Please Give Mental Illness The Same Respect You Would Give Other Illnesses

Not everyone understands what it is like living with a mental illness. I get that. Most people, at their core, mean well and are trying to help in one way or another.  Whether they are attempting to be supportive or trying to snap someone back into their perceived “reality”, they just don’t know what to say.  I understand that completely, too. But using tired old cliches about life that don’t apply to living with a serious illness does not help at all.  Nor does it help to offer outdated advice that has been proven to be both ignorant and ineffective.  They do much more harm than good. It not only minimizes our condition and our struggles, but it also tells us that you neither understand what we are going through nor do you take our illness, or us, seriously.

Please do not tell us that “everyone has problems sometimes“, “into everyone’s life a little rain must fall“, or that “nobody said life was fair“.  Likewise, please don’t tell us “it is what it is” or “everyone gets depressed sometimes“, as if our diagnosis is an everyday, trivial, meaningless bit of happenstance that is unimportant and should be paid no mind.  A mental illness is not an average, run of the mill problem, a typical bump in the road of life that everyone faces at some point and is easily cast aside or overcome. It is a medical diagnosis, a medical condition that drastically affects every aspect of our lives.  You wouldn’t tell someone with cancer that everyone has problems sometimes, laughing it off like it was nothing. You would show an appropriate level of concern over their health and well-being. You would encourage them to see a doctor and take care of themselves. You would be supportive. You wouldn’t dream of minimizing their condition because, left untreated, it could have deadly consequences. So could my mental illness and it deserves to be treated in the same regard.

Asking us if we’ve “just tried being happy“, telling us we “need to just learn to focus on the positives” or otherwise suggesting we’re not trying hard enough misplaces the blame on us for our diagnosis. The patient is never to blame when their body goes haywire and runs amuck. We understand that sometimes our bodies malfunction, become unbalanced, and horrible things like tumors occur.  You can’t will away cancer with a positive outlook and trying harder won’t make tumors disappear. The same goes for mental illnesses.  We don’t tell someone with cancer that it is “all in their head“, “mind over matter“, and expect them to become healthy again by sheer willpower alone. We encourage them to see a doctor immediately, get everything taken care of and treated so their body can work properly and be healthy again. Untreated cancer can eat a person alive from the inside out, deteriorating their health and destroying the quality of their life in every way. So can mental illness. The only difference is cancer mainly attacks and destroys the physical body while mental illnesses primarily attack the mind.

Please don’t judge us on our appearance, telling us that we “don’t look sick” or that we “just need to smile more” as if our diagnosis is even remotely dependent on our outward appearance.  Also, please don’t tell us that we “don’t look all that sad to you” or that we “looked just fine the other day” because we have briefly managed to put on a brave face or wear a mask to hide our pain.  Having a good day here and there does not negate all the bad ones.  Invisible illnesses are still illnesses.  Like many other serious health conditions inside the body, you cannot often or easily see mental illness with the naked eye.  Not seeing a tumor growing inside someone does not make it any less real or dangerous.  Not seeing a diabetic’s pancreas malfunctioning does not mean it is not happening or that they do not need treatment.  Someone with cancer or another serious medical condition occasionally smiling, laughing or briefly enjoying life does not mean that they are instantly cured and tumor-free.  Just because you cannot see our mental illness does not mean we are not suffering.

Asking us “why can’t you just be normal?” or suggesting that we “need to stop feeling sorry for ourselves” not only blames us for our diagnosis but treats us as if we’re somehow broken or flawed and it is all in our head.  Nobody asks to have a mental illness nor does anyone want to be sick.  We are not doing this to ourselves.  We are not having pity parties. Please don’t suggest we’re just looking for attention or tell us that “the only one we’re hurting is ourselves” either, as if we’re intentionally sabotaging our own happiness by entertaining the absurd idea of some make-believe malady.  Mental illness is a very real medical diagnosis, one that is often completely beyond our control.  Our behavior did not cause it any more than a person’s attitude or imagination can cause tumors.

Please do not suggest we should just “snap out of it and get over things already“, either.  A person cannot snap out of a mental illness diagnosis any more than they can snap out of diabetes.  There is no set time frame that someone should be better, or even show marked improvement.  Like diabetes, a mental health diagnosis often lasts a lifetime.  And the healing process with most illnesses is not linear.  A diabetic can alternate between periods of stability, and episodes of sugar spikes and crashes, dangerous highs and lows that drastically and dangerously impact their health.  Similarly, even when in ongoing mental health treatment, a series of good days can be interrupted by periods of downward spiraling or numbness, and worsening symptoms as we attempt to balance medications and work through both past and new traumas.  Along the same lines as the fact that we refuse to take the blame for our illness, we are also under no obligation to heal on anyone else’s schedule or whim.  It is our illness, our treatment, and we will take as long as we need to take to heal fully and properly, even if it takes a lifetime.

Do not remind us that “every cloud has a silver lining” or tell us to “look on the bright side“, suggesting that we need to look for something positive at the core of our struggle.  Likewise, please never tell us that “what doesn’t kill us makes us stronger” or tell us that “it is God’s will“, as if our suffering was some divine gift or that it will be worth it in the long run.  Again, it is an illness, a medical diagnosis.  You would not confront a diabetic who must have their feet amputated due to their condition and suggest that they would somehow come out stronger for their loss.  You would not imply to a patient who cannot keep down any food because they are undergoing chemotherapy that the silver lining is that they always did want to lose a few pounds.  You would not tell anyone that their illness was a blessing in disguise, that they should be grateful for their suffering and pain.  Comments like those would be not only wildly inappropriate but also extremely insensitive, as well.  You would offer the person suffering your compassion, sympathy and support.  People with mental illnesses deserve the same.  There is nothing positive about our diagnosis or our struggle so please don’t insist we look for a silver lining or a bright side that is not there.

Please don’t tell us that “other people have it worse“, as if our struggle is insignificant because someone else has struggled more.  Don’t ask us “what do you even have to be depressed about?“, expecting us to justify our diagnosis or quantify our suffering so you can determine its validity.  A mental illness is a bonafide medical diagnosis that deserves acknowledgement and actual medical treatment regardless of its severity in comparison to someone else’s.  It is always a serious health condition that can continue to worsen if left untreated.  You wouldn’t shrug off anyone’s cancer diagnosis as trivial or be so unsympathetic as to suggest their tumors were insignificant because someone else had larger ones.  Cancer is always taken seriously.  Mental illness should be, as well.

If we trust you enough to open up about our diagnosis, please don’t shut us down by telling us “there are just some things you just shouldn’t talk about” or reminding us that “some things should be kept private“.  That is ignorance and stigma talking.  Yes, we understand that mental illness is uncomfortable to discuss.  So is any other serious medical diagnosis.  The difference is that families and friends will discuss other illnesses and the impact they will have on everyone’s lives.  We sincerely apologize for any discomfort our diagnosis might give you, but please know that we are not confiding in you hoping you can solve it or make anything better.  We are sharing our diagnosis because we consider you an integral part of our lives and we want you to be aware of everything that is going on.  Don’t tell us that we shouldn’t talk about mental illness as if it is something we should be ashamed of having.  The biggest reason this diagnosis has become so rampant in society today is because no one talked about it for far too long.  No one talked and nobody sought treatment.  But silence won’t make the problem go away.  Health issues don’t vanish because you refuse to acknowledge them.  It will only make it worse.

Please stop shaming us for our diagnosis altogether or our efforts to seek treatment.  Don’t tell us that “all we really need is some fresh air and some running shoes” in order to feel better.  Don’t tell us that “only weak people rely on medication” or suggest we try vitamin regimens, scented oils or other homeopathic remedies instead of what we have been prescribed.  We have seen actual doctors.  Medical professionals have given us a verifiable medical diagnosis and prescribed us the appropriate medications to treat that diagnosis.  You wouldn’t shame a diabetic for using insulin to balance their body so please stop shaming us for taking our prescriptions to balance our minds.  You wouldn’t tell a cancer patient that they didn’t need chemo, to just go for a brisk run or take a nice, long bath instead.  That is because it is widely accepted that chemotherapy is used to treat cancer and insulin to treat diabetes.  If you are willing to accept other medical diagnoses and treatments as valid, please accept ours, as well.

Please don’t attack us, demanding to know “what have you even done with yourself lately?” or otherwise question why we are not able to function as well as a healthy person.  Don’t interrogate us about what we have and have not accomplished recently, either, as if our level of productivity must meet your standards or our activity must be on par with yours.  Having a mental illness takes a lot out of a person, both mentally and physically.  It is perfectly acceptable for someone who has just undergone chemotherapy to spend a day in bed if they so need it.  If a diabetic has a sugar crash and feels under the weather, others will suggest they go lay down and feel better.  Healing and recovery time is acceptable for all other illnesses.  It should be for mental illnesses, too.

For so many years, mental illness was treated as something shameful, something you just didn’t discuss, something whispered about in dark corners.  With the continuing rise of suicides, addictions and other mental health crisis in our society, mental illness is being spoken about today on a scale previously unimaginable.  I understand that it might take some time for everyone to fully understand how to openly discuss our diagnosis with both compassion and respect after being shrouded in secrecy and stigma for so long.  When unsure how to proceed, many people turn to old cliches and outdated advice that they believe have stood the test of time.  However, many of those statements and sayings are not at all appropriate or applicable to mental illnesses.  If you are unsure what to say to someone with a mental illness, a good place to start would be to ask yourself if you would say those words to someone else with any other serious illness.  If you cannot imagine saying it to someone with cancer or diabetes, for example, it’s a good bet that it is not an appropriate response to our diagnosis, either.

After all, people with mental illnesses are not asking for special treatment.  We are just asking to be treated with the same courtesy you would treat anyone else who is ill.

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I Have Depression.. But I am Happy..

I have struggled with depression my entire life, in part due to a genetic mutation passed down to me from my parents that affects the way my body metabolizes specific chemicals my brain needs to moderate my moods.  I regularly go through horrendous downward spirals where I feel completely broken and worthless, where life feels utterly hopeless.  I struggle with long periods of numbness where I have difficulty functioning or even finding the motivation to get out of bed.  On bad days, I will cry until my face is sore and my voice is hoarse, and it is unlikely I will be able to accomplish much more than basic self-care.  I am battling an illness that warps my very perceptions of life and continuously exhausts and pains me both physically and mentally.

