two to eight weeks for the new medication or combination of medications to become effective.

    This two-part misconception can add to the idea that I talked about last week, that people that live with a mental illness are "unstable" as a permanent state of existence. It can also make it seem like the person is suddenly getting worse or maybe not trying as hard to stay on top of their mental health. That isn't accurate, though. Just because new symptoms emerge or medications need adjusting or changing doesn't mean someone is getting worse or not trying hard enough. It just means things have changed, and now we have to learn how to cope with these changes that we didn't expect, which can feel like starting the whole journey over again sometimes, depending on how severe the new symptoms are.

    Mental illness is extremely unpredictable that way. Every person won't experience the same symptoms or the same symptoms in the same order. The medications for a specific condition won't work for every single person with that condition, and so it's trial and error until the right medications can be figured out by the healthcare team. My point is that mental illness doesn't look or feel the same for everyone. Mental illness may not even look or feel the same week to week for one person. That doesn't mean that one person is "worse" or more "unstable" than the other. It just means their brains are different.

    I'll end with this: People don't just keep experiencing the same symptoms of their mental health condition over and over again. Symptoms and triggers can change over time, even though someone is going to weekly therapy and taking their medication(s). Mental illness is unpredictable in that way. Medications won't always cause continuous symptom improvement either, because medications can stop working, or the dosage may need adjusting from time to time. These changes don't necessarily mean that someone is becoming "unstable", getting worse, or not trying as hard as before to be well. It just means they may have been thrown a curve ball, and now they need the time to adjust to this new situation.

Walking on Eggshells

    There still seems to be this idea that people that live with mental illness are "unstable" as a constant state of existence, like we're walking the line of a delicate balance between normal and having a breakdown. This idea often leads people to "walk on eggshells" around those of use with mental health conditions as they watch, wait, and maybe expect some sort of breakdown to happen, because since we're "unstable" a breakdown is always lurking, ALWAYS imminent.

    I didn't notice that people with mental health conditions were handled so "carefully" until after I was diagnosed with panic disorder and OCD. Then, once people found out about my conditions, I started hearing things like, "Well, I didn't tell you about this because I didn't want to upset you." Or, "I just didn't want you to stress about it, so I didn't tell you." Or even, "I didn't tell you X because you have anxiety, and I didn't want it to get worse."

    Honestly, I don't need people to do that. Most of us with mental health conditions don't need or want people hiding things from us or shielding us from all of life's stress and unpleasantness because of our mental health conditions. (That can just make me feel like people think I can't cope, and THAT is a sure way to make my anxiety worse.) Life, in general, is stressful. Life is unpleasant at times. Situations can be bad situations. But...if we've gone to therapy, we have coping techniques and management strategies for all of those things, including the stress that can exacerbate our mental health conditions. 

    Just because someone lives with a mental health condition doesn't mean that they're always hanging off the ledge about to tumble into a breakdown. A large number of us are actually stable pretty much all the time, and we have regular "stable" lives with healthy relationships, good school performance, and demanding jobs like everyone else that walks through life without a mental health condition. 

    Sure, sometimes people with mental health conditions can have periods in which they become "unstable", but that doesn't mean that being "unstable" is a going to be a permanent state of existence. People can recover from those "unstable times", sometimes with therapy, the addition or adjustment of medication, or (occasionally in more severe or extreme cases) with in-patient treatment for a short period of time. (I recovered with weekly therapy, supplements, meditation, and support from friends and family, and I've been "stable" since I took my "mental health detour".) 

    For some of us, those "unstable" periods may only happen once or twice in a whole lifetime with mental illness. For others it may happen more often depending on the person and the illness, and for some, those periods of being "unstable" may NEVER happen. 

    I'll end with this: Having a mental health condition does not automatically mean that someone is "unstable". A breakdown isn't ALWAYS imminent. Even if someone had a period of being "unstable" before, that doesn't mean that being "unstable" is now a permanent state of existence. People can recover from those periods and achieve a more stable state of existence. If you know and love someone with a mental health condition, there is no need to "walk on eggshells" with them. Most of the time, we just want to be treated like everyone else as much as possible instead of being like something is wrong with us.

You're Allowed to Ask

    I know, to a lot of people, mental illness is this big mystery. Mental illness is a thing that a lot of people haven't experienced, and (to their knowledge) is a thing that they don't have a lot of experience with in their relationships with other people. Most of us don't even learn about them in school, unless we take a psychology class in high school or college, and even those classes can leave us with a lot of unanswered questions.

