Terms and Conditions Apply

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

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

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

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

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

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

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

It's a Full-Time Job

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

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

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

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

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

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

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

If You Don't Love Yourself

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

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

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

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

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

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

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

I'm Not Qualified for That

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

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

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

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

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

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

The Other Part of Prevention

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

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

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

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

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

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

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

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

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

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

Make it Funny

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

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

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

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

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

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

I Don't Have the Mental Space for This

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

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

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

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

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

Who Would I Be?

I had an interesting conversation with my therapist a couple of sessions back. It was one of those sessions in which we had talked about my life with mental illness and my identity as a disabled person with cerebral palsy. She asked me, "So, if a magical cure, like a pill or a shot, existed that would completely and permanently cure the cerebral palsy, the OCD, and the panic disorder, would you take it?" She assured me that it was okay if I didn't want the hypothetical magical cure because plenty of people wouldn't want it.

The cerebral palsy and the OCD and panic disorder are the three things that most often make my life significantly more difficult than it needs to be. So, of course I told her I would definitely take a magical cure that could permanently rid me of those three things. I was surprised that some might refuse such a cure for their disability or mental illness. When I mentioned my surprise, my therapist explained that some people would be worried about taking the hypothetical magical cure, especially if they had been disabled or mentally ill for their whole life or most of their life, because they might not know who they were without those pieces of themselves. 

After she said that, I remembered that I used to think that way. For my whole life, I was "the disabled person," and that label stuck with me well into my healing journey in adulthood. Then while I was at my worst with mental illness, and while I was operating in survival mode, being "the mentally ill person" was all that I had the mental space to be. If my cerebral palsy and mental illness would have spontaneously disappeared five years ago, I definitely would have thought, "Wait! Now, who am I supposed to be? That was all I was used to, and it's gone!" Since I was so busy just trying to survive my own mind, which left me no spare mental space or time to nurture any other parts of myself, I definitely wouldn't have known who I was without the cerebral palsy and the mental illness five years ago. Suddenly finding myself without what felt like the BIGGEST pieces of who I was at the time would have been terrifying.

Then somewhere along the way, as I healed and stopped operating in survival mode, I had stopped thinking of the cerebral palsy and mental illness as the biggest things that made me who I was. Over time as I learned to manage my mental illness and finally made peace with the cerebral palsy that I had hated for my entire childhood, I was finally able to free up enough mental space to carve out other pieces of who I was as a person. I intentionally worked on discovering new pieces of myself that weren't related to being "the mentally ill person" or "the disabled person."

When my therapist assured me that it was okay if I was unsure about or definitely didn't want the hypothetical magical cure because I wasn't sure who I'd be without those three pieces of myself, I was able to honestly tell her that I actually didn't feel that way anymore. Because I had worked so hard with her in therapy, I was sure I would still be who I am right now because I had worked hard to intentionally become this person and carve out previously unknown or ignored pieces of myself as I healed. Taking away the things that make my life difficult wouldn't change that because all the new, more important, and bigger pieces that I've found would still be there. (Although, without the cerebral palsy, I might have tried a sport...maybe...)

My therapist seemed pleased with my answer, but that wasn't the point. The point was that I was happy with my answer and that I meant it. I had reached a point in my healing that I no longer thought of my mental illness and cerebral palsy as the biggest pieces that made up who I am or the things that prevented me from becoming who I was always meant to be. I finally saw my cerebral palsy and mental illnesses for what they actually are, just health conditions that I accept and make room for in my life while I discover and nurture other pieces that make up the complete picture of who I am now.

I'll end with this: If difficult things like a disability, mental illness, or trauma have felt like the biggest pieces of who we are for a long time, it can be terrifying to think about the possibility of healing from those things. It can feel like, once those biggest pieces become smaller with healing or treatment, then we'll have to figure out who we are all over again, especially if we haven't had the mental space previously to discover the other pieces of ourselves. But, as you start healing and managing the difficult things that were your biggest pieces, as you free up the mental space, discovering the "new" pieces and allowing them to become bigger than the difficult things can get easier.

Screaming into the Void

 I'm a person who regularly "screams into the void." What that means is that I write this blog, and I occasionally post on social media about my own mental health in the hope that somebody, somewhere out there in the void of the Internet hears something I've screamed and possibly even relates and connects with it so that we both feel less alone with our struggle. Screaming into the void is often the way I process life with mental illness, the trauma of living with mental illness, as well as how I'm thinking and feeling. I find that externally processing some of these things lessens the weight of them for me. 

Recently, I saw someone else screaming into the void as a way to process a traumatic event they had just survived. The person made a series of posts detailing how they reacted to the event while it was happening and how they were thinking and feeling in the aftermath of the traumatic event. I also saw, in the comments among the well wishes, prayers for healing and comfort, and validation of the storm of emotions the person was feeling, that there was a person who had bluntly and unkindly commented what basically translated to, "I've gone through stuff, too, but you don't see me posting about it online. This is a stupid way to process your trauma. You're really just looking for attention and sympathy from strangers on the Internet."

I know that everyone processes trauma differently. Some people prefer to be left alone with their trauma as they deal with it. Some people prefer to talk about it with their support system. Some people write about it as a way to process it, sometimes privately and sometimes publicly by "screaming into the void." None of those options are "attention-seeking" or "just a way to get sympathy." They're all valid ways to process trauma. (Extra tidbit: If you watched Sherlock on BBC, Dr. Watson's therapist asks him about the blog he's supposed to be writing to help him process his time in war.)

Experiencing trauma tends to isolate people. It's hard to talk about our thoughts and feelings about a traumatic event when we feel overwhelmed by them or when we don't really understand why we're thinking and feeling the way we are in the aftermath. Sometimes, screaming into the void is the only thing that keeps us from feeling so alone and feeling like we're drowning in the tidal waves of emotions we're trying to sort through. 

Screaming into the void often feels like a safer, more cathartic way to process trauma because it feels more anonymous than sharing with our everyday support system. When we see someone every day, like friends or family members, they develop these ideas of who we are as people, and they expect us to think, behave, and speak in certain ways that fall in line with that idea of who we are. We know this, so we may be worried about how these people think of us, and we'll probably be worried about shocking, worrying, or disappointing them. This concern for how they see us often leads us to censor ourselves to preserve their positive opinion or prevent disappointment, worry, or judgement. 

We don't have to worry about censoring ourselves if we're screaming into the void to people on the Internet that don't already know who we are. They don't have any preconceived notions about us or expectations for how we'll feel, think, or behave. This sort of distance can allow us to be more honest and more vulnerable than we would be able to be with people we see all the time, sort of like how the airport phenomenon works. 

