Sorry Not Sorry: My Mental Well-Being is a Priority

It has been a rough couple months.  Horribly frigid and snowy weather, as well as a revolving door of various sicknesses in my home, have combined with my mental illness to create a perfect storm.  I endured what felt like a never-ending rotation of maladies, downward spirals and utter numbness. There were many days I felt like I could barely function at all.  I usually love the holidays but this past year, the festivities felt hectic, rushed, hollow and empty.  As much as I beat myself up for not being more present, more in the mood, more cheerful and jovial in general, I just could not snap out of the funk I was in.  And the guilt of it all was eating me alive.

After two and a half months of struggling to get from day to day, unable to even inspire myself to write, I am finally emerging like the groundhog in early February to start anew.

Periodically, this happens to me.  When life gets hard, I pull in on myself, much like an armadillo rolling in on itself for protection or a cell phone going into power saver mode so it doesn’t shut down completely.  This cycle has repeated itself from time to time throughout my life.  Whenever everything would get hard, I would pull inward, isolating and conserving my energy in order to survive.  On the other end of this pattern would always inevitably come unfathomable guilt and pressure to make my recent absence up to everyone.

I have struggled my entire life with depression, always feeling as if I was broken, as if I was always letting everyone down by not always being able to do, to be, everything others needed and expected of me.  I consistently felt like a failure.  Like I didn’t even deserve to be on any list of priorities.  After every struggle I endured, I always felt like I was playing catch up, that I owed it to everyone else to use whatever energy I could muster to make it up to everyone else for letting them down yet again.

Christmastime this past year was especially hard.  I usually do a marathon cookie bake as part of my holiday traditions.  Three days of baking. Fifteen types of cookies, plus candies and fudge. Everyone in the house getting sick delayed the grocery shopping and my baking was put off until the last minute.  What is usually three comfortable yet full days of baking was ultimately crammed into a panicked day and a half.  Pushing myself that hard utterly burnt me out.  I existed in a heavy fog of numbness for the remainder of the year.

Speaking afterwards to my doctor, she inquired, “If you only had half the time, why didn’t you just bake half the cookies?”

I started to explain that people were expecting the cookies.  My kids love all the cookies every year and give away boxes to their friends. My fiance needed cookies to bring into work.  We had friends and family that we gave boxes to every year.

She countered by asking why I exactly felt so obligated.  Was anyone was paying for the cookies in any way or if I was just doing it out of the kindness of my heart?

I began defending myself again, insisting that I didn’t want to let anyone else down.

In a perfect check-mate moment, she asked, “What about letting yourself down? Is doing for others out of the kindness of your own heart really worth burning yourself out and running yourself down?  At what point do you fit into the equation? If you only had half the time, why couldn’t you just bake half the cookies?  You’re still being kind to others that way.  But you’re also being kind to yourself.”

Our conversation bounced around in my head for hours. Days. Weeks.  Again and again, I pondered where I fit into the equation of my life and why I didn’t seem to matter at all in most cases.

I ultimately determined that I needed to restructure my priorities in order to find a place for myself in the equation.  I had to be willing to reserve what little energy I do have during rough periods on what should be most important in my life – my family and myself – without becoming guilt-ridden afterwards.  The addition of “myself” towards the top of my list of priorities is honestly fairly new and admittedly still somewhat uncomfortable.  For much of my life, I was on the bottom of the list, if I appeared at all.

That was a feeling that I desperately needed to address.

Whenever I struggle to apply my own self-love or self-care, I stop to consider what I might tell someone else in my situation.  I would never discourage anyone else from pulling back in order to take care of themselves.  I would never accuse anyone else of being a bad person for wanting to matter, too, or for feeling like they sometimes had to prioritize themselves in order to make it through to tomorrow.

Let’s be honest here.

Wanting to matter, too, is not being self-centered.  Wanting to do self-care when you need it does not mean you don’t care about others, as well.  Nobody is saying you can only choose one or the other, help others or help yourself.  The two are not mutually exclusive.

Not writing for a couple months honestly ate at me very badly.  I felt terribly guilty, like I was letting my readers down by not writing more content, not sharing my journey more frequently.  But after that pivotal talk with my doctor, I am no longer guilt-ridden.

The truth is that I had a few months where I was struggling badly.

I had a few months that I desperately needed to devote any energy I could muster into self-care and self-preservation.

That doesn’t mean that everyone else doesn’t matter, as well.  When I have enough time, enough energy, enough willpower to reach out and advocate for others, I still will.  I cherish every time someone has reached out to me letting me know my words have impacted their life. This journey is too important to give up.

I will still help others whenever I can.

But I must help myself, too.

I cannot carry the world on my shoulders, struggling to keep others afloat if it means I go under and drown.

I will always prioritize my family because they are the cornerstone of my world, but from now on, I will be prioritizing myself, as well.

I cannot help others if I cannot help myself.

I will take care of myself whenever I need, however I need.  If that means I do not write for a period of time, so be it.  If that means I only bake half the amount of cookies because I only have the time and energy to do that much, then that is all I will do.

Over the last decade, I have grown my hair out repeatedly, only to cut and donate it when it gets long enough to do so.  My hair was down to my mid-back, with perhaps nine months to a year to go until my next donation.  However, the meningioma tumors on my brain have been causing pressure migraine headaches in increasing frequency of late.  The added weight of all my hair does not help.  As much as it would be nice to donate yet another ponytail to help others, realistically it would not be fair to myself to endure almost a year more of harsher migraines in order to make another donation.  I can still help others, just not at a detriment to myself.  In an act of self-care, I cut my hair shoulder-length.  The intensity of the majority of my headaches has lessened noticeably since then.

