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!

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.

The Guilt of Being a Support Person and the Guilt of Being the Sick One

In recent weeks and months I have been spending more and more of my time on the support person side of the mental illness equation. For about five years previous to that, I was the sick one, the one who needed to rely on others to support me and help me with some pretty basic things. I still have to do that sometimes now, but I’ve started to find myself stable enough to take on the role of support person for certain friends and family.

There’s something that I want to say to everyone who has mental illness in their life, on both sides of the relationship: it’s not your fault.

The more time I spend interacting with my own and other people’s mental illnesses, the more I see the overwhelming feeling that drives the experience is guilt. The guilts look different.

When I was sick, the guilt was the guilt that I was a burden, that I was sucking too much time and energy from the people I loved, that there was something wrong with me that could never be fixed. It’s easy to feel guilty when you see how much you are hurting the people around you simply by trying to survive. And when your brain is in the midst of serious depression, any criticisms start to feel like commentary on your worth as a person. It’s easy to live completely within guilt, and start to feel as if you need to apologize for your existence. Being the sick one is something that comes with a side helping of guilt not just internally, but from a society that asks why you can’t deal with things on your own, why you’re so sensitive, or why you have to be such a burden.

But what I didn’t understand until recently was the guilt of being the support person.

Right now, some of the people I’m trying to support were there for me through my mental illness. There is a part of my brain that interprets that as an obligation I now have to return. They were there for me, which means that I am never allowed to abandon them. There are lots of versions of this form of guilt: I love this person and they love me, so I must be there for them. This person supported me through grief or illness or childhood or any other difficult situation, which means I must be there for them.

There is the guilt that comes with not being able to do anything. You can sit and watch someone you care about hurting, and there will be times when there is absolutely nothing that can be done to change it. There’s the guilt of taking care of yourself, perhaps the most insidious guilt of all. No one can be on all the time. No one can always be available and ready to provide support and care, or even just time to listen. Every support person (and every “sick” person) gets time to set boundaries and do what they need to to take care of themselves. But the narratives around support tend to be all or nothing rather than nuanced: you are always available, or you are never available.

I understand all of these guilts. The problem is that mental illness is no one’s fault. Difficult things in life happen. Hard emotions happen. There are certainly ways to respond to them that should elicit guilt, but their existence or your inability to eradicate them is nothing to feel guilty over.

I think what I want more than anything is to be able to talk about the guilt. Whenever I say that I think it’s my fault I get empty reassurances. I want to sit down with the people I love and break down the ways that the mental illness makes our lives suck and then remember: none of us caused this. None of us are required to fix it. Are you doing your best? You have no cause for guilt.

But you get to feel guilty. If you need to. No matter which party you are.

Asking for Help and Taking Responsibility

When someone you care about is dealing with depression or a mental illness, it can be incredibly hard to figure out how much to help and how to take care of yourself while also being there for them. And when you are suffering from a mental illness, sometimes it feels like all you can do is just yell for help. Two things that all parties are often told is that everyone is responsible for their own emotions and that it’s important to ask for help. I have found that on both sides (as a support person and as someone suffering), these two things often feel contradictory.

Let’s say you’re feeling really down. You go to your best friend and you tell them you’re struggling.  You tell them you don’t know what to do. You say “help”. From your perspective, you’re taking responsibility. You’ve owned up to your feelings and now you are asking for help. From their perspective, it seems like you’re foisting off the responsibility for your emotions and they’re expected to simply fix what’s happening, make it better, make you happy. Who’s right? Where’s the balance?

There is a difference between asking someone to help you take care of your mental health and making your mental health someone else’s responsibility. No one else is capable of fixing your depression or anxiety or sadness or whatever else might be getting you down. Sure, they might be able to alleviate it for a while (especially if you’re dating them and you get the nice fluttery feelings around them), but that doesn’t actually turn out to be a long term fix. It’s too much pressure to be the only source of someone’s happiness, to be expected to turn on a switch that makes the bad go away. It’s taken some time for me to start to identify the signs of “fix me” rather than “help me”, but for those who are still navigating a relationship in which mental illness plays a role, here are some things to watch out for.

1. Diversify

We all need people. It’s part of our emotional needs. We need to socialize, we need to talk, we need people to take care of us when we’re sick and people to share things with. All that makes perfect sense. But as adults, we also need to realize that no one person can meet all of our emotional needs. There’s simply not enough time in the day. That’s why we have networks with a variety of people. Our networks don’t have to be huge: mine is basically my parents, my boyfriend, and one or two close friends (plus my therapist). But each of these people provides a new perspective and can support me in different ways. It means that when my mom is having a horrible week at work, I can give her some space and go ask my boyfriend to hang out with me for a bit. No one should be required to always be on call, and if you find that you’re constantly waiting for one person it might be a good time to think about building up some other relationships.

