The Real Violence of Mental Illness

One year ago Niki died. You may not know Niki. I wish you had. She was loud, smart, thoughtful, funny, and very, very ill.

She was physically ill and mentally ill. She was the kind of mentally ill that makes people look away, or say “Oh, THAT kind?” She was the kind of mentally ill that people sweep under the rug. She was the kind of mentally ill that doesn’t get services and doesn’t get PSAs and doesn’t get sympathy. She was the kind of mentally ill that makes service providers label you “resistant to treatment” or even avoid giving you a diagnosis because there’s too much stigma.

She was the kind of mentally ill that people bring up after shootings. In fact she was the kind of mentally ill that people are starting to talk about right now, after this very shooting, to explain how someone could be so violent.

And one year ago Niki died.

Niki died because she was the kind of ill that doesn’t get noticed, that doesn’t get services, that doesn’t get support. She died because she could not access disability services. She died because no one wanted to recognize that the people most likely to be hurt by someone who is mentally ill is the person themself.

All of you want to talk about mental illness. Let’s talk about the real violence that is associated with mental illness. Let’s talk about how this society is saturated with ableist cruelty that enacts violence, pain, and suffering on the mentally ill every day and ends in deaths like Niki’s every day.

I see you all talking about how we need better mental health care now that your comfortable neurotypical lives have been disrupted. I see your silence when people die of suicide. I see the way you blame us. I see your silence when funding for our services is on the table, and I see your silence when we want to talk openly about our lives and our struggles. I see you calling us dramatic, mocking us for asking for trigger warnings, ignoring our calls for help and support. I see you ignoring mental health parity in health care legislation.

And I SEE YOU only bringing up mental health care now. Now, when you can blame us. Now, when you need a way to understand violence that says “it’s over there. it doesn’t belong to me. It’s people like them. I am not responsible”

You want to say that it’s people like Niki. People like me. People with personality disorders, or “severe mental illness.” We are the violent ones.

Well guess the fuck what? You have done so much violence to us. How dare you, how fucking dare you point your finger at one of the most vulnerable communities when there is no evidence to suggest that mass shootings are more likely to be perpetrated by the mentally ill? How fucking dare you continue the stigma that literally kills people like Niki, and go on to say that we are the violent ones?

I know that there will be some of you out there saying “wait, but I support mental healthcare!” Fucking great. What are you doing about it? What are you doing about it all of the days that our media is not exploding with news of a mass shooting? Are you calling and writing your legislator? Are you openly talking about mental illness, therapy, and services to break down the stigma? Are you talking about the fact that people with mental illness are more likely to be victims of violence than perpetrators, and looking for solutions?

Are you protecting people like Niki? Are you actively fighting the violence that happens to mentally ill people each and every day?

Or do you only care when it’s people like you, “normal” people, neurotypical people, the ones that you deem worth it?

I see you, and I have no more patience.

Racism Is NOT A Mental Illness and It’s Damaging To Say It Is

 

Fuck this this is shit in all the ways it is shit.

Ok, now that I’ve got that out of my system I still make no promises that I will not continue to call it shit over and over again. Because this is a steaming pile of garbage filth feces, and I am not about to censor myself on the way that mental illness gets thrown under the bus time and again to make other people feel good, safe, and normal. The lives of the mentally ill are always seen as less than, wrong, and bad. This kind of bullshit is why even liberals are willing to discriminate against disabled and mentally ill people. I apologize in advance if this is ranty and angry but it has every right to be because this video is senseless drivel, but it’s exactly the kind of senseless drivel that I see coming out of the mouths of people I expect better of.

DEFINITIONS

Let’s start with facts. The video posits that racism is a PTSD like mental health problem because racists exhibit irritability, aggression, and hostility. Let’s talk about what it takes for something to be a diagnosis in the DSM, and why we have diagnoses. First and foremost we have diagnoses so that people can receive treatment. A diagnosis is supposed to help providers understand how they can help someone. Now right off the bat, this video’s suggestion that racism is a mental health problem or that we should treat it as a mental health problem makes very little sense because hey guess what it turns out a. almost everyone has some racist tendencies and b. racists respond to different types of treatment. Some people just need to meet a black person they like, some people need to confront their own traumas and history, some people appear not to be open to any kind of change. There’s no one reason that people are racist or a best practice for interacting with them. These traits vary wildly among racists, and there doesn’t seem to be a higher rate or intensity of them in racists than in the general population (or even associated with instances of racism. People can be racist with a smile on their faces while thinking they’re being kind). So strike one on why we should approach it like a mental health issue.

“Irritability, aggression, hostility,” those are not enough to make up a mental health diagnosis, and NOT EVERY RACIST shows those traits. They would have to be exaggerated beyond all the rest of the population, impact a person’s day to day functioning, and be unique to racists in some way in order to quality as a mental health diagnosis

The other major problem with suggesting that racism is a mental health issue is that in order to be considered a diagnosis, the symptoms have to impair functioning in some major area of life (work, relationships, education, etc.). Now there are some extreme cases in which this happens, but overall racists are pretty functional in our society. In fact, it turns out that you can be openly, disgustingly racist and still get elected president. Our society is one embedded in racism, so the idea that being racist or doing racist things or having racist thoughts will make it hard for you to function is laughable. This is what we’ve been taught all our lives. It only makes sense. In my experience, actively fighting racism is far less functional in our society than accepting the basic racist premises that we grow up with.

