What Someone With Depression is Like

Tonight at dinner someone mentioned Silver Linings Playbook, a movie about people with mental illness. My uncle chimed in “It did a very good job of portraying what someone with depression and anxiety is like”.

I felt the hurt of it before I realized why. Something bubbled up inside of me with the need to yell “Here’s what someone with depression and anxiety is like. Your niece!”

Sometimes people with depression can make it through a whole dinner conversation, but sometimes they need to escape to the basement with the kids.

Sometimes people with depression are willing to chime in and talk, and sometimes they’re quiet.

Sometimes people with depression are manipulative and self-centered, and sometimes they are selfless and kind.

Sometimes people with depression eat pie. Sometimes they eat steak. Sometimes they eat ramen noodles from a package.

People with depression graduate college. Or not. They hold down jobs, except sometimes when they can’t.

They might be a dog person or a cat person, a people person, or not so much.

Sometimes they die of a drug overdose and sometimes they fly through school with straight A’s and land their dream job.

Someone with depression might be bounding with energy or they might take naps every day just to make it to the evening.

Some people with depression will let you know about it and others won’t.

Some people with depression have kids, others never will.

Some are chatty, chatty, chatty, others introverted.

Sometimes they make it through incredibly difficult times. You might not know they’re hurting so bad inside. Sometimes they crash and burn (but even when they do, they usually don’t want you to know).

A person with depression could be scrappy or smart or artsy or average or generous or really any adjective you might be able to think of to describe a human being.

Sometimes they hate themselves for having depression but sometimes they just hate you for using phrases like “people with depression” as if they’re a monolithic and foreign species.

Someone with depression might just be like that person sitting right next to you. Your niece, your cousin, your daughter. And they might just never open up to you about their depression if you say things like that.

Because let’s be up front here: people with depression are pretty much like other people. Some things are just a little harder for them. And it pretty much is horrible to be considered a foreign people that your family members need to watch movies about in order to get an inkling of how you work and who you are, or to be completely erased for a fictional portrayal of mental illness.

Unpacking the Spoons

Most of you have already heard the spoon metaphor by now. It was originally coined to describe what it’s like to have a chronic illness, although since then it has been used to describe mental illness as well. It’s an incredibly helpful tool, but I’d like to take a minute to expand on why those of us who have illness of one kind or another use up our spoons so quickly. There is an invisible aspect to illness that most of us don’t talk about. It’s oddly taboo, particularly for mental illness. Let’s shed some light on it shall we (I’m going to confine this discussion to my particular mental illness because that’s what I have experience with, but I know that this type of thing is applicable to all sorts of different illnesses).

When you’re mentally ill you have to think about more things. Let’s look at some examples of things that I have to think about on a regular basis that most people are blissfully unaware of: (trigger warnings for ED and self harm)

1.Are my hands shaking? Will someone notice? How will I explain it if they do?

2.Will the clothes that I’m wearing expose any of my scars or current cuts? Am I going to be somewhere that I care?

3.Will someone use the word “purge” today? How will I deal with this trigger if it comes up?

4.Will someone talk about my body or eating habits today and how will I quickly escape the situation if that happens?

5.If I eat something, will my stomach be able to keep it down or will it get uppity because it’s not very good at digesting anymore?

6.Will it look suspicious to my family or friends if I go to the bathroom immediately after a meal?

7.If I stay at someone’s house, do I have my meds? I cannot stay at someone’s house unless I have my meds.

8.If others want to do a physical activity, will I be able to keep up? Will I start feeling faint?

9.Did I bleed on my sheets or my pajamas after I cut last night? Can I get that stain out? Did it get on my computer, and will other people notice if I bring my computer out? Also gross.

10.Can I leave the house today without overwhelming self-hatred based on how I look in these clothes?

11.How distracted will I be today by my body? If my thighs rub together while walking, will I still be able to keep it together, or will I start having some really bad thoughts?

12.Will there be calorie counts listed somewhere that I go today?

13.How do I get all my hours in at work and get to 5-10 hours of therapy a week? How do I explain to my boss and coworkers that I’m not lazy it’s just really hard to find good times for appointments?

14.I usually get tired at around 9:00 (probably from nutritional deprivation among other things). Can I go out and socialize tonight? How can I see my friends when I have a full time job and I can’t stay awake past 11?

15.Was that slight chest pain just some anxiety or other minor something, or am I finally getting the irregular heartbeat that is supposed to come with my eating habits?