But I am happy.

I have an amazing fiance who is very supportive of me and my diagnosis.  I have healthy, kind, smart and all-around wonderful children who have grown into incredible adults.  My fiance’s children are both amazing, as well. Together we have all formed a beautiful, blended family that I love with all my heart and am proud to call my own.  I have a team of doctors who actually listen to me and a treatment plan that is slowly but surely helping improve my quality of life.  And I have a blossoming writing career that has given me a true sense of purpose and an ability to help others in need.  I have many wonderful blessings in my life to be grateful for, many reasons to be happy.

Yet I have been diagnosed with depression.

That is because a mental illness like depression has nothing to do with happiness.  Depression is not caused by being in the wrong frame of mind or just not trying hard enough to be happy.  Having a depression diagnosis has nothing to do with feeling sad, a little blue or under the weather.  People with depression aren’t being Negative Nancys or Debbie Downers who just need to learn to lighten up and look on the bright side.  My diagnosis wouldn’t just disappear if I just tried to smile a little harder or maintained a more positive outlook on life.  My depression has nothing to do with whether or not I am happy.

I have trained myself to find reasons to smile everyday.  I am usually the first to look for something positive in even the roughest of situations.  No matter how hard my own day might feel, I always try to show compassion and kindness to others.  If nothing else, I am grateful each day I wake up and thankful of all the loving and supportive people in my life and share that sentiment regularly.  I am hopeful for the possibilities the future may have in store for me, as well.  Some of my friends lovingly joke that I am the happiest, most positive little depressed person they know.

Yet I continue to struggle with my depression diagnosis.

My brain does not care whether or not I am happy or grateful, whether I am hopeful, compassionate or kind.  My mental illness is caused by my brain not working properly, much like a diabetic’s pancreas malfunctioning causes their condition.  I have no more control over having a mental illness than someone else having diabetes, heart disease or another medical condition they may have been passed genetically.  Yes, events in my life may have further exasperated my mental illness, much like having excessive sugar might worsen a person’s diabetes or having foods high in cholesterol might affect the severity of heart disease, but my condition preceded any of the traumas and abuses I have endured over the years.  I have even sought treatment to help resolve those issues to the best of my ability, yet my depression has remained.

Because depression is an illness, a medical diagnosis with both mental and physical causations.

It is not all in my head.

It is not a state of mind or an emotion.

Depression isn’t about being sad.

The cure for depression is not happiness.

Like any other illness, depression needs ongoing medical treatment.  Doctors need to not only diagnose the condition, but also to isolate and treat both the mental and physical reasons for the illness, as well. Though doctors often utilize psychological treatments like therapy, meditation and mindfulness, they usually also include psychiatric methods and medications to help treat the physical causation.  That is because doctors recognize mental illnesses such as depression as a verifiable disability that deserves a comprehensive, multi-pronged treatment.

In cases like mine where my depression has a genetic causation, my diagnosis is permanent.  I was born with it much like some children are born diabetic.  You would not blame a child for being born with a pancreas that was incapable of functioning properly so please don’t blame me for the fact that I was born with organs that malfunctioned, as well.  The only difference in my case are the organs affected.  No matter how happy I am or how positive my outlook is on life, my liver will never be able to metabolize the substances my brain needs in order to function properly.  I will have this medical diagnosis and need ongoing treatment until the day I die.

If I confide in you that I am struggling with depression, please don’t try to encourage me to try to be happier and more positive, or point out all the blessings I have in my life.  I am happy and grateful already.  You do not need to remind me to be hopeful for the future because I already am.  Please don’t blame me for my diagnosis either, insinuating that I wouldn’t be ill if I just tried a little harder.  I did not ask for this diagnosis, nor did I cause it.  What I need from you is the same compassion, understanding and support you would give anyone else with any other medical diagnosis.

Because, though I am already happy, knowing you were doing your best to be supportive and treat me with the same respect you would someone struggling with other illnesses would make me even happier.

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Republished on the Mighty on 4/4/19.

Four Days on Suicide Watch

Everything had been building up for months, years.

It was not that I didn’t have wonderful things in my life to be grateful for. I had healthy, compassionate, intelligent children that were growing into incredible adults before my eyes; I had reconnected with my first crush ever who has turned out to be the love of my life and we have a wedding to plan; I had finally found my calling as a mental health advocate and had the start of a promising writing career; I finally understood my struggles with my mental illness, having found a clinic that not only helped me to find the answers I needed, but also actually gave me hope for the future. In so many ways, my life was finally looking up.

However, it was overshadowed by a lifetime of struggling. I had been battling my own brain my entire life. And in recent years, the government and my insurance company, as well. It felt like all I ever did anymore was fight everyone, again and again. It seemed never-ending. I was so exhausted from fighting all the time, never getting to catch my breath, never getting a break.

Add to that discovering not one but two meningioma tumors on my brain. I had survived years of abuses that left deep scars that would never fully heal. My fiance and I were facing a possible pending eviction caused directly by the government’s prolonged inaction in my case and direct refusal to comply with a judge’s previous fair hearing decision in my favor.

The straw that broke the camel’s back, however, was the fairly consistent presence of someone toxic in my fiance and my lives under the guise of one of his  childhood friends who was hell-bent on causing problems in our relationship, repeatedly trying to split us up.

To give a little background on the situation, she had known him since she was thirteen and had a crush on him for close to thirty years, bordering on stalkerish. When he was staying with his parents following the end of his marriage, she would intentionally show up hours before he was due home from work and say she would wait in his bedroom for him as an excuse to sleep in his bed. Though they never had any type of a relationship because he never saw her THAT way, for years, she regularly borrowed hats and shirts from him and kept them, much like a girlfriend would normally do. Despite having a crumbling relationship at home she should have been devoting her attention to, she tried repeatedly over the years to supplant herself into my fiance and his family’s lives in any way she could whenever she could, often causing drama in the process.  Though he later forgave her to an extent, she even played a crucial part in the break up of his first marriage.

From the time we got together, she had been trying to cause problems between us and split us up. The first time I met her was a month into our relationship, shortly after his father went into hospice. She pulled me aside and tried to convince me that I had no idea what I had gotten myself into or the mess he was going to be so I should just walk away before I got in over my head. She told me he was mentally unstable, that she knew him well enough to know I could not handle what was in store. She seemed thrown aback when I told her I had known him longer than her and I was in it for the long haul.

When she could see I was not going anywhere, she switched tactics. Over the course of the next year, every single time she came over she would make negative comments about me and my mental illness, lecturing me that I needed to stop being lazy and do something with myself and my life. Whenever my fiance and I would both jump in to defend me and attempt to explain the disability diagnosis my doctors had given me, she would interject that she worked in mental health, too, and she “knew what she was talking about”. She worked in a mental health care adjacent position, as a glorified overnight babysitter at a facility that housed mentally or physically disabled adults, a job you didn’t even need a high school diploma or any certification to get, yet she swore repeatedly that she knew better than all my doctors over the years. She frequently trivialized my mental health writing as a waste of time and criticized everything from the cleanliness of my apartment to my cooking, as if nothing I did even remotely met her standards.

As if the constant attacks were not enough, she also was constantly attempting, albeit admittedly very poorly, to  blatantly flirt with my fiance in front of me. She would try to run her fingers through his hair and insist he let her cut it, to which he would pull away and say I will cut his hair when he needs it done. When he stopped shaving for no shave November and the couple months afterwards, she commented repeatedly that he should shave because he looks so much better clean shaven, that she prefers him that way, even offering to do that for him, as well. She was forever reaching out to touch him, swat at him or rub him with her hand while she talked, trying to take sips out of his drinks like a girlfriend might do and regularly found excuses to lift her shirt or drop her pants in front of him under the pretense of showing off numerous bug bites and bruises. She would often announce wildly inappropriate things that people wouldn’t normally discuss with friends, like she had just shaved her nether regions or talk about having sex, watching porn or masturbation when she came over.

We tolerated much more than we should have because honestly we felt sorry for her. She was always desperate for attention and, according to her, her problems were always ten times worse than everyone else’s.  For example, when we attempted to explain about my doctors finding my brain tumors, she cut us off by saying, “That’s nothing! Did I tell you I had to bring my car back to the shop again?!” as if car problems were somehow worse than brain tumors. She was loud, obnoxious, crass and crude with no concept of respect or boundaries, always saying or doing whatever she could think of to get all eyes on her. She was always talking badly about someone when she came over, usually my fiance’s ex-wife, even though she was supposedly still good friends with her, to the point where we began watching everything we said around her to avoid becoming part of her gossip. She also had severe substance abuse issues. In a year and a half of seeing her once to twice a week on average, I never once saw her even remotely sober regardless of the time of day – she was always drunk, high or both. We knew from everything she had talked about that things were bad for her at home, that her relationship was in shambles.  A lot of people had written her off already over the years for her behavior but we understood that she had a lot of issues so we tried to cut her some extra slack.

I had tried my best to be kind to her. On more than one occasion, I took the time to show her sons my sugar gliders and explain more about them. I even watched her youngest once for over an hour while she ran an errand. If we had leftovers when she stopped by on her way to work, I would send her with a plate or bowl. She would regularly fill her purse from treats I had put out in snack bowls. I baked her family Christmas cookies and sent her with extra for both home and work. I once even lent her an old pair of pants that were too big on me so she had something clean for work when she stained her own. I listened sympathetically when she complained of relationship issues, health problems or other stresses, trying to extend an olive branch of friendship. I even did my best to overlook her steady barrage of flirtation with my fiance because I realized it must have been hard to see someone you crushed on for decades happily with someone else.

But despite all my attempts at kindness, both her attacks on me and her inappropriate flirtation with my fiance not only continued but steadily increased. What originally may have been one off-handed comment about her believing my disability was nonsense became full-fledged rants. She began making snippy and snide remarks and telling us to stop whenever my fiance and I were affectionate to each other as if she resented anyone else showing him attention or love.  Over time, it had all became too much to bear. When my fiance and I began contemplating marriage, she declared we were not ALLOWED to both get married a second time because she had never even been married a first. When we officially announced our engagement, she responded by referring to me as (please excuse my language) his “fuck buddy”, saying outright that the only thing I did for him was give him my “roast beef curtains” and insist that he deserves better than me. That was the last straw and we agreed she was no longer welcome in our house or our lives.