    So, then when someone finds out that a relative, beloved friend, or romantic partner/interest has a mental health condition, they can be concerned about it and even afraid of it. Unless they have personal or first-hand experience with mental illness, they'll probably be confused by our diagnosis, and then things can get a little weird as they try to understand what our diagnosis means for us and for our relationship to them and the pretty much the rest of the world. We've all been there, right? I assume that we also have all been frustrated by that scenario and wish that the other person would just ask us about our mental illness and everything related to it instead of muddling through, suddenly treating us differently, and maybe even withdrawing while they figure it all out.

    I get it. Mental health is a taboo topic, and people are hesitant to talk about it. This idea exists, too, that the person with the mental health condition HATES talking about their mental health condition because it's shameful, which can make people think it's a bad idea to ask us about our mental health condition because we might be offended or embarrassed. That's not usually the case, especially if we've been clinically diagnosed and are in treatment. 

    Most of us that live with mental health conditions have learned through therapy and support not to be ashamed of them, and we've learned to be honest if we find something to be triggering. That's just part of our normal, but we get how it can be a bit confusing or even scary, if someone else has just learned that we live with something like OCD, PTSD, depression, bipolar disorder, or any other diagnosis. A lot of us don't mind talking about what life is like for us with a mental illness. Most of us realize that openly communicating about our mental health is a good way to make sure our needs are met and to make sure our loved ones gain understanding of the mental illness, the treatment, and the wellness journey.

    It's okay to ask us questions as long as the person asking does so in a respectful way and the question comes from a genuine need to understand a person and their mental health condition better than before. If there is something you don't understand or something you want to know about, you're allowed to ask, even if you feel like the question is probably stupid. (Hint: There are no stupid questions when you're trying to really understand something.)

    I mean, be mindful of the setting if you're going to ask questions, like don't take us out to a fancy or crowded place or wait until we're surrounded by strangers or even friends or coworkers and then expect a deep mental health conversation. (These conversations are best had in private if you want more than surface level answers.) Also, if we're dealing with OCD or PTSD, be mindful of the fact that talking about the intrusive thoughts or the trauma can be triggering, and some days it'll be easier to talk about it than others.

    I, and I assume most other people with a mental health condition, would rather someone ask us questions instead of running with the stereotype presented on TV or instead of having them start acting strangely around us as they try to figure stuff out on their own. If we don't know the answer we'll more than likely be able to point you to a website or article that can help you. (I actually used to have articles on hand that explained my subtype of OCD, and I had highlighted the important parts for easy reading.)

    I'll end with this: Living with a mental health condition can be confusing and sometimes scary, for us and for the other people in our lives. If you find out that a relative, friend, romantic partner, or potential partner lives with a mental health condition it's okay to ask them questions about it as long as you ask in a respectful way. We'd much rather someone ask questions than run with the stereotype they saw on TV or inaccurate information they may have gotten from someone else and then end up treating us differently.

Is Love All You Need?

     Person with a mental illness exists and has symptoms of their mental health condition. Then person with a mental illness meets someone, they fall in love, and suddenly, the mental illness disappears. Happily ever after happens and the mental illness is never mentioned again because love conquers all. I feel like we've all seen that trope in at least one movie or TV show.

    Even in normal, non-Hollywood society, there is this expectation that, when a mentally ill person gets into a (healthy) romantic relationship and the two people fall in love, that the mental illness will suddenly just become better. The other person's love will magically "fix" them. Then if the mental illness is still present, people usually say the other person just doesn't love them enough or that the mentally ill person isn't trying hard enough to be "better". 

    I feel like I shouldn't still have to say this, but...you CAN'T love someone's mental illness away, whether it's an anxiety disorder, depression, a mood disorder, or a substance abuse issue.  A mental health condition, like all other chronic health conditions, is a thing that exists outside of external factors or situations like a romantic relationship or a deep friendship. It exists as a result of internal factors. That means a person's mental health condition has nothing to do with their relationship status and everything to do with that person's brain chemicals (and possibly past traumatic experiences). Love is powerful and life-changing and great, but it can't fix a person's brain chemicals, and expecting love to be this cure-all especially when it comes to mental health is yet another facet of the mental health stigma (because this idea means we're still not taking mental health as seriously as we should be. I mean, nobody thinks they can love diabetes away...).

    I also feel like I shouldn't still have to say this either but...if you're in a relationship with a person that has a mental health condition, it IS NOT your job to "fix" them (or even to stay with them at all, especially if they aren't getting help or are refusing help and/or medication). I know this one, in particular, is hard for a lot of people. It's the mentally ill person's job to work on themselves, to go to therapy and take their medications and change their lifestyle to a healthier one. No matter how much you love them and want them to be "better" you can't force them to do the things that will make them better. (You can definitely encourage them and support them, but you can't force them.)  They need to be internally motivated to begin a wellness journey and keep it up for, you know, the rest of their lives.