I have entered a new period of my life, one where I learn to value myself as much as I have valued others in the past.  I will learn to set my goals and expectations based on what I feel I can handle instead of what others have decided to expect.

I will set new limitations and boundaries so that assisting others no longer harms me.

I will no longer put myself out there beyond my own capabilities in any way that will ultimately hurt myself in the process.

I will prioritize my mental health guilt-free.

I won’t ever again apologize for having to take care of myself.

Sorry not sorry.

My mental well-being matters.

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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.

Having A Positive Mindset Will Not Cure Depression

Many people assume that those who are suffering from depression are just caught in the wrong mindset, that we’re being Debbie Downers and Negative Nancys, wandering through life with a Trelawney*-sized penchant for doom and gloom.  They assume a great deal, if not all, of our mental illness could be solved simply by trying a little harder and adopting a more positive mindset.  I can tell you firsthand that is not the case.

I have been told by multiple people over the years that I am the most positive, cheerful, upbeat little depressed person that they have ever met.  I refuse to be a victim.  I am a fighter.  A Survivor.  Even in the roughest of circumstances, I still search for something positive to cling to like a life preserver in rough waters after being thrown overboard during a raging storm.  I am a firm believer that there is always something positive to be found if you look hard enough.  Even on the worst days, I am that one person you can count on to offer an encouraging smile and to point out something good to be grateful for in life.

I do not intentionally surround myself with negativity.  Over the years, I have systematically removed many so-called friends and family from my life who found more pleasure in knocking others down rather than helping each other up.  I’ve chosen instead to surround myself with people who believe in kindness and compassion, those who prefer to cheer openly for the success of others rather than privately snickering over their defeat.

I don’t carry within myself an undue amount of anger, hurt or resentment.  If someone has grievously injured me, I have learned to just remove them from my life as a doctor might amputate a gangrenous limb.  I do not allow their cruelty to continue to fester and grow but rather I accept that they do not deserve a place in my life and I continue onward without them.  I have accepted that not everyone belongs in my life and that some people were merely meant to play the passing role of a teacher of harsh realities.  I refuse to waste undue amounts of energy dwelling on the cruelty of anyone who would not give me a second thought.  I choose to focus the majority of my energy on improving myself and my future rather than dwelling on other people or a past I cannot change.

I have trained myself to consciously focus on happiness and positivity every single day.  Every day I strive to accomplish three goals.

  1. Every day, no matter how rough the day might feel, I look for at least one reason to smile, one thing to be grateful for in my life.
  2. Every day, I try to reach out and do something kind for someone else without expecting anything in return.  This could be as simple as holding open a door or reaching out to someone else to see how they are doing.
  3. Every day, I make sure to tell at least one person in my life that I love and appreciate them.

At my core, I have a very positive mindset.  I have a fundamental belief in the strength and resilience of the human spirit, that we as a species are stronger than we realize and are survivors at heart.  I carry within myself a genuine hope that one day things will get better and I am proactive in working towards that goal.  I encourage not only myself to power through and not give up on a daily basis, but I reach out to others, as well, through my writing.

I also have friends and family that I have opened up to about my illness.  I do my best to be honest with where I am at mentally and emotionally at all times.  I have constructed a support network of people I can reach out to if I need help so I am not facing everything alone.

I have not given up on myself.  I not only see my doctors regularly, but I push myself as much as possible to attend wellness activities such as yoga, tai chi, meditation and art classes.  I take my treatment seriously.  My wellness and emotional toolbox is chock full of useful techniques to use when I am struggling.

I make sure to eat regularly even if I am not feeling particularly hungry so that my body receives the nutrients it needs.  I do not smoke or use drugs and very, very rarely do I drink any alcohol, let alone have more than one drink.  I practice self-care and engage in hobbies such as writing, sketching and painting so I have positive outlets to focus my attention upon so I do not lose myself along the way.  Over the years, I have learned to love myself and to treat myself gently, with the same kindness and compassion I would show others.

I have not surrendered to my mental illness or turned a blind eye to it, pretending it is not there.  I read up on the latest studies on a regular basis.  I belong to multiple online support groups that share not only encouragement but share information, as well.  I want to remain knowledgeable about my illness so I can make educated decisions about my ongoing and future treatment.

My mindset is not an issue.

I am fighting every single day.  I am like the cancer patient who pushes herself to eat even though her chemotherapy has left her feeling nauseous because she knows it is what her body needs or to go for a short jog because she is determined to not let her illness defeat her.  I am like the woman with rheumatoid arthritis so bad that every step wracks her body with pain who still goes out to work in her garden because she doesn’t want to lose herself to her illness.  I am no different than many other people with hundreds of different debilitating diseases, illnesses and ailments who are fighting the good fight every single day not only to survive but to find some way to truly live despite their diagnosis.

Again, my mindset is not the issue.

All the positivity in the world will not negate my illness.  A wellness toolbox full of handy tricks will not fix it.  It is a medical condition that needs medical treatment.  As good as things like having a support system, a positive attitude, eating well, exercise and engaging in healthy hobbies might be for someone’s emotional well-being, they will not cure mental illness any more than they would cure cancer or arthritis.  I have learned to cope with my illness to the best of my ability but I still need ongoing treatment.

The main difference between other more widely accepted ailments and mental illness is that my condition stems not in my body but in my brain. That, and the stigma attached to mental illness that prevents others from viewing it as a legitimate, treatment-worthy condition.  Because it cannot readily be seen by the naked eye, it is often doubted, minimized and trivialized, treated largely as a joke.  Though it may be considered an invisible illness, I am fighting it every single day.

