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.

 

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!

Real Tips for Really Decreasing Your Anxiety

Anxiety sucks. Clinical grade anxiety is basically sweaty monkey balls.

Over the course of my time in therapy and various kinds of treatment, one of the things that I have wanted more than anything is to not feel anxious all the time. Unfortunately it isn’t as easy as walking in to therapy and having a therapist tell you what will make your anxiety easier. Typically you have to do some work on the roots issues before you can even get to the real, concrete strategies that you can use to make anxiety less intense or less disruptive.

I want to share some of the strategies that I have learned with you. If you’ve been diagnosed with anxiety, you may already know some of them, but there’s also a possibility that depending on the type of therapist you have, or whether or not you’re seeing a therapist, you may not have heard them before. Some of them might work for you, some might not. That’s ok.

It’s also important to remember that all of these strategies are for dealing with anxiety as it’s happening and for trying to decrease the immediate intensity of the anxiety. If you’re finding that you have intrusive anxiety on a regular basis, you may need to talk to someone or get on medication or do something else to help stabilize your basic emotional state so that these strategies are more effective and so that you don’t need them as often, but these strategies can help as part of a larger treatment plan aimed at decreasing instances of anxiety.

This one will be a little long, but hopefully that’s because there’s a lot of good information in it.

Mindfulness Techniques

The first series of techniques I’m going to talk about all circulate around mindfulness. Don’t get scared off by the name: it’s not spiritual or woo woo, it’s not doing nothing, but it is also not easy. Mindfulness is essentially paying close attention to what is actually happening in this moment. It will take time and practice to get good at, and I strongly recommend practicing it when you’re not anxious so that when you are anxious you can do it without getting frustrated or feeling like it’s pointless.

There are essentially two ways you can do this: you can pay attention to something internal or you can pay attention to something external.

Internal techniques:

1. Breathing

This is a nice one because you can do it anywhere. You always have your breath, and you can always take a minute to stop and pay attention to it. There are a few different things you can do to help yourself focus. One of the easiest is counting. Some people suggest breathing in to a count of four, then out to a count of four. DBT recommends counting your breath, and always breathing out one count longer than you breathe in. You can choose the number that feels good to you. Whatever you choose, pay close attention to the numbers and what it feels like to breathe. If you notice other thoughts, that’s fine. Just let them happen and then refocus on your breath.

Another way to use your breath is to pay very close attention to the actual physical sensations of breathing. What does the air feel like coming in through your nostrils? What part of your body expands as you breath in? Especially focus on trying to breathe from your diaphragm. You should notice your stomach moving rather than your shoulders or chest.

2. Visualization or other sensory imaginings

You can tailor this one to your own preferences: if you’re a visual person, then use imagery. If you rely more strongly on a different sense, you might imagine a song or smell. But the idea is to think of a place or sensation that is very calming to you, and to imagine it as vividly as possible. Put yourself in a place or setting that feels safe. Describe it in great detail in your mind. For me, I imagine a huge library. It smells like old books, and has thick, imposing marble architecture with nooks and crannies everywhere. There’s a huge, overstuffed armchair that looks out a large window onto an empty field. I can read whatever I like for as long as I like, with no impositions or tasks to do. It’s quiet, the special quiet that comes from marble soaking up sound, with the occasional tip tap of a librarian’s shoes across the floor. Take yourself to your safe place, wherever it is and stay there until your body has relaxed.

3. Body scan

I like to use this one at bedtime. It’s fairly simple, but takes some time and patience. Start at the top of your head and spend time focusing on each part of your body in turn. Notice what your scalp feels like, if there’s anything touching it, if it itches, if you’re tense there. Again, your mind might wander, and that’s ok, but simply notice then refocus on what you’re doing. Move down your body and do this with every body part. You can go as small or as big as you want, but the smaller you go the more likely you are to notice where you’re tense and find ways to relax.

4. Progressive relaxation

This is something like a variation on the body scan, with a little more umph to help you relax your muscles and body. This time, as you move down your body, at each muscle you reach, tense as hard as possible for a count of three, then release. That’s it! This is a slightly easier one to start with since it gives you something to do instead of just something to pay attention to.

External techniques

1. Descriptions

I find this one works very well if someone else is with me and they are trying to help. Anxiety is anticipation of a fearful event or situation, so one of the ways to combat it is to remind yourself that you’re safe. This technique works by asking you to describe in as great of detail as possible, the room or space around you. I like it because if another person is with you, they can prompt, or you can talk to them and it doesn’t feel as weird. It doesn’t seem as if it would do much, but if you pay close attention to what you’re describing, it can take your focus off whatever is making you anxious.