There are some other smaller problems, like the fact that not all racist people show irritability, aggression, or hostility (have you seen a sweet racist Minnesotan mom? I have), so if those are supposedly the defining characteristics of “racism”, why aren’t they associated with all instances of racism?

WHY DO PEOPLE DO IT

So factually it doesn’t make tons of sense to assert that racism is a mental health issue because the traits are not out of line with the rest of the population, seen in all racist instances, and don’t impair day to day functioning. What could be motivating this impulse that so many (mostly white) people have to say that racism is a mental illness? What are the larger impacts of this assertion?

The video seems to assert that this label helps us address racism better, because we can use “exposure therapy” a la the therapy for phobias. I personally think it’s a REALLY BAD IDEA to suggest that. First, there’s already a lot of gross misunderstandings about how therapy works, and how exposure therapy in particular works, to the extent that random people will just expose someone to their triggers and call it therapy. Saying that on a society wide level we can engage in exposure therapy by protesting and talking about our past traumas propagates these misunderstandings and suggests that any rando can do therapy. Additionally I don’t see why we need to label racism a mental health problem in order to be willing to talk about it openly and face it head on. We can do that anyway.

The video also seems to suggest that viewing racism as a mental health problem will push people to be more accountable. It says “don’t let your racist friend or uncle off the hook. You wouldn’t abandon them if they had a mental illness.” Now I have to laugh at this because mentally ill people get abandoned all the fucking time so that’s a fucking shitty appeal to people’s decency. But this also implies that people are racist through no fault of their own and we should address racism to help the poor innocent racists. WHAT. THE. FUCK.

STOP CENTERING WHITE PEOPLE DEAR LORD JESUS. The reason not to let racists off the hook is because they are actively hurting people of color. If that’s not a good enough reason for you, then you might be a racist. That’s it. We don’t need to save racists, they’re doing perfectly fucking fine. The more we cater to their fee fees, the worse off we’ll be.

Racism doesn’t HAPPEN to white people. White people CAUSE racism because it benefits us. The end.

SPLASH DAMAGE

Ok ok, so beyond being wrong, what’s so bad about saying that racism is a mental illness? Maybe it can help us understand the phenomenon better or give us ways to approach and change the problem, even if it’s not wholly accurate.

Well in addition to not actually being super helpful, calling racism a mental health problem is seriously hurting a whole lot of people. You know, those people who are ACTUALLY mentally ill. If you label things you disagree with or find offensive “crazy” or “mental illness”, you are part of the stigmatization of mental illness. You’re part of ableism.

Cruelty and dehumanization are not the same as mental illness. People with every diagnosis out there are capable of fighting racism and being good people. When you say that something you find immoral is a mental illness, you are implying that mental illness means violence, means treating people poorly, mean violence, means anger, means hostility. Sure, there are people who are mentally ill who do all these things, but this is the kind of rhetoric that suggests every school shooter has autism or every murderer was just crazy. It takes away people’s responsibility (the video gets it completely wrong on that front. Racism is not a behavior like drunk driving, it’s a belief system and it’s one for which you are responsible), while also opening up the door to mistreat mentally ill people because they are violent and dangerous.

Stop blaming bad actions on mental illness. I don’t appreciate being thrown under the bus so that you can feel like you understand your shitty friends better. It’s complete shit to equate these learned, chosen behaviors with the different way my brain was born.

tldr: it’s not crazy to be racist in our society. It’s not a fluke that so many people in positions of power are racist, it’s part of the system. Calling it crazy only hurts the mentally ill. STOP IT.

 

Tell Your Therapist They’re Wrong

This article is giving me life today, and not just because gratitudes lists make me throw up in my mouth every time I think about them.

It also is giving me life because it reminds me that sometimes mental health professionals are just wrong. Wrongwrongwrong. And it reminds me that it’s rare for us to teach people who are receiving mental health services how to advocate for themselves or determine if their therapist is wrong.

Now before anyone gets huffy, the usual disclaimers: I am PRO mental health professionals. I know these folks work their butts off, and that they can and do save lives. I know that we should encourage folks to see mental health professionals, and to reduce the stigma attached to seeking treatment. Yes to all of that.

But all of that being said, mental health professionals are human. And humans don’t really understand brains all that well just yet. Brains are widely varied, and every technique that we have for treating mental illness will only work on some people. Beyond that, mental health professionals work with hundreds if not thousands of people over the course of their career. Unless you’ve been with them for a hecking long time, you are going to have a MUCH better understanding of your personal quirks and preferences than they are. Sometimes they’re just tired or distracted, or they forget your personal preferences.

Which is all to say that sometimes mental health professionals make mistakes. Or they make a good suggestion but it turns out it doesn’t work for you. Sometimes you need to tell your therapist “No. That doesn’t work for me.” It can be completely mind blowing the first time you realize it’s ok to say no to your therapist sometimes. It’s empowering to realize that you are an individual and sometimes the struggle you’re facing (especially if your mental illness is proving especially difficult to shake) might not be because there’s something inherently wrong with you, it might be because the techniques that have been suggested aren’t right for you. I just want to remind people who are struggling or feeling like therapy isn’t working; you can tell your therapist. You can ask for something different. You deserve strategies that will work for you.

Of course it’s also incredibly hard to say no to your therapist.

The first reason it’s hard is because sometimes things feel uncomfortable or difficult or like they’re not working because growth and change are hard, slow, and difficult. There are times you may WANT to tell your therapist “nope, I’m not going to do that, I don’t like it,” but once you try the suggestion it ends up being helpful. It’s really challenging to suss out when you just don’t WANT to do something, versus when you’re really on target that it won’t be helpful or that it will be actively discouraging and a waste of time or energy.