For two weeks afterwards, she did not come around. Then late one night, well after one in the morning when we were already in bed, we heard a drunken knock at our kitchen window. We both knew exactly who it was because she was the only one we knew with the audacity to think that would be acceptable. I was livid and wanted him to tell her to leave immediately. He wanted to quietly let her in to avoid her making a drunken scene in our apartment building, to wait to tell her she was no longer welcome here another time, during more reasonable hours when she might be somewhat more sober and perhaps slightly more reasonable. Everything quickly escalated.

We were both beyond stressed at the time, not at all with each other but rather with life circumstances in general, topped off by our unwelcome, uninvited guest. Beyond all my own issues, he had been struggling terribly, as well. He had a lifelong battle with his own mental illness. In the last year, he had lost first his father then his job. The family dog that had been his parents’ for well over a decade had to be put down and he was struggling to keep his truck, one of his last physical connections to his deceased parents, on the road and in working order. We were both well beyond our breaking points on many fronts and the culmination of everything with her pushed us right over the edge. We fought terribly, something we don’t often do even in a mild sense.  It may have been the worst fight of our entire relationship. Afterwards, I retreated to the bedroom to cry, locking the door so I could be alone.

I did not have any plans to commit suicide. The thought honestly had not even crossed my mind.  I was not trying to hurt myself in any way. I loved my fiance and my children more than I could ever put into words and would never have wanted to hurt them in any way, either. I was hurt, angry and distraught over our fight, disgusted that we had tolerated someone so blatantly toxic for so long, and I was exhausted and overwhelmed with life in general.  I just wanted to be alone, wanted to try to calm down, to catch my breath, to stop feeling like I was free-falling through a world where I was never allowed to just be happy, never allowed to just rest and be at peace.

I dumped the basket of pills out on the bed and fished out various bottles of my take-as-needed anti-anxiety medications. In between sobs, I took a few. Then I vomited.

Seeing the pills floating there on top, I took a few more to replace the ones I had lost. I continued to sob and to vomit. To vomit and to take more pills to replace the others.

At this point, I was no longer thinking clearly, caught in a nightmarish loop, wanting desperately just to calm down, to stop feeling like this, and to get some much needed rest.

Eventually, sleep came. I started to feel dizzy and thought to myself, “..finally.. they are starting to kick in..”  It is the last thing I remember for almost two days.

I woke up a day and a half later in the hospital. He was seated at my bedside, looking ragged, like he hadn’t slept in days.

Baby! You’re awake! Oh my god I love you. I am so sorry about everything. How are you feeling? What do you remember?

I was confused and disoriented. On oxygen. Had a bunch of tubes and wires all over my body.  It took me a few minutes to realize where I was and what was going on. I could not remember anything since taking the pills, crying and throwing up repeatedly. I was not even sure what day it was.

I can’t believe you don’t remember any of it. I had to kick down the door, to call the police.

My chest hurts.

I can only imagine. One of the cops did a sternum check, pushing really hard on your chest, hoping for a reaction to the pain. You were completely unresponsive.

My throat hurts.

You had tubes down your throat. They had to restrain you for a bit because you started to flail and grab at the tubes. You have no idea how much you scared me baby. What you looked like, laying there hooked up to all those machines, all those wires and tubes. I thought I was going to lose you. Please don’t ever scare me like that ever again.

I wanted to talk about it all, to explain, but my voice was raspy, my throat raw. It hurt to talk. I couldn’t stop coughing. I wanted to insist I hadn’t meant for any of this to happen, to swear I wasn’t suicidal like I had been all those years ago before we were even together. I wanted to apologize for scaring him, for fighting over stupid things like people who were inconsequential and irrelevant. All I could do though was cry as he held me close, my tears flowing freely with his.

I had lost a day and a half.

But more importantly, I tarnished our relationship in a way I can never take back. The sight of me laying there unresponsive, of being carted out on a stretcher, of my laying there as the doctors frantically worked to revive me, will forever haunt his nightmares.

I spent the next day in intensive care as they closely monitored my heart, followed by three days on a secure floor on suicide watch. Again and again, I tried to explain it all to whoever would listen, to insist I was not suicidal.  However, protocol required a few days of observation no matter what was said.

My heart was constantly monitored, my vitals taken every few hours. My IV was moved numerous times as my veins collapsed and fresh bruises appeared up and down my arms. I was stuck in bed for the first couple days upstairs while I waited for nurses to find me clothes other than hospital gowns. The clothes I had arrived in had been cut off me in the emergency room when I arrived. I could not wear other clothes from home until after I was cleared for discharge.

I was not allowed many other items often taken for granted such as a phone charger or silverware. Well-intentioned staff reached out repeatedly to try to convince me life was worth living. Meanwhile, they rushed to confiscate any cans or other sharp items from meal trays and to take endless notes on everything I said and did to assist with my psychological evaluation. I had a constant companion, a nurse or aide to sit with me at all times to prevent me from possibly further harming myself. Though I was never by myself during those four days, I had a lot of time to lay in bed alone and think.

I was not suicidal but I have been in the past. I did not intent to harm myself, but I had in the past. Intentional this time or not, I found myself in the same place and, like my previous attempts in the past, it had not solved anything. On the contrary, it made everything much worse. It hurt the people I love, scared my fiance and my children to death.

I didn’t get any time to calm down, didn’t get that moment of peace I had desired so badly. The majority of the problems had not gone anywhere. I lost a day and a half, woke up in pain and discomfort only to face new problems created by my own actions.

I was extremely lucky just for the fact that I am still here to tell my story. I could have just as easily become a statistic that day. My story could have just as easily ended with my obituary, the words and questions of others left unanswered, adrift in the wind.

I cannot apologize enough for what I put everyone through. I feel stupid, ashamed, that I should have known better. There are no words that could adequately express my remorse. I would do anything to take back that night but there is nothing I could ever say or do that would erase the past.

I would love to say there is no excuse for my actions but when my depression and anxiety reach certain levels, I no longer always think clearly. I become increasingly overwhelmed, the world feels largely hopeless and I am no longer able to cope. Even when I am not actively suicidal, which I have not been for years now, I struggle regularly with suicidal ideation, not exactly wanting to die but no longer wanting to continue living my life the way it is, either. Though I never meant to fall apart like I had that day, unfortunately once I reach a certain point, I react before rationalizing the repercussions of my actions.

I would love to say there is an easy solution to this, that I could take a magic pill or think some happy thoughts and my mental illness would just fade away and disappear. I wish I could say it was a temporary phase even that I would eventually get over. My mental illness is caused in part by a genetic mutation. I was born with it and I will have it until the day I die. There is no cure for me. It is permanently hardwired into my genetics. I can receive therapy for past traumas and current issues, I can take medication to provide my brain with the chemicals my body cannot make itself, I can fill my coping toolbox with techniques and strategies for dealing with harder days and attend things like tai chi and yoga classes until the day I die. Yet I will always have a mental illness. It is a lifelong, permanent diagnosis for me.

Mental illness is my cross to bear. Though I truly appreciate that my loved ones are willing to stand by me and support me through my struggles with my mental health, it is not fair or right for them to suffer like they have for my diagnosis. Although I never intended to do so, I severely hurt everyone that matters to me. They all have tried to be compassionate and understanding, to forgive me for an illness that often wreaks havoc in my life, for a condition frequently beyond my control.

However, I am not sure I will ever be able to forgive myself.

Since getting out of the hospital, my fiance and I have not talked much about the incident beyond him being thankful that I am okay and asking me to please never scare him like that again. I have reassured my children that I am okay, as well, trying to minimalize the severity of it all to lessen their fears. Again, I wish there were some magic words I could say to take away the pain and panic in their eyes. I fear no apology will ever be enough.

It took almost a week before we could even sleep in our bedroom again. While I was in the hospital, he slept on the couch when he could sleep at all, the spilled pill bottles, vomit and towels still sitting where they were when the ambulance carted me away. I insisted on cleaning it up myself when I came home, my mess, my problem, but going into that room felt like crossing into an alternate nightmare dimension. Nevertheless, I fought my way through a bevy of anxiety attacks and breakdowns to clean it all up. Even after everything was cleared away, no trace remaining, we opted to sleep in the living room for the next week on our air mattress. We knew what had happened in there, we had lived through it, yet we were still not quite ready to fully face it.

The first couple nights that we returned to the bedroom, I couldn’t sleep at all. He continued to cling tightly to me all night while he slept, as he had done every single night since we returned home from the hospital, as if he was terrified that I would disappear forever if he let go for even a moment. I laid awake both nights, silently crying for the pain and fear I had placed in his heart. A month later, my anxiety still rises whenever I enter that room, my sleep restless and plagued by nightmares old and new.

I know I need to change many things, to put safeguards in place to prevent something like this from ever happening again. I cannot change the fact that I have a mental illness, but there are other things I can address, precautions I can take. I never want to hurt my loved ones like that ever again. For instance, no more locking myself away when I am upset. No more taking extra dosages of medication early, even if I have thrown up the dose I just took. No more tempting fate when I might be too emotionally irrational to think clearly.

I have a constant pressing need now to reassure him that I am okay, that he doesn’t have to worry. I catch him looking at me, watching me, more frequently now, and checking in on how I am feeling. We are trying to heal from this, to move forward, though I’m not sure we can ever completely move past it. He almost lost me that day. He is always going to worry just a little bit more now.

We have also agreed to remove certain toxic people completely from our lives, those who prefer to add drama and conflict rather than happiness and support. We learned the hard way that some people will take advantage of our kindness and tolerance, repaying us tenfold with cruelty and drama. The nail in the coffin of that childhood friendship was hearing from mutual friends that she had been going around laughing and bragging about “putting me in the hospital”, proud of the part she played in my breakdown. We will never again allow anyone like that into our lives. Whatever it takes to never find ourselves in that situation again.

Some people say that suicide is selfish because all it does is pass the pain onto others. Other people attempt to explain that those who make attempts just don’t want to hurt anymore themselves. Many nowadays recognize that suicide is often a tragic byproduct of mental illness. I have been suicidal. I have been in those moments of desperately wanting the pain to stop. I have had suicidal attempts in my past and now an unintentional attempt because I was upset, irrational and not thinking clearly. I have lost loved ones to suicide, and known others who have lost people they loved deeply, as well, so I understand all too well how devastating it can be from the outside looking in. Regardless of where you fit in the equation, suicide is always heart-wrenching and tragic.