16.What do I say if people bring up food habits? Fasting? (yes this has happened, e.g. how long have you gone without food). How do I keep myself from blurting out “yeah, I ate once a week for a couple months once”?

17.How much do I tell people?

18.If someone hugs me, will they be able to feel my fat? Will I be ok with it, or will I want to pull away (most of the time it’s pull away. Then I have to be polite)?

19.If I purge, will I smell like puke? Will I be able to get those nasty stains out of my clothes (yes, it gets everywhere. yes it is gross)? What happens if my boyfriend tries to kiss me?

20.How much of my day will I waste thinking about food and debating whether or not to eat and how much to eat? This varies from about 1 hour to my whole day, depending.

21.Sometimes I even waste my brain space wondering if what I expel from my body is the same as what I put into it (yes I am talking about poo).

22.How many layers should I wear? I’m always cold, but I can’t regulate my body temperature at all so I swing to really hot if I’m under blankets or layers.

23.Can I handle looking at myself in the mirror today? Will I look like a complete idiot if I get dressed and leave the house without a quick mirror check?

24.Will someone notice if I start poking at my wrists or my hips to feel the bones? Can I feel my bones? Am I too fat if I can’t feel my bones?

25.Have a fasted/restricted today? How long has it been since I last ate? How much did I eat? If someone tries to give me breakfast, how can I say no?

This was just a list I came up with off the top of my head. Imagine trying to get out of bed while thinking about all these things, plan your day while thinking about all these things, accomplish work while thinking about all these things. THIS is where the spoons go. The reason that doing simple tasks requires so much more energy and effort is not just the physiological difficulties of depression or illness (and yeah, those things often do come with some serious fatigue or pain), but also the fact that everything is inherently more complicated. You are constantly trying to protect yourself from whatever threat your illness brings. You have to plan ahead like nobody’s business. You have to be assessing what’s going on around you and what’s going on internally to make sure you’ll be ok.

With mental illness, many of these thoughts are intrusive, paranoid, and irrational. Unfortunately that doesn’t mean you can turn them off and that doesn’t mean that you’re expending less emotional energy by having them. These thoughts are intrusive, distracting, and oftentimes pervasive, which means you’re taking a lot of your executive function to refocus your brain on the task at hand. All the time. Over and over.

For many of us who are dealing with a low spoon count, we don’t even realize that this is where the spoons are going: all we know is that things feel hard. They feel exhausting. We’re more worn out than other people even when we’re doing what appears to be less. Again, the key appears to be patience with yourself and with others, as well as clear communication about what you’re feeling. Many of us don’t want to speak up about the things that are hard for us, whether because we don’t want to appear weak or because there is a strong taboo against them (most of the things listed above fall into this second category). If we can get better at telling others what we’re really feeling, maybe this whole spoons thing will start making more sense to everyone.

 

“Mental Illness is Not Biological”

I am a big proponent of being careful with language. I don’t think that we should oversimplify something simply because it sounds better or is better marketing. Especially when it comes to mental illness, we are so sloppy with our language as it is that I think we must be careful. I don’t like the idea that we should describe mental illness as “a chemical imbalance” because it deeply oversimplifies things. So I was fairly dismayed when I sat down to read an article in my local paper about the need to talk more about mental illness and it simply repeated over and over “mental illness is not biological” and that we need to spend more time talking about the pharmaceutical industry.

Many people do not pay enough attention to the biological factors of mental illness. Yes, we recognize that genes can cause a predisposition, but more than that, basic biological systems can deeply affect your mental health. A few examples: sleep deprivation can easily cause symptoms of mental illness. It can deeply affect mood, emotional stability, depression, anxiety, and other brain functions. Continual sleep deprivation can spur a mental illness. I’m not sure what one would call that if not a biological factor.

Similarly, food deprivation is deeply correlated with some serious signs of mental illness. In the hunger studies performed at the University of Minnesota, individuals who willingly deprived themselves of food became depressed, anxious, obsessed, violent, withdrawn…they had diagnosable mental illnesses that were not present before the removal of food. Again, this seems to be a strictly biological change that triggered a mental illness.

Factors like these are often heavily discounted when we talk about mental illness, particularly when we’re attempting to recover from mental illness. Not enough time is spent focusing on the fact that if you don’t have a healthy biological basis with adequate sleep, nutrition, and exercise, it is significantly more difficult to have a stable mood and recover from a mental illness.

