My Turn

Anxiety tortured my mother and my daughter, and now, it’s found me.

My head is spinning. I’m crawling in my skin. It’s like the walls are about to cave in. I feel overwhelmed and anxious.

I hate this.

My heart is pounding. I feel like an elephant is sitting on my chest.

Why do I feel this way? What am I so afraid of? I feel as though any minute the rug will be pulled out from under me. My thoughts are negative. I ruminate. This isn’t me.

I try to rationalize this. I want to understand why I feel this way. I want to know why.

Why?

But anxiety isn’t rational. It isn’t logical. It doesn’t need a reason to haunt me. It’s biological. The hormones and electrical signals in my brain are misaligned.

It’s genetic. GAD affects every member in my family. Why should I be excused?

I shouldn’t be surprised. The last few years have been extremely stressful. I’ve been through hell. And I’ve pushed through it all and kept going.

And now that life is quiet, my mind will not slow down. It’s as if my brain has been wound up so fast for so long that it doesn’t know how to slow down.

I try to calm my fight or flight instinct. Fear is an illusion. It’s a product of our imagination. Danger is real. I’m not in danger. I know I’m safe. Anxiety is pushing all my thoughts into the future conjuring up things that might happen. Fear is living in the future rather than the present moment.

I need to center myself. I need to meditate and spend time in prayer. I know this will pass. This is just a moment in time. It will get better.

I share this with you because I know I’m not alone. I’m not the only person fighting anxiety tonight. I know that somewhere out there someone else feels exactly the same way I do. And someone feels worse. And someone has felt this way every day for a long time. And they’re tired. And if that’s you, I want you to know that I’m on the struggle bus with you. I’m in the seat behind you. And if you feel like you’re going to fall, that the weight of it is going to crush you, know that I will help you. I’m tired but I’m not giving up. This moment will pass. We’re going to be okay.

Let’s Talk About Anxiety!

You know someone who has it. Maybe you have it. Anxiety is a mental health disorder that affects 3 million Americans every year. It’s more common than heart disease or diabetes.

Everyone has felt anxiety at some point in their life. You cannot be human if you haven’t experienced a moment of anxiety. Maybe it was nerves before a test in school. It might have been stress and worry while waiting to learn medical test results. The difference between anxiety and anxiety disorder is that 1) There is an identified source of your stress and worry 2) The stress and worry go away once the situation or person causing it resolves or leaves.

Anxiety disorder is different because the stress, worry, and fear persist for months, even years with no rational or logical explanation. Anxiety disorders can be debilitating.

There are five kinds of anxiety disorders-

Generalized Anxiety Disorder (GAD) – GAD is chronic anxiety, exaggerated worry, and tension. People who suffer from GAD describe it as feeling like there is an elephant on your chest 24/7.

Obsessive- Compulsive Disorder (OCD) – You ever hear someone say something like “I’m a little OCD about that”? Well, that’s actually a gross misunderstanding about OCD. OCD is not about preferring things be organized and clean. OCD is a debilitating form of anxiety that causes unwanted thoughts/obsessions and repetitive behaviors. Things like hand washing, counting, cleaning, and checking are done repetitively in an attempt to make obsessive thoughts go away.

Panic Disorder – Panic attacks are sudden unexpected episodes of intense fear. During panic attacks people go into fight or flight and experience intense physical symptoms such as sweating, shaking, racing heartbeat, pounding sensation in the chest, chest pain and tightness, difficulty breathing, dizziness, and fainting spells. People who suffer panic disorder live in fear of having a panic attack in public which can lead to another disorder called agoraphobia, which is a fear of leaving home.

Post Traumatic Stress Disorder (PTSD) – This condition is not limited to soldiers returning from battle. Victims of abuse, violent crime, natural disasters, traumatic events like a fire or car accident can all develop PTSD. Caregivers can develop PTSD.

Social Anxiety Disorder or Social Phobia – This is overwhelming anxiety and excessive self consciousness during normal everyday situations. Things like going out to dinner with friends suddenly feels too overwhelming and causes extreme nervousness causing a person to constantly cancel at the last minute.

Anxiety disorders are not rational or logical. Anxiety is not a weakness of character. There are three causes of anxiety.

Environmental – These triggers are the experiences, events, and people in the life of someone with anxiety. It could be a job, school, a personal relationship, or personal financial situation

Medical – Life threatening diseases like cancer and diabetes can trigger anxiety.

Brain chemistry – Disruptions to hormones in the brain can cause disruption in the electrical signals in the brain causing anxiety. Anxiety disorders like GAD, social anxiety, and OCD have genetic links and are shown to be passed from parent to child,

Anxiety has many symptoms. Pain in the joints, headaches/frequent migraines, stomach cramps and irritable bowel, hot and cold flashes, shaking, racing heartbeat, chest tightness, shortness of breath, and racing thoughts are all typical symptoms of anxiety.

People with anxiety will constantly check to see if everything is alright. They will frequently cancel plans at the last minute. They have difficulty sleeping and suffer severe insomnia. They over analyze everything. Friends and family of someone with anxiety are often frustrated with the person who has anxiety especially if they don’t understand what their loved one is going through.

Anxiety can be life threatening. Studies show that 70% of people who attempt to commit suicide have an anxiety disorder. It is important to understand that though anxiety is common it should not be dismissed. It’s important to know that anxiety is treatable. Therapy, medication, meditation, and exercise are all proven to reduce and help manage all five types of anxiety.

You can help someone with anxiety by educating yourself as much as you can about anxiety disorders. If you have a friend or family member who suffers from anxiety let them know that you want to help and ask them how you can help. It’s important to listen without judgement. Never say things like “that’s silly! What are you so nervous about?” or, “Everything’s fine! Get over it.” Instead learn to sit and listen without trying to fix the situation. Be patient. Understand that many who suffer anxiety develop their own coping mechanisms. A common coping mechanism is showering. A person with an anxiety disorder may shower more than five times a day. Don’t lecture them on how much water they are using or how many towels they went through. Showering is better than trying to slash a wrist or self harming like cutting. There is no cure for anxiety, so don’t try to fix the problem. This can lead someone suffering from an anxiety disorder to think that they are a problem, which will make the anxiety worse.