    A person can have the "perfect" life. You know...perfectly devoted and loving parents, did well in school, got their dream job in their dream location, found a soul mate, and all those great things that seem to (objectively) make a life "perfect", and they can still have a mental health condition and regularly experience symptoms of that condition anyway. It doesn't mean their partner doesn't love them enough. It doesn't mean that their partner isn't trying hard enough to "fix" them. It doesn't mean that their relationship isn't the "right" relationship. It doesn't mean that the mentally ill person isn't trying hard enough to be "better". It's just the nature of a mental health condition. Symptoms wax and wane independently of how great someone's life is and independently of how much other people love them. (Although stress can exacerbate a mental health condition.)

    I'll end with this: Contrary to what pop culture and the mental health stigma wants us to believe, mental health conditions are serious health conditions. You can't cure someone's mental health condition simply by loving them. You can't love a mental health condition away, just like you can't pray it away. Also, if you're in a relationship with someone who lives with a mental health condition, it IS NOT your job to "fix" them. They're decision to begin and continue on a wellness journey needs to be internally motivated, not solely motivated by their partner or relationship status because it's a journey that should last a lifetime and not just while they have a partner.

The Blame Game

     I used to blame myself for experiencing the symptoms of my mental health conditions. Every time I had an anxiety spike because of my intrusive thoughts or every time I had a panic attack, I blamed myself for it. I had obviously done something wrong in the way I managed my mental health, or I wouldn't have had symptoms flare up, right? I even used to go to my appointments and conclude the details of a bad time with, "I know I did it to myself..."

    My therapist was always quick to interrupt that thought. Then she would ask me something like, "What makes you feel like you did it to yourself?" Then I would have to ashamedly tell her how I had caught myself trying to "out-logic" my intrusive thoughts, or doing some kind of mental compulsion, or kept going to a worst-case scenario sort of place until I caused myself to panic. When it wasn't something like that, I would have to tell her that I had watched or listened to something that I found to be triggering, but that I forced myself to "hang in there" despite an increase in intrusive thoughts and/or feelings of panic. So, basically, if I hadn't done X,Y, or Z, I would have been fine, which just made me feel guilty and ashamed.

    My therapist never blamed me, even if I did do something that caused a flare-up in symptoms. She always explained that old habits of how I dealt with my mental health condition (like trying to out-logic the thought or mental compulsions) were hard to break. Of course, I would go back and fall into old habits sometimes because I was still learning and creating new pathways in my brain that weren't as familiar as the old ways. My anxious brain craved the same old routine, and that would be the place it would try to go to. Sometimes I'd catch myself and redirect, but then sometimes I'd slip up. It didn't mean I was doing it to myself on purpose, and so I didn't need to blame myself. I needed to forgive myself and move on. 

    As for the external triggers, she would ask something like, "Did you know it would be triggering beforehand?" Usually, my answers was something like, "Well, it wasn't triggering before." Or, "The last time, it only bothered me a little and then the anxiety dropped after the first couple of minutes so I was waiting for it (the anxiety) to drop this time, too."

    Triggers, especially when we're dealing with something as unpredictable as panic disorder, can vary. Sometimes a past trigger may not feel as intense, and so I might not have a panic attack. Sometimes something that wasn't a trigger before suddenly becomes a trigger, but then it isn't a trigger the next time. (Panic and OCD are different like that. I know my OCD triggers, but I may not always know if something is going to trigger a panic attack until it does.) My therapist understood that and she would always re-affirm the idea that panic triggers are unpredictable, and so I shouldn't blame myself for not realizing or spotting a trigger before the attack starts every time. 

    I even still catch myself combing back through the day to see what I did wrong on a bad day, but I eventually (mostly) stopped blaming myself for the slip-ups. I shake it off as best I can, promise to do better next time, and move on. Old habits, especially if you've had them for a long time and especially if they helped you manage something as traumatic as a mental health condition, can be hard to break. The point is that you're TRYING to break the old habits and redirect to better, more helpful ways of managing symptoms.

    I'd also like to point out: Sometimes we can do everything "right" in the way that we manage our mental health condition, and we will still experience symptoms. That doesn't mean we did anything wrong or that the symptoms flare-up is our fault. It's a chronic health condition, and symptoms come and go sometimes, no matter how well we've been managing it. So, instead of blaming ourselves for it, we should strive to handle the situation with compassion and understanding. (Having compassion and understanding toward myself is also something that I still struggle with, but I'm working on it.)