Part of the work of therapy is tuning up your inner compass so that you can trust it to send you in the right direction. I know after many years of hearing mantras and positive thinking slogans in therapy, that those just make me angry. I’ve tried it, it wasn’t effective. I’ve learned to trust that when people suggest something that sounds saccharine or something that ignores how hard life actually is, it will not be for me. On the other hand, I was very skeptical of mindfulness when I first heard about it, but when it was presented to me in a scientific way it made a lot more sense and has been quite helpful. I’ve become more open to things that have mixed evidence for them.

A big part of doing this is simply trying a lot of different stuff and seeing what works. But once you’ve done that, you start to have evidence of what is effective for you and what isn’t, and you can start to trust your instincts about what types of treatment you want to put your time, energy, and money into.

Which means that you can start advocating for yourself.

Here’s where I want to get practical, and it’s the second element of why saying no to your therapist is hard. It’s because self advocacy is a skill. There are absolutely things that everyone can do to advocate for themselves in therapy from the very beginning, but there are also skills you need to practice and things to learn about yourself before you’ll be really effective.

Telling your therapist that they’re wrong is one of the more challenging pieces of self advocacy, because it can often feel like the therapist has the power in any given situation, or like you need to respect their position. It can be helpful to remember that you are paying them for a service, and beyond that that BOTH parties are integral for the success of that service. The trust you feel for your therapist is one of the highest predictors of success in therapy, and if you can’t let them know you disagree, that trust is breaking down somehow.

But there are things you can do to make it a little bit easier. There are lots of ways to advocate for yourself in therapy, and I may touch on those in future posts, but for now I’m going to focus on speaking up when you think something isn’t working or you disagree with your therapist.

A good way to start is by simply disagreeing about small things. I don’t mean be argumentative, but if your therapist says something that you normally might have let slide, practice just saying “I don’t agree with that, but here’s what I think.” I’ve started to do this a lot in therapy, and I find that it’s far more productive than trying to argue with the therapist. It actually has made me feel a lot more comfortable when I say that and the session goes on without any kind of major repercussions. Those smaller, less important disagreements are a way to practice and to teach yourself that the world won’t end if you tell your therapist no, or let them know something isn’t working for you.

Another helpful thing to do if you’re worried that the strategies you’re getting aren’t helpful is to gather some data. I like to track things, which is why I use a daily mood tracker, a sleep tracker, a habit tracker…I like data. But it can be really helpful to note your mood or a target behavior before your therapist suggests something (e.g. a gratitude log), and then note if your mood improves or your self harm decreases over time after you’ve started using the technique. If not, you can bring that in to the therapist and say “hey, this isn’t working for me.” Having hard numbers to back you up can feel a lot more empowering than just a vague “I don’t feel better.”

Sometimes I like to try to think like a therapist to be a good self advocate. In that, I mean setting goals for myself, thinking of the steps that I can try to reach those goals, and checking in periodically to see if I’m making progress. Most therapists are required to have a treatment plan, but not all therapists share that with their clients. If my therapist is suggesting a new technique or skill, I want to know what it’s supposed to accomplish, what goal it’s bringing me closer to. You can ask to see your treatment plan, or just ask what the outcome is supposed to be for a given technique. That helps you evaluate if it’s working.

All of these are concrete actions, but for me the biggest shift was one in mindset, and it’s a mindset that the article I started with shows off well. Therapy isn’t about doing what’s “right”. It’s about doing what works for you. There are thousands of different therapeutic techniques, skills, and practices. If one doesn’t make you feel better, then STOP DOING IT. Tell your therapist. You deserve something that helps. Realizing that therapy wasn’t a class I needed to ace, but rather a service FOR ME was revolutionary. If it’s not working for you, you’re not broken. It is.

 

Rainbow, Spaceship, Learn to Let Go

This is part four in an exploration of Kesha’s new album ‘Rainbow’. Find parts 1, 2, and 3.

I’m not going to spend as much time on each individual song as I did on Praying and Boots, but instead will be clumping a few songs of similar themes together where it makes sense. In this case, there are quite a few songs on Rainbow that are about moving on, finding hope, or growing and changing after a challenging time. I’m going to focus on Rainbow, Spaceship, and Learn to Let Go for this post, as all three of these songs circulate around this attitude of healing and growing.

If I were to place these songs, they would be the songs of recovery, the ones that come after trauma, depression, an eating disorder, the darkest places. These are the songs that you can write when you’re coming out the other side. They are the joyful songs of the album, and I love that they coexist on an album with songs as honestly painful as Praying.

This is a side of Kesha that we don’t see very often and I really appreciate that she felt empowered to show it, to let us in to a sweet, naive version of herself. I love that part of her healing is not about being aggressive or strong or any of those things, but just being a kid again. She seems so intensely free in these songs and it feels very hopeful to me in a way that goes beyond the “you’ll find a rainbow” but in a way that says “you get to have joy after trauma.”

In her essay about Learn to Let Go, she writes “I’ve looked at this record, ‘Rainbow,’ as me being myself, Kesha Rose Sebert, my name without the dollar sign, genuinely for the first time ever. I mean that on every level but especially musically ― and that’s really scary for me.” This really comes through, especially in the video for Learn to Let Go, which puts home videos of Kesha as a child next to an adult Kesha reenacting the scenes.