If you suffer from anxiety or you think you do, you need to know that anxiety is treatable. Anxiety can be managed. Finding the right medication is a process of trial and error, but medication works very well and once you find the right one at the right dosage anxiety quickly becomes manageable and easier to live with.

Anxiety is hard to live with. My daughter has panic disorder. At its worst, she suffered between 3 to 5 panic attacks a day. Anxiety robbed her of her teenage years. My daughter’s anxiety became so debilitating I had to pull her out of her high school and enroll her in an online public high school because she missed so many days of school. To everyone on the outside she appeared to be a beautiful teenage girl from a good home with a family who loved her. She smiled on the outside but on the inside she was fighting for her life. Her panic attacks were particularly severe at night. My daughter’s primary coping technique was to take a shower. One night, after her fourth shower, my daughter took the picture of herself below to document what she looked like when her anxiety was high. It’s one of the most haunting photographs of my daughter I’ve ever seen.

This is my daughter at night when her anxiety is at an eight on a scale of one to ten. This was taken about 30 minutes before she had a panic attack.

This is how the rest of the world sees my daughter. I share these photos because I want you the reader to know that anxiety affects everyone at every age. I want you the reader to know that if you’re struggling with anxiety and feeling alone and overwhelmed, you’re not alone. You and my daughter are part of the three million people in the United States treading water trying to keep from drowning in fear and worry. And most importantly, I want you to know that you are not weak. No one who lives with anxiety is weak. People who live with anxiety are the most bad ass warriors to walk this earth. People with anxiety are battling the boogey man in their head every day and though it may not feel like it, they are winning.

Anxiety is normal. There is nothing about anxiety to be ashamed of. People with anxiety should feel as comfortable talking about their issue as do people with high cholesterol. It’s time to end the stigma around anxiety and mental illness.

So What’s in Your Mental Health Tool Box?

You’ve got a cupboard full of supplements that you use to make your morning shake. You’ve got a drawer full of vitamins that you researched thoroughly. You work out and track your steps and calories burned. You are on top of your health! You’re doing a great job taking care of your body, but what about your mind? You’re taking care of your physical health but what about your mental health? We need to stop focusing exclusively on the health of our body and adopt a whole wellness approach. Whole wellness means we take care of our body and our mind. We take care of our emotional and mental health as well as we take care of our body. Your physical toolbox is filled with your vitamins and exercise regimes, but what’s in your mental health toolbox? If you’re not sure no worries! I made a list of ideas below.

  1. Journaling – This may seem silly like a little kid Dear Diary thing, but a journal is a great place to put all your thoughts and feelings. Getting all your stuff out of your head is calming, and can help you sort out your problems and make decisions.
  2. Meditation – This is my personal favorite! It’s the duct tape in your mental tool box. You don’t have to know anything about mindfulness or how to meditate. There are loads of apps you can put on your phone that have guided meditations. All you have to do is close your eyes and listen to the instructor.
  3. Exercise and Yoga – Think of these as the WD40 in your tool kit. Yoga teaches you stillness and control while exercise releases endorphins and keeps your brain cells oxygenated.
  4. Reframing – This is the crowbar and hammer in your toolbox. The crowbar for deconstructing your negative thoughts and the hammer is rebuilding those thoughts in a more positive tone. For example, you may think to yourself “They don’t like me.” You can reframe that thought to “They will like me when they get to know me”
  5. Music – listening to music is an instant way to relieve stress and improve your mood
  6. Laughter – laughter is the power drill of your tool box. Laughter is the most powerful way to improve your mood. Watch a funny video on Youtube. When you smile or laugh it makes you feel happy and energetic
  7. Coloring – creative activities like drawing, painting, and coloring have been shown to improve anxiety and depression.
  8. Work-life balance – Take advantage of opportunities to work from home. Turn off your work phone when your home. Emails can wait until the next day. Putting your work aside for the evening allows you to spend more time with family and friends and also refreshes your mind and creativity.
  9. Social connections – Make time for your friends. Dedicate time to spend with your family. These are the people you can laugh with, cry with, and share all your stuff with
  10. Get a daily dose of sunlight – Sunlight increases serotonin in your brain. It doesn’t have to be a bright sunny day. Try to get 30 minutes of daylight outside every day

Got ideas not listed above? Share them in the comments section.

Mental Illness is a Brain Disease

Mental illness is not a choice.

Mental illness is not something a person can just snap out of

Mental illness is not something someone can recover from if they just try harder

Mental illness in kids cannot be fixed by putting your foot down or laying down the law

Mental illness is not caused by bullying, though being bullied can trigger depression and anxiety

Mental illness is not caused by having Satan in the brain

Mental illness is not cured by going to church

Mental illness is a physiological illness.

Mental illness is biological.

Mental illness can be seen on MRIs and PET scans

Scientists believe mental illness is caused by problems with communication between neurons in the brain

Scientists understand that mental illnesses are associated with changes in neurochemicals.

Scientists have studied changes in the brain associated with depressive disorders. PET scans show that brain activity in certain areas is significantly decreased in people with depression.

According to Dr. Charles Nemeroff, widely published professor and chairman of psychiatry at the University of Miami Miller School of Medicine “In the past two decades, we have learned much about the causes of depression. We now know from brain imaging studies that depression, like Parkinson’s disease and stroke, is a brain disease.

Dr. Thomas Insel, recent director of the National Institute of Mental Health (NIMH) says “Mental disorders are biological disorders involving the brain.”

Psychiatrist and Nobel laureate Dr. Eric Kandel says “All mental processes are brain processes, and therefore all disorders of mental functioning are biological diseases.

Mental illness is physiological. It’s biological. Mental illness is brain illness. There is nothing to be ashamed of. There is nothing to be embarrassed about. People struggling with mental illness deserve the same compassion as people struggling with any other disease.