2. I Spy

This is a variation on the description game that gets your brain a little more involved so that it’s harder for the mind to drift. Pick a color and find every instance of it you can. If you’re in a small room, find somewhere with more things in it and take a few minutes to play. I was surprised at how into it I got and how quickly the anxiety receded because I wanted to get every green thing.

 

Physical Techniques

Many times when you feel anxious it seems as if it’s your brain that’s making it happen. Your thoughts are spinning or you’re saying nasty things to yourself. In reality, anxiety is an incredibly physical experience, and even if your thoughts are what’s causing the anxiety, your body will react. Helpfully, this means that altering your body can also alter the anxiety in your mind. Here are a few ways to bypass the mental and go straight to calming down your body.

1. Deep pressure

Deep pressure is something that tends to work for people on the autism spectrum, but if you find it comforting, then GO for it. Deep pressure is basically what it sounds like: providing a lot of pressure on your body to help it calm down. This could be a weighted blanket, a strong hug, a weighted vest, or even just burritoing up in your blankets nice and tight and snuggly. Try experimenting and see what works for you!

2. Exercise

No, exercise will not cure your anxiety. Don’t worry, I will not tell you that. What exercise CAN do is a. work as a a helpful preventative measure, and b. help you to regulate yourself when you are feeling anxious. If it’s safe and healthy for you to do so, one method is to exercise as vigorously as possible for 5-10 minutes (full on sprint, or something equivalent), and then calm down to a walk or cooldown. Normal exercise can also help let out some anxiety, but at least according to my therapist, the intense exercise followed by a more relaxed pace does some tricky shit to your body that gets it to calm down quickly (I do not understand this science, nor am I a scientist, so take this with a grain of salt and see what works for you). Sometimes all it takes is a walk to shake up the anxiety.

3. Ice water

Be careful with this one if you have any heart conditions or similar issues. However if you don’t, and you have some time and space, this is one that can REALLY affect you and have immediate results. Fill a bowl with ice water. Now stick your face in it. Yup, that’s the whole thing. The important part is to get the ice water on the place just below your eyes. Again, some physiological magic happens that helps your body calm down. If that’s too involved you can hold ice against your face, or an ice pack, but focus on that area where you get bags under your eyes. I’ve never personally been a fan of this one, but it might work for you!

4. Intense sensations

One good way to distract from anxiety is to do something that you HAVE to pay attention to. Physical sensations are a great example. Hold ice cubes, punch a pillow, take a hot shower or bath, or listen to music that really speaks to you. Pay close attention to what you’re doing instead of on the anxiety.

5. Notice your body

Anxiety often comes with physical manifestations: tensed muscles, an uneasy stomach, or a clenched jaw. Take stock of what your body is doing, and if possible, adjust it. You can unclench any muscles or body parts that are tense. You might use breathing to calm your stomach. You might stretch if some of your body parts are feeling tight.

 

6. Notice your physical needs.

It’s really really easy to forget about your basic needs if you’re very anxious, but sometimes the most basic levels of self care are the most effective. Take stock of your physical needs. Are you hungry? Thirsty? Do you have a headache or other pain? Do you need sleep? Have you moved your body at all today? If any of these needs are not fulfilled, or if you’re dealing with pain, try to manage that first. You’ll often find that your anxiety decreases once you take care of your body.

CBT Techniques

These techniques are more about challenging the thoughts that are leading to anxiety. I don’t tend to find them as useful, but for some people they are the most helpful of all, as they head on address the anxiety. Test them out and see what works for you.

1.Check the facts

Of all the exercises for thinking your way out of jerkbrain territory, check the facts is my favorite. Essentially you sit down and see if your emotions are based in facts or not. Sometimes you might want to check in with other people to see if you’re perceiving a situation correctly. So for example if you feel incredibly anxious about a test, you might ask whether you’re prepared for the test, whether you have a history of doing poorly on tests, or whether the test is likely to have a huge impact on your future. If you have clinical grade anxiety, in many cases your anxiety will not be commensurate with the things that are actually happening.

2. Gratefulness

I personally despise these types of exercises because the good things in my life don’t seem relevant to whatever is making me upset, but for some people they work really well. Essentially you want to make a list of the things you’re grateful for in your life, as a way to combat anxiety about the bad things that are happening. If you’re feeling particularly down on yourself, you might also make a list of qualities about yourself that you like.