And, honestly, sometimes it's nice to have a wider reach to connect with other people, especially if we feel like our friends and family might not truly understand something we're going through. With as many humans as there are on this planet, surely somebody can relate to something we've screamed into the void at some point. Maybe they scream into the void, too, saying, "Hey, I feel that same feeling, and it makes it easier to carry knowing someone else feels it, too." Because some things are easier to carry when you know you're not the only person on the planet that has had to carry it and survived. (That's why I always looked for someone else writing online about dealing my same kind of intrusive thoughts whenever a new theme would present.)

I'll end with this: People process trauma differently. Some people sit alone with their trauma. Some people talk it out with their support system. Some people write about it privately in a journal or dairy. Some people "scream into the void" by writing about it online to feel less alone with it. Externally processing trauma isn't attention-seeking or sympathy-seeking behavior. It's a valid way to process that works for some people and not for others. 

It's a Mental Healthcare Issue, Too

*Warning: This post will be political as well as personal. Discussion of Roe v Wade. 

Mentally ill people are considered a vulnerable population. People with mental health conditions are more likely than people without mental health conditions to be victims of crime, including domestic violence and sexual crimes. In addition to that, many people with mental illness live in poverty because their mental health condition prevents them from getting and keeping a steady job. Many people with mental illness are on disability for their mental illness, and they can barely survive on that small monthly check when they have to pay rent, food, and utilities costs. Never mind about paying for medications that aren't covered by insurance if they even have insurance, a car with car insurance, or a cellphone. Many mentally ill people are so unwell that they can barely take care of themselves, let alone another human being.

I am a mentally ill person. For the rest of my life, I will be a mentally ill person. Now, I may have reached a point in my treatment that I can live alongside my mental illness without fighting it every day of my life, but I do still have some periods in which my mental illness severely affects my ability to function at my usual level. Keeping my mental health in a place where I have more good days than bad days is like a full-time job for me, and it's the kind of full-time job that I can't really slack off of or take a vacation from. 

I am also a person that does not want children...at all...ever...even under "ideal" circumstances for a lot of reasons that I won't go into detail about in this post. I did not make that decision lightly. I did not make that decision because I'm irresponsible, immature, selfish, lying to myself, too feminist, or any other stereotype that seems to be tossed at people who choose not to have children. I made the decision because being childfree is the best choice for me, my life, and my mental health.

Not only would having children be bad for my mental health because I would be trying to make myself fill a role that I felt I wasn't meant for, but I also already live with two clinically diagnosed mental health conditions. Treating, managing, and living healthily with those conditions takes a significant chunk of my internal resources. Parenting a child properly takes practically all of a person's internal (and in many cases all of a person's external) resources as well. So, when I consider the resources that I have and my mental health in thinking about whether I could adequately parent a child without my mental health or the child suffering, my answer is: NO, I COULD NOT DO IT. Yet, I could end up being forced to since I live in state with very strict abortion laws.

I know my story isn't unique. Plenty of people list mental illness as a reason that they have for choosing not to have children. Many people recognize that they don't have the internal and/or external resources to properly care for a child AND themselves. Many people don't want a child to suffer through growing up with a parent that has a mental illness that would interfere with parenting and/or don't want to subject a child to a genetic predisposition to a mental illness that would make life more difficult for them. In addition, many psychotropic medications (the medications used to treat mental health conditions) can cause birth defects, which can make babies unable to survive outside the womb or, if they do survive, they may be a child that needs expensive care or surgeries that someone who lives in poverty because of their mental illness wouldn't be able to afford. 

Since Roe v Wade was overturned by the Supreme Court, many states, including the state that I live in, have laws that will go into effect banning abortions in almost all cases. There are no exceptions for rape or incest in my state's ban. There are also no exceptions for birth defects in the fetus in my state. There IS an exception for the health of the mother, but it only applies if the mother's life is in danger or if a major bodily function would be irreversibly damaged. As you can guess, mental health is not included under the exception for the health of the mother. 

States like the one where I live already don't think of abortion as healthcare unless the person who is pregnant is teetering on the edge of death. So, of course, they completely ignore that abortion is a part of mental healthcare as well. For me, it doesn't seem that farfetched to be concerned that many people with mental health conditions will be forced to stop taking the psychotropic medications that literally save their lives once it's medically confirmed that they are pregnant because the fetus is already considered more important than the person carrying it, according to the coming law in my state.

With laws like these, we'll likely see an increase in suicide among mentally ill people who find themselves pregnant and can't access abortion and can no longer take their medications because they don't want to cause damage to the child they'll now have to raise. We'll see more children neglected and some actively harmed because they live with a parent who can't care for them because of a mental illness. We'll see more children who had the misfortune to be born with a genetic predisposition to mental illness left in foster care until they age out of the system because people don't want to adopt children with "red flags" like a family history of mental illness or possible birth defects. Those "unadoptable" children will grow up to be traumatized adults who will also need access to mental health services because the foster care system isn't actually the kid-friendly system people think it is. 

Forcing more children to be born to people who don't have the ability or the resources to care for them isn't saving children. It's creating more children that will end up suffering. (And no, having a child more than likely won't be the thing that saves a mentally ill person from their illness. It doesn't work like that.) It'll actually create yet another crisis in mental health and even more of a strain for agencies like the Department of Human Services and Child Protective Services.

I'll end with this: Safe, legal and easy access to abortion isn't just healthcare, for many people it's also mental healthcare. If people with mental health conditions are barely surviving to care for themselves, expecting them to care for another human being that is completely dependent on them for survival is only going to be a stress that can exacerbate their mental illness. In fact, forcing anyone to live a life that they feel they can't sustain and be healthy, or that they feel isn't true to who they are, is going to have mental health consequences for them and the child they're going to be forced to care for.

What's the Point?

Currently, no cure for mental illness exists, but mental illness is treatable and manageable. This means that once a mental illness shows up in a person's life, they'll likely be dealing with the symptoms of that mental illness for the rest of their life, even if they go to therapy, take their medications, and do everything they're supposed to do to manage it. This reality of mental illness can lead a lot of people to think, "If it's not even curable, and I'm going to continue to experience symptoms with treatment, then what's the point of getting treatment at all?"

I know, it's really hard to hear that an unpleasant condition is now going to be a thing that you have to make room for in your life instead of a thing that you can get rid of completely. I know it's discouraging to hear that you can do everything "right" and still experience symptoms that interfere with your life. I've been there, and I've felt all the emotions that go along with that realization. I will still tell you that treating and managing your mental illness is worth it, even though it won't be cured. 

