A Realistic Way To Look At Mental Illness

Mental illness carries a lot of stigma.  People often hide their diagnosis or minimize their symptoms because they are afraid of the judgment that will follow.  It seems easier for many to suffer in silence than to have everyone else look at them as broken or crazy, as something to be feared or pitied.  Many people would rather struggle every day to function than to become a pariah or a joke.

Realistically, there is no shame in having a mental illness.  A mental illness is, in the simplest terms, an illness of the brain.  Our brain is just one of many organs in our body.  When another organ isn’t working properly, we see a doctor and get treatment.  No one is shamed for it because we understand that the body is a machine and that all machines have issues now and then.  The more pieces to a machine and the more functions it performs, the more likely that the machine might have an issue or break down from time to time.

Take the pancreas for example.  It is the organ that maintains the glucose levels in the body.  When the pancreas isn’t working properly, a person can become hypoglycemic, hypoglycemic, or diabetic.  All those conditions can be treated.  Nobody is shamed for having these conditions because we understand that sometimes organs do not work properly.  People go to a doctor and are given medications and treatments that will help improve their quality of life.

Take the heart. There are many conditions that affect the heart.  Heart disease is an umbrella term that includes all the disorders of the heart much like mental illness describes all the illnesses that affect the brain.  Yet there is no shame in talking about heart disease.  Food packaging proudly advertises that food is “heart healthy” and people are reminded regularly to take care of their heart so they can live a longer, healthier life.

The approximate overall cost of heart disease in the United States is 207 billion dollars every year.  That total includes the direct cost of treatment & medications, as well as the indirect cost of lost productivity.

(Based on: https://www.cdc.gov/dhdsp/data_statistics/fact_sheets/fs_heart_disease.htm )

In comparison, the combined direct and indirect cost of only SERIOUS mental illness every year is over 300 billion. That total does not even take into account moderate or mild mental illness, JUST the serious cases.

(Based on: https://www.nimh.nih.gov/health/statistics/cost/index.shtml )

Yet when it comes to mental illness, the room becomes so quiet that you could hear a pin drop.  You don’t see cereal boxes displaying that they contain nutrients for a healthy brain though so many of them do.  You don’t see advertisements recommending meditation to strengthen your brain like you do ones recommending walking and jogging to strengthen your heart.  The fact is – WE SHOULD.  The only advertisements we see regarding mental illness are the occasional commercial for a prescription illustrating that if a person feels broken, their medication might fix them.

The brain is just another organ in our body.  Like the heart, it is needed to survive.  The brain is the most complex organ in our body.  It controls so many things, from basic tasks to thoughts and emotions.  As the most complex organ in the body, it also has the highest chance to develop an issue.  According to the latest statistics from the National Alliance on Mental Health, “1 in 5 adults in the U.S. —43.8 million, or 18.5%— experiences mental illness in a given year”.  Those numbers are staggering.  When you consider how many others are suffering in silence and haven’t spoken out or received treatment, you can only imagine how much higher those numbers might go.

(You can find NAMI’s mental health statistics at: http://www.nami.org/Learn-More/Mental-Health-By-the-Numbers )

With that many people affected, and so much money being spent on mental health treatment, it is clear that mental illness has become a crisis of epic proportions.  When the number of people affected by heart disease skyrocketed, it became clear that something had to be said and done.  Change was needed.  It is no different with mental illness.

Mental illness is the umbrella term to describe conditions that occur in the brain.  No more, no less.  There should be no shame when someone has a mental illness because it is no different than if they had diabetes or heart disease – only the organ affected is different.  No more, no less.

Mental illness needs to stop being that dirty little secret we are afraid to talk about.  The stigma needs to end.  We need to rally behind those with mental illness like we do other health conditions, encouraging them to speak up, speak out and receive help.  We need to stop letting stigma label those who are suffering.  We need to educate and to encourage wellness.

Like many other conditions that affect a person’s body and organs, mental illness can be treated.  It is ridiculous that so many people are untreated or undertreated because stigma has turned mental illness into a dirty word.

Republished on SelfGrowth.com on 10/17/17.