2. Make a good faith effort

If your first recourse when you’re depressed is to call that certain someone, this might be a sign that you don’t have other coping mechanisms or that you aren’t trying to rely on yourself. It’s certainly ok to call someone, but there should be other tools in your toolkit that you’re willing to reach for first (and this can be dependent on the seriousness of a given situation. If you’re experiencing severe suicidal ideation then PICK UP THE PHONE. If you’re feeling kind of blah and bored and empty, then see what options you’ve got). This can also be on a larger scale: if medical help is feasible, you should probably be willing to try that out (e.g. meds or therapy). You might try changing your situation (volunteering, getting out of a bad housing situation, etc.). Of course making an effort is one of the hardest things to do when depressed, but before you tell your friend/SO about how miserable your day was, you should at least have tried to get out of bed, shower, and leave the house.

3. Articulate what you need (as best you can)

One of the things that leaves a support person feeling like they should be able to snap their fingers or wave a magic wand and just “fix it” is when their loved one doesn’t give some hint of how to help. Of course there are times when we don’t know what we need and we have to do our best to explain how we’re feeling and ask for a general kind of help, but as best as you can, let the other person know what you need. Tell them if you need to vent or if you need to brainstorm solutions. Call someone up and say “I need a distraction do you want to go out” instead of simply saying “I’m bored help”. This means more work on your part. You have to brainstorm what might help you. That’s part of being responsible. If you can’t figure it out, you can ask for help figuring out what you need (e.g. “I feel horrible and I can’t figure out what to do. Do you have any suggestions?”). Simply expressing how you feel without giving the other person an idea of how they fit in feels like you’re just throwing your depression at them.

4. Be independent

This can mean a lot of things, but at its heart it says please don’t have one person be your only social life, job, or interaction all day long. Have a job, have interests, volunteer, have friends, have a side project. Have things that belong to you and that you’re willing to do by yourself or with a different friend. There’s something intensely unpleasant about having another person waiting around for you all day to entertain them. If your partner/support person sees you at the end of the day, your answer to “what did you do today” should not always be “nothing”. Sure there are days when you can’t manage anything. Sure, there are days when the depression gets too bad and all you can do is crawl out of bed. But if the only times you get out of bed, get dressed, talk to people, accomplish something, or have fun is when that one special person is there, you’ve made them responsible for you.

5. Never imply or say that the other person is required to be there for you.

I’ve had people tell me that they need me, that they’ll have to kill themselves if I leave, that if I’m not around they’ll hurt themselves, etc. etc. Don’t do that. Don’t call someone from your vacation and tell them how miserable you are because they’re not there. Make a serious effort to have at least a few examples you can point to where you were on your own and you were ok so that they can trust that you can spend a night without them.

That crap is not romantic. It’s cruel.

6. Be willing to feel like crap.

This might sound odd, but for people with mental illness, one symptom seems to be a serious inability to tolerate distress. Because many of us start to panic and look to bad coping mechanisms when we feel bad, our support people worry whenever we are in a bad mood. Something that is oddly reassuring is to tell your support person “yes, I feel like shit right now, but I will be ok. I’ll get through it.” As a corollary to this, if you have to ride out a shitty mood, your partner/support people get to choose how much they want to be around you. It’s nice to give them a little heads up: “I feel like crap right now. If you’d like to come over you can, but I’m going to be miserable company and that probably won’t change at least for today.”  This lets your support person take care of themselves. They can let you know they’re willing to be on call if things go really bad, but they’ll see you tomorrow, or they can choose to see you anyway and brace for a bad mood.

 

All of these things exist on a spectrum. Most of the examples I gave were towards the extreme end. Obviously it’s fairly abusive to threaten suicide if someone isn’t always around you, but that type of behavior can exist in a subtler way (the passive aggressive sigh and “I guess I”ll be ok with you”). But if you notice these types of behaviors in  yourself or your partner it might be a good time to reevaluate what’s happening to treat the mental illness in the relationship and have a frank discussion about who is responsible for what.

Bodies That Change: Weight Loss and Trans Narratives

There’s a parallel that’s been rumbling around in my mind for quite some time now that I’ve been hesitant to write about for fear of stepping into a topic that I know not nearly enough about. I’ve often noticed that whenever I read something written by a trans person, I see lots of parallels with recovery from an eating disorder and with weight loss narratives. And then last week I got a little kick in the pants from a friend who posted an article about weight loss and said they felt parallels with their experience of transitioning.