Calling life with a mental illness, particularly an undiagnosed and/or untreated mental illness, unpleasant is an understatement. Life with an undiagnosed and/or untreated mental illness is a miserable existence for most of us, and the longer a mental illness goes untreated the worse it tends to get until we reach a point at which we're no longer actually living; we're just...here, drowning in an invisible ocean of misery and barely surviving hour by hour. 

So, what's the point of treating and managing your mental illness if it can't be cured? The point is simple: you deserve it. You deserve to live a life that is made up of more than drowning in the invisible ocean of misery that your mental illness has created. You deserve to live as fully, as healthily, and as happily as you possibly can alongside your mental illness. You deserve the healing that happens as you learn to manage your mental illness and live peacefully with it. You deserve the treatment to be able to get to that place. 

Yes, the mental illness and its unpleasant symptoms will still be there, but your relationship to it and the amount it affects your life will change over time with proper treatment. The treatment and the management techniques make the mental illness less difficult to carry so that you're aware of it but it's not a thing that you're drowning in ALL THE TIME anymore. Bad days will probably still happen, but with treatment and mental health management, the bad days can become more spaced out and a little easier to recover from when they do happen. Treating and learning to manage your mental illness makes life a little easier to live, even with the bad days. 

 

I'll end with this: The reality of mental illness is that it can't be cured. It can only be treated and managed, which means symptoms are going to come and go, even when someone does everything "right" to treat and manage the illness. This reality often leads people to wonder, "Well, what's the point of treatment if I'm just going to keep having symptoms anyway?" The point is that life with an untreated mental illness is miserable, and you deserve to live a life that is filled with more than the misery created by your mental illness. You deserve to heal and to live as fully, healthily, and happily as you can with your mental illness, and treatment and management can help you along that path.

Trending: Mental Health Stigma

Recently, I've noticed people on social media, especially Twitter, saying something that seems to be a sort of slang that goes a little too far, especially when I think about the fact that we're still dealing with a heavy layer of mental health stigma as a society. Lately, I've been seeing people mention a personality trait, habit, or behavior and then say, "that's mental illness" as a way to emphasize that they don't like whatever the trait, habit, or behavior is. Not only are statements like those judgmental and unkind, but they also keep the mental health stigma alive and well. 

The knee-jerk reaction to my assertion about the mental health stigma related to the above-mentioned statements might be to think that I'm just nit-picking. People might roll their eyes and think, "Oh, come on. It's just the newest trend in harmless Internet speak. It'll pass soon enough." You might be right that the trend will pass relatively quickly, but it probably won't pass before somebody in your friend group or family who quietly lives with a mental illness is negatively affected by it.

Statements like the ones I mentioned above turn neutral terms like "mental illness" and "mentally ill" into an insult. When terms like "mental illness" and "mentally ill" are used to convey a dislike of annoying habits or even some problematic behaviors, then being annoying or a "problematic person" can become another generalization about or even another stereotype of mental illness. Once a generalization like that becomes thought of as common knowledge and a stereotype like that makes its way through society, then all people with a mental health condition start being thought of as an annoying and/or problematic person just because they have a mental illness, which can make things like entering into and maintaining a relationship or even finding employment even more difficult when or if they disclose the mental health condition. This extra layer of difficulty can lead even more people to refuse to get a diagnosis and treatment because they don't want to have to deal with the negative assumptions that society will make about them.

Using terms like "mental illness" and "mentally ill" as an insult is hurtful on a deeper level as well. Calling something like a habit or a behavior a mental illness just because you don't like or agree with it trivializes the struggle and pain of living with an actual mental illness. When words like "mental illness" and "mentally ill" start getting thrown around to mean or describe anything less than the actual, diagnosable conditions that take people's lives, the whole concept of mental illness can be seen as less serious than it should be. The mental health stigma already tells society that mental health conditions aren't real health conditions; we don't need slang on the Internet to play up that idea and make it even harder to fight that piece of the stigma.

I'll end with this: I know trends and slang change quickly, especially on the Internet. However, just because things like that come and go relatively quickly doesn't mean that they don't hurt people even after the words and their "updated" meanings have changed or faded from use. The words we use and the way we speak to and about other people matter. Calling something a mental illness that you don't like or agree with isn't only judgmental and unkind; it also helps the mental health stigma maintain its hold in society and makes life that much more difficult for people with actual mental illness.

Like Him

Full Disclosure: I struggled with the decision to write about this topic. This is probably the most personal blog post about my life that I will ever write. Trigger warning: This blog post contains details related to domestic violence.

I'm pretty sure I've mentioned in previous blog posts that my mom also lives with a clinically diagnosed anxiety disorder. I'm pretty sure that I've also mentioned that she does a great job at managing and living with her anxiety disorder. What I haven't mentioned before is that my other parent lived with bipolar disorder for which he refused to follow through on any kind of treatment plan. In addition to the untreated bipolar disorder, he also had pretty extreme issues with power and control that made him an abusive person. The fact that he self-medicated for the bipolar disorder with alcohol only exacerbated the power and control issues and worsened his bipolar-related impulse control issues. 

Growing up with my father in the house for the short time before the end of the relationship, I mostly remember fear. I remember his anger, the yelling, and the times when he would become violent. I remember other times, too, when he was downright cruel in very calculated ways that had nothing to do with impulsive, violent outbursts. I remember the multiple suicide attempts when my mother would try to get him to leave to end the abuse. I also remember the multiple times he had to go into in-patient treatment to get his medications and the rest of his treatment plan sorted out, but then he'd always go back to the same hurtful pattern as soon as he was released. 

His family and sometimes mine would make excuses for his behavior. He had bipolar disorder, and they blamed the anger issues and even the abuse on the bipolar disorder. For some reason, nobody ever really pointed out that it was his responsibility to treat and manage the combination of his bipolar disorder, his power and control issues, and his drinking in order to not be the abusive person that he was. 

As you can imagine, with the way people linked his violent behavior with his mental illness, I also made that same link in my young brain, and it stuck there for years. In medical appointments, I often heard doctors talk about my genetic predisposition for mental illness (which doctors made seem like an inevitable thing) because of my father's bipolar disorder. As a result of that kind of input, I was terrified of developing any mental illness, because in my mind, mental illness could make me more like the man that had caused so much fear and hurt in my family.

I spent a lot of time as a teen monitoring myself to make sure I wasn't LIKE HIM. I monitored my anger very closely. I monitored myself for signs of depression. When the intrusive thoughts made their appearance, one of my thoughts besides thinking I was possessed was, "Is this going to make me LIKE HIM?" This fear of being LIKE HIM may have played a small part in why I refused to acknowledge the fact that something was wrong and I why I didn't seek treatment. It definitely played a part in my earlier refusal to accept my mental illness as a thing with which I could co-exist peacefully.