Fighting Suicide From A New Perspective

I’m not going to lie.  I’ve been suicidal a handful of times in my past and have had a couple serious attempts.  I also struggle with suicidal ideation – those abstract thoughts not about wanting to die as much as just being so exhausted from struggling to live.  There have been so many times I have laid in bed sobbing, convinced I could not make it one more day.

These days, though I am still struggling with my mental health, I try to keep both active suicidal thoughts and suicidal ideation at bay.  Someone very dear to me almost lost one of their parents to suicide when they were a teenager.  They were the one who found them, who had to try to revive them and call 911.  Over a decade later, though their parent survived, they are still dealing with the aftermath.  Whenever thoughts of suicide or suicidal ideation creep into my mind, I think of all that they went through and tell myself that I could never do that to my own children, that I could not break their hearts like that.

For a while now, whenever someone has asked what keeps me going or why I haven’t given up, that has been my answer.  My children.  I love them more than I could even put into words and I would never want to hurt them like that.  There have been many times that my life has felt so hopeless, so horrible, that they were my only reason to keep going, my only reason to hold on.  I loved them too much to hurt them by giving up.

However, I saw something recently that threw everything on its side and turned my world upside down.  It was one of hundreds of little images that scroll along my social media feeds everyday.  Normally, while sitting online chatting with friends, I scroll by dozens of images like it, half-reading them as my attention strays elsewhere.  This one, however, not only grabbed my attention but shook me to the core. It said:

Suicidal people deserve better than to be told the main reason they shouldn’t kill themselves is because of how it might affect others. Suicidal people deserve love and help, not guilt trips.  Suicidal people deserve to feel like their life is worth living, for their own sake..  for their own happiness, their own experiences, their own possibilities, their own future.

I’ve been chalking my own battles with suicide as a victory merely because I have managed to push them aside and keep them at bay because I don’t want to hurt my own children.  Somehow that no longer feels like enough.  What if, heaven forbid, something ever happened to my children and I didn’t have them anymore as my reason to keep going?  Was I just going to throw in the towel, give up, lay down and die?  As much as I love my children, they cannot be my only reason to keep living, to keep fighting, to keep going on.  I deserve better than that.  They deserve better than that, too.

Right now, I am struggling in many aspects of my life.  I am dealing with a lot of personal issues above and beyond the ongoing battle of living with mental illness.  There are many days that I feel like I’m hanging on by a thread as my world continues to crumble at my feet.  I’m not going to lie and say that everything is peachy in my life because nothing could be farther from the truth.  I’ve spent too many years lying and convincing everyone that everything was okay as I was falling apart inside.  I cannot live like that anymore.  My life is a mess right now, but I own it.  It is MY mess.

But within the jumbled mess I call my life, I must find my own reasons to hold on, my own reasons to keep living, my own reasons to keep fighting, keep going and not give up.  I must learn to love myself enough that I do not want to hurt MYSELF the way that I’ve kept saying I don’t want to hurt my children.  I must learn to appreciate myself and all I have to offer.  I must plan for a future that I’ll be proud to live and aim for goals that will give me a sense of fulfillment for my own sake.  I need to get to a place where I am living for MYSELF and not because I don’t want to hurt someone else.

That is easier said than done.  It is easier for me to keep living for my children than to keep living for myself because in all honesty I love them more than I ever loved myself.  I have a long way to go.  I am just learning to like myself.  But it is a journey I must take and a goal I must meet.  One day, when I talk about all those times when life felt so horrible that I wanted to give up and someone asks me what kept me going, I want to be able to say “I kept going because I loved myself too much to hurt myself like that” and truly mean it with all my heart.

Until then, I’ll hold on however I have to and keep going, keep fighting because I can’t give up.

But one day, I WILL get there.

Because I owe it to myself to live for myself.

 

The Meltdown

I grew up with a mother who emphasized repeatedly that appearances mattered above all else.  As a child, behind all my decisions, my mother’s voice was ever-present, asking, “What would the neighbors think?”  The household was a dysfunctional battle-zone, but only behind closed doors.  From an early age, my mother implanted in my head the belief that neighbors gossip and the worst sin of all was giving them any fuel to add to their fire.

So I learned to carry myself a particular way, to walk tall, shoulders back, and smile like everything in the world was just peachy.  I built walls to hold in my pain and bolted on a mask to hide my tears.  I put on the performance of a lifetime for years, doing multiple shows a day.