From the time I wake up every day, I am fighting my own mind.  As much as I struggle to stay positive and focused, a very real part of me is trying to convince me that the world is hopeless.  Whenever I attempt to reach out to friends and loved ones, it tells me that I am a burden to them, that I shouldn’t bother, that I should leave them in peace.  It pushes for me to isolate, to hide my pain, to succumb and surrender to it.

There are days I am overwhelmed with emotions.  I feel everything so deeply and there appears to be no way to turn it off.  I have this intense need to cry, to weep not only for myself but for everyone else struggling, for everyone who’s lives have been made harder by my illness and for everyone else who has lost their battles along the way.  On those days, my world is overflowing with so much pain that it is overwhelming.

On other days, I feel nothing at all.  I find myself trapped in a dark void where nothing feels like it matters, least of all me.  There is no joy in that darkness, no light, no hope.  I struggle to even move because I feel swallowed up within its depths.  Everything on those days feels like an insurmountable obstacle.  Even simple tasks like eating make no sense because everything tastes bland, like nothingness.  That voice within my head echos through the darkness, asking what’s the point.

No mater how much the sun is shining, my world always feels dark, cold, hopeless and full of despair.  No matter how many times I tell myself that it isn’t truly the case, it still feels that way.  It is like my mind has constructed its own alternate reality and has taken me hostage within its walls.  I feel helpless like I have no control over my own life, let alone my body or my mind.

Every single day, I have to fight myself to even get out of bed.  It isn’t a case of laziness or just not wanting to get up.  The weight of everything I want to do and need to do rests so heavily on my shoulders that I often find myself immobile, incapable of action.  Every single day I am beating myself up for everything I know I should be doing but cannot manage to bring myself to do.  I desperately want to get up, do things and be productive, but the weight of my illness pins me down.  It then uses my inability to function against me as evidence that I am worthless and a waste of space.

Every single day, my mental illness presents itself in very real and physical ways as well.  My body is always as exhausted as my mind.  I ache all over.  My anxiety frequently has my head spinning and my heart pounding.  When confronted with stress, my chest tightens and my thoughts race.  My stomach is always in knots.  I regularly experience nausea and vomiting and have a recurring bleeding ulcer.  I have absolutely no desire to eat most days or to even do anything at all for that matter.  Every night, I struggle to get to sleep and to stay asleep.  I am plagued by horrible nightmares on a regular basis.  No matter how much rest I might get, I always feel sluggish, like I am running on empty.  It is like my own body has betrayed me.

My world feels hopeless.  I feel helpless.  I feel lost and alone.  I feel broken beyond repair.  There is not a single day that I do not have to remind myself multiple times that this is not reality.  This is my mental illness.  There is not a single day that I am not fighting with myself, pushing myself to do something, anything, even if it is just to pull myself out of bed and eat something.

I am not consumed by negativity, nor am I lazy or weak.  I have not given up on myself or the world.  I have hope for my future and a strong will to fight.  I am doing my best.  I refuse to let my mental illness beat me.

My mindset is not the issue.

My mental illness is.

I struggle every single day not because I am not trying hard enough to have a positive mindset but because I am ill.

 

*For those unacquainted with Sybill Trelawney, she is one of many wondrous creations from J. K. Rowling’s Harry Potter universe, the Divination professor who at one time or another had foreseen the death of every student at Hogwart’s.  Whenever I imagine anyone embracing hopelessness and envisioning a world full of nothing but doom and gloom, I think of Trelawney.

 

When People Talk About Celebrity Suicides..

When people talk about celebrity suicides, they always begin with comments about a light snuffed out before its time, a star that blinked out of the sky too soon.  Again and again, their final act is highlighted, the fact that they could have kept going but chose to give up.  People comment on what a truly great loss it is.

When people talk about celebrity suicides, they share all the ways that celebrity impacted their life.  Whether movies, music, sports or the fashion industry, people the world over share all the ways their life was forever touched by these larger than life strangers they only saw in the spotlight but never truly knew.

When people talk about celebrity suicides, they declare that it never should have happened, that better mental health care needs to be in place.  They converse about private struggles and the overwhelming fear they must have faced of coming out about the true depth of their illness.

When people talk about celebrity suicides, they talk about how brave that soul was for fighting such horrible demons for so many years.  They are praised for being such brave souls for fighting as long as they did.  Celebrities are seen as tragic victims who eventually succumbed to a horrible unseen monster.

When people talk about celebrity suicides, there’s a tremendous outpouring of love and  a universal demand for change.  Suicide is in everyone’s mind and on everyone’s lips.

Then, quick as it began, the sentiment fades.  Other news stories start trending.  Those losses are widely forgotten until highlighted again by an anniversary of their death or when a memory is randomly stirred by happenstance like an old movie or song playing in the background.

It has become second nature to acknowledge and mourn those who are larger than life who tragically take their own lives.  Timelines are filled with posts and tweets echoing wishes that souls can finally be at peace.  It has become second nature to highlight all the problems with the mental health system and the stigma attached to the illness itself.  But it always seems to be a passing fad, lost from people’s minds as soon as the words leave their lips.

But what of the average, run of the mill person who commits suicide?

When an average person commits suicide, people talk of selfishness and weakness.  There is an overwhelming sentiment that they should have fought harder, tried harder, said something, not given up.  The average person who commits suicide is seen not as a victim but as an offender, making a horrible choice that will drastically and tragically impact the lives of everyone left in their wake.