The thing that I didn't realize until much later than I should have was that I was never going to be like him, even if I developed a mental illness, even if I developed the same mental illness. Although his mental illness was often used as an excuse, it wasn't what truly made him the person that hurt our family. (Because, as we all know, living with bipolar disorder doesn't just make someone uncontrollably violent.) His choices made him that person. He actively made the choice to continually behave in ways that were violent, abusive, and cruel. He actively made the choice not to go to therapy and not to take his prescribed mood stabilizing medications. He actively made the choice to self-medicate with alcohol even though he knew it wasn't healthy. Since he actively chose to be the way he was, I realized that I could actively choose to be different from him, even with a mental illness. I was already actively choosing not to be like him before the mental illness became an issue, and I could continue making choices that were different from him as I learned to live with my mental illness.

I'll end with this: Having an abusive, mentally ill parent, especially when we actually hear people linking the abuse with the mental illness, can make us afraid of confronting, dealing with, and accepting a genetic predisposition to develop a mental illness because we may worry about becoming LIKE THEM with mental illness. But...just because we're genetically predisposed to develop mental illness because of genes we share with a terrible person doesn't mean that we will become a carbon copy of that terrible person if or when that mental illness appears. Our mental illness, even if we developed it because of the genetic bits we share with an abusive parent, will not be the dreaded, terrible, terrifying thing that makes us LIKE THEM. It's the choices that we make, whether we make the same harmful choices they made or whether we actively choose to make different choices, that make us LIKE THEM. 

Poor Mental Health vs. Mental Illness

Sometimes, I see and hear people use mental health and mental illness interchangeably. I especially see it when people equate poor mental health with mental illness. I can see why a lot of people often think poor mental health and mental illness are the same thing based on the broad definitions we find online, but poor mental health is not the same as mental illness. 

According to the CDC, mental health is simply defined as "our emotional, psychological, and social well-being." Everyone has mental health that varies from great to poor from time to time, just like everyone has physical health that varies in the same ways from time to time. Also, just like with physical health we need to do certain things to make sure we're doing everything we can to maintain good mental health like getting adequate sleep, taking time to rest and de-stress, getting appropriate exercise, having meaningful social interaction and connection, making sure we have time for fun in our lives, and making sure we have healthy coping strategies for the ups and downs that come with life. 

Just like everyone experiences periods of poor physical health, everyone will also likely experience periods of poor mental health. Too much stress can contribute to poor mental health. Not enough time to rest and relax can contribute to poor mental health. Spending too much time or not enough time having meaningful interactions with other humans, depending on whether you're an introvert or an extrovert, can contribute to poor mental health. Being in a career or working at a job that doesn't give you enjoyment and fulfillment can contribute to poor mental health. Not having adequate coping skills to deal with things like the death of a loved one, a relationship breakup, prolonged conflict and stress within a family unit, having to live or behave in a way that feels contrary to who we are, or any other negative life experience can contribute to poor mental health. Basically, any prolonged period in life in which your social, emotional, and psychological needs aren't being met can lead to poor mental health, just like not meeting your body's physical needs leads to poor physical health.

When someone has poor mental health that does not mean that they have a mental illness. Poor mental health is not always a clinical condition, unless a person has a stress-related or exhaustion-related breakdown of some kind that requires hospitalization. (Although, seeing a therapist to help sort out the things related to your poor mental health is GREAT. Grief counseling...stress management...family therapy...all are good options to help you find ways to meet your specific needs.) Poor mental health can be improved by regularly checking in with yourself to make sure you're doing everything you can to meet your body's needs as well as your social, emotional, and psychological needs. Sometimes, to "cure" a period of poor mental health you may only need to slightly adjust the pieces of your life so that you're able to put more energy into different pieces.

Mental illness is a different thing altogether from poor mental health. Mental health is a fluid state of being. A mental illness is a clinically diagnosed condition that has a specific set of symptoms that severely and negatively affect a person's life. Mental illness, unlike poor mental health, can't be "fixed" or cured. It can only be treated and managed, most often with a combination of therapy and medication. Living with mental illness isn't just about making sure you're meeting your social, emotional, and psychological needs; it's about actually correcting issues with how your brain works, like issues related to the chemicals that the brain produces, reactions in certain areas of the brain, and actual pathways that have formed in the brain.

The causes of poor mental health and mental illness are also different. Poor mental health can often be caused by major life events, things in a person's environment, and/or the way they're living their life at the time their mental health becomes poor. Mental illness, on the other hand, has an internal cause related to how the brain actually functions and may have a genetic component that predisposes a person to develop a certain mental illness. A person with a mental illness may not have even had poor mental health prior to the onset of the symptoms of their mental illness. 

I'll end with this: Mental health is a state of being, like physical health, that can and does change from time to time depending on how well our needs are being met and how well we're coping with our life experiences. Mental illness is a clinically diagnosed condition that has a specific set of symptoms that severely and negatively affect a person's life and is usually treated in a specific way with therapy and medication. Being in a state of poor mental health and having a mental illness are not the same thing. A state of being can be changed and remedied, but a mental illness can only be treated and managed for the rest of someone's life. 

Some is Better Than None

Many of us that live with a mental health condition have probably been told by our mental healthcare team that we needed to make some lifestyle changes as well as taking medication and going to therapy in order to help our unwell brains become healthier. We've probably been told that exercising would help improve our mental health along with getting more sunshine. If your therapist is anything like mine, they may have also suggested taking up a meditation practice, doing yoga, and even diet changes to help manage the day-to-day symptoms of our mental health conditions.

Being asked to make all those lifestyle changes at once can feel like we're being asked to do a complete lifestyle overhaul, and that can be daunting, to say the least. The knee-jerk reaction for many of us is to say, "I'm never going to be able to make these big changes like they've asked. I'm not even going to try so I don't have to fail at it." It's not that we don't want to do it a lot of the time, really. Sure, resistance to the therapeutic process might be a piece of the puzzle, but the other pieces of the puzzle are all real world based. Those big changes can be hard to make because of budget, time, energy, and actual physical limitations that we have to work with.

When I first began my meditation practice, I would constantly take this issue to my therapist. I knew from research that twenty minutes of daily meditation is the amount of time recommended by scientific studies to be the most beneficial for helping manage the symptoms of mental illness. I felt like I was failing at meditation because I just couldn't make it to the recommended twenty minutes. I could comfortably do ten minutes before I started to feel stiff and fidgety and before I got antsy for it to be over. There were also times that I couldn't even find the time in my day to do the ten minutes. 

My therapist would always remind me of the same thing. She would say, "Just remember that some is better than none. Just because the science says that twenty minutes of meditation a day is the MOST beneficial for our brains doesn't mean that less time isn't beneficial, too. Any time you spend in meditation, whether it's ten minutes in a quiet room, a couple of minutes in the car, or even a minute in line at the grocery store, is better than spending no minutes in meditation."