On extremely stressful days or periods when my depression is weighing heavily on my soul, I try to push myself to go out in public because that is my last line of defense.  Though I might break down and crawl into bed for the day in the privacy of my own home, when I am surrounded by people, my mother’s voice is ever-present with me.  Somehow, though I want to curl up in a ball and cry, that little voice continuously harps to “hold it in, hold it together, don’t fall apart“.  After all, what would those strangers think if I had a meltdown and became a crying, sniveling mess?

Every now and then, however, the cracks in my veneer begin to show.  As much as I try to hold everything together, my walls crumble around me and I become a quivering, sobbing mess as all the depression and anxiety that has built up inside me comes pouring out.

Usually it is in response to something someone has said or done to me, especially if they are unnecessarily hostile or aggressive towards me.  It pierces through my artificial calm and triggers my flight response.  Alarms sound within my mind to flee, to find somewhere safe before the fragile walls I’m hiding behind begin to shatter.

I honestly hate that I am so fragile, especially when it comes to conflict.  For me, hardwired somewhere in my brain is a connection between conflict and abuse.  When I was a child and my mother became upset, some sort of harsh and irrational punishment was guaranteed, whether or not it was warranted.  When my older brother saw red, I quickly learned to get away before fists began to fly.  Though that little kernel of logic in my brain might reassure me that not everyone who acts aggressively means to inflict physical harm, my mind and my body react impulsively as if imminent danger lies ahead.

When I can neither flee nor quiet that alarm sounding in my mind, panic sets in and a meltdown occurs.  The artificial calm demeanor I have created begins to collapse and it feels like the floor has dropped from beneath me.  I feel as if I’m tumbling down a never-ending hole with nothing to grab onto, no way to prevent myself from falling apart.

I begin to feel unsafe, unheard.  I am transported back to a time when I was a little child with a little voice that went unheard.  Instead of reacting rationally, the floodgates open and a river of emotions cascade out.

My hands begin to shake.  My mouth struggles to find anything coherent to say.  I want to cry out and run away, yet I feel frozen in place, my feet cemented to the floor.  I find myself sobbing, melting down, babbling this endless stream of verbal diarrhea trying to simultaneously explain and defend myself.  My thoughts and statements ricochet all over the place, from one topic to the next, following no pattern, rhyme or reason.

Inside, that young child is screaming that it is all too much, that I can’t take any of this, that it needs to stop!  She is in a complete panic, scrambling for the right words to say to make it all go away, to make herself feel safe again.  An endless stream of “No more! No mas!” echoes within every word she manages to squeak out between sobs.

Meanwhile, the older, wiser, more rational part of myself seems to be standing to the side, witnessing it all in disbelief.  That logical fragment passes judgment, demanding to know what on earth I am doing, insisting I stop making a spectacle of myself.

Back and forth they battle in the background as the meltdown continues.  The small, injured childlike facet of myself falling to pieces while the other more logical facet scoffs and demands I pull myself together.  Little by little, my body and mind exhausts itself and the river of sobs transitions into a slow trickle of tears. I find myself mortified that I allowed it to happen again because I know I should be stronger than this.  I’ve had a lifetime of building walls and bolting on masks.  They should be strong enough to withstand anything by this point.

I wipe away my tears, take a deep breath and take my walk of shame out the door because I know this won’t be the last time I fall apart or meltdown.  It is all part of the burden of the functional depressive.  Though we may put on a brave face and act like our world is full of sunshine and peaches, our walls are made of dirt bricks that cannot withstand the waves of aggression from others or our own flood of tears that follows.

Republished on The Mighty on 4/26/17.

The New York State Appeals Process: Apparently Not Everyone Who The State Certifies To Prescribe Medication Is Considered ‘Educated Enough’ To Defend Their Patients’ Prescriptions During An Appeal

Government Red Tape & Legal Loopholes At Their Finest

After forty years of struggling with treatment-resistant depression, I finally found a clinic and team of doctors that have not only helped pinpoint genetic causes of my depression but that have also helped create a wonderful multi-pronged treatment plan that is actually helping me.

The person I see for the medication portion of my treatment plan was the one who first sent me for my Genesight test that discovered my genetic mutation.