In addition, we do know that genes play some role in mental illness. We know from twin studies that many mental illnesses are far more likely to occur in an individual if they have close family members with that mental illness. For some mental illnesses, we have identified specific genes that might be linked to that mental illness. The most likely theory about mental illness right now is that we are genetically pre-disposed to an illness (to varying degrees depending upon the person) and social or environmental factors then can trigger that mental illness. And yes, neurotransmitters and brain chemistry are implicated in that mental illness. Yes, there are physical processes that have been disrupted when we are talking about mental illness. No, it’s not just a chemical imbalance, yes it is more complex than that, but of course it’s biological because our brains are a biological organ.

This is intensely frustrating, because it makes it seem as if the social factors that affect our mental health have no bearing on the physical existence of our brain. In fact studies done on chimps have shown that certain brain chemicals are altered over the course of years by trauma or isolation (if a chimp is isolated at a young age they will have different levels of certain brain chemicals when placed in isolating situations than a chimp not isolated at a young age and these effects last for many years). This is a physical change brought on by an environmental factor.

Of course it’s important to be careful not to oversimplify, but obscuring that there clearly is a biological factor to mental illness is not helpful either. In addition, the fear of labeling mental illness as biological plays directly into the fear of overdiagnosing and overprescribing. When we repeat over and over that mental illness is not a biological illness that revolves around neurotransmitters and brain chemicals, we become even more paranoid about prescribing medication (something that people are already worried about in the case of things like ADHD and Xanax). Speaking as someone who takes medication, this is incredibly damaging. Medication can be a complete life-saver: it made my anxiety manageable and so it gave me a window to actually begin dealing with some of my underlying issues. I was afraid to begin taking medication because I didn’t want to “alter my brain”. Repeating the myth that pharmaceutical companies are out to get us all and that medications are not the proper way to treat mental illness reinforces that stigma.

Of course we should include various kinds of therapy when we’re working on mental illness, but it is actually incredibly difficult to get medication for many mental illnesses and particularly difficult to get insurance to cover it. People are already afraid of medication. People are already afraid of being turned into zombies by pills or having unknown side effects. It is possible to advocate for improved standards for pharmaceutical companies AND accept that medication can be an incredibly important part of treating mental illness.

We need to recognize that mental illness is complex, requires a number of kinds of treatments, and involves a variety of factors including the biological, social, environment, genetic, chemical, and situational. While it is important to move past the “chemical imbalance” trope, that doesn’t mean completely removing any mention of chemistry or biology from our descriptions of mental illness.

I’m Worse Than I Used To Be

In my recent internet browsings, I ran across a Facebook status from a friend who suffers from depression. The status was fairly simple. It basically said: “I’m so much worse than I used to be.” This language is in a lot of places. “My depression has gotten worse”, “this is the worst she’s ever been” and so on. But there is an important distinction between saying “my depression is worse” and saying “I am worse”. One of these is helpful and is an assessment of the seriousness and difficulty of a situation. One of them reflects back upon yourself, and can have some negative consequences.

Here’s the thing: when you are in the midst of depression you are not “worse” than you were a year ago or five years ago. Your situation is worse. You however are exhibiting great courage and strength by continuing to get yourself out of bed each morning and struggle through each day. YOU are amazing in the moments that your struggle is the worst.

Let’s imagine a situation in which it is not your brain or your body that is making things difficult for you. Let’s imagine that you’re navigating a wilderness. Things keep trying to kill you, it’s desolate and dark, you don’t know how to get out, and you have little hope of it getting better. You struggle to keep going. You find tricks to make light, to find food, to keep yourself putting one foot in front of the other, moving in the hope that something might change. If someone were to look at you, they would certainly judge your situation as bad, but I seriously doubt they would say that you were doing worse than you had in a cushier circumstance. YOU as a human being are surviving, growing. You may not be flourishing, but you are learning tools to flourish.

Depression is just as difficult a mental landscape as this imagined world. You are navigating. You may not realize how much skill you are navigating with, but you are still alive, you are still moving, you have created your tiny lights to bring you through the day.

But why does it matter? What’s so bad about using this colloquialism?

We all know language is important. We all know that people already feel enough shame around mental illness. Many people struggle to succeed in day to day tasks when they’re in a difficult time with their mental health. It’s easy to feel like you’re “bad” or you used to be “better”. There is no reason to continue to reinforce that message to people, and in fact reminding people of their own power and strength is highly important to recovery. Especially when someone is talking about themselves, they need to remember that their own judgments can cut down their self-esteem and make it even harder for them to recover. Saying ‘things suck right now’ is a way to keep your own value out of it: you’re still kick-ass, but depression sucks.