When an average person commits suicide, people are afraid to even acknowledge their life.  It is as if their final tragic choice erased their entire existence, making it too painful, too shameful, to talk about. We cannot talk about them.  Their names are whispered in corners.  Have you heard about..?  Their entire life becomes summarized by their final act.

When an average person commits suicide, we don’t talk about mental health or the need for change.  The fact is that we don’t talk at all.  Those closest to the loss mourn tearfully in silence, lighting candles and quietly asking why.  The rest of the world continues on as if they never existed.

What if I told you that the celebrities who committed suicide were just average people, too?  What if I told you that, despite their status and their wealth, they had the same thoughts, hopes and fears as average people and struggled with the very same mental illness.  Would you mourn the average person’s loss as greatly or as deeply?  Would the average person then be remembered as much for their lives as their death?  Would change and better mental health treatment be demanded for the average person as it is with the elite?

We need to stop going through the motions of mourning celebrities and forgetting everyone else that we lose to suicide.  They are both equally tragic and both deserve so much more.  Celebrity suicides deserve to be remembered beyond when they’re trending.  Average people who commit suicide need to be remembered period.  And above everything else, change is desperately needed.

Mental illness is not a dirty word, a secret we can only talk about in hushed tones in secluded corners.  We need to stop letting stigma dictate our actions and inaction.  When one in five people struggles with mental illness and suicide is one of the biggest killers in multiple age groups across the board, it is no longer a problem we can ignore.

No one deserves to be shamed for their mental health or vilified posthumously because they lost their battle with their mental illness.  It is a very real condition and one that deserves treatment, for both those who are famous and those who are not.  It is an illness that has turned fatal for far too many people, not because their bodies ceased to work but rather because their minds lost the will to live.

Better access to mental health treatment is desperately needed.  We have to remove the stigma so those struggling, whether they are famous or not, are able to come forward when they are suffering, without fear that it will ruin their career or paint them as someone who is broken, crazy and just not trying hard enough.  We need to exercise compassion and encourage communication so that everyone who is struggling is able to receive treatment without fear.

We also need to do better when it comes to acknowledging suicide victims’ lives, not just if they’re famous and not only again on anniversaries of the tragedy.  We need to openly talk about their lives and their struggles, acknowledge the gorilla in the room and pull that monster out of the shadows into the light.  We need to make conversations about mental illness as commonplace as mental illness itself.  We need to face stigma head on and erase it.

We should not only be talking about suicide when a celebrity takes their own life.  We should be talking every time someone dies, demanding change.  We should not just go through the motions of caring about mental health when it is trendy but truly care about it year round.  The truth is that, on average, someone dies from suicide every 16.2 minutes.  If we vowed to talk about suicide for just 20 minutes every time someone died, it would never leave our minds or our lips.

Suicide is always tragic, whether the victim was famous or not.  Suicide is also always a needless, senseless death, one that could be prevented if there was better access to mental health treatment and less stigma dictating the choices and actions of everyone.

When a celebrity commits suicide, the topic is on the minds and lips of everyone.  It is the perfect time to start a dialogue, to begin fighting for change, to check in with those you know are struggling and see whether they’re okay.  It is the perfect time to reach out to those you know who have lost someone to suicide and share fond memories you’ve long ago locked away, to breathe new life into their memory.

We can do better.  We must do better.  Because people are dying.  Not just our celebrities but so many average people, too.  Our fathers, mothers, sisters, brothers, boyfriends, girlfriends, husbands, wives, children, friends, co-workers, neighbors.  It is an epidemic and one that is largely preventable.

If we, as a society, are willing to do better.

We must do better.

Otherwise, people are going to keep dying.

And suicide will periodically keep trending.

..Because people only want to talk about suicide when a celebrity dies.

mightylogoRepublished on The Mighty on 6/8/18.

yahoolife

Republished on Yahoo Lifestyle on 6/8/18.

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Republished on Yahoo News – UK on 6/8/18.

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?

 

Resolving Trauma Doesn’t Cure Mental Illness

When I explain that I am struggling with mental illness, I am often faced with people questioning why.  I usually start off with a fairly terse and technical response about it being a combination of genetics and life experiences but that answer rarely seems to appease anyone.  Though I am not quite sure why so many people feel I owe them an explanation about my medical condition, more often than not, people continue probing, wanting to know what could have possibly happened in my life that could cause a lifelong mental illness.

It is at this point that I usually explain that I grew up in a dysfunctional, often abusive, household.  I have endured physical, mental, emotional and sexual abuse multiple times each over the years.  I have been knocked down, stepped on, crushed to the core and had my very soul completely obliterated so many times I have lost count.

In response, I usually get the inevitable lecture about not holding onto the past, learning how to forgive, let go and move on.  Sometimes, they even throw in an additional reminder that I shouldn’t allow myself to be a victim for the rest of my life.

What I cannot seem to get through to anyone, though, is that my life experiences are only one small part of a bigger picture.  The traumas in my life did not cause my mental illness but rather they exacerbated it.  They also contributed unhealthy and dysfunctional behaviors and thought patterns.  Though they made a very difficult  situation much worse, resolving the traumas I have endured would not magically make my mental illness disappear.