So I’m just going to go for it. I think there’s a lot of rich support and community that could be built by talking across these boundaries and experiences, and speaking to similarities. I obviously am not trans, so I’m going to do my best not to make statements about the experience that I don’t know anything about, but I will try to pull from places that I’ve heard others describe it and the struggles that they’ve mentioned. I would love to hear any trans perspectives or challenges.

The thing that strikes me most about recovery, weight loss, and transitioning, is that all of these processes circulate around bodies changing (and along the way minds and identities). There is probably some sort of final goal (lose weight, gain weight, present as female/male), but there are all sorts of small changes that a body goes through that must be incorporated into a new identity, projected to the world, adapted to, accepted, and understood as “me” by the individual who inhabits that body. While the particular changes may be different, the experience of “is this me? How does this work? Where did that muscle come from?” is shared. And there are many elements to it that are confusing and difficult which could be made easier by shared conversation from a variety of perspectives.

At the core of all of these things is the process of changing body so that it fits into your sense of who your are: it is creating an identity through a body. In many ways, I think that all of these processes of changing your body are coping mechanisms for feeling that something is wrong with the way you view yourself or the way that others view you, or for feeling as if your body is standing in the way of you creating a healthy identity and life for yourself.

This process is hard. Really, really hard. It doesn’t make sense and there’s really no template for it because asking “how can I get people to take me seriously when my body  no longer takes up the same amount of space?” is not considered Real, Deep, Appropriate work in the social justice community. But this is work. This is the work of understanding that we are physical creatures, and that our physicality can change who we are. This is the work of creating our own identities in such a way that we fully accept the body that is a part of us. Sometimes that involves large, sweeping moments of self-realization and sometimes it involves little things like “I really liked the way I could pick up a heavy couch when I was fat. How do I do things that need strength when I’m skinnier?” It’s the process of learning yourself all over again, but it’s not particularly sexy and it’s not particularly interesting unless it’s your life and you can’t for the life of you figure out how to move your damn bookshelf.

Everything about your body can affect the way you interact with and view the world (or yourself). Having different muscles can affect your mood and energy level, hormone levels can affect your basic perception and sensitivity to stimuli, the sheer amount of space you take up will affect how big, intimidating, powerful, or potentially dangerous you see the rest of the world as. It may seem simple to change your body and switch from checking “female” to checking “male” on the census form, but actually understanding how your body changes your perspective is a much harder and much more subtle process that involves figuring out all those little pieces and putting them together into a new conception of “this is me and this is how I see things and this is how I do things”.

For myself, I have found the process of adapting to my changing body to be frustrating and angering. I’ve often wished that I could talk about it more openly with others, that people were there to commiserate, or that there was just some sort of guide book (will I keep gaining weight forever????). I have heard some of these frustrations echoed in other places, by Zinnia Jones, by those who have lost a great deal of weight. Many of us just want some reassurance that our bodies haven’t turned into something alien and unknown. We want to know that other people’s bodies reacted the same way or similarly. We want to know that we’re still ourselves.

But we also want to know how to relate to the world with a new body. A body that was fat and is now thin is going to take up space differently, move differently, have different strength, touch things differently…even something as simple as sleep differently (welcome to skinniness, where you can’t sleep on your side because your knee bones rub together and it hurts like a bitch). And so many of us are looking for a model of “how do I do stuff when I’m like this”. We’re trying to figure out how to tell other people about our bodies and how our bodies match our selves and what part of our bodies fits our identities. It’s difficult when you’re in recovery to explain your body. The body is often in flux, you’re not “skinny like you were supposed to be”, you don’t entirely understand your body as “right” yet. It doesn’t wholly feel like you. The process of labeling your body and then explaining yourself to others is difficult and something that anyone whose body goes through a drastic change must learn how to deal with.

Learning about how to talk to others about a new body is something we could all use help and support with. How do you respond when someone says “you look different” or “you look healthier” or “you look great!”? How do you tell others what you identify as? How do you look down at yourself or look in the mirror and think “yeah, that’s me. That’s just me”? For me, this process is hardest when I think about my body in the long term. I keep thinking that I’ll drop the weight again, that I’ll go back to the “real me”, that somehow this is just a temporary state of unreality. I have no idea if there are trans individuals who feel this way, but I have heard from some people who went through weight loss regimens that they think about whether the weight will come back, and worry that they’re in a temporary state. I imagine there might be some parallels when you haven’t reached a point of feeling comfortable in your gender identity (sort of in the “still transitioning” point of being trans). I think all of us wonder if the changes will stick, if we should commit to ourselves as we are.