3. Work!

As mentioned before, distraction is often a good way to decrease anxiety in the moment. If you know of something that requires your full attention, that can be a great distraction. Maybe it’s working, reading a book, doing a tricky puzzle, or some other form of work that is high concentration. Some people find that the anxiety distracts them too much, but if you can get focused, it’s a great way to distance yourself from the anxiety until you feel more calm.

4. Challenge your thoughts

It’s easy to think that anxiety comes directly from a situation. In reality, anxiety typically comes from thoughts about a situation. For example you might think that you are anxious because you are supposed to go to a party. But in all likelihood you’re having thoughts about the party, for example “I will be awkward,” “No one will like me,” “I won’t know how to behave.” Those thoughts are what leads to the anxiety. If you can identify which thoughts and beliefs are leading to the anxiety, you can ask yourself whether those thoughts are realistic or true. This can be another place to ask for help from someone who might have a less biased opinion about whether no one will like you. If you can start to believe thoughts like “I can find one or two people to talk to at this party” instead, your anxiety will decrease.

5. Probability estimates

If you like facts, this is a great technique for you. Many times we feel anxious about things that are not very likely to actually happen. It can be good to spend some time estimating how likely it is that the event will actually happen. If you’re very anxious about getting on a plane, you might read up on the statistics of how often crashes actually happen (it’s really, really rare). Focusing on those statistics can help remind you that you are most likely going to be completely ok.

Now that this post is over 2000 words long, I think it’s probably time to stop. If you have more ideas or suggestions, feel free to add in the comments. Remember that none of these ideas are a treatment plan that will help you address clinical and chronic anxiety. They’re just things that can help. Good luck!

 

What Needs to Be Said About the Orlando Shooting

I’m about to say a lot of things that will not be mind blowing. People have already said all of them, probably better than I can. But I try to think of myself as an ally, and ally is a verb not a noun, which means I need to do something. So if more straight, cis folks like myself need to keep repeating basic truths until America pulls our collective heads out of our asses, then I will do it. Repetition is a key to learning, and straight America has some learning to do.

The shooting in Orlando was a hate crime against the queer community. Gay bars are safe spaces for many people, where they go to find community, support, and acceptance. The shooter has made homophobic comments before. The choice of location was not an accident. This was an attack on the queer community. If you believe that with marriage equality the GLBT community is fine and should stop asking for more, stop and look at what just happened. 50 people were murdered for their sexuality and gender identities. People in the queer community die every day, of suicide and violence and poverty and AIDS left untreated and homelessness. This community is vulnerable, and that vulnerability was exploited in this attack.

The shooting further targeted one of the most vulnerable populations in the US: trans women of color. The club was a popular place for Latinx individuals, and hosted drag shows. It just so happened that the night of the shooting featured Latinx drag performers. This is not a coincidence. The fragile masculinity that pervades America says trans women are a threat to everything we care about. It’s not a surprise that they are the target of so much violence when their very existence is a symbol of fucking the patriarchy.

The shooting in Orlando was a product of toxic masculinity. When physical strength and violence are lauded as the symbols of masculinity, we create people who deal with their problems through violence. The shooter had a history of domestic abuse. When we excuse rape, intimate partner violence, and domestic abuse, we make it so much easier for the violence to just keep escalating. We send the message that violence is how to deal with problems. Toxic masculinity demands that men don’t show emotion and affection, which makes two gay men openly kissing a terrifying and horrifying prospect. It says that men have a dominant role, and any man taking on the woman’s role is a disgusting perversion, giving rise to further homophobia and violence against GLBT individuals, in particular trans women.

The shooting was related to the homophobia rampant in many Islamic communities. The shooting is not an excuse for Islamaphobia. This is where things get a little bit complicated, but I think we can all hold these two truths together. There is homophobia in many Islamic communities. It can contribute to the attitudes of the members of those churches. This is not unique to Islam. Many Christian churches contribute to negative attitudes towards queer people. We need to be able to criticize the damage that religious beliefs are doing without jumping to full blown Islamaphobia that says this man was an extreme terrorist sent by ISIL to destroy America. See the difference? Homophobia in Islam contributed. Every Muslim every is not an evil terrorist.

The shooting is further evidence of America’s gun problem. Yes, America is a unique place and we cannot wholesale import solutions from smaller countries or from Australia. But it is a fact that our gun violence far outstrips other comparable countries and we need to do something. It remains true that guns are dangerously unregulated, and individuals are capable of purchasing unnecessarily high powered weapons that can kill at a rate that knives or homemade weapons cannot. It remains true that guns are less regulated than cars or chemicals or all kinds of other things that are less dangerous. We need to face up to the fact that our obsession with guns is killing people, and we need to start actually doing research into how to make it better.