The truth is that I have come a very long way to resolving and coming to terms with many of the traumas of my past.  I have gone through a lot of therapy over the years and have come to terms with many hard truths.  For instance, I have accepted that my mother shooting my father was in great part due to her often untreated, always undertreated mental illness.  I have accepted that one of the main reasons I had tolerated  repeated infidelity from my romantic partners in the past was due to the fact that I never was able to hold my own father accountable for his transgressions against my mother.  I have accepted that everything in life is not clear cut black or white, good or bad, and have done my best to put myself in the shoes of others and accept the past as something that cannot be changed, letting go of the torment within myself and even forgiving in some instances.

I have even taken things a step further, systematically pulling apart many of my thought processes trying to rout out any dysfunctional or unhealthy behaviors and patterns.  I have put myself under the self-awareness microscope again and again, examining why I react like I do and making a conscious effort to change anything that I believed to be self-destructive or unhealthy.

Most importantly, I have learned to forgive myself and to accept myself for who I am.  I have accepted that I had done nothing wrong to deserve any of the abuse that I was subjected to over the years.  I have even learned to like myself as a person and to identify different traits I possess as being assets.

I don’t consider myself a victim.  I consider myself a survivor.  Though the traumas I have been through have greatly contributed to the person I am and they deserve acknowledgement for that fact, I refuse to let them control my life or dictate the person I am going to be.  I am not looking for pity.  I just want acceptance and understanding.

Though I have fought extremely hard to work through many of the traumas I have endured in my life and consider myself very self-aware, I still struggle with mental illness every single day.  Why?  Because it is a medical condition.  Much like a person’s diabetes may be made worse by a large intake of sugary foods, removing those foods will not magically make their diabetes disappear any more than working through my traumas will make my mental illness disappear.

Part of my diagnosis is a genetic mutation.  This mutation greatly hinders my body’s ability to make a substance my brain needs to moderate my moods.  In essence, my brain has been starving for what it needs my entire life, getting at best 20% of a specific chemical it needs.  Though the traumas I have experienced contributed greatly to the severity of my condition and have negatively impacted my life, my mental illness would have existed even if none of them ever occurred.

Another portion of my mental illness is genetic in general.  Both my parents struggled with various mental illnesses over the years.  My mother suffered from bipolar disorder and my father struggled with depression throughout his life.  Though a parent having a mental illness does not guarantee the diagnosis in their children, studies have shown that the five major mental illnesses can be traced the the same inherited genetic variations.  So much like parents can pass along their eye or hair color, they can also pass along the predisposition for mental illness.

I struggle every single day with my mental illness.  Regardless of whether the rational part of my brain tells me that today should be a good day, another large part of my brain is constantly sending out negative emotions and responses, which in turn sometimes presents itself in physical ways.  I am in a constant battle with my own brain and body.  Though difficult times might contribute to the severity of my downward spiral on a given day, the absence of bad days does not negate my mental illness.  It is always there.

Yet that technical explanation is rarely enough to placate anyone looking for answers.  Many people seem to believe that mental illnesses like depression occur when something bad happens and can be just as easily solved by resolving the underlying issue.  They look for key life events to target, assuming the person struggling will magically be cured if they can just get past that traumatic event.

I can tell you that it rarely is that easy.  Yes, there are some cases of mental illness that are predominately situation-based where the person’s mental health greatly improves when the trauma is resolved, like increased depression caused by bullying, for example.  Likewise, there are milder cases of diabetes where the person’s sugar levels can be moderated predominately by life changes such as diet and exercise alone.  But that does not make that person any less of a diabetic.  For the majority of diabetics, though, addressing their lifestyle is not enough.  They need ongoing treatment and monitoring in order to stay healthy because their illness causes one of the organs in their body to not work properly.  The same can be said for mental illness.  The only difference is that it is our brain that is malfunctioning.

Providing a detailed list of our traumas does not give a run down of how to magically cure our mental illnesses.  Time and again, we throw out our trauma lists out of frustration because some people cannot seem to wrap their head around the fact that we have a medical condition that affects the way our brains work.  It is approached as “mind over matter”, that if we just try hard enough to work through things and learn to let go, we’ll be happy again.  Unfortunately, it does not work that way.

There is no shame in having a mental illness.  It is a medical condition that statistics show now affects one in five people in the world to varying degrees.  We need to stop the stigma surrounding mental illness and stop judging everyone who is struggling to live with one.  Nobody would ask a diabetic why they had their condition because it is accepted that sometimes bodies don’t work as they should and people have to seek medical treatment in order to live a healthier life.  People accept that giving up candy bars or soda won’t magically cure a diabetic.  Likewise, working through the traumas in my past will not magically make my mental illness disappear.  No one should have to justify why they have a mental illness nor should they be met with accusations that they are just not trying hard enough to get past their medical condition.  We don’t owe anyone an explanation nor do we deserve being blamed for our illness.

mightylogoRepublished on The Mighty on 5/3/18.

yahoolife

Republished on Yahoo Lifestyle on 5/3/18.

yahoonews

Republished on Yahoo News – India on 5/3/18.

Republished on Yahoo News – Singapore on 5/3/18.

Stop Blaming the Entire Mental Health Community Whenever a Senseless Tragedy Happens

Mass shootings are commonplace in the United States these days.  One community has barely had a chance to mourn and bury their dead before another incident appears somewhere else on the map.  After the school shooting yesterday, a jaw-dropping statistic began to appear across the internet: In the U.S., there has been a gun incident at a school every 60 hours so far in 2018.  That is one every two and a half days.

Everyone is so quick to point fingers and lay blame.  One of the biggest scapegoats is the mentally ill.  Mental illness has become a dirty word.