And a big part of that is learning how to internalize this new shape as “me”. While I have never transitioned, I would imagine that it takes a bit of time after hormones/surgery/whatever to get used to the changes (hey I have boobs that didn’t used to be there! That’s odd). For me, it was more along the lines of getting used to being present when I wasn’t entirely happy with how I looked. I wish that I could speak to some of those trans people about how they learned to see their bodies as them, how they learned to view those new manly muscles as “me”, how they started to see boobies as part of their bodies.

One piece of identifying with a new body or a changing body is accepting that there are both pros and cons to any change. For me, I am highly aware of the cons of my changing body (uuugh I’m fat and my thighs rub together) but I often forget about some of the positives (I don’t feel dizzy all the time, I am more physically capable, I’m not nearly as fragile and don’t expect others to walk all over me because of my petite and sickly frame). I think because of the very positive framing of transitioning in the mind of the person who transitions, speaking to people who have transitioned could be an amazing way to remind me of the benefits I’ve gotten from my new body. On the flip side, I think the perspective of someone who is more hesitant to change their body could be useful for someone who is TOTALLY GUN HO about their new body and might need a moment to slow down and learn the ways that their body can’t quite keep up to past expectations.

There are elements to being larger, to being male, to being more muscular that are AWESOME. You take up space. You feel powerful. You feel capable. You even feel like your body protects you from smaller things like hard surfaces or the boniness of your own ankles. But there are elements to being smaller, to being female, to being dainty, that also rock. The world fits you. You get to wear awesome fucking dresses. You’re often allowed to express more emotion and enthusiasm without ridiculous policing. It’s a great practice to recognize the good things about being you right now and being the you that was (sidenote: I am not saying that “female” equals smaller, more dainty and “male” equals bigger and stronger).

Part of this is being honest about the nitty gritty changes, which I believe is a place where all of those whose bodies go through extreme changes can support each other. Your hair fell out, or you get diarrhea constantly, or you get bizarre heart pains, or your mood is all over the place, or your tits are really tender. For people whose bodies haven’t changed these are uncomfortable and overly personal things that shouldn’t be shared. But when your whole world is in flux, it can be extremely comforting to be able to tell someone. I think that’s true no matter the cause of the changes. Recognizing out loud that these are things that are happening can be a big step towards actually accepting yourself. And I don’t think that it matters exactly the experience of the person being open, whenever someone is willing to be vulnerable about these things it makes it easier for others.

At the end of the day, trans narratives, weight loss narratives, and eating disorder narratives are all focused around a body that changes, usually in an attempt to make that body fit with an internal conception of “who I am”. Nobody likes to talk about how the body actually changes, but rather they like to focus on external categories like “fat” “thin” “male” “female”. But in all of these narratives, bodies change slowly, with little adjustments in how we walk and talk, in how much space we take up, in our strength, in how alert and awake we feel, in our moods, in our flipping bowel movements. And for most of these narratives there are pros and cons. Hopefully each person makes a choice that makes them feel more comfortable and more confident in their own body, but change always comes with some cost. I wish that we could talk about what it means to see your body change, to adjust in small and large ways, to move into a new category and identity, to say good bye to some things you might have liked.

I think some dialogue across these spaces could be good for both: we have different concerns about the ways that our bodies change, but I believe we can provide insight to each other. Having an outside perspective that isn’t so wrapped up in the same concerns (ah! gaining weight! ugliness!) might help us see some of the benefits of how bodies change, help us deal with the difficulties, and give us support around the weird little things that happen. And if we can speak across some of these boundaries and labels, we might learn to accept others’ identities a little bit better when we see the parallels to our own.

I’m a Label Lover and I’m Proud

I like to label things. I find that having a word for something, a way to describe it, helps me understand it better. There are many people out there who find this tendency foolish. Just the other day I saw a Facebook comment who derided the labels “asexual” and “questioning” as pointless and a waste of time, bullshit as he said, because they weren’t oppressed in the same way as LGBT individuals. Others don’t like labels because they see them as limiting and don’t want to be boxed in by a word or a phrase.

I understand both of these impulses. I have been known to laugh in derision when I hear labels like “otherkin”, and I have certainly felt constrained by certain labels placed on me (as I’m sure nearly everyone has). But what many of these people fail to understand is the power in labeling yourself, as well as the way that identities build communities. They also forget that self-understanding is incredibly important to self-acceptance, and that having a word to describe yourself can facilitate understanding and acceptance.