The shooting is not evidence that the shooter was mentally ill. People with mental illness are far more likely to be the victims of violence than the perpetrators. There are many complex reasons that an individual chooses to commit horrific acts, but dismissing it with “they were insane” lets us off the hook for the ways that we have built a society that fosters violence. It also throws mentally ill people under the bus and makes them responsible for violence when in fact they are an already vulnerable group of people. We do in fact need better care for the mentally ill, but now is not the right time to talk about it.

Finally, and most importantly, if you consider yourself an ally, now is the time to show it. Speak up. Tell your queer friends they can rely on you for support right now. Give blood. Give money to GLBT organizations. This event was horrific, but if you are an ally then you need to step up. I am actively calling on my fellow straight, cis individuals to mop up our mess. Take care of the queer people in your life. It’s the least we can do.

My Self Care is Not Your Damn Business

I’ve been pissed off this week. Pissed off to the point of being incapable of doing my normal work and becoming so anxious and twitchy that I needed to call on some mindfulness skills that have gotten pretty rusty. I want you all to know this because I want you to know the consequences of trendy, uninformed, bullshit thinkpieces and their kin, the edgy Facebook status.

This week I just can’t seem to get away from people making commentary on others’ self care routines. Unsurprisingly, most of it hinges on “Tumblr self care,” that holy grail of joke fodder that is in large part created and consumed by teenagers and young adults. I want to make a note of that, because it’s important to realize that Tumblr is in large part young people struggling to understand how they exist responsibly in the world. It’s especially a lot of outcasts, introverts, and mentally ill folks who are young and trying to understand how to deal with the pain they feel while also maintaining relationships and contributing to the world.

So first and foremost, can we cut Tumblr a bit of slack? We all struggled with this same kind of thing when we were younger, so stop shitting all over today’s young people because they happen to be sorting it out online instead of in their basement. The world isn’t ending because young people are trying to figure things out.

But second, the messages that we are sending to these young people in response to their (honestly not that big of a deal) posts about self care are completely toxic. I want to start by giving you an idea of the types of messages that most people with mental illness hear on a regular basis. It’s incredibly common in the U.S. at least for the message “you are what you accomplish” to get ingrained at a pretty early age. Where I grew up, I was also often sent the message that we don’t talk about our feelings very much, we deal with them, and we move on. Once you commit to something you DO NOT back out of it or you’re a bad and flakey person. You don’t cause drama or act negatively, because no one wants to be around a drama queen and you’ll end up with no friends. Don’t be selfish, give more to other people than yourself, your life isn’t so bad, other people have it worse, why are you upset there’s nothing to be upset about get over it, I bet if you just exercised and ate healthy you’d feel fine, blahblahblah. No one is living their life in some sort of uncertainty about whether their friends like them flaking out or whether it feels really great to not be able to get out of bed. The messages of guilt and shame around emotions and mental illness start early and come often.

Unsurprisingly, people with mental illnesses also tend to be people with hyperactive senses of guilt and shame anyway. There are a few personality disorders out there that don’t have those as symptoms, but nearly every other mental illness includes guilt, shame, or self-hatred as some element of its symptoms. SO. Can we all please start from the understanding that there really isn’t an epidemic of depressed and anxious people parading around oblivious to the way their actions affect others, totally ok with the fact that they can’t deal with life? There MAY be the usual packs of teens and young adults who are still figuring out the ways their actions affect others, or how to find some balance in their lives, but that has to do with being 14-18, not with having a mental illness.

So with all of that history of serious guilt and stigma and internalized bias I get real pissed off when I see stuff like this:

“Seriously, nothing is worse than the writing and the ~comic strips about mental illness~ and the pandering videos which tell us that people with anxiety are these fragile butterflies who must be catered to at every turn. ‘Just take care of yourself,’ this rhetoric says. ‘Practice self-care! Take a bath! Cancel your plans! Don’t explain yourself! If your friends can’t give you space and be totally understanding, that means they’re not your friends!!! They’re toxic! GET THEM OUT OF YOUR LIFE. You have no obligation to keep around Toxic People. If you need to throw your phone into a river and spend two weeks locked in your room eating Ding Dongs, that’s what you need!! :3′”

There are approximately a billion things wrong with this paragraph, so I’m going to start with the most obvious one: this person doesn’t link to any evidence that these people or this advice exists. What I see when I go on Tumblr is a lot of people reminding each other that they’re valuable, that emotions aren’t bad, that it’s important to eat and sleep well, notes about taking your meds or exercising, and a few about the fact that it’s important to choose your friends carefully because some people will leave you feeling worse than you started. Some are little things, like goals to drink water or buy something that you particularly enjoy, or suggestions to try a coloring book or a bath. Some of them are about setting reasonable boundaries, and reminding people that they should take care of themselves IN ADDITION TO OTHER PEOPLE. And sometimes it’s just little reminders that things will be ok.