When someone does something senseless and tragic, one of the first things you hear is that it wouldn’t have happened if not for better mental health treatment.  When there is a shooting, people question how someone who was mentally ill had access to guns.  When someone drives a vehicle into a crowded area or a parent kills their children, people question why someone who was that mentally ill was even allowed out on the street.  People clamor for more laws restricting the rights of the mentally ill for the protection of communities at large.  Politicians respond by shouting promises that there will be change in lieu of this mental health epidemic.

As someone who has struggled with mental illness my entire life, what I see are torches and pitchforks, what I am hearing is one step away from “lock all the crazies up for the safety of everyone else!”  It is a slippery slope.

Please know that I am in no way disputing that those people who commit senseless atrocities like mass shootings are severely mentally ill and desperately in need of help.  What I am saying is that mental illness exists on a broad spectrum.  Mental illness is  term to describe a wide variety of conditions that originate in the brain.  The scope of mental illness extends from diseases of the brain to diseases of the mind.

Everyone suffering from a mental illness is not the same.  The Diagnostic and Statistical manual, or DSM, is published by the American Psychiatric Association and is used to diagnose mental illnesses.  The current APA list has around 400 different diagnosis, covering a wide range of mental, emotional or behavioral disorders.*

Yes, there are people that are mentally ill that are violent and commit unspeakable acts.  It might even be fair to say that someone has to have something wrong in their head to even be able to carry out anything as heinous as a mass shooting.  But the majority of people who have been diagnosed with a mental illness are non-violent.

According to recent statistics from the National Alliance on Mental Illness, or NAMI**, 18.5% of adults in the United States, over 43 million people, experience mental illness every year.  If a mental illness diagnosis alone was enough to determine a person was dangerous and likely to commit violent acts, with 43 million people suffering from mental illness every year, the numbers of violent crimes would be astronomical.

With millions of people in prisons across the United States and over a million more being sentenced each year to incarceration***, you would assume that prisons would be a hotbed of mental illness.  However, again according to NAMI statistics**, only 24%, not even one quarter of inmates, have had any recent mental health diagnosis.

The fact is that a recent study published in the American Journal of  Public Health shows that a person with mental illness is far more likely to be a victim of violence than the perpetrator****.  Based on this study’s statistics, almost one-third of adults who have been diagnosed with mental illness had been victimized in some way during the previous 6 month period, with over 40% being victimized multiple times.  Of the 23% of mentally ill persons in the study who had committed any sort of violent act in the previous 6 months, roughly 2/3 of the violence had occurred in a home or other residential setting.  A meager 2.6% of violence occurred outside the home in a school or workplace environment.  The most startling fact to come to light in this study, however, is that the victims of violence were 11 times more likely to commit violent acts themselves afterwards.

Yes, something has to be done in regards to mental health treatment in the United States.  But it is NOT because the mentally ill population is inherently violent and unsafe to wander the streets unrestricted and unregulated.  Mental illness and the way it is regarded in this country is a societal epidemic.  Those who have been diagnosed with mental illness must deal with constant stigma.  We are ostracized as being crazy and unbalanced, simultaneously a joke to be mocked and a dangerous monster who needs to be locked up for their own safety and the safety of others.  We often hide our diagnosis for fear of judgment or minimize our struggles to reassure others they have nothing to fear or worry about.

The way a mentally ill diagnosis is handled in this country has to change.  We need to be able to speak up, speak out and receive the treatment we need.  Though NAMI statistics show over 43 million people struggle with mental illness each year, only 41% have received treatment for their condition**.  Roughly one-fourth of the disability applications for Social Security list mental illness as their primary impairment.  Though NAMI statistics** show that 9.8 million people annually experience a severe mental illness that drastically impairs their ability to function, statistics from the National Institute of Mental Health show that only roughly 2.7 million people are deemed eligible for SSI or SSDI*****.  As I can attest, anyone who is applying for disability due to mental illness is advised to get a lawyer and to expect to be denied at least once, if not multiple times, regardless of how much documentation you have for your diagnosis.  Though my mental illness is due in large part to a verifiable genetic mutation I was born with, combined with well-documented trauma, I, myself, have been denied multiple times and still am deemed ineligible by government standards.  For years, I have struggled with red tape, jumping through hoop after hoop, hoping to get the help I need, only to hit brick wall after brick wall, having to begin the process all over again.

The lack of adequate treatment for mental illness in this country has grown rampant.  Suicide is currently the 10th highest cause of death in this country, 3rd highest among 10-14 year olds and 2nd highest for 15-24 year olds, according to NAMI statistics**.  Recently, a video of a disoriented mentally ill woman being cast out on the street by a hospital staff has gone viral.  According to the National Coalition for Homelessness, between 20-25% of the homeless population suffers from “a severe form of mental illness”********.  Mental illness is listed as the 3rd highest cause of homelessness.  People are falling through the cracks, wandering the streets untreated, people are dying, our children are dying, and yet nothing is being done.  The lives of the mentally ill are one by one becoming nothing more than statistics.

It should not be so hard to get help in this country.

There are others who are afraid to reach out for help due to government restrictions on the mentally ill.  There is an epidemic of mental illness and substance abuse among our military.  According to the APA, almost one-fourth of our soldiers, up to 24.4%, are struggling with mental illnesses such as PTSD******.  A recent study published in Science Daily from The University at Buffalo observing the mental and physical effects of law enforcement determined that not only was PTSD and depression a substantial issue, but nearly one quarter of police officers admitted to suicidal thoughts, much higher than the 13.5% of the general population*******.  And these are only the statistics of those who have willingly come forward seeking treatment.  Due to the push for politicians to pass laws regulating gun ownership, a mental illness diagnosis could result in losing the right to even own a gun.  How do we encourage our soldiers and police officers to get the help they need when it could mean giving up their livelihood in the process?