Share Your Story

As an advocate for mental health and those fighting mental illness one of the things I am most passionate about is ending the stigma that surrounds mental illness. I want everyone to feel as comfortable discussing their mental illness with friends, family, and coworkers as they do their allergies, diabetes, heart disease, or any other disease. We should all be able to talk openly and honestly about mental illness without fear of shame or discrimination. I’m going to start by sharing my personal story with all of you.

My mother suffered from bipolar depression and anxiety most of her life though I didn’t know that growing up, and neither did my siblings. Most of the time my mom was loads of fun. She wasn’t the type of mom to sweat the small stuff, and we always knew we were loved. But, like all parents she had her moments. Except her moments were extreme. I didn’t notice anything until I was a teenager. It was around this time that my mom told her doctor she had symptoms of depression and needed an antidepressant. My mom was a social worker who specialized in substance abuse counseling. She worked in the mental health care system of Flint, MI for years often stepping in to help on the psych floor of the hospital when they were under staffed. My mom was very knowledgeable about mental illness.

I didn’t really understand what depression or anxiety was when I was a teenager. What kid does? My mom had long periods where she just didn’t seem to want to do anything. If she wasn’t at work she was in bed, or in her recliner drinking herself to a stupor before stumbling into her bed. My mom could go months without having a drink but any big, important event she would get drunk just before going unless the event had an open bar in which case she would pound back cocktails as fast as the bartender could make them. It might not have been so bad if my mom had been the quiet drunk who sits in the corner, but mom was the loud obnoxious drunk who wandered from table to table annoying everyone in the room with attention-seeking behavior. It was humiliating. She showed up at a school band concert drunk. She dragged me with her to work events where she got drunk and made an ass out of herself in front of management and humiliated me in the process. Her drinking and the behavior when she was drunk cost her a lot of jobs and opportunities. I thought she was an alcoholic. Later, I realized she was self-medicating. Alcohol calmed the anxiety and put off the panic attacks I didn’t realize she suffered from. Alcohol calmed her racing mind and swirling thoughts. Alcohol silenced the roar inside her head. Eventually, my mother stopped hiding her symptoms from me though I had no idea her behaviors were symptoms. Every few months my mother would suddenly become furiously angry with me. Out of the blue she would accuse me of some strange wild transgression and then yell at me, and cry angrily for hours. She would accuse me of doing something to her behind her back. I would tell her over and over that it wasn’t true, that I had no idea what she was talking about, but there was no calming her. Her anger would only rise. She would sob heaving sobs, hyperventilating, while telling me how much I had hurt her feelings, how badly I had treated her. I would say I was sorry over and over but the truth was I didn’t know what I was supposed to be sorry for. Eventually, she would stomp to her bedroom, slam her bedroom door shut, and stay there crying loudly for hours. I would hide in my bedroom quietly crying trying desperately to understand what I could have done or said to trigger her. Lying in my bed I would stiffen with fear when I heard her walk into the kitchen and pour herself a drink. The next morning I would have a knot in my stomach waiting for her to wake up. Most mornings she would be fine and back to the sweet fun mother I knew. Some mornings the ugliness persisted and she wouldn’t speak to me for a few days.

As time went by my mom told me about growing up with anxiety and panic disorder. She was born in 1943, and mental illness was not discussed especially children with mental illness. When my mother would have a panic attack at school she was sent home with a note telling her mother that she needed a rest. My mother definitely had highs and lows. Her highs were harder to recognize because she could be loads of fun when she was manic. Manic mom would bake for days and days. Manic mom was the life of the party. When she was a child her nickname was Sandy Settle Down! Even as a child she had highs and lows. When she became older her lows became more severe. There were bouts of depression so severe she admitted she had suicidal thoughts but no motivation or plan to actually kill herself. These were the really dark days when she would not get out of bed except to go to the bathroom or get something to eat. She would become fixated on a particular topic. My Aunt’s boyfriend’s brother died, and my mother mourned for a man she never met for five days. She cried as though it was her own brother who had died. She stopped crying and finally let it go when I gently reminded her that she didn’t know the man or his family. I’ll never forget the look of surprise on her face and how instantly she stopped grieving as though the previous five days had never occurred. Mental illness affected her appetite. My mother struggled with obesity, but she didn’t eat her feelings. There were weeks where the only thing she ate was peanut butter toast and candy. Another low point had her making hamburgers for dinner every night for months.

When my mother moved to Traverse City I hoped things would get better. Traverse City had more mental health resources than the small Northern Michigan town we had lived in for 20 years. Her sister had recently moved there from California. My mom would have lots of family for support. I was hopeful that she would get better help and improve, but things only got worse. My mother did not have private health insurance. She had a combination Medicare/Medicaid. Few doctors in the Traverse City area accepted that insurance. The few who would take her insurance had a very long waiting list. We got my mom’s name on those lists and we waited, and waited, and waited. Meanwhile, things got worse. Much worse. My mother suffered from an autoimmune disease called ulcerative colitis. UC is a nasty, cruel disease. My mother not only suffered mentally, she suffered physically. Tragically, all treatment options for UC failed to put my mom into remission. The nature of her disease prevented her from being able to leave her home. This put her in social isolation. My mom was a friendly, gregarious, outgoing person. Being forced to remain home while everyone else watched fireworks on the beach, or go out for dinner. Her depression worsened. A particularly severe UC flareup landed my mother in the hospital. Normal treatment for UC flare ups is a short term dose of combination of antibiotic and high dose steroid. High dose steroids come with many risks and one of those risks is steroid-induced psychosis. The first night in the hospital my mother was her sweet, funny, upbeat self despite the pain and nausea. All of the nurses and nurses aides fell in love with her and she quickly became a favorite patient. Her doctor loved her jokes and salty language. The next day my mother was convinced there was a man in her room with a knife waiting to kill her. She was terrified. She was so terrified that my Aunt and cousin took turns sitting with her so she was never alone. My sister had undergone knee surgery during this time and I was helping her. We couldn’t be there with my mom. We both felt so helpless. It was heartbreaking to hear our mother crying over the phone while telling us about all the scary things she was sure were in her room. The next day she stopped crying. She stopped talking. She was gone. Locked inside herself with all the monsters in her head. The doctors told us we had two choices. We could let them treat her with high dose antipsychotic drugs, which would either bring her out of the psychotic state, or make it worse. My sister and I talked it over and told them to give her the medication. Thankfully, it worked. Mom received the dose in the late afternoon. In the middle of the night she woke up, back to herself. Her nurses and doctor were so happy they all cried. My mother was deeply ashamed. She was horribly embarrassed over the entire episode. That made me sad. What had she done to be ashamed of? She certainly didn’t do anything wrong. She was fighting a physical illness -UC, and mental illness every single day. My mom was a warrior. She was a fighter. But, I knew she was right in thinking the rest of the world wouldn’t see it this way. How many friends would be supportive to her face yet gossip about her “going psycho” behind her back? How many would quietly disappear? The fact is there is a stigma surrounding mental illness. People fighting cancer, MS, Parkinson’s, or any other disease are heralded as fighters. People fighting mental illness are viewed as a moral failure. They think the behaviors that come with mental illness are a choice. I’ve said it before, mental illness is not a casserole disease. When a loved one is in the hospital recovering from surgery friends, family, and neighbors turn up at your door with dinner and offers to help with housework and chores. Your coworkers will come together and sign a card and chip into send flowers. But when a loved one falls into a mental health crisis no one comes around. You’re on your own to manage the situation while trying to balance your work-life responsibilities. It’s isolating. It’s lonely. It’s overwhelming.