You know what I see nowhere? Ignore your friends and don’t tell them what’s up. You’re better off alone. I see the exact opposite of that. I see people trying to connect with each other. So the first issue I have is that this is responding to a problem that doesn’t exist. I also fail to see how people writing or taking a bath hurts ANYONE. The way people seem to equate “doing things for yourself” with “being selfish” is a serious problem and contributes to the ongoing struggle many people have with taking any time or resources for themselves. As you can see in many of the linked examples, people talk repeatedly about having a hard time with giving themselves time and care. That’s WHY the dialogue at the moment is so one-sided. We don’t need any more reminders that we should think of other people too. Those are already everywhere (as discussed above). So these messages exist to combat the current climate, and so don’t feel the need to pussy foot around things or talk about how you also need to take care of other people. People who only look at messages like “it’s ok to cut someone out of your life if you need to,” are ignoring all the messages that say “only bad people give up on their friends.” Do you see the fear in this article? It’s completely tinged with the terror that all the ways of dealing with mental illness are bad and wrong. We don’t need more of that. We don’t need more thinkpieces telling us that we’d better watch out or our mental illness will sneak up and make us jerks (and it will be our own fault).

Most of us have already had friends disappear on us, or been told we’re selfish and self-absorbed, or that we’re manipulative and abusive, even when we’re trying so hard to be ok. We don’t need more reminders to watch our backs, or keep from getting too selfish in our self care.

And beyond the people guilting us for just engaging in self care, I’ve seen the start of battles between people who like different types of self care. In particular, I see a lot of people who prefer more “active” or “accomplishment” type forms of self care looking down on self care that’s a little more basic. Most people with a mental illness know that they should get out of bed, take a shower, eat well, exercise, clean their apartment, call their friends, etc. That’s why there’s so much effort to validate the other kinds of self care: it’s ok to hide under the blankets sometimes. It’s ok to wear pajamas to go see your friends. It’s ok to spend a little extra on that latte if it means you’ll have the energy and emotional wherewithal to get to work today. None of this says “you should probably always do these things because they’re really productive.” It says they’re ok to do sometimes.

As someone who really does thrive on self care that is very sensory and very basic (footie pajamas, a mocha, my cat, a chewy necklace), I can guarantee that I don’t do these things to replace my basic life skills, nor do I use them to focus on myself over other people. I often end up feeling childish and incompetent. I need reminders from my friends that I’m not hurting anyone, and that there’s nothing inherently great about looking dignified. I certainly don’t need someone to tell me that I’m trite and my mental illness isn’t “real” or “gritty” enough because I use “cute” coping skills. I’ll use whatever damn well makes me feel better, even if it’s riding a unicycle while playing the kazoo. I don’t care how it looks, and the reality of mental illness is that when it hurts that bad you don’t care if you look stupid, you just need it to stop.

The hierarchy of “productive” self care over “useless” self care and the anxiety about being good to friends is not just thoroughly unhelpful in general, it also screws over people who happen to have physical disabilities or who can’t afford a gym membership and good food or people with chronic pain. It creates more stigma against people who can’t easily leave the house, or who might have days that are unexpectedly painful. There is no good reason to tell people that they should stop using coping skills that are working and that don’t hurt anyone.

Now what is true is that sometimes people with depression or anxiety do become self absorbed because their own pain overwhelms their ability to look at much else. This however, has little to do with someone’s self care routines and more to do with the actual illness: when you cannot physically get out of bed, you are generally not at your best as a friend. But the solution to this problem is to increase the number of coping skills and self care options available, not to increase the guilt and shame. The more blame we place on self-care, the more we miss that it’s actually helping improve the situation. I know that I am a better friend when I let myself cancel sometimes and show up when I will actually be a decent person to be around, when I take some time for myself so that I can listen and support my friends. I am a better person and a kinder human being when I treat my depression. That treatment includes self care, everything from the tiniest fidget to the expensive massage, and the showers and cooking and sleeping and cleaning in between.