One thing I can tell you, whether you are suicidal or not, whether your attempt is intentional or not, the result is always the same. Pain. Pain for everyone you love, everyone who loves you. Pain for yourself should you survive. And not just physical pain from tubes and tests and IVs. Emotional pain as you see that haunted look in their eyes, that kernel of doubt that appears every time afterwards that you insist you’re okay. Pain that will continue for years, that will likely never go away, whether you’re around to see it or not.

Pain and overwhelming loss for everyone who has ever cared for you. They will never be the same. You might carry physical scars from your attempt, but theirs will run much deeper and never fully heal. Those close to you will retrace all your interactions, looking for signs, real or imaginary, to explain what happened. They will question whether they should have said this or should not have said that. People who you have not seen in ages will question if they should have reached out, as if they could have magically known things were bad and somehow made a difference. They will all blame themselves for your actions and choices. Whether you die or not, they will be forever haunted by that one choice you made, something completely beyond their control. Yet, in their pain, they will embrace that blame, caught in a cycle of imagining every scenario that could have prevented it.

To those contemplating suicide or just on that edge of not being able to cope with life anymore, please know that I understand completely how hard it can feel, especially when you’re struggling with mental illness. You are not alone. But I wouldn’t wish the kind of pain I caused on anyone, not my worst enemy, not my loved ones or yours. Once it has happened, though, you cannot ever take it back. Even if they don’t lose you, your relationships will never be the same. I cannot change the pain I’ve caused, but perhaps, by sharing my story, you can spare your loved ones from the same fate.

Please be careful. Be careful with yourself and be careful with your loved ones. Life is a fragile thing, a light that can be snuffed out in a moment.  It may be hard sometimes, downright unfair. But life is also precious. As is love. Don’t take either for granted.

I know all too well that mental illnesses are rarely rational. When we are upset, we often react based on pure emotion. So take precautions now, during the calm before the next storm. Do not leave ways to harm yourself readily accessible when you might find yourself too emotional to think rationally. Don’t set yourself up to fail or to hurt yourself or those you love.

I thankfully am very lucky to still be sitting here, able to share my story. Many others have tragically lost their battles with mental illness without ever having a chance to tell their tale. Their stories are told in yearly mental health statistics and on memorial pages created by those they left behind.  We’re all in this boat together and we only have two choices. We can either become a statistic or we can keep going, keep fighting, and find some way to make a difference in this world, even if only to show others that it is possible to survive our diagnosis. There are too many mental health statistics and enough pain already in this world. If we have to choose anything, let’s choose life and love.

Much love, compassion, hope and faith that even if this does not find you well, it finds you strong enough to keep living. ❤

When Will Insurance Companies Realize Fighting Against Patient Care Is Not Cost Effective?

Other than my ongoing battle with mental illness, I have been relatively healthy my entire life.  I don’t drink, smoke or do drugs.  Prior to the last couple years, other than mental health doctors, I rarely went to the doctors at all beyond basic check ups.  Other than medications for my mental illness, I have rarely relied on any medication stronger than acetaminophen or an antacid, and only then if absolutely necessary.  Due to this fact, I had little experience with battling my insurance company for most of my life.  These last two years, however, have been a real eye opener.

I have struggled with severe depression and anxiety my entire life.  For years, I was labelled “treatment resistant” because no medication I took ever seemed to work.  A couple years ago, my meds doctor at my mental health clinic sent me for a genetic test to help determine what prescriptions might work better for me based on my genetic make up.

The test came back with an unexpected result.  I had a genetic mutation that rendered my liver incapable of metabolizing folic acid in any usable amount.  Broken down folic acid, called l-methylfolate, is used by the neurotransmitters in the brain to help moderate moods.  Because my own body could not metabolize folic acid into l-methylfolate in any usable amount, the neurotransmitters in my brain had been literally starving for what they needed for the majority of my life.

It was a fairly easy fix.  There’s a pill on the market of broken down folic acid.  It is, on average, under $200 a month.

It is something my body cannot make on its own and my brain needed to function properly.  Yet my insurance company fought me on it for almost 9 months.  In the meantime, my doctor had to prescribe me a collection of high dose antidepressants, anti-anxiety and sleep aids in hopes that together they might even slightly touch my mental illness.  I had a revolving combination of medications, anywhere from four to six prescribed at a time, with the dosages being steadily increased.

The cash price of the one anti-depressant alone that I took during that time runs on average $250-$300 per month.  The one anti-anxiety medication I took runs between $45-$85 per month.  The one sleep aid ran around $20 a month. Other medications we tried ran between $10-20 apiece.  Altogether, I was taking between $450-$500 a month worth of medications that were barely able to do anything for me because my insurance company did not want to pay less than $200 a month for the medication I truly needed.

After almost 9 months of fighting and multiple appeals and fair hearings, I finally got my prescription approved.  These days, I am taking my l-methylfolate, along with one moderate but inexpensive antidepressant and a natural sleep aid.  Altogether, the cost is still under $200 a month.  I honestly cannot fathom why the insurance company would have opted for 9 months to pay over double that amount on a less effective treatment instead of just approving what my doctor had initially prescribed me, what I truly needed.

I wish I could say that this was an isolated incident but over the past couple years, I have had multiple run ins with my insurance company in regards to my treatment.  Though relatively healthy for the majority of my life, these last two years have been plagued with multiple health issues, issues my insurance company has chosen to fight me on, as well.

Two years ago, I was rushed to the emergency room in severe pain.  It turned out that a large cyst had grown on my ovary.  Within the cyst, a mass of tissue had begun to grow, as well.  Together, they had put increasing pressure and weight on my ovary, contorting it and damaging not only the ovary itself but also on the veins around it.  The ovary was damaged beyond repair.  There was a concern that the mass within the cyst might be cancerous.  Rather than doing a biopsy then surgery that would prolong my suffering, my doctor opted to remove the ovary first then biopsy the mass on it afterwards.

Again, it was an easy fix.  The ovary had to come out.

Yet the insurance company dragged their feet for over two months.  For over two months, I was in constant agony, on bedrest, slowly awaiting the pre-op tests to get approved, let alone the surgery itself.  For over two months, I had to take pain medication and see my doctor almost weekly to check my blood pressure, monitor my pain levels and make sure no infection had set in.  For over two months, I had to have a coordinated care provider come to my house to assist with things I could no longer do for myself because I could barely move on my own without excruciating pain.

The ovary, along with the cyst and the mass of tissue within it, had to be removed.  The insurance company ended up having to cover numerous extra doctor appointments more than was necessary, along with added prescriptions and periodic home health care assistance, all because they delayed the approval of treatment that was ultimately going to be needed to begin with.  Dragging their feet and delaying approval did not save them any money.  Quite the opposite.

Most recently, during a ct scan it was discovered that I have two meningioma tumors on my brain.  Though 80% of meningiomas are benign, doctors still have to test them to make sure they are not.  I first saw a neurologist who, in turn, referred me to a neurosurgeon for testing.  The neurosurgeon ordered both an EEG and an MRI with and without contrast to be done so they can get a better look at my tumors.

It has been almost two months since the meningiomas were discovered.  The EEG was completed, yet we’re still waiting for insurance approval for the MRI.  Meanwhile, my neurologist keeps scheduling appointments because, until he knows for sure that they are benign, he has to keep monitoring me for signs of seizures or other averse effects.

Best case scenario – if they are small enough and benign, it is considered watch and wait, with them being periodically monitored and measured once or twice a year to look for changes.  Worst case scenario – they are malignant, I need surgery and radiation.  But until the MRI is done, it is a case of *Schrödinger’s tumor – we won’t know whether it is benign or malignant until the doctors get in there for a better look.

Meanwhile, I keep going in for more or less useless appointments where my doctor keeps checking in to ask how I am feeling and checks my vitals, then we sit around discussing how the insurance company still hasn’t approved the MRI.  Yet, he can’t put off these appointments until he knows for sure whether we need to worry about these tumors or not.  So the insurance company is getting billed for appointment after appointment to check in on how I am doing while we wait for the MRI instead of just approving the MRI that will ultimately be needed anyway.  These tumors are not going to go away on their own.  The MRI is needed to fully diagnose them and my neurologist is not going to allow me to fall between the cracks just in case they are malignant and surgery is needed.

I honestly do not understand why insurance companies fight patients and their doctors on treatment that is needed.  It is not like any of my treatment was something ordered on a whim.  There was a prescription for a substance my brain needed that my body could not make on it’s own.  There was a surgery to remove an organ that was irreparably damaged and causing me severe pain.  And there was a test needed to determine whether the tumors on my brain are benign or malignant.  Three cut and dry cases of treatment that was very much needed and not in the least extravagant or superfluous.

Yet, the insurance company’s decisions in each of these three cases over the last year has cost them, each time, much more than it would have cost them if they had approved the treatment the doctors in each case recommended.  If a prescription, a test or a procedure is ultimately needed and there is no other possible recourse to resolve the issue, why would the insurance company either deny it outright or drag their feet in approving it?  It will only end up costing them more in the long run.

I with I could say my experiences were isolated incidents.  In the course of my battles over the past two years, I have spoken to numerous others who have been and are currently fighting their insurance companies, as well, for the treatment they need.  It appears to be more commonplace than most people realize.

When did it change that healthcare became more about trying to cut corners and save money than in treating the patient and doing what was best for their health?  Has it always been this way?  Wealth over health.  Profit over people.  It’s honestly disgusting, despicable and deplorable.  Having been relatively healthy for the majority of my life, I never realized what a struggle it can be to get the treatment you need covered.

While I understand and acknowledge that fraud is rampant in medicine today and insurance companies need to validate claims before approval is given, once there is proof to support the medical treatment requested, it makes little sense to drag out or deny the claim further.  Insurance companies could ultimately save substantially more money not by fighting patients on the treatment they require but by approving and expediting it so that their overall treatment and recovery takes less time and costs less money.

 

* Schrödinger was an Austrian scientist in the early to mid 1900’s.  He developed a theory made popular in recent popular nerd culture, called the Schrödinger’s cat paradox in which a cat is sealed in a box with a flask of poison and a radioactive source.  According to his theory, it is accurate to assume that the cat is simultaneously both alive and dead because either option is probable.  Until you open the box and check, you do not know for sure.  I referred to my meningiomas as Schrödinger’s tumors because, until the MRI is done, there is no way to know for sure whether they are benign or malignant.