My mom’s UC continued to worsen as did her mental health, but she hid that from our family in Traverse City and my siblings. She worked so hard to appear normal but she had to have an outlet where she could be herself. People with mental illness are at their worst with those they love and trust the most. Sadly for me, I was the person my mom trusted to be her true self around. In the evenings my mom would call me crying. She would tell me that she saw my daughter playing in her closet. She would call me in an angry rage. The familiar snaps of fury I had grown up with. I would hang up from those calls emotionally exhausted, drained, and grateful to be in my own home sheltered from her episodes. When I tried to tell my family what was going on I was met with surprise, confusion, and disbelief. “I was just with her and she was fine” my Aunt would say. My Aunt would call her after I called, and then call me back to report that my mom was fine. No crying. No angry fits of rage.

Eventually we began to suspect that my mother suffered from bipolar. We tried to talk to her about it and get her to consider a change in her medication, but my mother did not want to discuss it. To my mother, admitting that she had bipolar was admitting that she was”crazy” and she too ashamed, embarrassed, and frightened to accept that diagnosis.

My mom died following complications from surgery to treat her UC. She was high risk for surgery because she had suffered multiple heart attacks and was anemic. However, she was tired of being sick every minute of every day, in constant pain, and confined to her room unable to enjoy her family and friends. So, she pushed for the surgery knowing the risk but decided she would rather be dead than continue existing with UC that was unresponsive to every treatment option. I was heartbroken when my mother died. My mother’s death was not the first loss I had experienced but I had never experienced that level of grief. It was overwhelming. It came in waves leaving me feeling like I was drowning. Through it, my life preserver was an image in my mind of my mom’s spirit leaving her body and seeing the light, realizing that all of her physical and mental pain was gone, and then hurdling herself into that light enveloped in peace.

My mother lived in fear and shame of her illness. She didn’t get the support she needed from her family because we didn’t understand what was happening. We didn’t know the signs of bipolar, depression, and anxiety, and when we did finally figure out what was going on we didn’t know how to help her. No one should have to suffer like my mom did, but too many do. No family should have to struggle like mine did, but too many do. I’m sharing this story about my mom so others who are going through the same will know they are not alone. I’m sharing this story with all of you because I am not ashamed of my mom. Now that I understand what she was going through every day, I am in awe of her. I used to think she was weak. Now, I know she was the strongest person in my our family. And, I want there to be no shame in the mental health game. I want you to feel free to share your story openly and honestly. There will be no judgment here. Only support, understanding, a listening ear, and if you live in my neighborhood I’ll show up at your door with a casserole because mental illness is a disease of the brain, and deserves just as much sympathy, support, and compassion as any other disease.

Why Should I Care?

You don’t have a mental illness. No one in your family has mental illness. In fact, you can’t think of a single person you know who has mental illness, so why should you care?

Because though you don’t know it, in fact, someone you know and love is suffering from a mental illness. They are suffering in silence and shame, and they might even be fighting for their lives while making sure no one notices. Often, these are the suicides that catch us by complete surprise. These are people like Anthony Bourdin, Kate Spade, Avicii, and Chris Cornell. They seemed to have it all, wealth, fame, family, so what drove them to commit suicide? Mental illness. Specifically, major depressive disorder and anxiety.

Mental illness isn’t always hidden. Sometimes, its misunderstood because it’s identified by its symptoms. Mental illness are the two kids in every classroom who are ADHD. Their symptoms and resulting behavior affect teachers and classmates. Mental illness are the people you work with who call in sick all the time because they’re silently struggling with depression and anxiety.

You should care about mental illness and mental health because nationally, unless you are wealthy, it is very difficult, if not impossible, to get access to quality affordable mental healthcare in a timely manner. Typically, when someone decides to seek medical treatment for their mental health they will call anywhere from 8-10 psychiatrists trying to find a doctor who accepts their insurance, is willing to treat their condition, and is accepting new patients. It’s important to note two facts here – there is a shortage of psychiatrists in the United States, and many are particular about which mental health disorders they will treat in their office. For example, I know someone diagnosed with Borderline Personality Disorder over a year ago. To date, this person has not found a psychiatrist willing to accept them as a patient.

Public clinics are underfunded and overloaded. As a result, they limit their treatment to those without insurance and in crisis.

You should care about mental health because it’s underfunded and there is a severe shortage of appropriate treatment facilities. State hospitals were not perfect. Many were awful, but as they were closed we never really replaced them. Mental healthcare is not a sexy field of medicine. There are no colored ribbons and fundraising campaigns for mental illness. There is no easy way to diagnose disorders and no quick fixes. Stigma surrounds the entire field. People associate psychiatric hospitals with horror movies and spooky stories. A nurse mentions they work in a psychiatric hospital and everyone wants to know about the “craziest” patient they’ve ever seen.

