I'm Still Here

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

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

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

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

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

The Monster in My Head

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

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

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

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

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

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

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

The Other Half of Forgiveness

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

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

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

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

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

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

Checking In

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

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

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

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

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

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

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

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

I'll Deal with that Later

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

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

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

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

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

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

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

Accountability

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

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

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

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

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

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

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

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

Christian Faith and Therapy

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

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

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

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

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

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