When You’re Struggling With Mental Illness, A Good Therapist Can Make All The Difference

For years, I struggled with my mental health treatment.  Not only was I considered “treatment resistant” because no medication my doctors prescribed seemed to even touch my illness, but I had become increasingly disillusioned with the therapy aspect, as well.

In theory, I have always believed therapy was a good thing.  Better out than in, as Shrek says.  I believed that people need to be able to talk about the issues in their life so that they did not build up, escalate and cause further issues down the line.

However, my personal experiences with therapy and counseling were disheartening to say the least.

When I was a child, my mother briefly took our family for therapy together.  On the very first appointment, when my brother and I both attempted to speak up and share our perspectives on the situation, we were cut off.  Our “family therapist” informed us that they were the parents, we were the children, that whatever they said goes and that our opinions on the matter were irrelevant.  From that point on in his sessions, I didn’t even bother participating because he made me feel irrelevant, as well.  The whole experience left a horrible taste in my mouth and made it harder for me to trust or open up to therapists from that point on.

As a teenager after my mother shot my father, I was briefly placed in counseling again.  The therapist that time did not seem interested in who I was or how I was feeling.  They simply wanted to know whether I had any plans to try and harm myself or anyone else.  Once they felt reassured that I was not a danger to myself or others, they saw no reason to see me any further.  Again, I was left feeling like I did not matter.

In my twenties, I had my first serious breakdown and my first true glimpse into the mental healthcare system.  I now not only was assigned a therapist but a meds doctor, as well.  I also had doctors that I saw for group therapy sessions.  I had a bonafide mental health team.

My therapist was always watching the clock and would interrupt me each session when we had ten minutes left, telling me to “wrap it up” because our session was almost over.  She chose the direction of our sessions, insisting we always talk about current issues because she didn’t believe I was ready to talk about my past.  I had no control over my own therapy.  I felt irrelevant to the whole process, like I was just going through the motions of getting help and she was only listening because she was being paid to do so.  If I ever needed to contact her in between sessions, I was directed to leave a voice mail, though her mailbox was often too full to leave one.

My meds doctor was equally as bad at listening.  He would prescribe me whatever the current flavor of the month antidepressant might be.  When I would explain that it was not even touching my symptoms, he would continuously up the dosages or add other prescriptions into the mix until the side effects became unbearable and I felt like a walking zombie.  Every time I spoke up explaining that nothing was helping and that I felt worse than before I began taking anything, I was disregarded and told that I had to give the medications time to work.

My “therapy groups” were laughable at best.  Everyone in the groups were told that we were not allowed to talk about anything too personal, nor were we allowed to discuss any topic that might be triggering to anyone else.  What we were left with was a room full of people sitting there uncomfortably, some wanting to cry, others wanting to rage, as we all muttered through gritted teeth that we were fine because none of us felt we were allowed to say anything more.

The mental health clinic I attended also had an impatient wing at an area hospital.  I was admitted there a handful of times over the years.  As bad as their other services were, those stints on the mental health floor of the hospital were the worst.  It always took over a day to get my medications approved so I felt even more unbalanced from the start.  On an average three to seven day stay, I only saw a doctor for ten to fifteen minutes on the day I was admitted and again on the day I was released.  In between, the only option for any sort of therapy were groups.  I was assigned groups with the same rules as my outpatient groups so nothing was ever talked about or resolved.  No one was allowed in their rooms during the day so you had hallways full of clinically depressed people walking endless laps around a secured wing, biding their time until their next mandatory group or meal.  Patients openly sobbed or sat around with numb expressions as if life itself no longer made sense.  Nurses sat in a large locked cubicle in the center of the wing, laughing and talking among themselves and largely disregarding the patients unless they had to intervene with a “behavioral issue” or direct someone somewhere.  There was no real treatment.  It was a corral to hold the mentally ill until the staff could pass them off to be someone else’s problem.

More than once, I stopped going to my treatment over the years.  I felt irrelevant, unheard, unhelped.  It all felt like a complete waste of time.  However, with or without treatment, my mental illness raged on and periodically I found myself having another breakdown and needing treatment again. Unfortunately, there was not a large selection of mental health clinics in the county where I lived, and the others all had long waiting lists, so whenever I needed mental health treatment I was sent back to the same clinic that had already previously let me down.  Over time, I became so disenchanted with the mental healthcare system that I just couldn’t see the point anymore.  I may have had a bonafide mental health treatment team but I walked away without any real treatment for my illness.

A couple years ago, I had yet another severe breakdown, this time thankfully in another county.  With the help of a coordinated care provider, I was able to get an appointment at a clinic that normally had a long waiting list and was not currently taking new patients.  Again, I would be assigned a mental health team.  I wasn’t going to hold my breath, though.  I had been through this process many times before.  My expectations were low.

I have never before been so pleasantly surprised or so grateful to be proven wrong.  The difference was like night and day.

My meds doctor actually listened to my previous experience with different prescriptions and did not try to push a large pile of pills on me.  Instead, he had me take a genetic test to determine what medications would work best for me based on my genetic make up.  Lo and behold, based on the results of this test, over half of the medications previous doctors had placed me on were listed as causing moderate to significant interactions for me.  The genetic test also revealed a genetic mutation I had that greatly contributed to my treatment resistance.  We worked together to create a treatment plan that actually suited me.

All my groups encouraged open dialogue, even if the topic was grief or pain.  My groups laughed together and cried together.  We fought our battles side by side and all felt heard.  This clinic offered a wide variety of groups beyond traditional therapy groups, as well, such as transforming anxiety through art, meditation, tai chi and yoga.  I found myself signing up for every group I could fit into my schedule.  Not only were they treating my mental illness, they were contributing to my mental wellness, as well.

My biggest blessing and godsend at this new clinic was my therapist. She lets me control the flow of our appointments and choose what I feel I need to address each week, never prodding or rejecting the topics I select.  She made allowances with her scheduling so that if we ever went over the session time, she never had to cut me off or make another patient wait.  She understood my struggles with verbalizing sometimes in between appointments and readily agreed to communicate via email or texts because that was what worked best with me.  Whenever I have emailed or texted her, she has responded back in under a day.  Most importantly, she truly listened and cared.

When I was struggling to find housing, she brought in resources and connected me to organizations that might be able to assist me.  She helped me navigate through registering my sugar gliders as emotional support animals.  She took the time to introduce me to others I would be attending groups with so I did not feel so awkward about not knowing anyone there.  When I was on bedrest following surgery, she did sessions over the phone so that I did not have a lapse in treatment.  She has helped and intervened with more than one personal crisis time and again. She regularly went above and beyond in every way imaginable.

Perhaps the grandest gesture she had done was only a couple months into our visits.  My mother had passed away on Thanksgiving day 2010.  In one of our early sessions, I had expressed to her how hard this day still was for me years later.  On Thanksgiving, she took time out of her day and her own family celebrations not once but twice to reach out and call to make sure I was okay.

Again and again, she has shown me that I wasn’t just a patient that mattered during those 50 minutes penciled in on her schedule.  She helped me to feel like I mattered even when I had trouble mattering to myself.  She always made me feel like my mental health was a priority, that I was a priority.  I have never felt more heard.

I honestly feel like I won the therapist lottery.  In under two years time, I have gone from hating therapy and thinking it is a joke to believing it can truly make a difference in someone’s life.  My life.  Everyone’s life.  Whenever I hear anyone talk about needing a therapist, I refer them to my clinic, insisting that even if there is not an opening right away, they are worth the wait.  I often share stories about my experiences with my therapist that end in “what therapist does that?!”.  The only difference is that now my stories come from a place of gratitude instead of disbelief and disgust.

There are wonderful therapists out there.  There are clinics that genuinely want to help their patients heal, who see them as people that are suffering instead of a steady flow of dollar signs in and out the door.  I understand how easy it is to become disillusioned with the mental healthcare system when it feels like you are unheard and irrelevant to your own treatment.  I’ve been there.  I went through a revolving door of sub par and inadequate treatment for years.  But please know that not all clinics and not all doctors are like that.  Some genuinely care about their patients and their well-being.

If you are feeling unheard or untreated, please don’t give up hope.  Don’t stop your treatment because your doctor is not hearing you or is not working in your best interest.  Keep looking.  Find a new doctor.  Your mental health matters.  Don’t settle for clinics that make you feel irrelevant.  Find a place where you feel heard, where you feel like you truly matter.  Find a place that makes you look forward to getting the treatment you need.  Trust me – It can make a world of a difference in your life.

I want to end this piece by taking a moment and thank Mary B. and everyone else at my mental health clinic for making such a dramatic impact on my life.  You are all truly a blessing not only to me but to all those whose lives you have touched.  Thank you sincerely.

To the Mother I Never Knew..

As Mother’s Day came and went this past year, I once again found myself with conflicting feelings.  Part of me wanted desperately to join in with friends who were fondly honoring their moms or mourning the mothers they had lost over the years.  Another part of me, however, felt numb and empty, because I never had that type of cherished bond with my mother.  I honestly never knew her.

No, my mother didn’t die when I was born.  She passed away 8 years ago this Thanksgiving Day.  No, she didn’t give me up for adoption nor did she abandon me.  The truth is that my mother was there throughout the majority of my childhood and sporadically at best throughout my adult years.  I just never really knew her because the woman she truly was was buried deep beneath often untreated, always undertreated, mental illness.

Growing up, my mother was one of my biggest abusers, both mentally and physically.  She was prone to severe mood swings that would shift into bouts of rage at the drop of a dime.  She had bipolar disorder.

We were estranged for the last few years of her life.  I could no longer handle the abuse nor did I want my children subjected to it.  It seemed that her medication was never quite balanced nor were her moods.  It always felt like what little treatment she did receive was not helping, was not working, and she was doing very little to proactively work towards correcting anything.  She felt to me like a ticking time bomb, one I was afraid would go off at any moment and I did not want my children caught in the crossfire.

Over the years as I have struggled with my own mental illnesses, I have come to deeply regret those feelings.  I was diagnosed with depression, anxiety disorder and PTSD, labelled treatment resistant for years.  No medication ever seemed to work.  It wasn’t until the last year or two that I discovered via genetic testing that my resistance was caused in great part to a genetic mutation.  I’ve often wondered since then if my mother suffered from the same mutation.