It gives a depth to the song that says “I’m not just letting go, I’m remembering who I used to be, I’m uplifting the parts of myself that give me life.” This video is 100% my favorite of the videos for this album. It is so unself-conscious, so free, so wonderfully joyful. Watch it. Watch it again. It’s so good.

Rainbow was written while she was in rehab for her eating disorder. She describes it as her promise to herself. I personally don’t love it when people say “oh it will get better, just think about the future”, but knowing that this is her reminder to herself, her mantra that she can return to changes it for me. And there are some amazingly honest lines in it:

“And I know that I’m still fucked up
But aren’t we all, my love?
Darling, our scars make us who we are, are”

Even as the message of “you’ll find a rainbow” is far from deep, there’s a lot more going on beneath the surface here, and you can see it in the musicality that happens around the lines “so when the winds are howling strong…”. It’s vivid, orchestral, intense. The rainbow she’s looking for isn’t trite or small. It’s a respite from the chaos you can hear in these lines. I love the imagery of color everywhere, of kaleidoscopes, of seeing everything the world has to offer again. There’s more here than the silly phrases that many people use to describe gratitude or the good parts of life. Instead, there’s a recognition that the world holds layers of wonder and beauty. It speaks to the ways that many people who feel broken or hurt often experience the world differently from other people, which brings me to Spaceship.

Spaceship reads very neurodivergent to me. It’s a song about feeling as if you belong somewhere else, and waiting for your people to come and get you, bring you home. That experience is so common in the autistic community, as well as for others who deal with mental illness. While Rainbow is about finding joy in this world, Spaceship seems to be about finding a place that doesn’t exist in this world: somewhere that is safe and where you feel normal and acceptable. When paired with a lot of Kesha’s more youthful songs on this album, it speaks to the ways that we’re expected to conform as adults, and how often that means losing an innocence that doesn’t need to go.

Even as this album is more musically complex than her past two, it seems to have less “polish”. It’s less produced. It’s more authentic. These songs get to the heart of that and are in many ways the heart of this album. They are not dealing with the past or the trauma, they’re an adult reclaiming their identity and their self, regardless of what has happened or the difficulties of what has happened in their life. I find the vulnerable emotions and unrestrained joy really refreshing.

My Friend is Depressed. What Do I Do?

It’s not uncommon for friends and family of mine to come to me with questions about mental health, support, and services. Recently, I’ve had a couple of people ask about how they can support someone with depression, anxiety, or another mental illness. Specifically, what do you do when you have a friend or family member who is really struggling and doesn’t know what to do. I hope to put together some ideas for folks who themselves are in the spiraling downwards stage of depression and link that here, so that you can pass it along if you’re worried about a friend, but in the meantime, how do you encourage someone to get help and support them in making healthy decisions when they can barely get out of bed?

Before I begin, these are suggestions. They are based on my experience of depression and what I found helpful. Everyone who deals with mental illness is different. If possible, ask your friend what would be helpful for them, and always check in to see if what you’re doing works for them. This one’s going to be a long one because I want to throw out a bunch of options for people to work with. You don’t have to try all of these things, but maybe try one a week.

So here are a few things you can do to support someone who’s in a nastybad place.

1. Be Honest

One of the things that was very frustrating to me about being incredibly sick was the way that people would dance around the topic. Very few people said to me straight to my face “You have an eating disorder. I’m worried about you. I want you to be healthy. What can I do?” It’s refreshing when someone says what they mean. It doesn’t have to sound like an after school special either. Use the language you normally would use, whether that’s “Hey I see that the jerkbrains have you down right now,” or “You seem really unhappy lately.” Whatever you do, don’t try to manipulate the person into health or sneak your support in without making sure they want it. Even if they are sick, they’re an adult, and they deserve the loudest voice in their treatment.

2. Be Proactive

It’s very common for supportive family and friends to ask “how can I help?” This comes from a very understandable place. You want to be helpful, you’re not sure what they want or what you can do, so you ask. Unfortunately, one of the things that is most overwhelming about being incredibly depressed/anxious is that you often have NO idea what will help. So instead of asking a really wide open question like that, I’d recommend making specific suggestions. Something like “Would you like me to make you food? I can make a sandwich or a salad.” “Does it feel better to talk about it or be distracted?” “I’d like to come over and see how you are today. Is that ok?” Depression is exhausting and makes every decision feel impossible. Keep the decisions as small as possible: yes or no, this or that. Don’t wait for them to give you an idea of how to help, come up with one yourself.

As a sidenote, this is a great way to help someone with things you think would be good for them. From the outside, it’s easy to look at someone who’s seriously depressed and think that they should eat better, go outside, move their body, leave the house…the list goes on and on. That can be incredibly difficult to do when you’re depressed. So instead of simply telling them that they should, help them. Offer to make them a meal, suggest you take a walk together, ask them to meet up for coffee (you could even say you’ll pick them up and carpool together to decrease the barriers they face). If you can think of something that is getting in their way that you could do for them, do it. This might sound infantilizing, but it’s just like any other acute illness. They’re spending all their energy fighting: you’re giving them a little bit of space to breathe.

3. Be Willing to Be a Normal Friend

Sometimes it’s important for you to jump in to “supporting and helping” mode. But someone who is in a crisis level of depression is still a person and still has the need for connection on a basic human level. Sometimes they want to talk about normal things or act like any other friend: they want to see a movie, they want to make a joke, they want to laugh or smile. So if they seem up for it, it can be nice to do a normal friend activity and not bring up depression for at least a little bit. If it’s possible to distract them from the overwhelming pain, that is a huge gift you can give.