Each time we reinforce the idea that mentally ill is equivalent to broken, wrong, bad, or inept, we are harming those who suffer from mental illness. It is far too easy to be sloppy about our language when we’re referring to mental health, and too many people already do this. Especially when there are so many fantastic ways of describing how frustrating it is to deal with depression (jerkbrain is laying siege! Release the hounds!), why would we fall back on words that repeat to us that we are not good enough for the world or that we were better when we weren’t sick? Why would we reinforce to ourselves that we have an obligation to get better because we suck so bad now?

Repeat after me fellow sufferers from all forms of jerkbrain: I am not bad. I am no worse than I was before jerkbrain struck. I am striking out into a wilderness that no one before me has braved and I am STILL ALIVE. It is dark and it sucks and I am afraid, but I am STILL ALIVE. I have survived things that the neurotypical cannot imagine, I woke up this morning and I got out of bed and no one can imagine how brave that was. I am a kickass jerkbrain warrior. I am the best I can be.

Gratitude: Mental Illness

It’s Thanksgiving this week, and I’m going to be cliche and talk about gratitude. I’ve unintentionally spent some time earlier this week looking at an experience that I was grateful for, but today is going to be a difficult exercise for me: I want to talk about something in myself that I am grateful for. This isn’t easy, but I suggest all of you try it as a way to see those things in yourself that are good.

I spend a lot of time griping about my mental health, but after a lot of thought, I am grateful that I was born this way. My mind is quite often a bitch to me, but I’m glad that it is the way it is. Despite the fact that my mental health is probably my biggest hurdle in life, it has forced me to become a better person, to learn many things that I otherwise could have easily avoided, and to simply be kinder.

I certainly can’t say that if I was given the chance I’d choose my mental illness, and I’m not saying I enjoy my life the way it is, but if I’m being honest with myself, I’m a better, more selfless, and kinder person because of my mental illness and the places it has taken me.

First and foremost, my  mental illness has required that I spend time with myself. I have spend more hours than most people could imagine delving into my deeper fears and insecurities, ripping apart all the myths and lies that I tell myself, and examining why I do the things I do. I have become a far more facts-based individual due to therapy. I have become better at assessing myself and my situations. Because I’ve simply had to really BE with myself, in an entirely present way, I’ve figured out what I don’t like about myself and made improvements, and because I’ve spent so much of this time with a trained professional, I’ve also started to notice when my perception is a little off.

I’ve also had to spend a lot of time with therapists who are unafraid to criticize me and my coping strategies and who want me to improve my relationships. This means a whole lot of real, honest feedback about who I am and how my behaviors affect other people. Because of this, I often get to think about things I screwed up without falling into a guilt trap and with someone there to help me brainstorm immediate techniques to improve the situation.

While I have spent a lot of time thinking about myself, I have also spent a lot of time thinking about how other people influence me and how I influence others: I have learned to shift the perspective away from me, me, me. Your actions aren’t about me, and my actions are small. I have learned that often I should be thinking about someone else instead of about making myself smaller to fit someone else in.

In addition, I’ve found that I understand emotions better, both my own and other people’s. This makes me far more effective at Not Fucking Shit Up. I’m extremely grateful for that.

I can’t imagine that I would be doing the things I’m doing today if it weren’t for mental illness. I would be locked away reading books somewhere instead. I’m so glad that mental illness has forced me to engage with the world, that it’s led me to my VISTA year, and that it’s demanded of me that I do more for others.

But the thing I’m most grateful for is the compassion I feel I’ve gotten for people whose brains don’t process quite the same as mine. After seeing the confusion and frustration in people’s faces when they try to comprehend what I’m thinking and feeling, I don’t want to be the person that dismisses another’s pain or struggle. While those experiences were horrible, I’m grateful that I think I’m a better person for it.

My mental illness itself has not given me much, but it has forced me into situations that have given me tools to help myself and to help others. I am grateful. I would never have thought so deeply, been nearly as effective, or been so perceptive without the drive of mental illness behind me. I’m grateful that I now have a habit of therapy behind me, that going forward I will now how and where to find appropriate tools to improve myself, and that I will continue to reflect on myself in this way. I’m grateful that when I ask others to go to therapy now, I have the weight of my own work behind me. I’m grateful that I am in a better position to help others now.