The truth is that mental illness changes a person, or perhaps more appropriately it snuffs that person out, dimming their light and dulling their soul.  The person that you are is trapped underneath, desperately needing to come out, wanting to shine.  But there is this dark hopelessness that oozes over everything, making it impossible to fully be the person you truly are.

I think about my own children and how my diagnosis has affected them.  They have only seen glimpses of the real me over the years.  The creative me who would spend half the day drawing huge murals with sidewalk chalk on the tennis courts at the park with them on summer days.  The silly me who would make paper pirate hats and eye patches, transforming our dining room chairs into a pirate ship to celebrate Talk Like A Pirate Day with them.  The nurturing and educational me who would catch tadpoles in buckets with them to show them how they turned into frogs.

More than anything, though, they saw my mental illness.  They saw the mom who was too exhausted just from going through the daily motions of life to do anything fun.  They saw the mom who opted for quiet family days indoors watching movies or playing board games because I was physically and mentally unable to do anything more.  They saw the mom who often emerged from the bathroom drying my eyes as I attempted to hide the tears I could never seem to stop from flowing.

They were vaguely aware of the person I truly was but they knew my mental illness well.

I remember when I first started taking the medication I needed for my genetic mutation and I had my first truly happy moment.  It was the first time in my life I ever felt that sludge of mental illness be lifted off of me, albeit for a short period of time.  The medication is not a panacea.  It in no way cures or stops my mental illness.  However, it does give my mind the ability to fight back in a way that it never could before.

That moment of happiness was beyond blissful.  I laughed, cried and hugged my boys, asking them again and again if that was truly what happiness felt like.  I had never experienced anything else like it.  That sludge continues to lift here and there sporadically and I have a genuine hope for the future now, that there might be a day when there’s more periods of happiness than illness.  But for now, more days than not, I still struggle.

I have heard from people that knew my mother at the end of her life, in those last couple years, that she had finally gotten the treatment she needed.  Her medication was finally balanced.  She was happy and more herself than she had ever been before.  She was doing crafts with the neighborhood children and even developed a fondness for Harry Potter.

Part of me envies them because I never knew that woman.  I never had the pleasure of meeting her.  All I ever knew was the sludge and taint of her illness.  On Mother’s Day, I mourned the ghost of a woman I never even met, a woman I would have loved more than anything to know.

Please keep in mind that when you’re dealing with people who are struggling with mental illness that they are not completely themselves.  The person they truly are is in there somewhere, beneath their diagnosis, fighting to get out.  Please don’t ever assume that we’re just not trying hard enough, that we’ve already given up or that we’ve lost who we are along the way.  It is a daily battle, a constant fight, against your own mind.  It is a never-ending struggle to push your way through a thick layer of darkness just to come up for air.

Looking back, I truly regret becoming estranged with my mother.  I had done what I thought was best at the time, trying to shield my children and myself from an illness that was not her fault.  She had no more control over her bipolar disorder than I do over my own mental illness.  I am sure she was trying harder, fighting more, than I ever realized.

To the mother I never knew – I’m sorry I was not there when you needed me.  I’m sorry that I allowed my fear to dictate my actions and choices and that I abandoned you when you needed me most.  I’m sorry I was not more compassionate and understanding of all that you were going through.  Most importantly, I am sorry I never had the pleasure to truly meet you.  Happy belated Mother’s Day.

mightylogoRepublished on The Mighty on 9/14/18.

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Republished on MSN on 9/14/18.

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Republished on Yahoo on 9/14/18.

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Republished on Yahoo Lifestyle on 9/14/18.

The Double Standard of Mental Health Support

Ever since Dwayne “The Rock” Johnson spoke up about his own struggles with depression, the story has been everywhere, appearing again and again on all my social media feeds.  Everyone loves The Rock.  It’s a great story.  It’s all everyone wants to talk about.  And beneath his story, you see the same sentiments being shared again and again.

“The poor guy having to suffer through that..”

“Good for him to speak out..”

“How brave..”

It’s a story that we’ve seen dozens of times before.   Celebrities speaking out about mental illness is quickly becoming a huge movement as more and more share their story.

We applauded and cheered when Kristen Bell talked about her battle with depression and anxiety because it made her so much more real. She wasn’t that perfect, ever-smiling, ever-happy Hollywood darling with no problems.  She was one of us!

When Demi Lovato spoke out about her own struggles with depression, bipolar disorder and drug addiction, her fanbase surged.  People admired her for being brave enough to speak up about such difficult topics.

Since he spoke up about his depression and thoughts of suicide, Jared Padelecki is continuously swarmed at cons by fans who love him even more for his brutal honesty and his “Always Keep Fighting” campaign.  The whole Supernatural cast has begun speaking out about mental health and have never been more beloved.

We admire and idolize Carrie Fisher for speaking so frankly about bipolar disorder and called her a national treasure.

When Patton Oswalt talked about the depression he went through after losing his wife, our hearts all went out to him.  We grieved with him and felt his pain.  We all wanted to hug him and to find the right words to say to lessen his pain.

J. K. Rowling.  Lady Gaga.  Selena Gomez.  The list goes on and on.  Speaking out about their struggles with mental illness makes them more relatable, less larger-than-life.  Our hearts all go out immediately to them when they share their stories and confide with us about their pain.  We sympathize, we empathize, we want to reach out to tell them that we’re here to listen even though they don’t even know us.

Whenever we see an actor, musician or a professional athlete taking time off from making movies, touring or playing a game to seek treatment for mental illness, we all say to ourselves, “Good for them, getting the help they need.  It’s such a difficult thing to admit or to face.  I hope they get the help they need.”

Robin Williams.  Chris Cornell.  Chester Bennington.  Whenever we lose an iconic celebrity to suicide, the whole world mourns for months.  The mourning is renewed each year on the anniversary of their death, as well.  Crowds weep together and share stories about how their lives were impacted by their presence and how greatly their loss will be felt.  Newsfeeds are filled with scores of pictures sharing quotes and sweet sentiments along with prayers that their souls are finally at peace.

If you only looked at how society treated mental illness by how we respond to our celebrities, you’d assume we are the most compassionate, enlightened society to ever walk the earth.  It’s truly laughable.

Please know I am not minimizing or trivializing any of their battles with mental illness nor am I diminishing the tremendous losses the world has endured from celebrity suicides in recent years.  It is incredibly brave to fight for your mental health, perhaps even more so in the public eye.

I personally admire them all for taking a stand to fight against the stigma of mental illness.  Like many others, I’ve cried when I read their stories and so many others like them because I could relate.  I’ve mourned those needless deaths because I have walked that edge myself on more than one occasion so I understand all too well how it feels to be suicidal.

I say it is laughable not because I take mental illness lightly or because I am mocking their pain but because the way mental illness is regarded with celebrities is so far removed from the responses the rest of the world gets.  It truly sickens me that the overwhelming support they receive rarely extends to normal, average, everyday people with the exact same diagnosis.

When the average person opens up about their struggles with mental illness, we’re rarely met with any support and encouragement.  More often than not, we’re hit with judgment and persecution.  We’re treated as if we’re exaggerating or making something out of nothing.

“What do you even have to be depressed about?”

“Have you even tried to just be happy?  It’s not that hard.  You just have to be more positive.”

“You’re still not over that yet?  You need to just learn to let go of things that get to you.”

“Everybody has problems.  Stop being such a drama queen and learn to deal with them like everyone else does.”

We mention going to our doctor and getting on medication and are confronted with comments and memes about how we don’t need pills, we need things like sneakers and fresh air.

We talk about seeing a therapist and are told we shouldn’t be putting our private life out there to strangers who are only listening because they are paid to do so.

We’re told it’s all in our heads and that we should be grateful we don’t have “real problems”.

We’re told we’re just not trying hard enough, not doing enough.  Told we just need to try harder, do more, and we’ll get out of that funk.

Everyone has an answer for how to “get rid of our illness” but none of them have anything to do with the actual medical treatment needed for a medical diagnosis.  Be on your phone and computer less.  Go outside more.  Join more activities.  Start more hobbies.  Get a dog.  Get a girlfriend or boyfriend.  Make more friends.  Watch happier movies.  Read more positive books.  Listen to more upbeat music.  None of this would cure any other illness but that doesn’t matter.  Since others cannot see our illness, it must not be worthy of any real treatment.

We see those with mental illness painted as monsters or mocked as jokes.  We’re told that only the weak-minded can’t deal with their feelings.  We’re portrayed as unhinged, broken, unbalanced and unsafe, someone to avoid at all costs so that our crazy doesn’t rub off or spill out onto others as if we’re contagious.

We’re expected to suck it up, hold it in, don’t talk about anything that might make anyone else uncomfortable.  We’re supposed to pretend everything is okay, pretend we don’t feel anything at all even though we feel like we’re slowly dying inside.

When we reach out for help, we’re more often than not denied because it is an invisible illness that they cannot see.  We’re forced to fight, to prove there’s anything wrong and that it’s bad enough to justify getting help.

And Heaven forbid someone loses someone they love to mental illness.  They can’t even mourn without others commenting about how selfish suicide is, as if no longer being able to live in constant torment somehow makes them a bad person that deserves to be forgotten.  If an average person kills themselves, you’re not even supposed to acknowledge their life or their death because it might make others uncomfortable.

For the average person, mental illness is a bad word.  It’s that gorilla in the room that everyone knows is there but nobody is willing to talk about.  It’s that monster on our backs and in our souls that is eating us alive that we’re supposed to pretend isn’t there.

Mental illness doesn’t just happen to celebrities.  It does not discriminate.  It affects everyone around the world regardless of age, gender, sexual orientation and identity, religion, race, occupation, political party, or socio-economic status.

Mental illness isn’t some rare fabled unicorn that only lives in legends and fairy tales, some mysterious creature whose very existence is highly doubtful.  It is all around us.  Millions suffer from mental illness every year.  An average of one in five people struggle with it.  It is an epidemic of global proportions.  It is a very common health problem.  And average, everyday people deserve the same compassion, admiration and support as celebrities do for fighting the exact same battles.