(The full story explaining my genetic mutation and how it relates to my depression can be found HERE.)

He prescribed me a medication called Deplin, which provides my brain with a key substance my body is incapable of making on its own in any useful amount due to my aforementioned genetic mutation.  He started me on samples of Deplin right away and there was an immediate and extremely positive result.  For the first time in 40 years, I felt actual hope that I could have a life above and beyond my depression.

My insurance company, CDPHP, denied coverage of the prescription and my long battle began.  When I was called by the insurance company about the first denial and I explained my case further, it was suggested we re-apply for coverage, only to be met with yet another denial.

Meanwhile, I kept taking my samples, though the supply began to dwindle.

I spoke both with Assurex Labs who make the Genesight test that discovered my gene mutation, and PamLabs, which is the company that makes Deplin, about my ongoing battle for coverage and they both offered to help.  For my internal expedited appeal, I included not only approximately 50 pages of data showing the validity of genetic testing in the treatment of depression, but another approximately 50 pages specifically explaining my genetic mutation and the use of Deplin in its treatment.  Altogether, the paperwork I sent in alone, not even counting what my clinic sent in on my behalf, totaled well over a hundred pages.

Despite all the work put in by everyone involved, the internal appeal was denied.  Ironically, though CDPHP had over a hundred pages of paperwork faxed in, they rendered their opinion a few hours after the faxes were sent in, well short of the 72 hour time frame they had to review everything.  There was no possible way they could have reviewed everything before calling with their decision.  I’m honestly not sure they reviewed any of it at all.

I don’t believe it was ever a matter of the best interest of the patient with CDPHP.  From the beginning, their only concern has been saving money and avoiding adding another medication to their list of things they had to cover.  All explanations about how this medication was the only possible treatment available to me fell on deaf ears.

(My journey within the appeals process has been documented HERE.)

Meanwhile, my supply of samples of Deplin has been exhausted and I have found myself back where I once was, drowning in a sea of treatment-resistant depression that nothing seems to touch.

(The Explanation of the meds crash that followed can be found HERE.)

We began the process of filing for an external appeal with the state because, in New York state, even if an insurance company denies coverage, the state can overrule it if they see fit.  Unfortunately, as it has been explained to me by my treatment staff, appeals don’t always go well because insurance companies and the section of the government that oversees their decisions usually work in tandem, proverbially washing each other’s backs.

I began correspondence with a local newscaster, as well, who was well-known for her health advocacy work.  She advised me that, in her experience, external appeals tend to go 50/50 and to please let her know how it turns out because she was interested in the story.

Meanwhile, the gentleman in my treatment team who was in charge of my medication prescriptions began the lengthy process of formatting a detailed external appeal for the state, explaining once again that there is no alternative medication for my condition and including multiple articles from approved medical journals based on their guidelines that support his diagnosis and prescription of Deplin.  He sent in his portion of the 72 hour expedited external appeal last Thursday, 3/16/2017.

I heard back from a reviewer from the consumer assistance unit of New York State Department of Financial Services today, Tuesday, 3/21/2017, that they have not yet assigned an examiner and cannot do so until they receive an attestation from a doctor, specifically someone with an MD or DO after their name.

The gentleman who has been doing my medication management for two-thirds of a year now is licensed to prescribe medication in New York State.  He has a multitude of letters after his name, including CAQ & PA-C, however, though New York State AUTHORIZES him to prescribe to patients, he apparently is not allowed to assist in their medication appeals because he does not have an MD or DO after his name.

As explained by the reviewer, “The law says the attestation has to be completed by a physician.  The education law defines a physician and an MD or DO.  So in order for this to go external you will need to have the attestation completed by a physician.”  This means that, though New York State allows people with other degrees to PRESCRIBE medication, their appeals department uses a specifically restrictive and exclusionary definition as a legal loophole to mark as invalid and discard any appeals sent in by the treating physician unless they have one of two specific abbreviations after their name.