So thanks mental illness. You’ve made me a better person.

Falling Through the Cracks: When the DSM Can’t Find You

This week in my DBT group, we were talking about what Borderline Personality Disorder is and how it’s diagnosed (DBT was originally formulated for BPD). Essentially, there are nine traits that are used to diagnose BPD. If your diagnosing therapist sees five or more of them in you, then you are diagnosed with BPD. If you have less than five, but still have some, you are diagnosed with what’s called BPD Traits. I had never heard of BPD Traits before, and I don’t think most people have. Insurance is far less likely to cover something that sounds subclinical like that, and it’s far less likely to be understood by the general public. It simply sounds less severe, right?

 

Unfortunately, this system has a few major flaws, and it seems to me that these flaws are indicative of many of the problems with the DSM as a diagnostic manual. The main problem with this system of diagnosis is that many of the traits of BPD are things that everyone has to some extent or another (things like anger issue, or efforts to keep people from leaving you), and so they only become diagnosable when they seem to be excessive or problematic. This leaves a great deal up to the discretion of the diagnosing therapist. It also means that that therapist has to draw a hard line about what counts as problematic and what doesn’t, when in reality these traits exist on a spectrum. So you could be just over the line and counted as having the trait, or you could be so far over the line you can barely function on a day to day basis, and in the eyes of the diagnosis, you have the same trait.

 

This also means that the difference between BPD and BPD traits isn’t as clear cut as it might seem in the first place. For example, someone with BPD might be just over the line on five traits, but someone with BPD traits might be way, way over the line in four. Who’s to say which is more severe, or that one should receive a full diagnosis that allows them access to treatment, while the other receives a diagnosis that gets them almost nothing?

 

Overall, this illustrates something that is definitely wrong with the DSM: mental illness and mental traits all exist on spectrums. There is no on or off switch to depression, anxiety, paranoia, or any other problem that may be diagnosed as a mental illness (with the possible exception of hallucinations). However in order to diagnose someone (and particularly for that individual to gain coverage of treatment), symptoms are treated as present or not present. Occasionally we use modifiers like “severe” or “mild”, but more often than not it’s either there or it’s not.

 

This seems to be a recipe for disaster for people whose symptoms either don’t present as traditionally understood, who are barely subclinical, or who have an odd constellation of symptoms. I find that I often have this problem: I have lots of issues (oh LOTS and lots). I have bits of OCD, OCPD, ADD, BPD, depression, anxiety, bulimia, anorexia, and really probably a whole host of other things. But because many of them are subclinical, or I don’t have the right pairings to fit into a particular diagnosis, I have been left without any sort of personality disorder diagnosis, or larger diagnosis to fit it all together. Despite how severe my eating disorder was, I was lumped in the EDNOS category, which is far less often covered, and is often treated with less respect and as less severe than other eating disorders.

 

This is a serious problem if we want to provide proper services for those people suffering from mental health issues. We shouldn’t have to wait until a symptom is truly interfering with someone’s basic functions before we give them help. There are many problems with the DSM, and trying to posit a replacement for it is extremely difficult, but one element that really could use replacement is this all or nothing thinking. There is no “partially depressed” or “sort of ADD”. You either have it or you don’t. One improvement could be seeing mental health on a spectrum. We all have different traits, and many of those traits are spectrum style traits. Understanding that moving towards the extremes is always a problem is one great way to view mental health in a more understanding and helpful way, because it allows us to try to help everyone move towards a more balanced place, and could allow us to provide treatment for those who have not yet reached the critical zone.

 

Another issue with this system is the amount of discretion that it allows for the diagnosing clinician. Let’s look at a particular example. One of the criteria for diagnosing BPD is “inappropriate, intense anger or difficulty controlling anger”. This is fairly vague. What counts as inappropriate anger? How might things like race and gender fit into this (hint: black women will always be viewed as having inappropriate anger)? Shouldn’t there be specific examples of things that might constitute inappropriate anger, or the consequences in someone’s life for “difficulty controlling anger” or the number on an emotional scale of what constitutes “intense” anger? How often does one need to be intensely angry to get this trait? All of these things are left up to the discretion of the diagnosing clinician, and unfortunately this allows for a lot of bias.