She had the same approach to exercise and diet. Some smaller healthy changes that build to a bigger change are better than making no healthy changes in diet and exercise at all. If you can't do a complete diet overhaul, swap one unhealthy snack for a healthy one each day, like swap carrots, olives, or an apple for your usual potato chips or swap water for one of the sodas or sugary juice drinks each day. If you can't do a full work out because of time constraints with work or school or because of physical limitations, find some stretches to do at your desk or find some targeted exercises that work with your physical limitations that you can do so you're doing some exercise. 

The point is that we're trying to make the changes that will help our unwell brains. Instead of getting hung up on how big and daunting the changes feel before you start, and instead of remaining locked into the same patterns that are unhealthy because you have no idea where or how to start, just remember: some is better than none. Some of a good change in whatever area you need to work on is better than no good change in that area. You can always build on the "some" and the small changes as you go along and figure out what you have to work with in your life until you reach your goal.

I'll end with this: Being asked to make lifestyle changes in order to help our unwell brains can feel like we're being asked to overhaul our whole lives, which seems impossible to manage for a lot of us with budget, time, energy and/or physical limitations. But...we don't have to do the whole overhaul at once if it doesn't fit in the confines of the resources that we have. It's okay if you can only make smaller lifestyle changes, and you shouldn't feel like you're failing or that those smaller changes won't be beneficial for you. Remember you're doing your best with what you have to work with, and also remember that some healthy lifestyle changes are better than no healthy lifestyle changes. You can build on the "some" whenever you have the ability to do so, but you can't build on anything if you don't start it.

Who Am I to Tell You?

 I recently saw a series of tweets by Allison Raskin, a mental health advocate that I respect and admire, and I've been thinking about her tweets ever since. In these tweets, she talks about how she used to "gate-keep" OCD diagnoses. She said that she used to be someone who didn't want people to say they had OCD unless that person had been diagnosed by a mental health professional. She went on to say that she felt differently now because she realized that, basically, she didn't have the right to say whether another person had "OCD tendencies or enough symptoms for it to significantly impact their life."

I hadn't realized it until I read the words of Allison Raskin that I'm also guilty of gatekeeping mental health diagnoses, especially OCD diagnoses. I've had a few people in the past earnestly tell me that they believed they had OCD. A dear friend once told me that he believed he had "a touch of OCD" after I disclosed my diagnosis to him. My response was usually to tell the person something like, "Well, unless you see a mental health professional and get a diagnosis, you can't really just go around saying that." After my dear friend said he thought he had a touch of OCD, I remember telling him, "You can't have a touch of OCD, really. You either just have it or you don't, and you need to see a professional to find out for sure." I have to admit that I was also a bit offended when people would say they had OCD if they hadn't been clinically diagnosed. 

My reasons for gatekeeping are similar to the reasons Allison Raskin laid out in her tweets. Like her, I also felt like people self-diagnosing OCD (or any mental health condition, really) would minimize the condition and the struggle of living with it. My other reason for gatekeeping was well-intentioned, but it was still gatekeeping. I didn't want people to self-diagnose mental illness because they might be wrong. I was worried they would self-diagnose a mental health condition and get the condition wrong and then apply the wrong at-home treatment approach or that what they thought was a mental health condition could actually be a neurological condition or some other physical health problem that needed timely medical intervention.

Thinking about it now, of course, Allison Raskin is absolutely right. Who am I to say whether or not someone has a mental health condition? I don't live in their body with their brain. I don't live their life with them every day. Who am I to say whether or not and to what degree something impacts somebody else's life? I don't have the right to tell them that they can't say or think they live with a certain mental health condition because they haven't been given a clinical diagnosis from a mental health professional. Not everyone has access to a mental health professional to even get the clinical diagnosis. 

My job isn't to police whether or not someone has a mental health condition based on whether or not they have seen a mental health professional to tell them they have the condition. My job isn't even to observe them to see if they actually have symptoms of the mental health condition so I can disprove or approve their self-diagnosis. My only job is to ask, "How can I help?" and then listen to them when they tell me what they need from me, whether that's helping them find information about the disorder they're concerned about, helping them navigate finding mental health services, sharing what I've learned in therapy, just listening to them as they think out loud about it, or just checking on them every so often.

I'll end with this: Recently, thanks to Allison Raskin, I realized I had been gatekeeping mental health diagnoses and that I shouldn't have been. I don't have the right or the knowledge and insight to tell someone whether or not they have a mental health condition or to what degree it affects their daily life. I don't live in someone else's body to experience the way they think and feel, and I'm not a mental health professional qualified to observe and diagnose them. In situations in which someone believes they have a mental health condition, my only job is ask how I can help and then actually listen to what they need from me.

My OCD Didn't Make Me a Better Person

I get varied reactions when I mention that I live with a subtype of OCD called primarily obsessional OCD and that my obsessions tend to be religiously and morally based. Some people are confused but curious because they never knew OCD could be more than the stereotypical contamination or checking type of OCD. Some people think I'm joking when I tell them that I can't lie. Some people are dismissive because the particular type of OCD I live with doesn't seem like a "real" mental illness. Then some people say things like, "Well, at least your mental illness makes you a better person."

I know, or at least I hope, the person is saying that statement from a place of kindness. I try to remind myself that the person is probably trying to find the silver lining in a situation that they don't really understand. However, statements like the above really hit a nerve with me. 

On the surface, the statement feels dismissive of my mental health struggle. On a deeper level, it feels uncomfortably close to the "transformed by suffering" trope we see over and over again in movies and books in which something tragic happens to a person who consistently lives in a moral shade of gray, and then they suddenly realize they need to be a better person after the tragic thing happens to them. It feels, to me, like the person is softly implying that my OCD is the tragic thing that turned me into a better person, which isn't really how OCD works.

The thing about OCD, according to my therapist, is that it tends to attach to the areas of a person's life that are most important to them, and then it tortures them with it. For people with morally based OCD, sometimes called Scrupulosity, those people are already morally upstanding people that are doing their best to be honest, kind, and helpful, but OCD makes them doubt that and then tortures them with intrusive thoughts related to falling short of their version of moral perfection. For people with religiously based OCD, they're already walking in a path of faith and doing their best to live their lives according to that faith, but the OCD torments them with thoughts related to their sins, their higher power's anger at them for falling short of perfection in their religious practice, and terrifying blasphemous thoughts. This aspect of life that the OCD is attached to is so important that the person often feels a crushing amount of guilt and shame. With OCD there is no such thing as "good enough"; it has to be complete perfection or we're complete garbage. 