I know that this has gotten long and ranty, but there is nothing that ruins my day faster than people saying that there are right and wrong ways for me, in my own life, to deal with my mental health, and then heaping guilt on me for not doing what they think is right. There’s a reason the dialogue around mental illness has turned to (perhaps too much) validation and love: it’s because those things work a whole lot better than shitting on someone. There is no reason to continue perpetuating stigma against mental illness under the guise of being “edgy” or “real.” Stop.

Neurodiversity is Not An Autism First Movement And Cannot Be Autism Exclusive

Disclaimer: this post is about my personal experiences with the neurodiversity movement. If others have more positive experiences, please point me in the direction of those communities. I would love to find them.

The concept of neurodiversity originated in the autism movement, and was created by an autistic person (from the research I have done, it was created by Kassiane, although as an internet term it’s a little bit difficult to know who was the first person to ever use it). Most everything I’ve ever read about neurodiversity is written by an autistic person or is focused on autism acceptance. Few mention other neurodivergences by name.

Ableism is unfortunately incredibly common, but for some reason I see a disproportionate number of conversations about ableism circulating around autism, and when people are accused of not understanding or being comfortable with neurodiversity, it’s nearly always that they have not respected autistics or their needs well enough. This first came drastically to my attention a year or so back when an autistic writer got into it with Rebecca Watson over using the phrase “too stupid to breathe,” (and apparently additional comments, although no one has been clear to me about what those comments were). It ended with Rebecca asking that writer to leave the site.

Many people have criticized Skepchick of being ableist since then, but for some reason no one brings up the fact that nearly every writer on the network has some combination of depression, anxiety, PTSD, eating disorders, ADHD, dyslexia, or a personality disorder. There are many writers who write openly and often about those issues on Skepchick (including yours truly). IT is of course possible for a place to include many neurodivergent individuals and still be ableist, but it seems odd to not address those neurodivergent individuals when asking if the place is welcoming to them or not.

Note: none of this is to speak one way or the other on how that incident went down. It is to say that many other writers who are neurodivergent were blatantly ignored in the conversation. I find it telling that none of them have autism but do have mental illnesses or learning disabilities.

I’m incredibly grateful to autism advocates for starting this movement. What I’m not ok with is the way that any form of neurodivergence other than autism seems to disappear in discussions of the movement. Sometimes learning disabilities or ADHD get a shout out, but despite the fact that I am deeply enmeshed in the movement, I still find myself unsure if mental illnesses “technically” count as neurodivergences. But if anything is a sign of your brain working a little differently, chronic anxiety, depression, or a personality disorder has to be it. And if the neurodiversity movement wants to be serious about accepting and supporting all diversity, they have to be willing to accept those whose brains changed over time, not just those who were born that way.

I am multiply neurodivergent. I only found out this month that I am autistic, and still have not talked publicly about it very much. I have never felt welcome in the neurodiversity movement. I often find that my experiences are talked over by folks with autism because mental illnesses occupy a hazy status in the movement. Some people don’t want to be associated with them because they are more clearly “broken” or “disordered” than autism. That is not ok.

If someone doesn’t understand autism or isn’t willing to make certain adjustments for autistic individuals, it doesn’t seem to matter whether or not they have been strong supporters of folks with other neurodivergences. And I understand that doing well many times doesn’t fix messing up. But why aren’t we even talking about it?

The latest incident happened over at The Mighty. They posted something fairly shitty, people called them out on it, they took it down and apologized. I feel like it should have been an open and shut case, because they took full responsibility for a lapse in judgment and did what they had been asked to do. But instead, people started jumping on the ‘fuck you Mighty’ bandwagon. Now there have been a number of criticisms, some of which seem really legit (way too much inspiration porn, not enough people getting paid) and some of which I have issues with. Namely that many criticizers say that the Mighty is prioritizing parental voices over the voices of people who are autistic and disabled, and that they don’t post from people who actually are disabled.

Which is, to be honest, bullshit. The post that fucked up in the first place was written by an autistic. I write for The Mighty and I am clearly, openly, someone with not an NT brain. The one place on the Mighty that does seem to be parent dominated is autism articles, but if you look at the mental health writing it is primarily by people who have mental illnesses. For some reason that all gets ignored and talked over by the people who say that we need to have platforms for people with disabilities.

You don’t get to ignore the voices of people who don’t agree with you and act as if their identities don’t exist because they aren’t how you express your identity. There are autistic people on The Mighty who are parents and post those Mommy Blogs you hate so much. And those people are still autistic and they still have a place in the autism community. There are people on The Mighty who post useful, interesting information about how they deal with their mental illness or disability. They count as part of the neurodiverse community that we’re aiming for, even if they aren’t autistic.