4. Do the Minutiae

Most of helping someone with depression isn’t listening to them late into the night or giving them a great speech that convinces them not to hurt themselves. Most of it is actually really boring. It’s sitting with someone while they call their doctor because otherwise they won’t make an appointment. It’s checking in to see if they’ve taken their meds. It’s doing a load of laundry for them so that they don’t feel too disgusting to leave the house. If you really want to be the supportive friend, you have to truly accept that not only are you seeing them at their most vulnerable, you have to be vulnerable too. You have to be willing to get messy and be bored and do unpleasant things. It’s worth it though.

5. Accept the Awkwardness

One of the more vulnerable things in life is letting another person see you when you are really struggling with your mental health. Imagine someone seeing you when you can’t seem to dress yourself, feed yourself, wash yourself, or do other basic tasks. It’s an experience that can be embarrassing. It’s easy to feel like a child. You are witnessing someone in this situation and they are fully aware that they’re asking for help with things that seem like second nature to you. So recognize that someone is showing you an incredibly vulnerable side of themselves. You may even want to let them know that you’re aware, and that it’s OK, that they can take as much or as little time as they need to do things, and that they can ask you for anything.

6. Validate

It’s easy to see someone who’s struggling and follow your first impulse to try to make them feel better, or tell them it will be ok. What often gets forgotten is that when you’re overwhelmed by depression and anxiety, it can seem like one half of your world isn’t real. There’s such a huge disconnect between your internal emotional experience and the behaviors you witness in the rest of the world. You can feel like you’re losing your grip on reality, or like you must be making things up. It helps a lot for someone to just say “those feelings are totally real. You are not making up how bad it is. You really are fighting a hard battle, and it seriously sucks, and I’m so sorry.”

No, it doesn’t fix anything, but it is incredibly validating to hear that other people believe you, see what you’re doing, and recognize your experience as real. It helps to bridge some of those gaps between internal experience and external reality. It can particularly help if there are negative things happening in someone’s life to point out “Hey, you are not making this up. You’ve been dealing with hard things and maybe your reaction is particularly strong, but it makes complete sense to struggle with this.”

7. Walk the walk

Take care of yourself. I know in many other places in this article I’ve recommended being willing to do anything. What I mean by that is not letting pride get in the way. However you have limits too. If possible, demonstrate healthy boundaries and good self care. Saying something like “I’d really like to help out, but I can’t do x night because it’s date night. Can I help you on y night instead?” If you’re having a chat with them, it’s good to mention things you’re doing to take care of yourself, e.g. “I saw my therapist the other day and we talked through x problem.” It helps to normalize the steps that you’re asking the other person to take, and it also helps them feel less lonely. They’re not especially broken and sick. Other people are working on the same things.

8. Be Willing to Be a Safe Place

This one might be a little bit controversial, but it’s something that I think we should talk openly about. I and many of my friends who have dealt with self harm and suicidality have an intense fear of someone calling 911 on us. Especially for people who are black, autistic, trans, or another vulnerable group, interacting with the police is something to be avoided at all costs because it is dangerous. If you have a friend who has told you that they do not want to go to the ER or interact with the police, please respect that. Work with them to find other ways to keep them safe. Drive them to the ER yourself to get them stitches. Forced hospitalization is not fun for anyone, and if we can avoid it that’s great.

As a side note, one of the things that was most stressful to me when I was self harming was managing other people’s emotions about my self harm. I know that seeing someone you love injuring themselves is AWFUL. It is terrifying and it is painful. Those feelings are real. However in the moment when the person has hurt themselves is not the appropriate time to have that conversation. That’s the time when you need to be calm, ask them if they need to be cleaned up, if they need stitches or a bandage, and hold them tight. I cannot express how big of a deal it was for me when I finally met someone who reacted to my self harm in a calm manner rather than with fear and anger. There is something so validating about a person who loves you accepting that you’ve done this and still communicating that they love you. Save the fear and anger for a less charged moment.

If you have any other suggestions, feel free to drop them in comments!

Resilience and Mental Illness

Content notice: eating disorders, suicidality, self harm

The last couple of months have been trying for me in ways that would be challenging even to the most even keeled and mentally healthy of human beings. Today, my mother told me to remember that I am resilient. I am holding up well.

I have lived through some fairly horrific things. So much so that when I think back on the worst times in my life, I feel completely disconnected from them. Someone else must have done them, because I do not understand how anyone could have done what I did. For some reason I’ve been thinking about college lately. At the time, I hardly thought that anything I did was impressive. I didn’t change the world, I didn’t start my own club or create an initiative, travel abroad, or do anything particularly outstanding, as far as I was aware.

In college, with little variation, I did not eat more than once every two days. There were periods (up to a month or so) during which I ate once a week, supplemented by coffee with milk. In the picture above, I hadn’t eaten in days. My body was remarkably resilient. I could feel it falling apart under me. I was weak and tired, and found my heart and lungs struggling. But every doctor told me that there was nothing wrong, my blood work was good, I could still run and swim and bike and climb. I kept going.

One summer, I took two classes over the course of a month and a half. I could count the number of times I ate during that time on one hand. I walked away with A’s. I don’t understand how I did it, and when I think back on the time, it feels like it must be someone else who did it. That was too much, too painful, too cruel. I could not have done those things. How did I do those things? How did my mind follow a single sentence, much less Kant and Aristotle, Nietszche and Mill? When it was happening, it hardly seemed extraordinary. But now? No one could survive that.