I posted recently about a TED talk that described how certain labels can change from an illness to an identity. These include things like homosexuality, autism, and deafness. In describing the change, the speaker focuses on how these communities created a culture under the umbrella of their label, and how that label has come to signify something good to them. These communities are built because people are brought together through a common label. The labels we are given by society point to a certain constellation of traits. We can choose to focus on the negative aspects of those traits, or we can build something positive and different out of them. When we create a culture, a different way of being, out of our labels, we have created identity.

As someone who struggles to find an identity, labels are very helpful. When I can pinpoint a label for myself, I can add it to my conception of my identity. I’m a learner, I’m gray ace, I have depression and anorexia, I’m a writer…each of these helps me to pin myself down and feel more certain of who I am and where I’m coming from. They can create a grounding of self. Additionally, they can help someone see their identity in a positive light. Especially when a label illustrates that there are others out there who are the same or similar to you, it can provide a sense of safety.

Labels can also help to normalize something that feels or appears deviant and unwanted. They can put you in touch with others who have had similar experiences and may be able to provide insight. They give a shorthand to explain yourself to others. And in many ways they can be liberating because they can provide a framework for understanding. Oftentimes a label will focus someone’s attention in a new way on different elements of their self. My therapist recently gave me a new label to try out: explorer. Looking at how this maps onto my personality makes me feel free to explore new things, free to move away from things that scare me, free to see myself positively. While many labels may not appear to be liberating in that way (something like depression for example), they can still provide a path forward.

An important part of this liberation is the fact that a label does not have to keep you from gaining other labels, or even from changing. Many people look at labels as either/or propositions: you are either straight or you are gay. Labels are to me a both/and proposition. I am both gray ace and heteroromantic. I am both depressed and exploring. I was allosexual and now I’m questioning. Giving a name to one facet of your personality does not negate all the others, nor does the label necessitate that you fit exactly every element of the definition. Some people think that if you identify in one way and you behave out of the “bounds” of that label, you’re lying or wrong or betraying the group. If a woman who identifies as lesbian has sex with a man once, that does not negate who she is or how she has felt attraction in the past. A label is a way to name behavior, not force it in particular directions.

More than anything I find that a label gives me a sense of safety, a way to protect myself from endless explanations or defenses of who I am and how I am. A label allows someone to stake out a territory: this is mine. This is my space. This is my self. For some, this is less important than others, but for those who feel pushed around by the world it can be incredibly important. It gives you access to others who will help defend you and show solidarity.

 

An example of all of this would be my experience with the term asexual. An identity like asexual might seem utterly superfluous to some. However when I discovered the term, many of the traits that I had suddenly made sense to me. I saw that others had experienced similar things, people confirming to me that I wasn’t broken or wrong. I saw that people had jokes and bonds over shared experiences that had come out of discovering this label. I saw all the ways that individuals had chosen to express the same shared trait: some people were in relationships, others married, others poly, others kinky, others single and solely interested in friendships.  It opened up new possibilities of what I could do in my life, of what I might want in my life, and of how I could be happy.

Labels can help many people feel better about themselves and their experiences. They can help build community and identity. Some people don’t have these experiences of labels, but it seems unnecessarily cruel to deride others for having those feelings or for wanting labels to help them gain these experiences. For those who find labels helpful, it would be great if everyone else could just back off and choose not to label themselves.

NAMI Week: What Can I Do?

Welcome to National Eating Disorder Awareness Week 2014! I’m going to try to spend this week blogging about issues surrounding eating disorders and eating disorder visibility as my own small part of eating disorder awareness.

To start out the week, I want to try to make eating disorders a little less scary. Oftentimes when we try to shine a light on mental health issues, the average joe who does not have whatever condition we’re talking about gets overwhelmed. What am I supposed to do? If I see someone who seems like they might be dealing with this how do I help?

These are important questions because we are just scratching the surface of psychology and neuroscience, and for the most part we don’t have good understandings of the etiology of mental illnesses. It’s hard to tell someone what to do to help fight a particular illness when we don’t know what causes it. It isn’t like diabetes where we can promote healthier eating and more exercise. Eating disorders are complex beasts that can react negatively to almost anything you throw at them. So during this week of heightened awareness, what sorts of things can you commit to to improve relationships with bodies and fight against eating disorders?

To me, the best place to start is at home. We learn from each other and there are very few models of healthy body image and healthy eating. In a world filled with shitty messages about how you should treat your body and how you should relate to your body, the hard work of feeling at home in your skin is fairly radical.