You should care about mental health and mental illness because by the nature of the disease those who suffer often cannot advocate for themselves. With limited available treatment options and no support those who suffer end up in crisis state. Crisis state is the stage where bad things happen. This is the point that a person becomes suicidal. This is when a person’s behavior gets them arrested. This is when a person becomes homeless. Or worse, this is when a person becomes homicidal. Our prisons have become makeshift psychiatric hospitals.

You should care about mental health and mental illness because we know how to treat these disorders with evidence-based medicine. Successful treatment requires a team approach between a social worker, therapist, and psychiatrist. Sadly, there are not nearly enough resources.

You should care about mental health and mental illness because a small handful of legislators in Congress have consistently, and persistently fought for mental healthcare reform. Mental health reform bills have passed through congress with bipartisan support only to languish in the senate. Mental healthcare reform is a topic that gets drowned out by the debates over gun control and universal healthcare. We need to put pressure on our legislators to pass these reforms now.

Care is a simple four letter word. But, to those who live with mental illness it is one of the most powerful ways to change and save lives.

Caring is an action. It’s what you can do when you don’t know what to do.

Caring is a feeling. People feel loved when someone cares. People feel heard when someone cares. People recover when someone cares.

I care about mental health and mental illness, and so should you.

May is Mental Health Awareness Month!

Mental health is something everyone should care about, and I mean everyone. Why? Well, consider the following facts:

  1. 1 in every 5 adults in the United States experiences a mental illness every year.
  1. 1 in 25 adults in the United States experiences a serious mental illness every year.
  1. 46.6 million adults in the United States manage a mental illness every day.
  1. 50% of all mental illnesses begin by the age of 14.
  1. 75% of all mental illnesses begin by the age of 24.
  1. 90% of the people who die by suicide have an underlying mental illness.
  1. But only 46% of the people who die by suicide have a diagnosed mental illness.
  1. Suicide is the 10th leading cause of death in the United States.

Suicide is treatable and preventable if the person is given the right support and treatment. We talk a lot about health and wellness. There are loads of Instagram influencers who talk about diet and exercise. We talk about how important it is to avoid sugar and eat super foods. We talk about vitamins, supplements, and shakes, but we never talk about mental health or mental illness. Mental health is used as a marketing tool to sell fitness and supplements, but it’s never seriously discussed. It’s a taboo subject.

Here’s another interesting fact: there is an average of 11 years between the time a person first experiences symptoms of mental illness and the time they start treatment. Can you imagine living with the symptoms of a broken leg for 11 years before you saw an orthopedic doctor? The top 3 barriers to treatment are cost, stigma, and transportation.

Let’s knock out items one and three first. Mental healthcare is not cheap or affordable. It’s expensive. It’s really expensive. Most healthcare plans only cover a portion of it leaving you to pay the rest out of pocket. If you have an outstanding bill most psychiatrists, therapists, and mental hospitals will not see you until that bill is paid, which means a lot of people are turned away when they do reach out for help. Specialty clinics and group treatment facilities are really expensive and either don’t accept insurance or are not covered by insurance plans. Mental healthcare is hard to find. People who live in rural areas have to travel an hour or more by car to get access to quality mental healthcare. People who live in large cities have to travel to the suburbs for the same.

Stigma is the biggest barrier to treatment. The dictionary defines stigma as a mark of disgrace associated with a particular circumstance, quality, or person. Stigma to those with mental illness means fear of losing their job, their families, and their friends. People with mental illness are rejected, bullied, and discriminated against so much it is the norm rather than the exception. Navigating life with a mental illness is hard. The isolation, blame, and secrecy that is driven by stigma create the biggest challenges for people to reach out and ask for help and seek treatment. Stigma can push people to the brink of suicide. No one chooses to be mentally ill. Eating disorders and addiction are not choices that people make. They are the result of mental illness.

May is Mental Health Awareness month. Thirty one days dedicated to raising awareness, busting myths, teaching and learning about mental health and mental illness. I will be devoting all of my blog posts to mental health and mental illness this month. I will share resources. Mental illness has affected me and my family profoundly. I want to help those who don’t understand how they can help. My small hometown in Northern Michigan has been plagued by teen suicides this past year. I’ve watched heartbroken as the community grapples with grief, confusion, and disbelief. They want to know why. They want to know how to prevent more kids from taking their own life. I want to try and answer those questions.

Please google the following organizations:

National Alliance on Mental Illness (NAMI)

Mental Health America

Anxiety and Depression Association of America

These organizations are a great place to start to learn more about mental health, mental illness, and suicide prevention.

On May 15th at 2pm there will be a live Twitter chat hosted by Dr. Kevin Chapman and Dr. Debra Kissen. These experts will bust common myths surrounding anxiety and share the actual corresponding facts. Anxiety is the most common mental illness and one of the leading culprits for suicide. Use the hashtag #Mythbusters to join the conversation and ask questions, and follow @Got_anxiety for updates.

Living in Our Disrupted World

One of my favorite sermons was delivered by Pastor Rob Bell on his Podcast aptly named The Robcast. The sermon is called The River, The Mountain, and You. It’s the second episode of his podcast and it’s worth checking out if you like podcasts.

The gyst of the sermon is this: a river is a river, and a mountain is a mountain. Until, the river is no longer a river and the mountain is no longer a mountain. Then, a river becomes a river again, and the mountain becomes a mountain again.

What the hell? When I first heard Pastor Bell say this I was struck dumb. What the hell did that mean? Okay dude where are you going with this one? Hang in there and I’ll explain.

We all start out in life viewing the world through a fixed lens that is shaped by our family, our teachers, our religious leaders, our friends, our society and the culture we grew up in. All of these influences shape how we see the world. It’s through this lens that we form our values, ideals, and beliefs. Up is up. Down is down. We see things as right or wrong. A river is a river.