But I did survive. I put one foot in front of the other. I held down a job, and I took my classes, and I graduated, and years later, I finally started to eat again. I became healthy. I felt joy again. I felt like I was giving up, over and over again. My body kept moving but I felt no purpose. I’m not sure if that constitutes resilience. I know that I could not live through it again, even as I know that nothing I experience now could ever feel as awful as spending years of my life actively suicidal every moment of every day. Is it resilience if you only keep going because you know you can? Because you know you’ve been through worse? I don’t understand how I did it, but it is hard evidence that I can survive nearly anything.

I suppose it doesn’t matter why as long as you keep going. Your boss tells you your work isn’t quite up to par and it feels awful, but you keep going. You haven’t seen your friends in weeks and you know you should, but you just keep going. Is this resilience? Because if I’m honest, it feels awful.

I don’t particularly want to keep going anymore. I want to collapse on the couch and eat tubs of ice cream. I want to drink a bottle of wine in one sitting. I want to stop picking up my phone and disappear from work. Perhaps that’s the secret of resilience: knowing how to be miserable for days and weeks and months on end. Not knowing if it will end, but moving forward nonetheless. I’ve found that most traits that keep you healthy feel awful in the moment. I suppose mental health is no different.

So I guess that I will keep feeling hideous and broken. That’s how it’s supposed to feel right now. In a year or two years I will look back and wonder “how did I survive?” And then I will continue to live through the seemingly unlivable parts of life. It is mundane how much pain there is in a single life, even as living that pain is an experience that is full of awe and fear. I think on the enormity of living in starvation for years, and how simple it seemed at the time. How normal. The juxtoposition with how overwhelming this feels is stark. I can feel my feelings now. But I will hold on to the resilience I had when I was cold and sick and broken. It is one of the few lessons that my eating disorder has given me.

Just pick up one foot and put it in front of the other. Repeat.

 

My Work Is My Mental Health

A couple of weeks ago I started to realize that thanks to a large pile of external stressors, my mental health has been suffering this winter. Pretty normal. Even someone who didn’t have some vulnerabilities would probably be struggling right now. But as someone who does have vulnerabilities it became quite clear to me that for the next month or until things start to feel better, my job needs to be caring for my mental health.

I’ve heard people use that phrase before, but I don’t know that it’s always clear what it means. Particularly when you have an actual, literal job, and responsibilities, what does it mean to make your mental health a priority? Why do people choose the “job” or “work” metaphor when they’re talking about mental health? For people who haven’t been through the process of managing depression or anxiety before, the whole idea can be overwhelming, so I wanted to break down my process a little bit to show others how it can be manageable.

One of the main reasons I like the job metaphor is because it gives me a clear picture of how I can successfully approach being more mentally healthy. It’s easy to just say “I want to take care of myself” or “I want to deal with my depression”, but when you approach it like a job you recognize that you have to set concrete goals, that you have to work with other people to achieve those goals, that you break your goals down into steps, and that you might have to try a variety of different techniques to achieve the results you want.

For me, it helps to have something like a “workplan” so that I can know what concrete actions I’m taking and what I hope to get from those actions. For example I’m currently trying to decrease my stress and anxiety. To break that down, I have brainstormed with my therapist things that have helped in the past (being more social, working less, doing mindfulness exercises, being more physically active) and set goals for each of them (see friends 3x a week, do 10 minutes of mindfulness a day, go climbing 3x a week etc.). In a few weeks I can see how I’m doing at those tasks and if each task is helping.

I also find that when I think of it as a job, it becomes a priority. I write it on my to do list each day (and then I have to do it), which helps me to reprioritize, as well as remember to check in regularly and see what’s working and what isn’t. For me personally, including things on my written to do lists keeps it at the forefront of my mind because I am seeing it regularly. That to me is what it means when my mental health is my job: no matter what else I’m doing, my well being is always in my brain. I’m at work? Cool, I’m also doing deep breathing regularly. Out with friends? Great! Make sure you’re also eating enough and venting when you need to. No matter what else is happening, self care is taking priority. If something isn’t serving your long term well being, stop doing it.

Of course there are times where it becomes difficult to know if it’s helping or not. For example I am stressed due to a bunch of big expenses coming up. I’m worried about money. In order to deal with that stress I have been taking on more freelance work to build up a better savings account. Of course taking on more freelance work means that I have less down time and less time with friends, more work to do, and less flexibility in my life and schedule, leaving me with higher levels of stress. Which is more important right now…the money stress or the immediate scheduling stress? For me it’s easier to think of it as a business trade off: which will earn company Olivia more Joy in the long run? Can we outsource any of this work? In this case, it helped me realize I needed to talk to my fiance and family and see if there were alternatives to Olivia just dealing with it, which it turns out there are.

The metaphor might not work for everyone, and this might not be what everyone thinks of when they say “my mental health is my job right now.” But I find that it’s an appropriate metaphor because it restructures the way I approach things, and it makes me more serious about the real amounts of work it takes to take care of myself.

Do you have a different metaphor that works when you need to prioritize mental health? What helps you kick self care into high gear?

 

2017 Was a Year of Mourning

It’s the new year! Hey 2017. Good to see you.