 

There is a difficult balance here, because having that kind of specificity means that you could be very close to a diagnosis, but not quite reach the correct number of episodes, or the right “level” of anger to reach diagnosis. It seems to me that having these specific levels combined with a spectrum view of disorder would allow clinicians to have less individual discretion that can lead to variability in diagnosis, but would also allow more people to get the treatment that they need. It is widely recognized that we need some changes in the DSM, but these particular issues are ones that I have seen in action in myself and in people around me, and that seem as if they could be fixed without great difficulty. Get on that DSM.

Strengths and Mental Illness

Lately, our culture seems to be all about optimizing our strengths. At work, we’ve been taking Strengths Finder and analyzing our strengths up the wazoo. We’re often told how we need to play to what we’re best at. While in the past, we were often told to focus most on what we were worst at to bring it up to speed, we’ve had somewhat of a shift to focusing on how your strengths can help you across the board.

While hearing all of these comments about strengths, and how to optimize myself, I found myself somewhat frustrated. It can be hard to imagine excelling at things when it’s a struggle to get out of bed in the morning. In addition, my strengths in Strengths Finders came up as competition, achievement, input, intellection, and learning. Essentially, all of these things at their root have caused me a great deal of heartache and stress. I can’t imagine I would have the mental illnesses I do without them, particularly without competition and achievement. It was hard for me to see how those could be strengths, how they could help me succeed and flourish in life. I was also frustrated at the idea that we should focus on our strengths and not worry about our weaknesses because we would never excel at them. As someone whose weaknesses are not just a nuisance, but are in fact seriously debilitating, this doesn’t seem far practical to me.

So what can someone with a mental illness learn from these strengths based ideas? Can we use them to our advantage? Can mental health treatment benefit from this movement towards strengths?

The first thing that stuck out to me when contemplating strengths is that I spend a lot of time in the mindset of my strengths. Perhaps too much time. When we were discussing them in my office, we mentioned that one could over rely on one’s strengths: focus too much on one way of doing things, and get lost in that. This can be damaging, and actually turn your strength into a weakness of sorts. As an example, let’s look at competition. This strength is about being able to compare yourself to others, to see where you fit in, to see how others are doing things, and to use that comparison as motivation. When you rely overly hard on it, everything becomes a competition, you start to be extremely hard on yourself if you’re not first at everything, and you can become vicious in your attempts to win at all costs. You don’t focus on the larger picture of how competition is helpful, and instead compete simply for competition’s sake. This happens to me quite often. In this case I’m relying way too hard on one strength to get me through, using it as my sole motivator, and I’m not allowing myself to be balanced.

I am used to looking at my competitive nature as a weakness, as something that needs to be fixed. I’m used to seeing it as the source of many of my problems. I’ve been told not to compare myself to others because it will make me miserable. But truth be told, I feel quite lost when I can’t compare myself to others. If I don’t have a benchmark, I’m not sure where I should be. If I don’t know that I’m getting better, I feel a bit lost about myself and my accomplishments. Having this shift to seeing it not as a weakness, but simply as a strength that I need to be more aware of has been incredibly helpful.

Another way to look at this is to circumvent some of your perceived weaknesses. I’m not so good at a lot of the including, social type skills. Social anxiety and me are best buds. This can make my life harder when it comes to things like making phone calls or doing the customer service portion of my job. I’ve spent a lot of time trying to figure out how to get past this social anxiety. However it might be more helpful for me to put my time and effort into projects that come more naturally to me, or to try to approach social engagements as a way to learn something so as to engage the things I do feel good at. I feel good at explaining things to others, so if I view myself as simply a help desk rather than someone trying to make a deep personal connection, I feel far more comfortable.

However despite how helpful focusing on your strengths can be, there are times when weaknesses require your attention (e.g. when you can’t get out of bed in the morning). This can make focusing on your strengths difficult. This might be a time to think about balance, and to think about how strengths and weaknesses are related to the myths that we carry. In DBT, we like to talk about myths. These are things that you are convinced are true, that were probably helpful coping mechanisms at one point, but are not any longer. They include things like “anger is not acceptable”, or “I can’t ask for help”.

Oftentimes, we internalize myths about what our strengths should be, or about how heavily we should rely on our strengths. To go back to competition, I often tell myself that I need to be the best at everything I do. This is a myth. And it means that I obsess over my competition strength. It may even mean that I force myself into it in situations that I don’t want to use it. Perhaps if I didn’t feel the weight of having to be the best at everything all day long hovering over me from the moment I wake up, I’d have a bit more spring in my step upon waking. Thinking about the values that you assign with your strengths can help illuminate some of those myths and help you understand how pulling back on a few of your strengths may help you with some of your weaknesses.