I am an average person with an average illness that affects one in five people in this world.  I am fighting the same battle as millions of others fight to varying degrees every single day.  I’m tired of being treated like I am invisible just because my illness is.  Whenever a celebrity speaks out about their own battles with mental illness it reminds us that they are just ordinary people, too, with the same problems we all face.  If we support some “ordinary people” in their battles with mental illness, shouldn’t we support all?

 

An Honest Dialogue About the Realities of Mental Illness

I woke up this morning to a message in my inbox on my Twitter author account.  Admittedly, I rarely open up messages on that site these days because the majority of them are either bots or phishing scams.  But, even by the small preview pane, I could see this one was different.  They began by explaining they had been reading through some of my writing.  I immediately opened it up to read through it and respond.

I won’t divulge any of what they wrote about because it is not my place to share their story, but as I read over my responses, I couldn’t help but believe that I needed to share my own words further.  To them, I wrote:

…Good morning. No need to apologize at all. I’ve written so very much that unless you’ve stumbled onto certain pieces, it’s unlikely a specific question would be answered. Honestly, it took me hitting a horrible low before I could find my voice. I had to reach a point where something desperately had to change or I knew I was not going to survive..

…As for overcoming my depression, I honestly don’t think there is such a thing, at least in my case.. It was more a matter of accepting my diagnosis for what it was and recognizing my limitations instead of letting the stigma surrounding mental illness control my perception of myself. I still very much have good days and bad days, but at the same time, I’ve gotten better at identifying when it is my depression versus when it is reality.. I’ve also filled my coping toolbox with so many different things so that I have different tools to help me cope with bouts of depression and anxiety.. I’ve learned to look at my mental illness much like diabetes – it’s an illness that causes one of the organs in my body to not function properly – there is currently no cure and it needs regular monitoring and care – but it is possible to exist and live with mental illness just like it is possible with diabetes.. I find myself still struggling, as well, to find a combination of medication that works right for me but I have sincere high hopes that in the future, when that combination is discovered, things will be much better and it will become easier for me to function..

…I apologize if you were hoping for some sort of secret cure all, or some way to make it go away on it’s own.. I don’t think something like that exists at this point, at least in cases such as mine.. I think, for me, it was a matter of changing how I viewed my illness and changing how I viewed myself.. Accepting that I am not broken or crazy but that I have an illness that affects my brain and that I deserve not only treatment but compassion and understanding, as well. I speak out and write a lot about what it is like living with mental illness because I want others to know, as well, that they’re not alone.. that others are struggling to fight similar battles and that we cannot buy into the stigma surrounding our illness, that we are not to blame for our illness, that our illness does not define us and that there is no shame in being mentally ill.

…I apologize for all the typos.. I was typing in the dark on my laptop.. I wanted to answer your questions right away and found my fingers struggling to keep up with my mind as I threw my answer out there.. I hope some or all of that helped.. I thank you for taking the time to read so much of my story and I sincerely wish you the best.. Please stay strong and don’t lose hope.. A mental illness diagnosis does not define you and it doesn’t have to be the end of anything. I truly love that the mental health community has embraced the semicolon ( ; ) as a symbol because it is used when a sentence could have ended but the author chose, instead to keep going. None of our stories are over either. We just have to keep fighting. If you are able, have a wonderful day. If that isn’t possible, please at least have a day. Keep going, keep powering through. And know that you’re not alone.

…Reading over all of this, part of me honestly feels horrible if anything I had written gave the impression that I had in any way found a path beyond my illness. As you can tell by much of my writing, I still struggle with horrible lows and have days where I consider getting out of bed, eating and doing my dishes as a victory. I’ve learned to differentiate between my illness and reality but that in itself does not change the physical things going on within my mind and body. My mind and body still go haywire regularly – I am working with my doctors to find a way to get them under control much like a diabetic manages their illness with insulin and glucose.. I know talking about looking at my illness differently doesn’t sound like much but it has been a huge stepping stone for me because it has allowed me to stop beating myself up for being ill, to stop hating myself and treating myself as if I am broken or crazy. By recognizing it as an illness and not something messed up inside myself, I was able to take back some control and begin working towards getting my illness under control. Things may be rough right now but this illness can be treated.. It just takes time. I’m not sure there ever will be a point where I’ll be fully functional, but I’d happily settle for being more functional than I currently am.

I honestly felt I needed to put this out there, to make sure everyone reading my writing understood that I am in no way touting any magical cure all for mental illness, nor am I implying in any way that mental illness is anything that a person can overcome by sheer willpower alone.  Mental illness is just that – an illness – and it needs treatment.  It won’t go away on its own.

I do believe, however, that we can destigmatize our illness and take back control over our lives.  We cannot will away how our symptoms present themselves but we can change how we view them and how we treat ourselves.

Please know that I’m a realist.  I’m not going to throw out those tired cliches about trying harder to be happy or how life will somehow magically be better if you let go of your past because I’ve been there myself and I know how infuriatingly useless they are.  I’ve worked through issues from my past and my mental illness still remained – because it is an illness that needs treatment.  I know firsthand how rough this illness can be and I won’t sugarcoat it because it does none of us any good to minimize our symptoms for the comfort of others.  I speak openly and honestly about what it is like to live with mental illness because I know holding it in and pretending things are okay doesn’t work.  Those of us suffering can barely wrap our own heads around our illness – how can we expect those who have never experienced it themselves to understand unless we throw it all out there and tell them?

I apologize if anyone who has been following my journey feels misled, hoping for some panacea, some advice or trick that will help their mental illness magically go away.  As far as I know, no such thing exists.

I may be a realist, but I’m also an optimist.  Since I have changed how I view my own illness, I have newfound hope for the future.  I have seen marked changes and improvements in the last couple years alone.  Though my fight is far from over, I truly believe that further advancements are possible and that things can and will continue to improve over time with continued treatment.

I write about mental illness not because I have all the answers but because I know it is a problem we cannot solve by pretending it isn’t there.  We need to talk about mental illness.  We need to fight the stigma.  We need to share our journey with others who are struggling so that they know they are not alone.  We need to stop blaming ourselves, stop hating ourselves, and accept our condition for what it is – an illness that needs medical treatment.

For everyone else out there fighting their own battles with mental illness, please stay strong, keep fighting, don’t give up hope.  See a doctor.  Talk about everything you’re going through without minimizing or sugar coating it.  Stop blaming yourself and hating yourself for your condition.  Please know that you’re not alone.  And most importantly, even if you cannot have a good day, at least still have a day.  None of our stories are over and we can get through this together.

Suicide Without Dying

Suicide without dying.  It happens more often than you might think when someone is suffering from depression.

I have suffered from depression my entire life.  I was born with it.  Due to a genetic mutation, my liver was never able to metabolize a usable amount of a simple substance my brain needed to function properly.  The chemical my body could not metabolize is needed for the manufacture and transportation of neurotransmitters such as serotonin, dopamine, and norepinephrine. Because my body could not make the substance my brain needed, my own body struggled to make the neurotransmitters it required and the paltry amount my body was able to make had no way to get where they were needed.  Even antidepressants did not work because my brain lacked the substance required to transport them where they were needed.

The discovery of my genetic mutation is fairly recent.  For most of my life, I struggled with a depression that appeared untreatable without ever knowing why.  Over the years, I have seen multiple doctors for the treatment of my depression.  I have rotated through a myriad of combinations and dosages of antidepressants and anti-anxiety medications.  Nothing worked.  I was labelled treatment resistant.

I have never experienced a single day without depression looming over me.

Nothing any of my doctors did seemed to help.  They would increase dosages until the side effects were unbearable or until I was a nonfunctional zombie.  Then the process would begin anew with different doctors, different medications, different combinations, different dosages.  It was a living nightmare.

No one around me understood.  They were all confused by the fact that I had been in treatment for years and had taken all types of medications without any results.  Their questions were hounding and relentless.  How was I not better yet?  Was I even trying to get better?  Was it really THAT bad that I was struggling to function and needed help?  Was I even being honest about how I felt or was I exaggerating or faking it?  What did I even have to be depressed about anyway?  So many people in my life who I tried to turn to for assistance were unsupportive and quickly became tired of dealing with my depression.  The nightmare just kept going and going.

Life felt unbearable.  Nothing my doctors did helped.  I had very little support system or assistance.  Every single day, it felt like I was not only fighting against myself and my own brain, but the rest of the world as well.

I couldn’t keep living like I was.

So I gave up.

I didn’t kill myself.  Instead of ending my life, I just stopped living it.

I stopped going to see doctors because nothing they did helped anyway.  I stopped turning in or following up on paperwork for assistance for my depression because it all felt futile.

I was too tired to fight anymore so I just gave up.  I began shutting down and isolating myself.  I put off responding whenever anyone reached out, tossing out apologies for not seeing their messages sooner and making endless excuses to friends about being busy or being sick.  I kept everyone away so they could not see how bad things had become.  Avoidance was easier than explanations.

I stopped talking about how I was doing and feeling because there was nothing anyone could do to change things anyway.  I’d mutter something about being fine then clam back up or changed the subject.  In truth, I was the farthest from fine a person could get.  I had given up.  I didn’t have the energy to explain how I felt or to defend myself from their judgments.  I didn’t want to burden anyone.  I didn’t think anyone would want to be there anyway if they knew how much of a mess I had become.

As I spiraled farther down into the dark abyss of depression, I began avoiding things that used to spark even the slightest happiness.  Why bother partaking in anything that used to give me joy when my numbness would only serve as a painful reminder of how bad things have become?  I cleaned up less often around the house, hiding dirty dishes, clothes and clutter if anyone was coming by.  I put off even basic self-care, showering once or twice a week instead of daily and keeping my hair pulled back so I wouldn’t have to tend to it.  I’d stay in pajamas for days because it wasn’t like I had anywhere to go, anything to do or anyone to see.  After all, my friends all thought I was sick or busy and going to my doctors was a waste of time.

I spent whole days laying in bed crying.  Even more days, I sat or laid around feeling completely numb, bingewatching shows I barely paid attention to or remember, puttering around the house doing nothing in particular and just napping on and off, letting the days pass me by.  I often didn’t bother eating because it felt like too much effort to even move.  I would ignore the growls of my stomach for hours much like the cramps in my bladder until the pain became too much to bear.  What I did eat was usually chosen for ease and convenience not desire.

Days and weeks blended together in nothingness.