I personally know many people who are afraid to have a record on file about their struggles with mental illness.  They are people who hunt for recreation and are legitimately afraid that a diagnosis would take away their 2nd amendment rights and their ability to feed their families.  They are people who fear a diagnosis would negatively impact their career or their ability to advance due to the stigma attached.  They are people who have seen firsthand how poorly the mentally ill are treated in this country and do not want to be labeled as crazy and unbalanced, as well.  So instead, they suffer in silence, without treatment, until something cracks and breaks.

Yes, there is a mental illness epidemic in this country that is leading to horrifically tragic events.  But it is NOT due to people with mental illness having access to guns nor is it due to mentally ill people wandering around free and unfettered.  It is a direct result of society’s treatment, and lack of treatment thereof, of the mentally ill population.  Please take a second again and consider the facts.

Fact: Over 43 million people every single year struggle with mental illness**.

Fact: Only 41% of those with a mental health condition have received medical help for their condition in the last year **.

Fact: One third of people with a mental illness are victimized and abused every six months and those who are victims of abuse are eleven times more likely to commit a violent act themselves****.

We desperately need to change how mental illness is viewed and treated in this country.  The mentally ill population does not need more restrictions and regulations.  We need more access to health care, better support and protections.  We need assurances that it is okay to seek help and guarantees that the millions of us with a mental illness diagnosis will not all become vilified due to the actions of a minute few.

We need the stigma and persecution to end and the help and healing to begin.

That is the only way that things can change.

mightylogoRepublished on The Mighty on 2/20/18.

* AMA literature with the DSM codes for the broad spectrum of mental illnesses can be found at:  https://dsm.psychiatryonline.org/doi/book/10.1176/appi.books.9780890425596

** NAMI’s Mental Health by the Numbers statistics can be found at:  https://www.nami.org/Learn-More/Mental-Health-By-the-Numbers

*** Bureau of Justice Statistics page that provides incarceration numbers can be found at:  https://www.bjs.gov/index.cfm?ty=tp&tid=11

**** Study entitled “Community Violence Perpetration and Victimization Among Adults With Mental Illnesses” can be found at:  http://ajph.aphapublications.org/doi/abs/10.2105/AJPH.2013.301680

***** Statistics from National Institute of Mental Health can be found at:  https://www.nimh.nih.gov/about/directors/thomas-insel/blog/2015/mental-health-awareness-month-by-the-numbers.shtml

****** APA Statistics on Veterans can be found at:  http://www.apa.org/advocacy/military-veterans/mental-health-needs.pdf

*******Study on Law Enforcement done by the University of Buffalo, published by Science Daily can be found at: https://www.sciencedaily.com/releases/2008/09/080926105029.htm

******** The National Coalition for Homelessness report on Homelessness and Mental Illness can be found at:  http://www.nationalhomeless.org/factsheets/Mental_Illness.pdf

Are We To Blame For Our Depression?

Someone in a group I belong to recently posed the question “Is it my fault I’m depressed?”.

People immediately began chiming in on both sides of the fence, with the overwhelming majority stating a firm and clear “absolutely not”.  I hesitated to answer because I don’t think there is such a clear cut yes or no answer.  Life is rarely simply black and white.  There are many shades of gray.

I spent many years struggling with my own mental illness.  I saw many doctors, took a multitude of medications in all different dosages and combinations.  I tried changing my diet, exercising more, busying myself with arts and crafts, talking long nature-filled walks, everything anyone had suggested might work.  In my case, nothing helped.

Last year, my newest doctor sent me for a genetic test and we discovered that I had a genetic mutation that prevented my body from breaking down a specific vitamin my brain needed to function properly.  That broken-down vitamin is used by the brain to transport the chemicals, whether made naturally or in the form of antidepressants, where they are needed. Because my brain never received that substance, nothing my body made, no pill I took, even had a chance to work.

There is a pill version of that broken-down vitamin on the market.  My doctor prescribed it.  It took almost a year of fighting my insurance company to get it covered.  Now that I have it, there is a noticeable difference.  It is not a panacea, my depression is still here, but it is a start.  I have a long road ahead of me but at least I am finally on the right track.

It brings to mind a quote from Maya Angelou:

“Do the best you can until you know better. Then when you know better, do better.”

For years, I tried again and again to get help even though nothing worked.  I cannot blame myself for not knowing that, on a genetic level, my body was incapable of making what it needed in order for any treatment to work.  But now that I know better, I am doing better.

I do not believe we can blame ourselves when our bodies malfunction.  When someone is diabetic, their pancreas is not making the proper amounts of insulin and glucose.  People go to a doctor and get treatment so they can live a healthier life.  They are not to blame for their organ ceasing to work.  With mental illness, the only difference is the organ involved.  No one has any control over their brain not working properly.

But everyone does have control over whether or not they get the treatment they need.

I know some people will play devil’s advocate and say a diabetic wouldn’t have gotten diabetes if they hadn’t eaten so much sugar and likewise, someone who is mentally ill may have made poor life choices that put them in their predicament, as well.  However, that is not how it works.  Millions of people drink soda and other sugary drinks every day, yet not all of them have become diabetics.  Likewise, many people struggle with everything from drinking, drugs, bad relationships and dead-end jobs without experiencing depression.

There are many known hereditary and biological causes for mental illness.  Many people are predisposed to depression, having been passed through their family line.  For others, it can be caused on a genetic level from mutations.  In some cases, the onset is caused by an unforeseen tragedy or event that shakes a person to the core.  With me, it is a combination of them all.