Perhaps mental health treatment focuses too much on what we can’t do and the ways that our brains hurt us, rather than imagining what we do right and asking us to rely on those things. Perhaps spending some time thinking about what we do well can help us find workarounds for the things we don’t like.

What Discrimination Looks Like

When you think about discrimination what do you imagine? Most likely someone without a college degree, working a less than stellar job. Perhaps someone who has been abused. Do you imagine someone with a college degree, nearly no debt, working for a nonprofit and happily able to pay their bills? Probably not. Do you think it’s even possible for that person to be discriminated against? Do you think it would affect their life?

I’d like to use myself as an example of how discrimination can hurt those who look highly successful, and how discrimination is far more pervasive than we think it is as it’s often invisible. Often, people who experience discrimination but who are doing fairly well in other areas of their life won’t report because the police and legal system aren’t stellar towards people who are in an oppressed category, and because it’s long, painful, and sometimes expensive. You never know who has been affected by discrimination or how it’s changed their life. These are my examples. I am one of the more privileged people I know, so I’m sure that nearly everyone else out there reading has more, but if I can have my life impacted by discrimination, then so can anyone else. It is a serious problem.

From the moment I entered the workforce I have experienced discrimination. The following story reeks of privilege and I understand that, but even with that reeking of privilege, I want to point out the gender discrimination that happened. When I was 16, my parents decided that I should probably get my first summer job. When my brother was my age, he had gone to work for my dad’s company. My dad worked for a company that made staging equipment, and my brother went to work in the shop doing physical labor. He was paid $10/hr. Obviously having parents who can get you a well-paying summer job is a huge privilege. I am not denying this. However when I reached the age to start working, my father made the same request: could his daughter work the same job that his son previously had? The company responded with “we don’t let girls work in the shop. It’s not the right environment.”

As some background, I was entirely physically capable of any job that my brother was. I was swimming almost 12 hours per week at the time and in incredibly good shape. There was absolutely no reason that I should be denied that job. The company didn’t even try to cover it up by saying they didn’t think I was capable of the job, they simply said that they would not hire me because of my gender. What they offered me instead was an office job paying $8/hr. Now as all of you know this is highly illegal. Thankfully, my mother is a lawyer and not someone who takes that kind of shit lightly, so she called them up and kindly informed them that they would pay her daughter the same amount of money they paid her son or she would sue their asses off. I was so lucky to be able to get a job for $10/hr, but they didn’t hire me back the next summer and hired someone for a lower pay rate, despite the fact that I was an incredibly dedicated worker at a really sucky job (data entry is the most soul-killing endeavor ever). My brother on the other hand worked for nearly 5 summers there, easily making more than I made at any other job I could get. I now know for a fact that I’m starting out my post-college life with less than he did. In addition, in college he was offered a job through my uncle’s river rafting company that a. paid well and b. was amazing. I was not offered this same opportunity despite expressing interest.

Again, I understand that these things didn’t leave me in a really bad situation. I am not homeless. I am not without a job. I wasn’t left with no way to start saving for college. However they did leave me with a significant dent in my finances that my brother didn’t have, when in nearly every other way we were identical (with the exception that I had a better GPA than he did, but apparently that counts negatively??). In the long term, these things make a difference. They limit my ability to do things like take unpaid internships. They make my current position as a VISTA a much more significant risk than it would be for him. They mean that I’ll be starting with less resources than he has, and that impacts my future. They have significantly contributed to my anxiety surrounding money. They have left me feeling like less of a person in many ways. They have impacts, even where it appears that they don’t.

But beyond sexism, and the effects of discrimination that I may be able to make up for in other ways (like be being a super awesome badass), I’m also currently experiencing some discrimination that may seriously impact my life and will likely be a lot harder to recover from. Last week, I asked my therapist if she would consider basically “prescribing” me an emotional support animal (a cat to be specific). As y’all probably know I have an eating disorder, depression, generalized anxiety disorder, and sub-threshold borderline personality disorder. One is entitled to an emotional support animal if you have a disability which affects your ability to do basic functions in your home (I would argue that the inability to eat due to eating disorder, the insomnia due to anxiety, and the lack of personal safety due to self-injury would qualify here), and if the animal will improve those symptoms and is not an undue burden to the landlord. This applies even if the landlord has a no pets policy. Cats really do alleviate my symptoms. They are incredibly helpful for soothing anxiety, they lighten my mood, they help me sleep, they calm me if I’m having a bad day or having difficulties with food, and they are really really good at interrupting purging and self-injurious behavior (seriously have you ever tried to hurt yourself when there’s a cat who keeps knocking your razors on the floor? It’s too ridiculous to even attempt).