And that’s true of a lot of sites that are criticized for being ableist. Other disabilities, especially things like depression, anxiety, personality disorders, or eating disorders, get ignored. Sites are criticized for not listening to disabled voices when the people being criticized ARE THEMSELVES DISABLED. This is mind boggling to me, as the neurodiversity movement purports to be helping all people who aren’t neurotypical.

If you want to have a conversation about the right and wrong ways to talk about and approach disability that’s fine. But when your criticism is “you’re not listening to disabled people and you’re silencing disabled voices” you better make damn sure that you’re not talking to any disabled people because you have just erased their identity. And I see that happening over and over in incidents when neurodiversity advocates are calling out ableism.

There are important criticisms to be made of a variety of sites that host parents of people with disabilities or even people with disabilities themselves. There is such a thing as internalized ableism, and it’s important to call out things like inspiration porn or sites that host more parents than individuals actually affected or parents sharing personal information without a child’s consent. We should talk about these things. But those sins are not the same as silencing disabled voices. They are about balance and how all people (including neurodivergent individuals) tell stories about disability. And more often than not, an organization is not all good or all bad. It is more and more common for a site to be hosting mentally ill individuals writing about their own experiences but focusing on parents instead of developmentally disabled folks. That’s a dynamic we should be talking about.

But I do not feel welcome in the neurodiversity movement when the (very real) criticisms about autism parents are allowed to eclipse any writing that I may do or the fact that there are boatloads of neurodivergent people speaking up about their (not autistic) experiences. Those experiences just don’t always match up with what neurodiversity advocates think they should be, and they often aren’t about autism. There needs to be space in neurodiversity advocates for all kinds of neurodivergence. The movement cannot prioritize the needs of autistics over anyone else. I recognize that the focus on autism comes from a history of abuse, but autistics aren’t the only ones who have lived that history. Neurodiversity movements need to do more work to accept and support the diversity part of  neurodiversity.

I want to love the neurodiversity movement. I just don’t see it loving me back.

Depersonalization vs Dissociation

Recently I’ve seen a good article on depersonalization disorder floating around. Like many people, I’d never heard much about depersonalization, despite the fact that I have experienced it for extended periods of time in my life. But when I read this description, I felt both a sense of overwhelming familiarity and also some serious confusion. Because what they were describing was something I had been told was called dissociation.

So just to clear things up, I have researched the differences between depersonalization and dissociation so that you don’t have to. Both of these are surprisingly common experiences that don’t get a lot of airtime and could use more attention. So let’s clarify terms and learn! Huzzah!

 

You can find this full post at Aut of Spoons.

Flavors of Depression

There are many, many things that make coping with depression difficult, and I’ve talked about many of them over the course of this blog. But one that I’m not sure if I’ve touched on yet is what I can only call the different flavors of depression. A friend of mine recently brought it to my attention by pointing out that different difficult times come from different needs: sometimes you may need to unwind and feel distracted, other times you may need connection, still other times you may need to feel accomplished and useful.

For me, it can be incredibly difficult to feel out what I need when I’m in a depressive episode, especially because what I need can change drastically from day to day (and sometimes hour to hour). So the best I can do is try to suss out what kind of depression I’m feeling. I don’t have a clear sense of what I want most of the time, so I try to pay attention to what I’m feeling. Of course I’m feeling depressed, but what KIND of depressed.

For people who don’t experience depression, it might not be clear that depression refers to a wide variety of different feelings and states. Sometimes depression is an incredibly strong and passionate kind of a feeling. It can feel as if everything is going wrong and everything hurts. That flavor of depression is often the self-hating variety for me. It’s an incredibly immediate feeling that often comes with crying fits. But sometimes it’s not an emotional experience at all to be depressed.

Sometimes depression is feelings of complete and utter numbness and emptiness. Sometimes my mind will pull out and out and out in perspective until my entire life feels tiny and pointless. Those are the days that I’m not sure I can even get out of bed because I don’t know why. Everything feels far away and my body does not feel like my own. It comes with dissociation and suicidal thoughts. This is the flavor of depression that scares me more than anything because I feel dead inside.

Of course the overwhelming feeling in almost every depressive episode is something like “bad no good can’t do not like” which is incredibly unhelpful. Instead of getting overwhelmed at that point, a good strategy for me is often to try to listen to what I want.