Living a rough life does not guarantee depression any more than drinking a soda guarantees diabetes.  On the contrary, people from all walks of life, all socio-economic backgrounds, different races, religions, sexual orientations, upbringings all struggle with their mental health.  A hard life might contribute to a person’s mental illness but it does not cause it, much like drinking sugary drinks are a contributing factor to diabetes.  There is a big difference between causation, though, and a contributing factor.

Though we have no control over whether any of our organs are working properly, I believe there is a clear line here where we need to accept personal responsibility.  As Maya Angelou said “..when you know better, do better”.  Once we realize something is not working correctly in our bodies, it is our responsibility to take steps to fix the problem.  We need to do what we can to be healthier, live healthier.

Once a person has realized they are struggling with a mental illness, they need to at least attempt to get help.  I understand the frustration all too well when nothing seems to work, but we need to at least try.  Again, to quote Maya, “Do the best you can until you know better”.  Try therapy, meditation, medication, homeopathic remedies.  Something.  Anything.  Embrace whatever works for you.  But at least DO something.  Don’t suffer needlessly.  Take care of yourself the best you can. Then “..when you know better, do better”.

Nobody asks to be depressed.  No one has any control over whether or not they are diagnosed with a mental illness.  But you do have control over whether or not you treat your illness and you ARE to blame if you knowingly neglect yourself and your well-being.

Please take care of yourself the best that you can.  Get help when you need it.  Don’t let the judgment or stigma from anyone else prevent you from taking care of your mental health.  It is okay to need help, especially when your body is not working like it should be.  There is no shame in having a mental illness.  The only shame is in not getting the treatment you need.

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

Government Red Tape & Legal Loopholes At Their Finest

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Except to New York State.

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

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

 

Depression & Genetics

Please note: I don’t often write about the technical side of my treatment because I know that it is a very personal thing and what works for one person may not work for another.  I do not want to appear to be endorsing a specific path for anyone else because I am not a medical professional by any means.  What I am sharing is not a recommendation for anyone else but rather my own personal experiences.  Please talk to your doctor before making any changes in your mental health routine.

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I have had a lifelong struggle with depression, anxiety and ptsd.  Not too long ago, I was asked to write a piece about when I first realized I was suffering from a mental illness.  I honestly just laughed because I cannot remember a time I have not.  Throughout the years, I have tried prescription medications on and off to help balance my moods and alleviate the symptoms.  Again and again, it felt like the doctors were playing whack a mole with my health, randomly trying different drugs in varying strengths and combinations until I was a drugged up mess.  I had pills to wake myself up, pills to drag me throughout the day and pills to put me to sleep.  Each time, I felt like I was becoming a mindless zombie.  Each time, I would take myself off the medications because I would rather endure all my pain than to lose myself completely.

When I recently reached out for help again, I was adamant about my stance on drugs.  I never again wanted to return to that state with horrible side effects and a comatose-type demeanor where every day blended into the next in a drug-induced stupor.  Looking over my medical history, my new doctor could find no rhyme or reason to my long list of past medications prescribed by others.  Instead of prescribing something purely on a hit or miss basis, he opted to send me out for genetic testing through a company called Genesight.

Apparently, there are genetic tests now that can determine which drugs your body will be able to metabolize based on your genes.  This test can also determine which medications are likely to cause side effects and even rank the severity from mild to moderate to severe.  When the test results came back, ironically the majority of the medications previous doctors have put me on were listed under moderate to severe side effects.  No matter how much they increased the dose, they were never going to help me because my body had always been unable to break them down.  My new doctor had done a full panel so now I knew what medications would and would not work in my body.

The most exciting result, however, was not among the medication listings, but on the cover of my packet itself.  According to the lab:

This individual is homozygous for the T allele of the C677T polymorphism in the MTHFR gene.  This genotype is associated with significantly reduced folic acid metabolism, significantly decreased serum folate levels, and significantly increased homocysteine levels.

In layman’s terms, it means I have a gene abnormality that affects my liver’s ability to break down folic acid.  In normal, healthy livers, folic acid is broken down into a compound called L-methylfolate.  L-methylfolate is used by the brain to regulate the hormones associated with emotions.  Without that compound present in my brain, it would be near impossible to thoroughly treat my depression and my own body was incapable of producing it in any meaningful quantity.

It turns out that genetic test was a godsend.  Normal lab tests would not pick this up.  A blood test would show the levels of folic acid in my blood and doctors would infer my levels must be fine, not realizing that my liver was incapable of processing it.  Only by looking at the genetic level could they see that my liver was not able to convert any of that folic acid into anything useful.

What makes this an even bigger deal is that a pharmaceutical company has found a way to break down folic acid into L-methylfolate and put it in pill form.  Getting what my brain needs and my body has never been able to provide will be as simple as having a prescription written.  I honestly felt excited.

My doctor was very clear that this is just a big first step, not a cure-all.  This prescription is by no means a panacea.  It, however, is a stepping stone.  It means that antidepressants will finally be able to work because the L-methylfolate will be able to help get them where they are needed.  It means that if my brain actually attempts to regulate my own moods, there is at least a very real possibility of success where previously there was absolutely none.

I took my first pill yesterday and admittedly felt a noticeable difference right out of the gate.  I had more energy and a greater sense of calm.  The depression is by no means gone or even diminished but the fact that I felt anything noteworthy at all on the very first day was enormous for me.  For the first time in a long time, I truthfully am hopeful when it comes to my medication.