Having this animal is important to my safety and mental well-being. In fact, it directly impacts my quality of life, my ability to function at work and at home, my health, and perhaps even my life (I don’t imagine I’m anywhere near a suicidal state of mind right now, but it’s happened before and it is a very real possibility for someone with my conditions). However when I called my landlord to run it past him, let him know that I had appropriate documentation, and make sure he didn’t have any questions, the response I got was “No, no way no how, you are being underhanded and dirty, you are an improper tenant, and you don’t get to live here if you want to have this animal that you need for your health”. This response has directly put me in jeopardy as my anxiety and anger shot through the roof. Since then I have been exhibiting some unhealthy exercising and eating practices, and it took all my self-control not to self-harm after that phone call. Looking at me, no one would know the kind of impact that this discrimination is having on me, but it is serious and it is potentially life threatening (because yes, not eating, over-exercising, purging, and self-harm are all potentially life threatening).

In all sorts of places that you would not expect, there is discrimination and its consequences are real and they are serious. For all the privilege I have dripping out of my ears, I have now been put into a seriously unhealthy position because of my mental health. I am now left with the choice of whether to attempt to manage my mental health without what would be an extremely helpful tool, or to try to go through a court battle (which I don’t have the money or time for, which would stress me out immensely, and would most likely exacerbate all of my symptoms). No matter what someone looks like or how their life appears, you have no idea how systems of power affect them. They are pervasive and intensely harmful. This is one life, one set of stories. Imagine multiplying that by all the people my age, or all the people with my mental health status, or all the women. We have not solved these problems. They are very real.

P.S. The little cutie in the featured picture is the baby that I really want to take home with me.

Fat Stigma: Change of Perspective

Hello all! Today’s post is going to be short and sweet because it’s my birthday and I said so. This week is fat stigma awareness week, and so I wanted to talk a bit about my own experience of fat stigma through the lens of something that happened to me this morning. I am well aware that I have internalized a lot of fatphobia and it’s something that I fight against as often as possible.

This morning while I was on the bus, someone who was overweight and using a walker got on. I noticed that I instantly questioned why she needed the walker: whether it was just because she was overweight, or did she have “actual” health problems. Particularly because she left it at her seat and went back to pay the bus driver, I was judgmental. I noticed this and told my brain to shut the fuck up because it was none of my damn business and I didn’t need to police anyone, but I knew that I was still judging her.

This woman was sitting next to me, and as the bus went around a corner her purse fell off the walker and onto the floor in front of me. I bent down to pick it up, and as I did her wallet fell out and some business cards spilled onto the floor. I apologized profusely and picked them up for her, and as I was doing so I noticed that one of them was for The Emily Program, the same place that I get my eating disorder treatment. Instantly any judgment I had for this woman was gone and all I wanted to do was hug her and punch her eating disorder in the face. I wondered what else her eating disorder had taken away from her besides her mobility and I wished I could help. It was amazing how having one thing in common with this woman suddenly humanized her. It was a major lesson for me. Despite how hard I had told myself to judge her not before, it was only once I had the tiniest glimmer of understanding that she struggled that I could have real empathy. And that’s a problem.

From now on, I’m going to imagine that every person I come across who is different from me has something written on a card that tells a bit of their story. I’m going to imagine seeing it fall to ground and imagine how it would change my perspective and give me sympathy for them. EVERYONE has those things. We need to learn how to see them.

Dissociation: What Is It, How To Help

Dissociation is a major factor in a number of psychological diagnoses. One of them is Borderline Personality Disorder, something I have at a subclinical level. Dissociation is often overlooked as an element of mental illness though. People rarely discuss it, and unlike “triggers”, it’s not thrown around as an explanation for behaviors. However dissociation is very real and has some serious consequences. It’s also something that many people experience without knowing what to call it or how to deal with it, and it can be debilitating and terrifying. For these reasons, I’d like to give an overview of some of the ways I’ve experienced dissociation, and how I’ve fought back against it.

To read the rest of this post, please visit Aut of Spoons.