I have a lot of friends who are not fans of 2016. I agree with them on many fronts about the dumpster fire of the last year. 2016 was objectively one of the hardest years I have ever had on a personal level. There was simply too much happening. Some of it was amazing, but some of it was truly horrible, and I cannot really process it all. For some people, 2016 was awful because of the election and celebrity deaths and large, communal events, things that didn’t appear to affect them personally but which they’ve reacted to anyway. Let’s talk about that. Let’s talk about what it’s like to have group experience that affect your perception of the world and the people around you.

I have seen some people shitting all over the idea that someone should be sad at the deaths of celebrities or at the election of Trump. These things don’t make an immediate impact. Other celebrities will die. Trump isn’t even president yet. 2017 will be worse. Just wait until their policies get enacted. Don’t complain, act! That’s not the RIGHT way to react to horrible things. 

I am not inclined to be particularly forgiving to anyone telling another person how to feel, but in this case, I think that naysayers have missed a major part of WHY others are reacting in the ways that they are and so I am particularly annoyed. One of the most common refrains that I’ve heard amounts to “get over it. It will just get worse so you need to toughen up and figure out how to deal with it.”

I have news for those naysayers: this communal outcry? The complaining, the jokes, the GIFs of a dumpster fire? That IS us getting used to it. It’s called grief and it’s a process, and 2016 was a year that was all about realizing that loss and cruelty are a part of our lives, then grieving for the reality we thought we knew. Grief happens in all kinds of ways. It’s not always rational, it’s not always clear, but it is necessary emotional work, and it will take time. People have to feel these emotions before they can move on to creating positive change.

I particularly want to focus on a brand of criticism that I’ve found frustrating and harmful. After Trump’s election a lot of people had a lot of feelings. Many people acted on those feelings in ways that made themselves feel more safe, or because they wanted to feel sure they would have birth control/be married/be able to get citizenship/whatever else they were worried about before Trump could make any changes. I have friends who moved up their wedding dates, people who invested in long term birth control, acquaintances who suddenly started volunteering and giving money at high levels. People are making changes. To some, this might appear rash. Trump isn’t going to take away marriage equality tomorrow, why are you having your wedding right now?

It’s true that in the sense of practical action, some of people’s behaviors aren’t necessary. People probably don’t need to worry about their healthcare disappearing the moment Trump gets sworn in, or about their marriages being annulled in a few weeks. Some of these behaviors might even be a little bit irrational in the strictest sense. I don’t really want to get in to a discussion of “how scared should people be”, because honestly it doesn’t even matter. These actions are serving a very important purpose that is completely separate from their existence as political actions.

People are doing things because they are sad and afraid. A world that they thought had existed is gone. They are mourning the loss of that world and the illusion of safety it had provided. Sometimes, when you are mourning, it is perfectly reasonable to do things just to make yourself feel better. You get to act irrationally, especially if it’s not hurting anyone and it makes you feel safer. You get to focus on yourself for a little bit.

When you understand people’s behaviors not necessarily as calculated political action but rather as personal grief, it makes a lot more sense, and hopefully can give us all a lot more patience with each other. Maybe things will stay as awful in 2017 as they felt in 2016. That’s certainly a possibility. But what I doubt will stay the same is the way people are behaving. Human beings require time to adjust to change, particularly unpleasant and difficult changes. 2016 was a year of realization for many people: the world is not what I thought it was. People are not who I thought they were. Death is a regular part of my life. Suffering cannot always be avoided.

2016 was a year of mourning those realizations and the loss of some hope and security that came from not believing those things. As we move into 2017, I hope we can start to grow from mourning to action. But I also want to recognize the people who are still coping, or still struggling to cope. Emotions move at their own pace. People feel and understand emotions differently from each other. None of us should be heaping shame and guilt on each other for the feelings we have about 2016.

I want to publicly witness your mourning. I want you to know that it’s ok. I want you to know that the fear and grief make sense. I want you to know that you aren’t alone. I want to recognize that there are moments in which communities collectively see and understand change, and that this isn’t just the same as usual, and maybe this is our new normal, but we take time to adjust to normal. It’s ok to feel like 2016 was a big and important year. Recognize those feelings. It’s the only way to move forward, and the only way to truly adjust to the world as it is. There’s no call for shaming each other.

You Can’t Always See Anxiety

I want to give you all a glimpse behind the curtain of anxiety for a brief minute. Maybe this is stupid and you all already know it, but I feel as if the outside face that I present to people makes me look way more together than I am.

 

So you all know that I’m getting married, and you all know that I’m a pretty hyper organized person. Basically everyone I have spoken to about my wedding has been nothing but compliments on how far ahead I am in terms of planning and organization. People have told me over and over that they are impressed with the way I’m working ahead and doing so much DIY far in advance, how good I’m being at keeping everyone up to date and making lovely spreadsheets and lists and staying right on schedule in terms of what needs to get done.

 

And I smile and say thank you and “Oh I really hope so”. Because what I can’t say in the moment is “this is all just a coping mechanism.” Underneath the very competent exterior, I am regularly feeling so anxious and overwhelmed that I’m giving myself headaches and nausea. I am having trouble being social because I’m so nervous that I’m behind. I regularly will just start crying at Jacob that everything is wrong and I don’t know how to fix it because there’s no way I’m going to finish everything on time and the wedding will be a disaster.