Then, something happens to change our view. Something disrupts the lens through which we navigate life. It might be something as simple as reading a book, or it could be more complex like a life experience. But in that disrupted moment, up is no longer up. Down isn’t down anymore. What we thought was right may be wrong and what we thought was wrong may be right. The river is no longer a river.

When our world is disrupted we become confused. We look for the familiar. The more things change the harder it becomes to navigate through the world with our old lens. We become angry and defensive. We feel overwhelmed and then frightened. We yearn for the days when the mountain was a mountain.

Eventually, we adjust to the changes. As we adapt to the changes in our world the lens through which we view the world adapts. Finally, the river becomes a river again, and the mountain becomes a mountain.

I reflect on that sermon nearly every day. The first time I heard it was nearly a year ago. Here’s what I’ve been thinking.

Right now, we are living through one of the biggest technology disruptions in history. The internet is changing the way we live, the way we work, the way we communicate, and the way we connect with others. Our homes and our cars are becoming ‘smart.’ We can do our grocery shopping online and have it all delivered to our front door in less than two hours. Shopping malls are struggling to survive because of the convenience of online shopping.

Technology is changing how we work. The traditional office setting is becoming obsolete as more professionals utilize the internet and video conferencing to work from home. Blue collar jobs are being automated displacing thousands of workers. Walmart is adding 3,900 robots to their stores across the United States. The robots will clean the floors, scan products, sort shipments, and ready online purchases for pickup. Our future has never looked so uncertain. Adding to that stress and fear is the steady stream of live distressing and violent news coming to us 24 hours a day. Technology has advanced so quickly in the last 15 years. We have gone from relying on desktop computers to more portable laptop computers to much smaller tablets and smartphones. Smartphones are computers in the palm of our hands. Through our phones we are bombarded with information faster than our minds can process and evaluate. The internet connects us and brings us closer together. That’s great for bringing family and friends closer. But, it also brings us closer to the uglier parts of life. The violence in places far away now feels close to home. Sure, we’ve always known that the world had dark places and violence but that was delivered to us once a day through the evening news after the event when journalists had time to edit. They told us about the boogey man but they told us gently. Today, terrorists live stream beheadings. We watch helplessly on our TVs and phones as children die in school shootings. We think our neighborhood and community is a nice safe place to raise our kids until we download the app to our phone that shows where all the registered sex offenders live. The internet has also provided us with a more powerful tool to share messages than we have ever had in human history. Through social media we are talking about issues and topics once thought too taboo to discuss. We are challenging our society’s long held views on religion, race, politics, sexual orientation, and civil rights. Where is the river? Where is the mountain?

Life seems to be louder, faster, and lonelier in this disrupted world. We have thousands of friends and followers online but how many people do we connect with face to face every day? When you have your groceries delivered to your door you don’t have to talk to the cashier or the person putting your stuff in bags. Technology is beginning to have a dramatic change to the way we receive medical care. Feel like you have a sinus infection? Got an earache? You don’t need to leave your home and go to an Urgent Care or doctor’s office. Apps like Amwell allow you to be treated by a physician through your phone or tablet. Robots are being used to diagnose conditions like stroke in emergency rooms and even perform some surgeries. Technology is changing how we connect with each other. Online churches are beginning to grow. Teens don’t get together at the mall. They use FaceTime and WhatsApp. The river is not a river and the mountain is not a mountain, and this time we can’t simply adjust our lens. Life has changed so dramatically, so quickly, that we need to build a new lens.

All this change is overwhelming. We’re still trying to figure out how to use the technology we have when newer, faster, better technology is released. We can’t possibly process all the new information coming at us every day all day. It’s frightening. It’s exhausting. We reminisce about the good old days when things were simpler, easier, safer, better. But, were they really? It’s easy to romanticize the past especially when the present is so hard and the future uncertain. We just want to go back to a time when a river was a river and a mountain was a mountain.

The good news is that we are not the first ones to live through technological disruption. The printing press was first developed in 1439. When it was perfected Martin Luther used this technology to print copies of the Bible he had translated to German from Latin and Greek. This led to the Protestant Reformation. In 1908 Henry Ford redesigned the horseless carriage into the Model T and created the assembly line. This created the automobile industry which transformed where we lived, worked, and played. These disruptive technologies gave us great things but even Henry Ford found himself living with regret for the amount of change his Model T had created. He longed for the good old days of his childhood so much so that he created a museum dedicated to preserving different moments of American Life. There, at Greenfield Village, he moved his childhood home where it was preserved just as it was when he was growing up. A time when, for Henry, a river was a river and a mountain was a mountain. Eventually, everyone adjusted to all the changes and as they adapted the lens through which they viewed the world it became hard to imagine there was ever a time when books were so rare only the very wealthy and churches had them. What was it like before automobiles when you couldn’t travel farther than a day’s walk? We’ve never lived through those experiences. Society had adapted to the changes. The rivers had become rivers again, and the mountains had become mountains.

It will be no in this disrupted age. There is an entire generation that has never known a world without the internet. They and the younger generations will be the ones who make the new rules and social norms and transform our disrupted world into their world.

This brings it all around to the title of the sermon – The River, The Mountain, and You. How do we live in this age of disruption? We are trying to cope with the anxiety and fear by using meditation apps, gratitude journals, therapy, and antidepressant medication. Fear-based religious teaching in mega churches are drawing ever larger crowds. Trump was elected because he promised to “Make America great again!” One of the leading Democratic candidates for the 2020 Presidential election is Pete Buttigieg, a millennial who doesn’t wax poetic about the way things used to be but rather focuses on what the future could be. As we try to find the rivers and mountains we are divided into those who look back and long for the way things were and those who look forward for what could be. I think that one of the most important things we must all do to bridge this gap is to remember that no matter how different we think we are we are really much more alike than we realize. Most importantly, when we feel really overwhelmed and the change seems terrifying, remember that just like all the times before, the river will become a river again, and the mountain will become a mountain again.

Practicing Gratitude

Gratitude is the latest buzzword in wellness. You can buy cute gratitude journals in which you can write lists of all the things you’re grateful for. You can buy coffee mugs and T-shirts and home decor preaching the gospel of grateful. But that’s not really practicing gratitude is it?