Now to be clear, what I want is definitely not always what I need when I’m depressed. But I can typically get a better feel for what needs I am not fulfilling when I think about what sounds appealing in a given moment. That can help me suss out if I’m the kind of depressed where I should hang out with people or the kind of depressed where I need to take a break from life for a little bit or the kind of depressed where I need to go work out.

For example if all I want is to lie in bed and do nothing (as has been the case recently), I know that anhedonia is one of the problems, and that what I’m really craving is something that makes me feel accomplished. It also tells me that I need to spend as much energy as possible finding something that will feel enjoyable in this moment, because anhedonia saps my ability to feel pleasure in anything.

At other times all I want is to talk. Sometimes it doesn’t even matter who, I just feel as if I’m drowning in my own mind. This one is pretty easy to figure out: it means I’m missing connection and community. I feel lost and I’m starting to lose the ability to differentiate between rational, reasonable thought and the thoughts that my depression and anxiety mix in.

When I first became depressed, I didn’t quite get the ways that depression has moods. No person’s emotions remain completely static for days and months at a time. Even when you’re depressed, the subjective experience, the focus, and the strength of that depression shifts and changes just as it would for anyone else.

This is one of the things that makes it difficult not only to determine what coping skills are best for you at a given moment, but also how to ask for help. Many times a friend or partner will ask me what I want to do or what sounds helpful and I cannot answer. That’s because depression changes regularly, and in order to figure out what would be helpful I have to do the emotional work of sifting through all the feelings to determine which flavor I have today. In the midst of an episode, that can seem overwhelming and impossible.

If I could ask anything of support people, it’s helping me through this sorting process. Asking me easy questions like “what is your first impulse of what to do right now?” or “tell me what it feels like.” Those questions can help guide me to understanding what I need.

If I could ask anything of myself it would be patience. I always want to fix things. With depression, I need to understand them first.

Curb Cut Effects and Mental Health

This weekend I was at a work conference about autism for my new job (which is as a side note the best job ever), and I was once again struck by something that other people have noticed before: curb cut effect. The basic concept is that many things that disability advocates push for actually help more people than just those who are disabled. People in wheelchairs pushed for those areas on curbs that have a little ramp instead of the sharp curb so that they could make it from street to sidewalk easily. It ended up helping people from parents pushing strollers to the elderly, even though no one imagined that it would help anyone but people in wheelchairs.

I have an anxiety disorder, which is a big part of why I’m a fidgeter and a finger picker. When I don’t have something to fidget with I often end up ripping at the skin around my nails until I bleed, sometimes without realizing it. As part of the merchandise at the conference there were tons of little fidget toys, things like tangles, silly putty, and other small things you can play with to keep your hands busy. They’re incredibly popular and helpful for people with autism who need sensory input or have trouble focusing. And although I am nowhere near the autism spectrum (I’m more on the overly emotional end of things) I jumped at them and got a couple that didn’t leave my hands the whole weekend. They helped with my anxiety and left my fingers fully intact after a long weekend of difficult socializing.

Over the weekend I spent a lot of time around people who had learned to communicate in a very straightforward manner, and found that I could better understand social cues. There were also a lot of precautions to keep things relatively quiet and calm on the sensory spectrum so that those who were sensitive could stay around and be comfortable. And let me tell you it was absolutely fantastic.

The curb cut effect doesn’t just apply to physical disabilities. It applies to mental illness and mental disabilities as well. This is something that is widely ignored, but could be incredibly helpful for mental health advocates to keep in the forefront of their mind as a way of reducing stigma. One great example is therapy. Most people assume that making therapy widely available, covered by insurance, and easy to access is good for people with depression or mental illness. It turns out it’s probably actually great for just about everyone, since almost every human being needs some support for their mental health at some time in their life, and no person comes fully equipped with emotional skills. These are things we all need to learn, and therapy can help with that.

The more we keep in mind that therapy is something that helps everyone, but that some people might get more out of it than others, the more we can lessen stigma. It changes therapy from something exclusively for “crazy” people and into something that all healthy people do. (Disclaimer: not everyone has to go to therapy and therapy doesn’t work for everyone, but it can be helpful for people in all kinds of situations.)

Even things that seem far more specialized, like social skills training or fidgets or even just asking the people you’re with about their sensory preferences, can help tons of people who might have a little anxiety or body issues or social anxiety. But for some reason those things are only available if there’s a complete breakdown.

I think the curb cut effect can teach us a lot about preventing problems, and if we apply it to mental health it might go a long way towards giving people the tools to take care of their own mental health before something snowballs into a bad place. Mental health tools should be available to everyone.