    I'll end with this: As with all trauma, it's so easy to slip into looking for someone to blame. With mental health conditions, the person we land on to blame is usually ourselves. That's not okay, friends. We don't need to blame ourselves for our mental health conditions, for experiencing the symptoms, or for the little slip ups that may cause symptoms to present. The old coping habits and management techniques are hard to break, and we'll all slip up sometimes and go back to them. The point is to recognize the slip-up without assigning blame and to try to use a better strategy next time. 

Another Jewel in the Crown

     "You're suffering now, but that just means another jewel in your crown when you get to Heaven." 

    "You're suffering now, but when you come out on the other side of it, you'll be on a path to do great things."

    "There is a reason you're suffering, and it'll help you find your purpose."

    Over the years that I've been living with my mental health conditions, I've heard so many things like the above statements. I know the person saying it always means it in a comforting way. But...I don't find statements like the ones above comforting at all. If I'm being completely honest, I find those statements infuriating.

    Statements that basically mean, "You're suffering right now, but, later, some really great things will come your way," are a way that I've noticed that people try to beautify suffering. They're a way to try to find a meaning where there (often times with mental health suffering) isn't a recognizable meaning other than the nature of mental illness itself with its waxing and waning symptoms. They're a way to "pretty up" the idea of suffering without actually having to do anything to try to ease the real life suffering because the prospect of a new path/new purpose/divinely-given rewards SHOULD be enough to pull someone through the suffering without anyone else expending effort. Statements like those I mentioned above are a pretty way to gloss over an "ugly" thing instead of acknowledging it and then manage it (if you can).

    It's SUFFERING. It isn't beautiful, poetic, or anything else like that. It's UNPLEASANT, so unpleasant in fact that it can be hard to see outside oneself to focus on anything but the mental suffering that often comes with a mental health condition.

    When I'm having a bad time with my mental health, I don't need someone to tell me that my suffering is going to translate into a new life purpose, a new life path, or more heavenly rewards in the future. When I'm actively suffering, I don't care about the future. I don't even care about a few hours later. I only care about making it hour by hour or minute by minute until the suffering is alleviated. I don't need pretty words, I need someone to say, "Okay. I know you're suffering right now. How can I help?"

    When someone is suffering as a result of their mental health condition, statements like the above aren't helpful in a whole other way. The suffering doesn't have some philosophical meaning for our lives...it just IS because our brain chemicals are out of balance. The suffering that comes with mental health conditions isn't a life-changing event, it's a (possibly) regularly recurring state of existence. Suffering as a result of mental health conditions doesn't really equate to a new life path or life purpose because of the the recurring nature. When that kind of suffering is alleviated, sometimes the grand purpose someone has is simply to get back to their loved ones, their job, and their life as it usually is, not to fix anyone else's or the world's problems (and that's okay).

    I'll end with this: So many people use statements that basically say, "You're suffering right now, but it'll be worth it in the end because you'll find a new path/purpose/divinely-given rewards" as a way to comfort someone that is suffering. The thing is that statements like that aren't actually comforting. Those statements just serve as a pseudo-explanation and a way to beautify and then gloss over the suffering. Suffering in any form isn't beautiful or poetic or a path to enlightenment, and we need to stop thinking of it that way, especially when it comes to mental health. 

Room to Grow

     This week in my phone therapy session, my therapist and I were talking about the ideas of growth and change. She talked about how it was okay to experience large-scale changes as we grew, like changing life paths and then restructuring our lives to match who we currently are. Humans aren't meant to stay the same forever, we're meant to grow and change and become different throughout our lives. (This was one of those topics, that if it were acceptable to say "Amen" to your therapist, I would have done so.)

    Sometimes, I look back at who I was from the ages of twenty to twenty-five, and I don't recognize that girl at all. I look back at the choices I made and the the way I thought about so many things, and I think now, "How was that me?" I look back over that time when I feel like I was pretty much controlled by my mental health conditions, and I'm internally screaming, "That doesn't feel like me!" The differences between five years ago and today are stark, and sometimes shocking, even to myself. 

   I feel...different now. Inwardly, I think and believe differently. My opinions are different. My goals are different. The picture I always had in my head of my happiest life doesn't AT ALL match the picture I have now in my head of my happiest life. I feel like I'm on a different path now.