There are lots of sound reasons why we should all take up the practice of gratitude. Studies conducted by the National Institute of Health show practicing gratitude rewires the hypothalamus in our brains. The hypothalamus is the part of our brain that regulates body functions. We literally cannot function well without grace. Pick up any popular fitness magazine and there is an article listing out the benefits of gratitude from reduced stress, better sleep, to a reduction in chronic pain. And, all of this is true but what they don’t tell you is how to practice gratitude.

How do you practice gratitude? I’ve been thinking about this a lot. Developing a gratitude practice is the logical first step in any wellness plan. So what is a gratitude practice?

I’ve been following the website gratefulness.org which is devoted to the writings and teachings of Brother David Steindl-Rast. Brother David is a Benedictine monk who has written books and given speeches on gratitude. Brother David teaches that the practice of gratitude has three steps.

  1. Wake up. To be grateful we need to open our eyes, our minds, and our hearts to all the opportunities and gifts that surround us every day. As Brother David says “You start your day by being grateful you have eyes with which to see the world and all it’s beauty.” Ask yourself “Isn’t this surprising?” Surprise is a helpful lens through which to view our day because it helps us to see all the things we take for granted like our two eyes that let us see the faces of our loved ones whether they are right in front of us or on the screen of our tablets and smartphones.

2. Be aware of opportunity. Ask yourself “What’s my opportunity here?” Ask yourself this question as you prepare for the mundane tasks of your day as well as the challenges. Life presents us with opportunities every day but we must open our minds and our eyes to see them.

3. Respond alertly. If you can allow yourself to be surprised by the simple joys all around you, and learn to recognize the opportunities in every situation, then this last step happens naturally.

Practicing gratitude is more than just saying your prayers or giving thanks before a meal. It’s more than reading scripture or keeping a gratitude journal. It’s as much a part of the way you move through your day as eating and sleeping. My favorite quote of Brother David is that if you live every day as though it was both the very first day of your life and the very last day of your life then you will have spent that day very well. I had to think about that for a bit.

What if today was the very first day of your life? Imagine you arrived in this world just as you are right now with your body as it is, your finances as they are, etc. Would you hate your reflection in the mirror? Would you be disappointed with this life you’ve been given? I wouldn’t. I would be grateful to God for giving me this life and this day to start living it. I would be grateful that unlike the rest of the people walking around in the world I wouldn’t have a past. That’s the key to understanding what it means to live each day of your life as though it were your very first. If this is your first day of life then you have nothing to compare it to. You have no history to remember all the negatives. No failures to remember. No broken hearts and failed relationships. No mistakes. No missed opportunities. No hurts, abuse, or bad memories. All you would have is the moment you came into this world and all the possibilities that go along with it. How beautiful is that? Brene Brown famously said that comparison is the thief of joy. If we live each day as though it were our very first then there is nothing to compare it to. All that happened before becomes irrelevant. There is only here and now, and the future with all of its possibilities. Every day we are given the opportunity to start over. Isn’t that surprising?

What if today were the very last day of your life? Steve Jobs famously wrote an essay stating he asked himself this question every day and the answer determined how he decided to live his life each day. Well, what would you do if you found out you only had hours to live? I doubt you would cling to your previously held expectations and pride. All of your fears of failure and rejection disappear in the face of death and like the previous question of today being your first day, the last day of your life is not likely to be spent remembering all the failures, lost opportunities, and regrets. Rather, you would remember all the good times and great people who were a part of your life. You would embrace every opportunity for joy, for love, to make lasting memories. What opportunities are here?

The mantra from Brother David encourages us to see today as it was meant to be seen. Today, and every day is a brand new day. It’s a clean slate. A chance to achieve, to succeed, to learn, and to grow. The mantra also reminds us not to dwell on the past. Life is short. Time is finite. We are given a limited amount of time in this space with the people around us to seize the opportunities in front of us.

This is what a gratitude practice looks like. It’s not down on your knees in prayer reciting bible verses. It’s not writing lists in cute journals. And, it’s not posting memes on your social media feeds. It’s minute by minute, it begins when you open your eyes and ends when you fall asleep, and begins again the next day. It does not happen naturally. It’s s mindful practice. It requires intention. The benefits far outweigh the effort. It’s time very well spent.

The Long Lonely Nights

One of the biggest challenges for those who live with mental illness is sleep. This may come as a surprise to some because from the outside it looks like people with mental illness sleep all the time. Some people think my daughter sleeps too much. This is a logical conclusion because when they try to call her during the day she’s asleep. I’m constantly being lectured about how much she sleeps. It’s exhausting and frustrating to listen to. I’m so tired of explaining why she sleeps when she does that I’ve stopped trying. My daughter lives with bipolar depression and anxiety with panic attacks. When she is manic she has severe debilitating OCD symptoms. She can’t walk across the carpet. She sleeps on her bed with no sheets. These are just a few of the frustrating ways her mania manifests. Her anxiety disorder is at the more severe end of the spectrum and drives her to have panic attacks and suffer from a condition called agoraphobia, which is a fear of leaving the house.

Alexa’s anxiety rises sharply every night starting around 9 pm. In addition to her anxiety this is when her bipolar swings manic. The combination leaves her wide awake all night. Do you live with this? If you do then you’ll know what happens next. My daughter is up all night alone. She listens to music and reads, and she tries very hard not to have a panic attack. She used to have severe panic attacks all night. How many nights have I sat up with her holding her hands, wiping her tears while the monsters in her head waged war? More than I can count. By early morning her anxiety melts enough that she can start to relax. She reads for a couple of hours. Eventually, around 8 or 9 am, exhausted from fighting the demons in her head all night, she falls asleep. On a good day she’ll sleep until 4 or 5, which gives her 7-8 hours. On a bad day she wakes up at 2 or 3 exhausted and feeling like she’s waged a battle and lost. But, whether she sleeps 6 or 8 hours she feels embarrassed and ashamed when she wakes up. She’s ashamed of herself for sleeping all day. She’s embarrassed about being up all night. She feels remorse for keeping me up during the night, and she’s frustrated because she knows that once evening rolls around her anxiety will creep and the cycle will begin again. Rinse and repeat. If this happens to you I want you to know that you’re not alone. I want you to know that you are not a bad person or a lazy person. This is not a behavioral issue. This is one of the difficult parts of the medical illness you live with every day.