I was already doing my best to be a good person. I was already doing my best to walk thoughtfully down my faith path. My OCD didn't make me a better person or a more devout Christian. All it actually did was give me an unhealthy dose of moral perfectionism, and it made me hate myself so much that I thought it would be a blessing if I didn't exist anymore. I didn't need all the mental anguish that comes with living with a mental illness to grow as a person or to push me to strive to be the best version of myself. What I needed was to be able to love myself while allowing myself to be as human as possible so that I could learn from my mistakes and grow as a mentally healthy person without the rigid black and white thinking and self-loathing that comes with OCD. 

I'll end with this: Some people think that certain mental illnesses like morally themed OCD and religiously themed OCD make the people that live with them better people. On the surface, sure, it might look like that because the person is really honest and kind or really devout. But...that's not actually how OCD works. OCD actually attaches to an area that is really important to someone and then basically tortures them with it. Since that area was already super important, the person was actually already trying their best to be morally upstanding or trying their best to walk thoughtfully down their faith path. They didn't need to be made into an even better or more devout person by irrational fear, mental anguish, and self-loathing. 

The Balance of Moments

     A lot of the time, living with a mental illness can feel like living with a bully inside our heads. It can feel like OCD and other anxiety disorders hoard our worst fears or our most embarrassing and most shameful memories to use against us when we start to feel the least bit secure or confident. Another way that our mental illness can be a bit of a bully, too, is by making us feel like we're difficult to deal with or a burden to our family and friends. 
    Life with anxiety comes with its fair share of panic attacks and stress crying. Sometimes, I end up catastrophizing in a situation, and all I can see are bad, worse, and end-of-the-world types of outcomes, which, of course leads to panic, hopelessness, and crying. Then loved ones have to deal with me after the crying or sometimes even during the crying. I'm frustrated that I've catastrophized myself into a panicked meltdown when I can logically see that I have catastrophized AGAIN, but I can't stop it once that ball starts rolling. They're frustrated because they may not even know why I'm crying or how to talk me down from that panicked ledge that looks right down at the end of the world.
    After it's all over, I'm left feeling, at best, like I was difficult in a situation that didn't even need to be made difficult by me or, at worst, like I'm a burden that my loved ones probably wish they didn't have to deal with at all. After every panicked meltdown I have that my mother has to witness, I'm so sure she's just going to be so tired of having to deal with me that she kicks me out of the house. In reality, she would never do that, but my anxiety often is not based in reality. My anxiety makes me feel like I'm such a difficult person, that I'm so hard to live with most of the time, that the only logical option is that people must not want to have to deal with me at all. I mean, some days I don't want to deal with myself either, so I get it.
    When I talked to my therapist about these feelings, she told me that just because we have moments that are difficult doesn't mean that we, as people, are difficult or a burden. She asked me if I had a friend who was experiencing something and catastrophizing until they cried if I would think they were difficult or a burden. Of course, I wouldn't. So, she asked me, "What makes you different from your friend? What makes you feel like you're more difficult and that people don't want to deal with you?" I didn't have a logical answer that didn't have to do with my mental illness. 
    My therapist also asked me to think about the balance of the moments. Sure, there are difficult moments. Sure, there are moments when I'm a difficult person to deal with and people get frustrated with me. However, there are also good moments in my relationships with people...moments in which I'm funny, moments in which I'm caring, moments in which I'm the one listening to loved ones and offering helpful advice, and moments in which I make people's lives a little bit better because I'm part of their lives. She also reminded me that it's likely that the difficult moments don't actually outnumber the good moments and that the difficult moments don't take away from the good moments. 
    It's also important to remember that all humans have moments when they're difficult to deal with, whether or not they live with a mental health condition. Nobody is pleasant and agreeable all the time because we all have changing moods, unpleasant thoughts, and days that feel like they're terrible for lots of internal and external reasons. What's important is to view the bad days in the whole balance of good and bad moments and to try to remember not to believe everything you think.
    I'll end with this: Life with mental illness comes with its fair share of moments that are difficult for us and of moments in which we're difficult to deal with. The moments in which we feel like we're being difficult or making a situation difficult can often lead us to feel like we're too difficult so that our loved ones wish they didn't have to put up with us or like we're a burden. Instead of letting that feeling take hold it's important to take the time to view the difficult moments in the whole balance of moments in our lives. Sure, you were difficult in that one moment, but that doesn't mean there weren't moments before and won't be moments after the difficult moment in which you did or can improve the lives of your loved ones by being yourself and being the kind, understanding, funny, and/or helpful person that you usually are.

Therapy Doesn't Work?

    Sometimes when I bring up therapy, people tell me that it doesn't work. I hear this from people who have never tried therapy at all, sure. However, I also hear this from people who have gone to therapy for a mental health condition who feel like therapy didn't help them, or worst-case scenario, that therapy made their mental illness and/or trauma worse than it was before. 
    I get it. I've been there. Through no fault of her own, my first therapist felt like she made my OCD and panic disorder worse. While I was in therapy with her, I probably would have been a person that was extremely hesitant to recommend therapy to other people because, at the time, I felt like therapy didn't work. Then I met my current therapist, and I finally started to manage my mental health conditions well enough to truly improve and begin a real wellness journey with the things she was teaching me.
    A lot of people think that just starting therapy sessions with any licensed mental health professional is the most important thing about therapy. It isn't actually. The most important part of starting therapy is actually finding the right therapist for you. This means finding a therapist that matches you in certain areas like their area(s) of expertise, the therapeutic techniques they use to treat clients, their treatment plan for you as a client, their ability and willingness to be available when you need them for regular sessions as well as emergencies, and their goals for your treatment. If you don't match with your therapist on these key elements, then, of course, you're not going to get what you need to improve from that therapist, and you're going to have the idea that therapy doesn't work because you're not improving. 
    My first therapist, although I was attached to her because she was the first professional that ever told me there was a name for the thing that made me hate myself and that it was a treatable condition, was not the right therapist for me. I needed more frequent sessions that she was able to offer me. She also didn't have the experience she needed to be able to adequately treat my subtype of OCD. So, of course, if I wasn't getting the treatment I needed from her, my mental health was going to continue to get worse. 
    It also seems like a lot of people expect therapy to work faster than it possibly can, and then they start to think therapy doesn't work because they aren't getting "better" fast enough. Therapy is a slow process. It's literally rewiring your brain and forming new neural pathways to make your brain healthier. You can't go to a month's worth, or even three months' worth, of therapy sessions and expect your mental health condition to magically disappear. If that's your expectation, of course it's going to seem like therapy doesn't work, and you'll be more likely to stop going to therapy before it has the chance to truly work. (Medication can generally help chemically rewire a brain faster than therapy alone for some conditions, but that's an option that people need to discuss with their treatment team.)
    I should also point out that some mental health conditions can be medication-resistant in some people. This naturally means that treating mental health conditions in those clients will be more difficult and will take longer. This doesn't mean that therapy doesn't work for them. It just means that it doesn't work as quickly as it does for clients that have medication as part of their treatment plan. 
    I remember when I first started therapy with my current therapist. I cried every week in my sessions for at least the first two months, and I cried more at home as I was learning to process and manage my anxiety and my other emotions in healthier ways. Even after I stopped crying in my sessions, it took a few more months to notice myself feeling, thinking about, and interacting with my OCD and panic disorder in a healthier way. I had to learn to let go of my expectations about how quickly I would get better and actually give the things I was working on in therapy time to change my brain. That's when I was able to let therapy do its job without judgment and impatience, and that's when I was sure therapy was working for me. But, before I saw that progress, man, did I want to give up a few times. (I'm really glad I didn't.)
    I'll end with this: Some people think that therapy doesn't work. They're not completely wrong, but they're not completely right in thinking that either. Therapy with the wrong therapist, the wrong treatment plan, the wrong treatment goals or expectations, and/or the wrong medication(s) will be therapy that doesn't work. When one of those things isn't right for someone, it can be discouraging, and it can make anyone want to give up on therapy altogether. It can even make us feel like it's our fault that therapy isn't working for us even though we desperately want it to work. However, therapy DOES actually work when you find the right therapist for you, and you actually give the therapy the time it needs to start working on your brain. If therapy hasn't worked for you before, or it currently isn't working, it may not be that therapy doesn't work at all; it could mean that one of the key elements doesn't match for you and something needs to be changed in order for you to get the help you need.