It does not matter that, according to the Merriam-Webster dictionary, physician is defined as “a person skilled in the art of healing; specifically :  one educated, clinically experienced, and licensed to practice medicine as usually distinguished from surgery”.  Speaking from a legal perspective, the Law Dictionary defines a physician as “A practitioner of medicine; a person duly authorized or licensed to treat diseases; one lawfully engaged in the practice of medicine, without reference to any particular school.”  Speaking from a medical perspective with regards to the term physician, the Medical Dictionary states “In the UK it refers to a specialist in internal or general medicine. In the USA it is a more general term for a medical doctor.”  Despite the seemingly broader and unified consensus of this definition, New York State has its own much smaller and less inclusive definition of physician which they apparently use to disregard and nullify otherwise valid patient appeals.

My mind is beyond blown at the loopholes this department is using to prolong this appeal.  In my disgust, I went so far as to ask them if I am supposed to see yet another doctor beyond my treatment team and to please explain to me how the state can certify someone to treat patients and prescribe medications one moment and then in their next breath deem them unqualified to speak on a patient’s behalf as to why they need that prescription.  It’s irrational to the point of being ludicrous.

Thankfully, when I spoke to both the director of the clinic where I am in treatment and the gentleman in charge of my medication management and they both assured me there was a supervising psychiatrist who would be in the office tomorrow who can assist me further.  This supervising psychiatrist apparently has the correct letters after his name to re-submit paperwork on my behalf.

I am beside myself with disbelief at this whole fiasco.  None of this should be THIS hard.  It’s a matter of simple facts.

FACT: I have a gene mutation that renders my liver incapable of breaking down a nutrient my brain needs in order to treat my depression.  Without this broken down nutrient, the neurotransmitters in my brain cannot function properly.

FACT: There is a synthetic version of this nutrient on the market called Deplin.  I have tried it for months and it works for me.

FACT: There is no other alternative on the market and no other possible treatment that could give my brain what it needs.  This is the ONLY treatment available for my genetic mutation and the ONLY way that any other antidepressants or anti-anxiety medications prescribed would work for me in the treatment of my depression.

Those three facts alone should be enough reason to approve this medication for me.  Yet the insurance company has denied it multiple times and now the state is dragging its heels, refusing to even assign an examiner until someone with the correct letters after their name signs and submits the same forms that have already been submitted.

You would honestly think that anyone who can prescribe medications in this state could defend their prescriptions in the appeals process on behalf of their patients.  It makes perfect sense.

Except to New York State.

It is complete insanity.  The people making health coverage decisions need to start considering the lives and the health of the people involved instead of worrying about saving a few dollars here and there.  They need to start considering doing what is in the best interest of the patient and not worry about “winning” or “proving points”.  This is NOT a game.  I’m fighting for my life and my mental health here.  I’m fighting for the ability to get the treatment I desperately need so that I can get better.

My heart goes out to everyone out there fighting the appeals process, trying to get their treatment or medication covered.  It should NOT be like this.  Doctors, therapists and insurance companies should be working hand in hand to do what is best for the patient, not denying coverage just to save a buck.  I am blessed to have an amazing treatment team that has been standing behind me every step of the way and assisting wherever they can, yet most days, I am still overwhelmed and frustrated beyond belief trying to deal with this lunacy.  My appeals process has been ongoing for over half a year now and it is becoming harder and harder each day to keep fighting and not just roll up in a ball and cry.  Some days, there is no fight left, only tears.  I cannot imagine having to deal with something like this on my own yet unfortunately many people do.  My heart sincerely goes out to each of you.  Stay strong, keep fighting and please don’t lose hope.

 

…So Tired Of Being Judged For My Depression

I recently had someone ask me why I was depressed.  Mind you, this was not a doctor or trained mental health worker but rather a coordinated care provider of sorts.  I met with her as one of many hoops required when dealing with the bureaucratic red tape sometimes needed in order to get treatment and not fall through the cracks.

I was honestly surprised at the question but began to explain the technicalities of my depression from a scientific point of view.  Since my genetic mutation was discovered, I’ve done a good deal of research and have a much better understanding of why I suffer from depression from a physiological aspect.  She interrupted me a couple times, stating that wasn’t what she meant.  I began again multiple times trying to explain from a physiological standpoint why I was depressed, trying to explain everything from different angles.

After my third attempt to explain, she cut me off brusquely, telling me she didn’t want to hear any medical explanations.  She wanted to know “specifically what I had to be depressed about”.

I was beside myself with shock.  Here was this woman with no medical or psychological training, assigned to help me with other issues and paperwork, demanding to know why I felt somehow “entitled”, for lack of a better word, to “claim” I was so depressed that I was struggling to function.