    Outwardly, I'm different, too. I interact differently with people now that I'm no longer carrying around the weight and the trauma of my mental health conditions. I also dress and do my makeup differently than I did pre-therapy. (I mention this because, before therapy, my OCD made me feel like only certain types of clothing and makeup were "safe", and now I get to actually choose the way I look based on what I like. It feels like a big deal, to me, to have that freedom.)

    When people on TV/in movies/pop culture talk about going to therapy and healing and personal growth, they usually mean it in this poetic, romanticized way that doesn't really mean much about their life has actually changed since they've gone to therapy. So, that idea factored into my expectations of therapy. I expected that I would go to my weekly sessions and that therapy would ONLY help me understand, manage, and treat my mental health conditions. I thought it would end there, and that it wouldn't impact other areas of my life. Boy, was a I wrong, my friends.

    I know I mentioned in a previous post that the therapeutic process, and the healing stage in particular, changes us. When I say that I mean it in the most literal sense. That's why I needed to take some time for self-discovery and getting to know myself all over again. I wasn't prepared for that amount of growth and change because that was something people don't usually talk about when they talk about therapy. I also have to admit, when I noticed such big changes in myself, I was a little bit frightened by them, which is a perfectly reasonable reaction to have when you feel like you no longer recognize yourself. (Don't get me wrong, I like myself, but change is scary.) I thought I would want to get back to my life as it had been, but instead I discovered that my old life didn't feel like me in a lot of ways. I had to restructure accordingly to get a life that felt like the current me.

    Before you start therapy, give yourself permission to change and grow. Give yourself permission to grow out of things and even people and to grow into other things and people. Give yourself permission to figure out who you actually are and then BE THAT PERSON, not the person that other people or your mental health condition(s) tell you that you have to be. Create the space ("wiggle room", if you will) that you need to be able to explore and restructure. It's also a good idea to give yourself permission to be a little uncomfortable or even a little scared of the growth and change as it happens. 

    I'll end with this: People don't often talk about the fact that the therapeutic process, particularly healing, literally changes us, and discovering that for yourself can fill jarring, at the very least. But...humans weren't meant to stay the same throughout their whole lives, we're meant to grow and change. You are under no obligation to be the person you have always been. Before you even start therapy, give yourself permission and create whatever space you can to grow, change, and restructure your life to match who you actually are now.

What Could Have Been

     What would my life be like if I didn't have OCD and panic disorder? Who would I be right now if I'd never experienced the first symptom of OCD that day in art history class? Would I have chosen a different major? Would I have chosen a different career path? Would I still live in my small hometown? Would I have actually been married by now? These are just some of the questions I've asked myself when I've let myself drift into the land of "what could have been".

    It's so easy to let ourselves drift into the land of "what could have been", to imagine if just one thing was different about our lives, to imagine who we could have been under different circumstances, especially when we live with a mental health condition. It's also super easy, once we've fantasized about what could have been, to resent our unwell brains for all the choices we think we could have made differently if our mental health conditions wouldn't have been in control at the time. It's so easy, particularly on the bad days, when we feel like our mental health condition is robbing us of peace and normalcy, to say, "If only I didn't have this condition, then maybe I could have..."

    All those "what could have been" scenarios are fantasies, though. None of us has the TARDIS or any other time machine, so it's not like we can go back and re-make the decisions we wish we could change. None of us can go back and just decide to opt out of our mental health conditions. We can't change our genetic predispositions. The past is the past, and living in "what could have been" tries to keep us rooted there, which doesn't help us on our journey to wellness.

    I had to let go of the idea of "what could have been" in order to stop thinking about my mental health condition as the thing that ruined my life so that I could fully accept my new normal and learn to find and create my own happiness in the reality that I actually live in. I had to let go of "what could have been" to acknowledge how far I've come instead of belittling my own progress by focusing on the things I wish could be different.

    Focusing on "what could have been" also stops us from looking at what could STILL BE. We can make different decisions in the present and the future. We can still do things we feel like our mental health got in the way of in the past. We can make changes and correct certain decisions (like finishing school/changing career paths/moving/making new friends). We can still create the lives we wanted, even if we feel like we missed out on "what could have been" in the past. As the old saying goes: We're all one decision away from a completely different life.

    I'll end with this: Focusing on "what could have been" if your mental health condition hadn't gotten in the way stops you from thinking about what could STILL BE. The idea of "what could have been" is a fantasy that is rooted in the past and the person you (maybe) were at one point in your life, and it doesn't allow for growth and change. The idea of "what can STILL BE" is rooted in the reality that takes into account how you've grown and changed, and it contains all the possibilities that "what could have been" holds you back from.

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.