I tried to put on a brave face, a smiling face for my children on the portion of the week they were with me, but it was just going through the motions.  Instead of fun outings, we had more and more family movie nights at home.  Instead of the bigger meals I used to make, I would throw together quick and easy cheater meals.  I made endless excuses to them for the funk I was in.  I was tired.  I just wasn’t feeling well.  But I was fine.  But I wasn’t fine.  I had given up.  As much as I tried to shield them from it, looking back, I have no doubt that on some level they knew.  That my depression had such an impact on their childhood will always be one of my biggest regrets.

I have gone through this cycle where I have pulled away from everyone, isolated myself and stopped living numerous times over the years.  It always seemed to happen the same way.  Treatment wasn’t working, getting assistance began feeling impossible, nothing felt like it was ever going to get better and no one else seemed to understand or truly care.  I felt completely broken and all alone in the world.  It was not a world I wanted to live in so I just gave up and stopped living altogether.

Finding out about my genetic mutation and its role in my depression has changed my perspective on many things and has sparked a new journey in self-reflection and self-improvement.  It has also forced me to accept many hard truths.  Perhaps one of the biggest is the fact that every time I gave up, every time I pulled away and isolated myself, every time I stopped living my life, I was committing suicide without dying.

Yes, I was still technically alive but I was barely doing anything more than existing, going through the bare minimum of motions to get from one day to the next.  I had stopped living my life, stopped finding reasons to enjoy life, stopped taking care of myself and shut myself off from the rest of the world.  I may have been breathing and had a pulse, but I was not living.  I had given up just as surely as if I had taken my own life.

I was also putting those I cared about in the position of having to mourn me again and again, to deal with the loss of who I used to be and the bonds we used to have.  I was removing myself from their lives, forcing them to face that loss again and again.  Every time I would resurface and reenter their lives, I considered it a victory that I had climbed back out of that hole, never stopping to consider how much they must have struggled to reconcile with the endless roller coaster I had put them on, being slingshot repeatedly between mourning my loss and having me back to varying degrees.

I know there are some who will question my comparison of severe depression to suicide without dying.  There will be others who will angrily declare they are nothing at all alike, swearing that they know because they have lost loved ones to suicide and I am still here, still breathing, that it is not at all the same.  Please know that I am in no way diminishing the tremendous loss that comes with suicide.  I have been on both sides of that fence, having been both suicidal myself and having lost people I loved to suicide so I would never trivialize it in any way.

People ask so many questions after someone commits suicide.  Why would they do this?  How did this even happen?  How did their life get so bad that they felt giving up was the only option?

As someone who has struggled with suicide myself, I can tell you – it all starts with giving up.  It starts with that feeling that you just can’t go on anymore like you are, that everything is hopeless and that nothing is ever going to change.  It starts with that feeling that you just don’t want to live anymore so you don’t.  You pull away from everyone, you stop taking care of yourself or seeking out help or treatment, you turn your back on anything that used to bring you joy.  You sink so deeply into depression that you just don’t see the point of doing anything anymore.  From that low point, it isn’t a far leap to physically ending your life because you have already stopped living it anyway.  After you’ve already mentally and emotionally committed suicide, you can rationalize physically letting go, as well, because you believe you have nothing left to live for.

I can also tell you that it is a slippery slope.  At first, it’s easy to consider withdrawing and isolation as a kindness to others because you’re still around in some way.  But isolation often leads to thoughts of others being better off if you were completely gone, if perhaps you never existed at all.  While not everyone who pulls away due to depression is actively planning to physically kill themselves, that isolation makes it easier to rationalize taking that final step.  When someone has reached the point of wanting to give up and stop living, it’s not a far stretch to decide to stop breathing, too.

What starts as feelings of hopelessness and despair transitions easily into suicidal ideation, where you don’t want to die but you don’t want to keep living like this anymore either.  Many people suffering from depression experience suicidal ideation from time to time, sometimes frequently.  When thoughts of suicidal ideation turn to action or inaction, and someone stops living altogether, it is not a hard transition from not going through the motions of living anymore to deciding to stop living anymore altogether.

Even consciously knowing and acknowledging the cycle, I still find myself pulled down towards it again whenever my depression gets bad.  When things in my life aren’t going as planned or they begin to fall apart, everything starts to feel hopeless again and I struggle to pull myself up, keep myself going, to not give up.  It is a dangerous edge to walk on and one I fight daily to distance myself from.  I fight a constant battle to stay vigilant and self-aware, to catch myself whenever I start to spiral down and begin to withdraw from life.  Whenever someone is struggling with depression, it’s important to watch for those markers of isolation and giving up because once someone has decided life is no longer worth living, it becomes so much harder to justify continuing to live it at all.

If you see someone in your life start to withdraw, talk to them.  If you notice they are lessening their self-care or beginning to cut everything they enjoy out of their lives, talk to them.  Don’t buy into their excuses and allow them to isolate and pull away.  Be there.  Be persistent.  Listen even if you don’t have any resolutions to offer.  Listen just so they’re heard.  Chances are their feelings might feel uncomfortable or overwhelming to you at first, but know that they need to get them out.  Better out than in.  Encourage them to get help and stay positive but don’t judge them for their struggles to do so.  They need support and encouragement not judgment.  Be a consistent presence in their lives, a counter to the negativity trying to pull them down.  Just be there because them being alone and isolating themselves is the worst place they can be.

If you’re struggling to find reasons to keep going yourself, let those feelings out.  Don’t hold them in.  Talk about them even if they don’t make sense to you just to get them out.  Talk to someone whether it’s a friend, a doctor, a clergyman – anyone.  Just don’t sit home alone in the dark and let those feelings fester because they will only continue to grow and get worse over time if you never let them out.  Don’t push away people that care enough to ask whether you’re okay or lie to them that you’re fine if you’re not.  Don’t worry about scaring them with everything you are going through – if they truly care about you, they would rather deal with some discomfort and worry now than to lose you entirely down the line.  Don’t give up things that make you happy.  If anything, keep seeking out other things to make you smile, even if you have to force yourself to multiple times a day.  Surround yourself with positive things, good things, things that remind you that the world is not completely dark, ugly and hopeless.  Take care of yourself the best that you can.  Eat.  Go to the bathroom.  Shower.  Even if the only thing you manage to do today is take care of yourself, that is enough.

When someone commits suicide, it is permanent.  There is no bringing them back, no changing anything.  It is final.  When someone takes those first steps and decides to stop living, it is often a precursor to suicide.  We need to be more vigilant, with ourselves and with others, when we see those signs of withdrawal and isolation, when we see ourselves or someone else starting to give up and stop living their lives.  We still have the power to change things before they reach that point of no return, before that loss becomes permanent.  I have stopped living a few times before and am still alive to tell the tale.  It is possible to die inside, to give up on life, while still breathing.  It is also possible to come back and live again even after you’ve mentally and emotionally given up.  It is not an easy task but it can be done.

Please know that I understand how hard, lonely and hopeless life can feel.  I know how low depression can pull you.  I know all too well that feeling of not being able to take anything anymore, of just wanting all the pain, all the stress, all the struggling to stop.  I know how unbearable it can all feel.  I understand how someone can reach a point where giving up feels like the best option, the only option.

But it doesn’t have to be.  Please stay strong.  Choose to live.  Choose to keep going.  Even if you can’t do as much as you’d like or as much as you feel you should be able to do, do whatever you can do.  Just don’t give up.  Don’t give in.  Don’t stop living.  Don’t allow any part of yourself to die.

Depression is NOT Caused by Circumstances or Lack of Effort.

Time and again, I have seen people who did not understand mental illness or who have based their opinions on stigma, accuse others of causing their own mental illnesses.  They assume that depression is simply someone being sad for having a bad day or that if they just tried a little harder, worked a little harder, to improve their lives, their mental illness would simply fade away.

Depression is a mental illness.  It is not someone just being too negative, refusing to look on the bright side of life.  It is not someone being lazy, not trying hard enough to improve their circumstances.  The onset of depression might be triggered for some by a traumatic event but the condition itself is a physical imbalance in the brain.  Correcting the situation will not instantly cease the symptoms of depression.  Depression is a medical condition that needs professional treatment.

Depression is also more than just simple sadness.  There are periods of numbness, where it feels almost impossible to function.  There are also periods of extreme negativity and self-loathing, when everything feels hopeless and you feel alone in all the world, you believe deservedly so.  Depression can be increased by difficulties in life but they are a catalyst, not the causation.  Removing those difficulties might help improve the situation but it is not a panacea.  The depression will not just go away on it’s own.  Again, it is a medical condition that needs professional treatment.

I have struggled my entire life with mental illness.  Yes, it has been drastically worse during the lower parts of my life, but even the better times were tainted by depression.  Regardless of whether my life had collapsed or things were finally coming together, the depression was still there.  Regardless of how hard I’ve tried to work on myself and improve my situation, my depression was still there.  Because depression is a medical condition that needs professional treatment.

I have begun taking steps to improve my mental health.  I have taken yoga, tai chi and meditation classes to help find an inner peace and calmness.  I have taken other more specialized classes that focus on mental wellness, like transforming anxiety through art.  Though each has given me new tools for my coping toolbox, none of it is a cure-all.  Working harder on my mental wellness will not make my symptoms disappear because depression is a medical condition that needs professional treatment.

My personal life has greatly improved, as well.  I am no longer in a dysfunctional, abusive relationship.  I am finally with someone who loves, appreciates and accepts me for who I am.  I have managed to rebuild friendships with old friends I had drifted apart from over the years.  I have wonderful children I love dearly and am very proud of who they have become.  I have a budding writing career and a new calling that gives me a purpose I had previously lacked.  I have so many blessings in my life, so many things that make me smile and feel true happiness.  Yet my depression still rages on.

I am in treatment.  I see a therapist regularly and take medication.   I did not ask to be mentally ill nor am I sitting back complacently, refusing to do anything to improve my life or my circumstances.  I am actively fighting to be as healthy as I can be.  But that doesn’t change the fact that I have an illness that affects the way my brain processes my emotions.  Though the rougher times in my life have contributed to the severity of my illness, my depression was never caused by any situation or lack of effort on my part.  I am not to blame for my mental illness.  Despite what stigma and ignorance might lead some to believe, depression is a medical condition.  Medical conditions do not improve by changing situations or with sheer force of will alone.  Treatment is needed.

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Republished on The Mighty on 11/9/17.

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Republished on Delaware Health Information Network on 12/3/17.