I felt judged, like I was being put on trial, that I had to justify myself and my diagnosis to this woman who had no mental health training whatsoever because she was unable to wrap her head around the idea that anyone could be able to fade in and out of functionality, being able to “deal” with life one moment only to collapse the next.

I found myself bursting into tears in her office, spewing out a long list of what I could only imagine were reasons she might find “acceptable” for why I was suffering from depression, beyond the physiological reason that my brain is missing a key substance needed to moderate my moods due to a genetic mutation.  I threw out how, as a child, I had suffered from physical, mental, emotional and sexual abuse, how I was gang-raped at eleven, how my world was turned upside-down at sixteen when my mother shot my father and how I found myself on my own at seventeen.  I listed a myriad of abusive relationships and losses in my life.  Sobbing, I continued, highlighting one reason after another that I felt my depression was “justified”.

Even after my outpouring of pain and trauma, this woman was still unable to wrap her head around why I am struggling to function.  She continued to push and probe for answers.  She saw the large stack of paperwork in front of me that I had collected for my insurance coverage appeal and could not understand how I could put so much time and energy into that but still insist I was incapable of doing other things.  She insisted if I put even a fraction of the work I had put into my appeal into other aspects of my life, I should have no issues at all functioning.  She had seen me smile and laugh with my children at times and commented how I didn’t “seem all that depressed”.

I tried my best to explain.  For every one hour, one day I am able to function and be productive, I have four times as many hours and days where I just collapse, having trouble to even pull myself out of bed to eat or to pee.  I have no control over any of it.  It comes and goes at it pleases, regardless of what might be scheduled for that day.  And there are so many more bad days than good.  On some bad days, I am able to bolt on a smiling mask, pretend to be okay and manage to go through the motions.  Other days, I struggle to do anything at all.  There are days I just can’t stop crying, when my world feels like it is spiraling down beneath me and days I’m completely numb and cannot function at all.  I tried to explain how I do have good days, too, but they’re as unpredictable as the bad and that, especially when it comes to my children, I hold myself together as best as I am able and paint on smiles because I don’t want my illness affecting them any more than it has to do so.

Contrary to what some people might assume, I don’t happily skip around, enjoying a life of leisure.  I have not made up some imaginary illness to use as a scapegoat to escape any responsibilities.  I struggle every single day to simply function.  I am not complacent with my diagnosis, either.  I am in treatment, working very hard to try to heal, hoping that I can one day somehow function better than I am today.  I take my illness very seriously.  I wish others would, too, and be more respectful of my diagnosis instead of passing judgment.

I’m faced by that kind of judgment all the time by people that just do not understand depression.  They assume I just need to try harder to be more positive, that thinking happy thoughts will magically cure me, carrying me off like a dusting of pixie dust to Neverland.  People assume I’m either lazy or faking it, that nobody could possibly be “that sad” that I’m unable to function.

Even worse than those that make me feel like I have to justify my illness are the ones that either look at me with pity like I’m some poor, broken, fragile creature or those who back away from me like I’m dangerous or contagious.  Perhaps, worst of all are those that feel inclined to throw random motivational sayings my way, as if their reminder to stay positive is all I’ll need to chase the blues away forever.  Trust me, if all I needed to cure my depression was to smile more or think positive more often, I wouldn’t be struggling with mental illness.  It’s NOT that easy.

No matter what the judgment is, though, I always prepare myself for one because more times than not, there is one and it rarely is anything positive.  Seldom does anyone truly understand and empathize.  Again and again, I’m put on the spot, forced to justify what I’m feeling, usually while being reminded that someone has it worse or that they, themselves, have managed to get through rough times so I should be able to, too.  I’m told I should “suck it up” and “get over it”.

Though this may be the first time that specific person has inquired about my condition, no one ever takes into account how many others have intruded on my mental health and demanded answers even when they had no right to do so.  While some might mean well and ask out of concern, very few use tact or compassion in their inquiries.  I’m almost always put on the defensive, made to feel like I have to justify how I feel.

Even after I do my best to explain everything, though I don’t quite understand it all myself, I am met with doubt, suspicion and accusations.  I am treated like I’m lying or lazy, exaggerating or broken beyond repair.  I’m looked at as a monster or unbalanced and crazy.