Fight against Cartesian dualism and see if you can’t learn to see your body as an integral part of yourself. Practice less negative self-talk and judgments. Try engaging in activities that ask you to take up space, like dancing, and revel in taking up space. It may not seem like a lot, but your good mental health can be great for someone else. Some really concrete ways of doing this can be cutting out calorie talk. It’s one thing to say you want more protein and less sugar, but calories are actually really unhelpful at assessing the healthiness of a food and feed into diet culture.

Another thing to try to cut down on is “bad food” talk. Many people like to say things like “Oh I’m being so bad” when they eat something sugary or fatty. No, you’re not, you’re eating something tasty. There is no such thing as bad food and it is not a moral failing if you eat more fat or sugar than is maximally healthy. See if you can stop putting moral judgments on any food. It’s hard. You will see how ingrained size, food, and morality are. The more we can cut those ties the more we create a healthy environment.

But there’s a lot more to eating disorders than food and food discomfort. Obviously. So is there anything you can do to help create a positive environment that will help combat some of the underlying fears? YES! Something that I’ve noticed over and over with my friends and acquaintances who struggle with eating disorders is feelings of inadequacy, feelings that our emotions are bad and wrong, feelings that we will never be good enough or perfect enough.

A great thing to practice towards all people in your life is validation. Validation at its most basic is just letting someone know that what they’re feeling is real. It’s acknowledging their emotions and not passing judgment on those emotions. It can be as simple as saying “wow that sucks” when someone tells you they’re having a rough day. This can be done in conjunction with all sorts of other types of interactions like problem solving, but I’d suggest practicing validating all kinds of people for all kinds of things. You never know who needs it and it’s a good skill to get in the habit of doing. Your coworker says they’re swamped. Instead of one-upping or asking if you can help, start by simply saying “wow that sounds exhausting”. This may not seem like a lot but if you make a practice of it you can do a lot for other people by sending them the message that their feelings are valid, real, and acceptable.

Another good idea might be to educate yourself on some of the basics of mental illness. NAMI has some good resources. I would suggest in particular getting a basic understanding of depression since it’s one of the most common mental illnesses out there. A little bit of understanding can go a long way. Hand in hand with that it’s a good idea to keep your own mental house in order. If you’re struggling, be willing to see a therapist. Take some time to think about how you communicate and how you can improve your communication skills. Make sure you’re taking responsibility for your own emotions and learning about how to keep yourself stable and content. Tall orders yes, but the more we all work on these things the easier it is for people who have serious hurdles.

So say you’ve done all of this and made your best effort to keep yourself and your environment validating and fairly healthy. You’re paying attention to your friends and family, trying to be a helpful person, and you start to notice some of the signs of an eating disorder in a friend. They’ve suddenly become obsessed with food, they’ve started to isolate themselves, they avoid situations that involve food. They may have lost weight suddenly or just become secretive about their eating habits. You hear them making cruel remarks about their body. They start going to the gym ALL THE TIME, or eating huge amounts and then disappearing suddenly. You can tell their mood is down. What on earth do you do now that you’re faced with the real beast that is an eating disorder?

One of the most important things to remember in these kinds of situations is that you cannot fix your friend. It is not your responsibility nor is it possible. Hard to accept, but super important. It can be hard for someone who’s depressed or in the midst of an eating disorder to reach out for help. One good thing to do is offer yourself and your time. Ask them to hang out instead of waiting for an invitation (mustering up motivation and intention to do these things can be nearly impossible when depressed), make sure they know you’re available to talk to, offer to go for a walk with them or do something else you know appeals to them.

It’s important to remember that confronting someone about food is probably the least helpful thing you can do. The eating disorder will interpret this as a threat, double down, and make life hell for everyone. If you’re extremely close to the person you  might suggest that they see a therapist because their mood has been off or down and you’re worried about them, but food is a scary place for someone with an eating disorder. Provide them with options, make sure you’re eating enough and that you’re offering them opportunities to eat, and validate the hell out of them.

There is no one perfect answer to what you should do to support a friend or family member. These are some places to start, but there are also support groups available for friends and family members at some eating disorder clinics and that’s a great place to get yourself if you want some additional ideas and people to rely on. If you can spend some quality time with your loved one, try to listen to what’s really bothering them underneath the food. That may be the most helpful thing you can do.

10 Real Reasons Not to Self Harm

Obvious massive trigger warning for self harm.