Your Friends are Not Your Therapist

    A lot of people think that therapy is just an un-interrupted hour in which people talk about their feelings, vent about their problems, and/or get advice from their therapist. Because that's the way so many people think of therapy, they also think that talking to their friends and going to therapy with a licensed mental health professional are the same thing. Those same people are also quick to point out, "Therapy costs money, and I can talk to my friends about the same stuff FOR FREE."

    Yes, it's always good to be able to talk to your friends about your life, including your mental health. Yes, your friends can be great at listening to you and helping you sort through some life-related issues.  But...YOUR FRIENDS ARE NOT YOUR THERAPIST and expecting them to be is unfair. I also feel like this needs to be said: talking to your friends about your mental health, although it can feel wonderful to unburden yourself to someone when you're dealing with a mental illness, is not the same thing as actually treating your mental illness so you can recover and heal your brain.

    On the most basic level, your friends are not qualified or trained to be able to SAFELY help you with your mental illness. Psychology (and counseling since it's part of psychology) is an actual science that takes years to study, understand, and use properly. Therapy is the actual scientific treatment plan that a licensed mental health professional uses with their client to be able to treat and manage the mental illness and the other ways that our brains can become unwell. Expecting your friends to take on the responsibility of being your (unofficial, untrained) therapist isn't only dangerous for them because they may take on your trauma as their own trauma since they aren't trained to properly set up boundaries like a therapist; it's also dangerous for you as well because your friend doesn't really understand how your brain is unwell in order to help you, which could actually create new ways for your unwell brain to become even more unwell when your friend says or does the wrong things.

    On a deeper level, treating your friends like your therapist will ruin your relationships. When you treat your friends like your therapist it can make you and your friends feel like they're responsible for your healing. That's a lot of weight to put on someone else's shoulders, especially when they weren't meant to pick it up in the first place. It's impossible to maintain a friendship when you expect things from the other person that are literally impossible things for them to give you. Your friends can't heal you from your traumas, especially when you're dealing with a mental illness that you're refusing to get actual treatment for, because your healing is your responsibility, not theirs. 

    I'll end with this: Talking about your mental health with your friends is generally a good thing. Expecting your friends to be your therapist instead of getting the real therapy that you actually need, however, is never a good thing. Your friends are not your therapist and expecting them to be is unfair and dangerous for you, your friends, and your relationship with them. 

It Takes a Team

    Friends and family will often say things to me like, "I'm going to ask my doctor for some Prozac or Paxil or Zoloft. I've been feeling depressed/anxious, and I just hate feeling that way." Then they'll go to their general practitioner family doctor, and they come back with a bottle of the psychotropic medication because the doctor wrote them a prescription for it, pretty much because they told the doctor they wanted it. When I ask them about a therapist and a psychiatrist or mention the words "mental healthcare team" they incredulously reply, "I don't need any of that stuff. I just need these pills from my doctor, and I'll be fine." (Spoiler: Most of the time, they're not fine with whatever they asked to be prescribed, and then they're angry that the medication didn't make them feel "fine". Sometimes the medication even makes them feel worse.)

    It's common practice in my state for general practice family doctors to prescribe psychotropic medications to their patients without consulting or referring to a psychiatrist or a licensed therapist for counseling. Family doctors here hand out anti-depressants, anti-anxiety medications, and some mood stabilizers like they're Advil or Tylenol. Pediatricians even prescribe ADHD medications for small children and anti-depressants and anti-anxiety medications to their teenage patients. Here, a person's general practice family doctor is usually the first and last stop for mental healthcare.

    Did you know that your general practice family doctor isn't supposed to prescribe medications to treat mental health conditions? I did not know this until I was majoring in psychology in college, and most people in my area do not know this. Let me put it like this: Getting psychotropic medications from your general practice family doctor is a bit like asking your cardiologist to prescribe the right eye drops to treat your eye infection.

    A general practice family doctor doesn't have the specialized training that is required to know how medications for mental illness (AKA psychotropic medications) work with the brain to treat the mental illness. Sure, they know what the pharmaceutical sales rep told them, what's on the package insert, and they know what the medication is prescribed for...but that's not enough to SAFELY prescribe them. They don't understand what these medications do as they work with a person's brain chemicals to make them feel differently or how they interact with each other if more than one medication is needed. The only medical professional that is specifically trained to understand how psychotropic medications work in the brain, with the mental illness that lives there, and what combinations of medications work well with or against each other is a psychiatrist. A psychiatrist is actually a medical doctor who specialized specifically in the study of the brain, mental health conditions, and the medications meant to treat them.

    Your general practice family doctor should definitely be involved in your mental health treatment, but your general practice family doctor should NEVER be the only person treating your mental health condition. Treating mental illness should ALWAYS involve a team of professionals. That team should include a therapist for counseling, a psychiatrist for prescribing any needed medications if medications are part of the treatment plan, and then your family doctor to help monitor the medication in your body and to consult with the psychiatrist about side effects and medication levels and your overall health.