I beat myself up already more than enough for not being able to do as much as I feel I should be able to do.  I already feel every single day that I am failing everyone around me, failing my children and myself because I honestly want to do more, feel I should be able to do more and cannot understand why I cannot seem to be able to do it.  I hate that I crumble and fall apart so easily and am not able to do all the things I feel I should be able to do.  I have judged myself far more harshly than I should ever have done and have been trying to be kinder and gentler with myself.  I don’t need anyone else’s judgments on top of my own.

Everyone says they want to understand and demands answers, yet very few are supportive when I try to give any.  It is exhausting to have to explain everything again and again, mentally preparing myself each time for the responses and judgments to come.  I often isolate because it means less people to put me on the spot, less people I have to defend my diagnosis to in the long run.  I paint on a smile and reassure people that I’m fine, pretending everything is okay even as I’m sobbing inside because it is easier to lie than it is to have to defend myself for having an illness that I have no control over.

In the last year, I have begun talking more and more about my own struggles with mental illness not because it is in any way easier or takes a weight off my chest, but because I am completely exhausted from having to justify and defend myself.  I am tired of the stigma that is attached to my diagnosis.  Nobody would suggest someone with cancer should just try harder to be well or accuse someone with a broken leg of being lazy because they are unable to walk.  I am mentally ill.  Doctors have diagnosed my condition.  I should NEVER have to justify my diagnosis or defend myself over how my symptoms present themselves. I am tired of being made to feel like I should be ashamed of my diagnosis or that I have done something wrong in some way because I am ill.

I am speaking out because things need to change.  I am tired of being judged.

Republished on The Mighty on 03/09/17.

Responding to Voices from My Past

In the last month or so, I have received a handful of messages and emails from people from my childhood: old friends, neighbors and classmates I haven’t spoken to since I was a teenager almost twenty five years ago.  They had seen my t.v. interview, read my book and my blog and all felt the desire to reach out to me.

I haven’t been able to bring myself to reply to any of them yet.  It isn’t that I doubted their sincerity or that I didn’t appreciate their compassion or empathy.  Truthfully, each letter brought me to tears and meant more than any of them could imagine.  It’s that honestly I do not yet possess the words to respond.

For almost twenty five years now, I’ve been running from my past.  When I was a child, I was trapped in a hell I never thought I would never escape.  When my mother shot my father and my world turned upside down, I saw it as an opening, my one chance to get away and free myself from my past.  I began to run, pushing everything behind me, hoping if I ran long enough, fast enough, far enough, I might one day finally be free.

I still carry with me an odd mixture of unresolved feelings from those years.  Beyond the hurt and the anger that others might feel is only logical, there resides other emotions that are not as easily explained and even harder to process and move beyond.

I carry with me shame for some of the things that happened, because I allowed them to happen, though I know deep down that I was just a child who had her will crushed and had lost her ability to say no.

I carry with me guilt for not being stronger, not being able to fight harder, to be braver, to make it through more intact instead of the crumbling mess I often feel I become when I allow myself to return to that time and place.

I carry with me regret that I distanced myself over the years from so many people, due to no fault of their own, simply because their place in my life existed in close proximity to traumas I was trying to escape.

I carry with me an irrational fear of reopening doors from my past because my past is where all the most terrifying monsters I’ve known reside and part of me worries that reopening one door might open the floodgates, allowing everything to rush back at once.

Beneath it all resides a jumble of other feelings I have yet to even unearth or decipher.  Just when the waters surrounding me appear to calm, they wash over me unexpectedly like waves in a storm, threatening to throw me overboard again.  For years now, I’ve been fighting to stay afloat while I work my way through each wave as it appears.

I’m slowly letting down walls, reaching out and trying to let people back in but it is not easy.  It is a painfully slow process, untangling those threads of my past from the jumble of razor wires that had cut me so deeply all those years ago.  I am truly grateful beyond the words I currently possess for every kind and gentle word they have extended my way and do not intend to leave their letters unanswered.  I just need to first find the strength to delve back into my past, the courage to face my fears and find the words to help rebuild bridges I burned long ago in my haste to flee from the nightmares I feared I would never escape.