Nights like these are long and lonely. Alexa is wide awake when the rest of the world is asleep. There is no one to talk to. No one to watch a movie with. This is the most dangerous time for those fighting this disease. The weight of depression becomes crushing. Those suffering are tired of being numb to all positive feelings. Desperation sets in and this is when some start self harming. Cutting and other forms of self harm are desperate attempts to prove to themselves that they can still feel something even if it’s pain. Ask a person who lives with clinical depression what it’s like to live with indifference 24/7. Their answer might surprise you. It will also help you understand why people who seem to have it all commit suicide. When her panic attacks were at their highest, and she was fighting against suicidal ideation, Alexa would FaceTime with a member of our family who would spend hours during the night talking her down off the ledge while I tried to get some sleep. They say it takes a village to raise a child. Well, I’ll tell you, it also takes a village to be a caregiver for someone with mental illness but unfortunately we go it alone. The Village doesn’t show up for depression, bipolar, of any other mental illness. Alexa and I are fortunate because we have a very supportive family who will help out, and on those long lonely nights it’s something neither of us takes for granted. We are so very grateful to have them.

If you are living with mental illness and you are battling the long lonely nights please remember you are not the only one who is is going through this. You are not a terrible person. You are not being ridiculous. It’s not “all in your head” and you can’t “snap out of it.” You are not weak. You are not a crybaby. You are a warrior fighting for your life all night while the rest of the world sleeps. I know the night gets long and lonely, and the battle makes you weary. Here are some suggestions that have helped some folks battling night monsters:

  1. Try meditation. There are loads of free apps with guided meditations. My personal favorites are Breathe, Unplug, and Soulvana. Meditation is wonderful for quieting anxiety.
  2. Try indoor gardening. I know this sounds crazy but hear me out. You’re awake. You’re not going to sleep anyway. Rather than lay in bed fighting this reality try to reframe it. Make use of the time. Nighttime can be peaceful. You can buy indoor gardening kits and grow everything from herbs to vegetables. If you don’t eat them, grow them anyway! Give them to your neighbors, family, and friends. Donate them to a local food pantry. Give them to the homeless. Bonsai trees are wonderful for helping you to center your thoughts and focus on something external rather than the internal noise in your brain. Gardening is proven to relieve anxiety, lift depression, and calm mania. Give it a try!
  3. Color. Adult coloring books allow you to direct all your energy and focus onto the page in front of you. Put on some music and color.
  • If you’re a caregiver like me, I know how exhausted you are. We live in a constant state of hyper awareness. Fearful of what our loved one is doing or may do while we sleep. We sleep with one eye open, or we don’t sleep at all. The most important thing to remember is that we must take care of ourselves first. It’s like when the plane hits turbulence and the oxygen masks drop. You are supposed to secure your oxygen mask first before you help anyone else otherwise you risk dying and not being around to help anyone at all. Its critical to get your sleep. Set firm boundaries. When my daughter came home from her last hospitalization we made an agreement. Going forward she would try to manage her anxiety during the night utilizing the coping skills she learned while in the outpatient program. This is her first line of defense. When that fails she can reach out to me or our family for help. I have to say she has been doing a fantastic job. Her new medication regime is working very well and allows her to sleep soundly, through the night, without night terrors. This past month her symptoms worsened and she found herself battling the long lonely nights again. But this time she used the coping techniques taught to her by her therapist. She reads and watches movies. She has woken me only a handful of times. She saw her doctor recently and her medication dosages were tweaked. It’s been two days and the improvement is dramatic. It gives us hope. It’s a tiny flicker of light at the end of this long dark tunnel. I say this because again, if you live with this I want you to know that it does get better. It will not be this way forever! But more importantly, I want you to stop berating yourself. Don’t listen to those who lecture you and tell you to straighten up and toughen up. You are strong. You are stronger than those who tell you that you’re weak.
  • For those who do not live with this I thank you for reading this post. I hope it helps you understand this disease a bit better. I think most people on the other side sincerely want to help. I see you posting memes on Facebook telling people to stop bullying. I see you sharing the suicide hotline. I know you care deeply and want to help. Here is what you can do:

    1. Stop judging. Stop lecturing. Stop trying to ‘fix’ it. This is a symptom of a physiological illness. These people are not assholes behaving badly. They are suffering. They need your understanding. They need your patience.

    2. If you are in a position to be up at night, and you know a friend, relative, neighbor living with this, offer your companionship one or two nights a week. Having someone to sit up with and pass the night is so comforting. Offer to come over and then, most importantly, just be there. Don’t try to fix the problem. Don’t offer your opinion or advice. Offer to play a game of cards or monopoly. Offer to make some popcorn and watch a movie. Or, just sit beside that person and hold their hand. They may be fighting the battle for their life inside their head and your hand is the only thing they’ve got to hold onto. Offer to pray with them but do not, under any circumstance, try to bring them to Jesus or save their soul. You will not be helping. You will instead only reinforce all the negative horrible thoughts running through their mind. I’m not saying you shouldn’t pray for them. Pray for peace. Pray for relief. Pray they are given the strength to keep fighting. But do this on your own. Now is not the time to force your religious beliefs on this person. When you see someone clutching their chest having a heart attack, do you grab your bible and start reading to them? No. You don’t. You call 911, you put an aspirin under their tongue. You perform CPR if necessary. And when that person is lying in intensive care in the hands of a medical team trained and skilled for this issue, then you retreat and pray. Mental illness is no different. When someone is having a mental health crisis holding them and letting them cry with no judgment is CPR. Staying up with them and offering your companionship is first aid. Mental illness is a disease like any other. It’s time to stop dismissing it as a moral character failing. If you want to help, if you want to stop suicides of friends, family, and neighbors, then it’s time to step up and be the village.

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