There are many, many lists and articles and comments and emails and conversations and every other form of interaction out there about why you shouldn’t self harm. If you have ever hurt yourself and anyone has ever found out, you’ve been subject to a litany of reasons. There are many good reasons to not self harm and lots of really stupid reasons to not self harm. Some people find the generic lists on the internet extremely helpful, but I have never been particularly convinced when I’m in a bad place. They come from a place that assumes I believe in my own worth, and when I want to hurt myself I’m rarely in a state of mind that recognizes that. At a guess, I would suspect that I’m not alone.

At this point, I’ve mostly kicked the habit of self-harm, and I think it can be really helpful for those who have been there to share what helped for them. So here is my list of real, honest to god reasons that I have stopped.

 

This post has been moved to my new blog at Aut of Spoons. Check out the list there.

Changing Habits: The Reaction

In the process of treatment and trying to recover from the grab bag of mental health issues I have, I’ve made a serious effort to change many of my habits. Everyone knows that changing habits is hard: adding a meal where there was none requires a fair amount of effort and planning, adding in more socialization requires thought and energy, changing emotional habits is one of the hardest of all. Everyone knows that in order to change a habit you need to do something consciously for many months before it will begin to become ingrained (generally experts say 1-3 months).

And yet despite the amount of personal effort that I’ve put in to changing my habits, the thing that has actually been the most difficult has been the reaction of those people who are closest to me. People act confused, they tease, they joke, and often they make a big deal out of small changes. I’m going to take one example that’s a little bit trite, but sticks out to me as an example of how difficult it is for others to see you in a different light and how that can affect your ability to make changes long term.

I have a sweet tooth. I love chocolate, I love cake, I love ice cream. For most of my life I have never passed these things up. In the process of dealing with my eating disorder, I’ve made an attempt to make my eating more even and balanced: to pay attention to my hunger cues instead of simply eating if something tastes very good or if I force myself to, to stop when I’m full, to eat when I’m hungry. This means that I’ve also been trying to be more careful about not simply asking for ALL THE CHOCOLATE whenever it is offered to me. When I do that, I often feel guilty, unwell, or just angry at myself, and I often feel as if I’m binging if I eat sugar simply to eat sugar.

The other night I said no to a piece of cake at a family gathering. I got stares, exclamations of “Are you ok?”, people feeling my forward as if to imply that I were sick. Needless to say, this was not helpful in affirming my decision to listen to my body that it was full and didn’t want cake. Of course in this situation I didn’t feel I could explain my choice so I muttered something about not liking carrot cake and tried to make myself small.

Obviously it makes sense to comment on something that has changed, or to continue treating someone based on their past behavior if you don’t have an indication that they have changed. However over the top reactions really can make someone feel singled out and belittled for their changes, as if they’re weird or wrong for trying to make those changes.

In general, people don’t want to hear your negative comments about their changes.  Not only do they have to be mindful of making the change, but they have to continue to justify it to themselves every time it’s pointed out, and even if they don’t it certainly feels as if they do. Ideally, changing a habit is about simply doing something different without even noticing that it’s different: it’s habit when you do it without thinking. Drawing attention to it makes it so much harder to have it become second nature.

People expect you to be the same always. When you change habits, you are changing your identity to some degree, and people don’t always take kindly to that. Other people also have to learn to see different things about you, and it’s easy to fall into the mold that others expect of you. You see this when you hang out with someone you haven’t seen in a long time and act in ways you haven’t for years. So if others continue to expect something of you, it requires extra resolve to do something different, to be clear that what you want now is not what you wanted in the past, and to communicate to those around you in a polite fashion that you are different now. Each time someone remembers the old version of you, you’re left grappling with that self as well.

An added difficulty is that oftentimes family and friends may not realize how difficult or serious a choice that you’re making is. They may joke or tease, when you feel you’re doing something important and hard. When that happens, it can feel like you’re stupid, oversensitive, or just wrong about the importance or difficulty of your choices. It feels like you’re going crazy, as if your reaction to things were totally irrational and you should be ok with joking or light-heartedness. Imagine if you made a choice to improve a serious physical health issue and people teased you about it: it certainly would not feel easier.

So this is a general plea: if you know someone in your life is in the process of making some big life changes, let the little changes slide too. It may be better to ask someone about a change when it’s not in the exact moment so that they don’t have to go through the momentary personal crisis that is reminding themselves why they’re not eating that piece of cake. A quiet comment or question when someone makes a decision out of the ordinary is one thing, but it is unnecessary to make a big deal, and can make the person feel as if they’ve been put on the spot or as if they have to defend their actions to you. And for those who are making changes, letting others know ahead of time can take the pressure off of you in the moment, even if you just tell one or two trusted people. It makes it easier for them to run defense and change the subject.