 

If you knew me in college you knew I was typically a week ahead on any work. Everyone always acted as if this must mean I didn’t feel any stress over deadlines. This could not be further from the truth. I was SO terrified of deadlines that i had to work that far in advance. I felt all the stress of pulling all nighters and working straight up to the deadline, but weeks in advance, because if I wasn’t ahead I was behind. That is how I feel about my wedding. Every day I wake up and feel short of breath and tight in my chest, and I look over my to do lists again and again and see that I’m doing perfectly fine and wonder what am I missing? What haven’t I done? What is slipping through the cracks? And then I find something that needs to get done and I panic and wonder how it’s ever going to get finished on time and do it all right this instant, but the feeling of “this is too much I will never finish it” lingers and lingers, and every time I find another to do it builds on every other lingering certainty that I will never finish in time.

 

No amount of rationality dispels the continued anxiety from every project that has to be done and even the ones that are already finished (am I sure they’re complete? Are they ALL THE WAY complete or do they still have things to be done? What if they need to be changed?). In my mind I am carrying every single task that it takes to put on a wedding ALL THE TIME.

 

THAT is why I’m so far ahead on everything. If I let a single ball drop, the panic comes crashing in. Maybe, just maybe, if I’m weeks ahead on my to do list, I can put it all down for a minute and relax. I can accept that it will all get done on time. Maybe if I finish it all a week or two weeks before the actual wedding I’ll have time to calm the fuck down and actually enjoy my time.

 

But when you look at me and think that I’m really competent and have everything under control, what you miss is that the reason I hold so tightly to everything is because it feels like a mass of chaos that I’m barely grasping at all. THAT is what anxiety is.

Note: this was cross posted from my Facebook because it seemed like it needed to be a blog post.

The Holidays: Now With Bonus Political Stress!

I hate the holidays. I know, I’m a Grinch, but eating disorders don’t get along well with Thanksgiving, and social anxiety is not a fan of large gatherings with people you only see once or twice a year. Any kind of chronic physical or mental illness makes holidays seriously challenging, which is truly a giant pile of butts because I love my family and I wish I didn’t have to spend so much time prepping for seeing them and recuperating afterwards. This post is in fact late because of stress induced sickness from a very long Thanksgiving. But better late than never, and I’m glad I spent the time taking care of myself.

I know I’m not the only one out there who despite loving their family and friends finds the excessive social nature of the holidays overwhelming and exhausting, and who is more tense than usual thanks to the heightened political climate this year. So with that in mind, here is a guide to not talking about things you don’t want to talk about. Because socializing is hard and it’s even harder if your family is made up of Trump supporters and you have social anxiety.

My first and biggest recommendation is to decide ahead of time what your boundaries are. Once you know how much you’re willing to discuss or tolerate, you can create plans to deal with the situations you foresee. Are you willing to talk about politics at all? Are there specific people you will talk about politics with, but not others? Do you have a limit to how much you’re willing to talk politics? Is it too stressful to even hear others talk about politics? Answer these questions and try to plan for any problem situations you can foresee.

One of the most important skills you can work on is escaping conversations you really don’t want to be in. This is useful no matter what your boundaries are. You can use it to get away from a problem person before the conversation turns sour, to get out of a conversation with someone you normally like who has turned to obnoxious topics, or when you’re just feeling overwhelmed. One option is to enlist someone you trust for help. Let them know you might need to get away for a little bit, and text when you need a hand. They can come in and say they need your help with something. Other alternatives include telling your conversational partner you need to use the restroom, or getting a refill on your drink. Practice a couple of get away lines before you go. It might seem ridiculous, but it helps to have something at your fingertips.

Escaping a conversation is a good way to deal with a situation if you don’t want to talk to someone anymore or if there is somewhere else you can go hang out. But what if everyone is engaged in the obnoxious conversation, or this is the cousin you never see and would really like to catch up with? Well you’re also allowed to set boundaries with your family members. This can be one of the more challenging things to try because it is more direct than simply quietly escaping. Start by naming what the people are doing, then identify how it makes you feel. For example “You’re talking a lot about politics and I feel really uncomfortable with that topic.” Then you state your boundary: “Please stop talking about politics with me.” If the person accepts the boundary and moves on, great! If they do not, you have to introduce some kind of consequence. “I asked you to stop talking about politics and you didn’t. If you keep talking about this, I’m going to go in the other room.” You may have to scale the consequence. If everyone in the house will not stop doing something that you have asked them repeatedly not to do, it is OK to leave. You don’t have to do it in a big huff, but simply inform people “I’ve asked people not to do x, and people continue to do x. I’m going to leave now because my boundaries are not being respected.”

 

You can practice these skills ahead of time. Role playing might seem silly, but I have done role playing for setting boundaries and it turns out it helps to have said the words out loud before you try to use them in context. It can also help remind you of your limits so that you stick to them. You may also want to set a reminder somewhere so that you don’t forget to take care of yourself: that could be a close family member who checks in, an alarm that goes off partway through the party so that you check in with yourself, or a note in your pocket. Just make sure that once you get into the social situation, you don’t forget all the planning and work you did ahead of time.

Finally and perhaps most importantly, you cannot get through the holidays if you only focus on the obvious things like gatherings and family time that might be stressful. This month set goals to sleep enough, eat well, and move your body on a regular basis. When you are physically taken care of, your emotional baseline is simply more stable. If you have anxiety or some other illness that makes holiday times hard, you probably know your coping skills. You know the things you can do that will make you feel better about yourself. Focus on those this month. The more you can keep your overall stress level low, the better you will be able to handle each individual instance of stress.

Good luck and I hope all of my fellow socially anxious folks actually have some fun this holiday season! You deserve it.