    I'll end with this: Treatment for mental illness isn't a thing that can be accomplished by one single medical professional. Mental health treatment requires a team that includes a licensed mental health counselor for therapy sessions, a psychiatrist to prescribe medications, and your family doctor for things like monitoring the medications and side effects. Your general practice family doctor should NEVER be the only member of your mental healthcare team, and your family doctor should NEVER be the person prescribing your psychotropic medications. The only person with the proper training and knowledge to SAFELY prescribe psychotropic medications is a psychiatrist. 

Focusing on the Good

    Sometimes, feeling hopeful is hard. I feel like we've all had a period in our lives in which we hope for things, and then it feels like one gut punch after another when most or all of those things don't work out the way we had hoped or needed them to. After each gut punch, it gets a little bit harder and a little bit scarier to hope. It can feel like the next logical step is just to stop hoping and accept that things won't work out because that seems to be the pattern we're stuck in.

    Feeling hopeful has been particularly difficult for me for the last few years. More and more often over the last few years I've found myself thinking, "Yeah. There's no point in even hoping for that because I know it won't happen." Recently, I got a little worried about myself when I realized that hope-squashing thought had pretty much become my life motto.

    I addressed this concern with my therapist in my session. She told me that instead of only thinking about the times that I hoped for something that didn't work out, that I should think about the things that I had hoped for that did work out. She also told me that instead of focusing on the things that I felt like I wanted but didn't have in my life yet, to focus on the good things that I already had in my life while I wait.

    It's sort of like that saying, if you're always on the lookout for a spider, you're more likely to find a spider. If you're on the look-out for something, your brain is more likely to find it or, sometimes, even generate it for you. By thinking, "X happening is the pattern," you're programming your brain to pick out the examples that support that thought and disregard examples that don't support that thought.  Of course, if I'm thinking there's no point in hoping for something, I'm going to find more examples of when I hoped for something that ended up not working out. If I'm thinking that it might be okay to have some hope, I'm more likely to find examples of when I hoped for things that ended up working out. 

    Whenever I feel that hopelessness creeping back in, and whenever I catch myself thinking that I shouldn't hope for something because it won't work out, I try to think of a list of times when I hoped for something that did work out. Then I can shift my thinking to, "Yeah, things feel impossible right now, but X, Y, and Z also felt impossible at the time, and those things worked out. So, something has to work out eventually. The waiting is really hard, and I hate it...but right now I have X, Y, and Z that I hoped for in the past."

    My default is still to tell myself not to hope, but I made a New Year's resolution to try to be more hopeful in 2022 so I'm working on it. Some days, I literally have to list off everything over the last year or so that I hoped for that I have now so I don't get completely lost in the land of hopelessness. It's still a work in progress, but I can feel it making a small difference. 

    I'll end with this: The way we think about certain things programs our brains to cherry pick evidence from our lives that supports the way we already think and to disregard the things that don't support the way we think. So, if we think we shouldn't hope for things because it won't happen, of course, our brains are going to only pick out the instances that support that thought, which is going to feed that feeling of hopelessness. The only way we can actually fight that feeling of hopelessness so we can start feeling hopeful again is by focusing on the good instead and thinking about all the times we hoped for something that worked out. 

"Real" Trauma

    Sometimes, when I talk to my therapist about things like going to church, some details about my Evangelical upbringing, or the Baptist school I went to during childhood, she'll listen and then she'll say something like, "That was traumatic for you." Or, "X is hard when there is trauma related it." In my earlier days in therapy, I always felt weird when she'd mention trauma related to those areas of my life. I was even quick to dismiss it to myself and occasionally to her as "not real trauma" because the things I was dealing with didn't meet the definition of trauma that I had in my head because they weren't really "serious" or "big" enough. 

    When we think of trauma, we typically think of "big", objectively terrible events like war, natural disaster, car accidents, being the victim of a violent crime, living in a domestic violence situation, or witnessing the sudden death of someone. If any person lived through any of the things I just listed, they would be reasonably expected to have trauma as a result, meaning the event would have mental health-related consequences, like anxiety, panic attacks, depression, or another clinically diagnosed mental health condition.

    But...what about the events that aren't objectively terrible that still cause a person trauma? This kind of "smaller" more subjective trauma is often dismissed as "not real trauma". People tend to say, "Oh, this isn't a traumatic event for me, so it can't be a traumatic event for you either." 

    That's not actually how trauma works, though. According to the American Psychological Association's Dictionary of Psychology, trauma is defined as, "any disturbing experience that results in significant fear, helplessness, dissociation, confusion, or other disruptive feelings severe enough to have a long-lasting effect on a person's attitudes, behavior, or other aspects of functioning." That definition points out the part of trauma that most people miss. The "any disturbing experience" part of the definition highlights the subjective piece of trauma.

    Trauma isn't caused by the event itself, really. Trauma is caused by the person's experience and perception of an event. Different people experience and perceive events completely differently because different people bring different feelings, thoughts, and associations to the event that color how they experience and perceive it. Trauma, like mental health treatment, isn't a one-size fits all kind of thing. An event that causes trauma for one person might be a normal day for someone else. Many events can cause significant fear, helplessness, and other disruptive feelings for someone depending on how any individual perceives that event.

    An example that comes to mind for me when I think about how subjective trauma actually is, is my own experience with going to Tuesday chapel in college as a person with religiously-based OCD that involves blasphemous intrusive thoughts. Since I went to a Baptist college, chapel was a requirement. Every Tuesday that I had to go into church, I was absolutely sure that, before the service was over, I was going to be struck dead in my pew because of my intrusive thoughts. Can you imagine the fear and the helplessness I felt going to church, sure I was going to die each time but being forced to go for a school credit requirement? Some days I would actually dissociate, only to snap back into reality as I was walking to my first class. For everyone else, chapel was just an average Tuesday while I perceived it and experienced it as the event that would immediately lead to my death. (Thank God for my therapist, y'all, because I'm not in that place anymore.) Just because everyone else didn't experience Tuesday chapel as a traumatic event like I did doesn't mean that the resulting trauma I had to work through with my therapist was any less real than someone else's trauma after a car accident or some other objectively terrible event. 

    I'll end with this: The trauma that results from a traumatic event isn't caused by the event itself. The trauma is caused by the way an individual perceives and experiences the event. Sure, some events are objectively terrible, and anyone that went through any one of those objectively terrible events would be expected to have trauma as a result. However, "smaller", more personal events can cause trauma as well because the trauma depends on how the person feels and thinks about a thing they have experienced. So, just because something wasn't traumatic for you, or just because the thing wasn't an objectively traumatic event, doesn't mean it wasn't a traumatic event for someone else.