Empathy for the Neurotypical

Note: for the purposes of this post I’m using “neurotypical” in a more inclusive way than usual. Generally it’s used to contrast with Autism Spectrum Disorders. In this case I’m going to use it to refer to anyone without a diagnosis of a mental illness or disorder.

I have to admit something: I am not always a person who has a lot of sympathy for others. School comes easily to me, so when I hear someone say “I had to study for TEN HOURS for that test”, I have a hard time replying “That sounds horrible” instead of rolling my eyes and saying “Why the hell did you waste all that time? I didn’t study at all and I got an A.” I’ve spent a lot of time trying to teach myself the empathy required to understand that I’m highly privileged in that regard. But the area that’s actually the MOST difficult for me to be sympathetic is one in which I am highly underprivileged: depression, sadness, and difficult life situations.

One would think that with all my colorful and varied experiences of depression and mental illness, I would be the perfect person to talk to when you’re having a rough day. I’ve been there. I understand. I get that feeling. When I’m talking to someone else with mental illness, I”m fairly good at this (except when I can recognize stupid behaviors that I’ve done in the past like emotional manipulation or passive aggression or compliment fishing). But this week I had a neurotypical friend who is generally very happy and who has had a fairly easy emotional life get hit with something really hard and I’ve been trying my absolute best to be there for him. And I’ve found that my patience dwindles a lot more quickly than I would have expected.

Because here’s the thing: I have spent the last four years of my life spending the vast majority of my days in the emotional state that this friend is in. For the most part I’ve kept quiet about it to him and the majority of those in my life. I’ve worked and worked and worked to even survive to where I am right now. For the most part, my friends have been kind, but they haven’t particularly wanted to hear about how I hate myself. Getting through a week of depression is every week for me. And so when someone says they don’t know how they’ll survive because they’ve spent four days hurting I just want to scream back “THIS IS MY LIFE EVERY FUCKING DAY. EXCUSE ME IF I DON’T ROLL OVER AND ASK WHAT I CAN DO TO FIX YOUR WEEK.” I realize that it makes no sense to compare suffering. Just because my base level of suffering is higher and I’ve learned to handle it doesn’t mean that what my friend is feeling is any less of a major life crisis for him.

But when you see someone have their privilege taken away and they’re landed in the same boat you’re in all the time, it’s hard to work yourself up over it. So for those of us who do not have privilege and who spend all of our lives battling in a way that’s invisible to the privileged, we might have to practice empathy in a new way. We are totally familiar with these experiences and feelings. But we have to have the empathy of remembering or imagining what it’s like to experience them for the first time, to get hit with that wave of depression and anxiety without knowing what it is or whether it will end and how to get through it. We have to remember that we’ve built up skills and resistances, that we have had an education in emotional regulation simply by existing with our mental illness, and that those around us don’t necessarily have that education.

Very rarely do I suggest that the un-privileged take a lot of time out of their day to practice empathy towards the privileged. But when the privileged get knocked off their pedestal, they’re left in a place that those of us who live down here have never experienced, a place that’s scary and lonely and neither privileged nor un-privileged. It is often an eye-opening experience for those people, and if we can bring ourselves to see that they’re experiencing something we don’t have to experience every day, we can help them take some good lessons from that experience. Hopefully it can help us create a situation in which the neurotypical is left with a greater understanding of what it’s like to have a mental illness, and the neurodiverse person is left feeling like they have been compassionate and kind, and gained a stronger friend or ally from the experience, as well as helped stop a cycle of oppression.

And for the neurotypical among us, let me just say that your behavior towards your neurodiverse peeps when you’re doing ok can have a big impact on how much empathy they’re willing to have when you’re in a rough spot. If you never give them the benefit of empathy or of listening to their experiences or of accepting that their experience of the world is radically different from yours, they’re not likely to try to do the same for you. If you tell them they should just change their attitude, or that nothing’s really wrong and it’ll all be ok, or that you just don’t get why they’re unhappy or how they can be so introverted because it makes no sense, they’re not likely to spend the time understanding the nuance of your problems. Empathy goes both ways.

All of that said, no matter what the situation, taking care of self comes first (ESPECIALLY WHEN YOU HAVE A MENTAL ILLNESS). You don’t have to practice empathy at the expense of your own mental health. If you’re having a low spoons day and your friend is breaking down about not getting a job, you get to beg out of being the shoulder they cry on because you never have to give out of what you don’t have. If the difficulties your friend is experiencing and word-vomiting everywhere are triggering to you? You get to tell them to tone it down or stop.  Relationships are always about finding the balance between your own needs and the needs of the other.