7 reasons I speak up about mental health

Imagerymajestic/FreeDigitalPhotos.net

I grew up with a perception of mental health that was skewed in the way I assume it is for a lot of people. I thought you had to be really crazy to see a therapist. I believed that you either did or you didn’t have a mental illness and it didn’t occur to me that it’s really a spectrum that everyone is on. I reckoned that I probably knew a few people with some kind of “mild” mental illness, but didn’t know that one in four Americans struggles with a mental illness in any given year (NAMI). 

Boy, was I wrong about a lot of things. But I didn’t know that until I sought treatment myself and had years of experience in the therapeutic environment. As my progress with mental health increased, I also took classes on psychology in order to better understand what was going on both with myself and with others. And here I am, running a blog about the very topic that I so deeply misunderstood when I was younger.

So what changed for me to go from a stigmatized and uninformed perception to being a voice for the mentally ill? There are a few major factors.

1. I was so confused and even hurt by the mental health system that I didn’t want anyone else to have to navigate it alone and uninformed. I am empathetic and I truly just want to make this process easier for even just one person. 

2. I heard the stories of others. Whether through reading, classes or conversations, I learned about other people with struggles similar to my own. I realized that I am not alone and that when I speak up for myself, I am also standing up for a whole invisible community.

3. I realized that the mentally ill are underrepresented in society at large. Because there is so much stigma, people don’t always speak up. But silence will not change things and I feel like it’s the right path for me to be vocal about this topic. 

4. I was sick of hiding who I am. Trying to keep up a front of everything being okay was exhausting and just made me feel even worse. While I had a lot of fear about being open, everyone who is close to me now knows that I struggle with mental illness and have (eventually) been great in their responses.

5. I want to do my duty as a citizen. They say that when letters and phone calls are being made to politicians, they estimate that each person speaking up represents over 1000 people who feel the same way. I want to bring another 1000 people’s struggles to attention.

6. I want to live in a world where I can say I have a mental illness the same way others can say they have diabetes or a broken leg. I don’t want a negative, judgmental, uninformed and awkward response. I want the same courtesy and sympathy that is given to those with physical illnesses.

7. I don’t want my mental health issues to be meaningless. These are the cards I have been dealt and I choose to play them in a way that can bring hope and healing to others. 

I acknowledge that it’s a difficult topic to speak about and that not everyone wants to do so. I didn’t either, for a long time. That changed and now this is a large part of who I am.

But you don’t have to create a whole blog to be a part of the conversation. Even a single post on your blog draws attention to the topic. Today is Mental Health Month Blog Day, sponsored by the American Psychological Association. If you submit your post about mental health here today, it will be added to a list along with other people’s posts. Even if you don’t submit anything, check it out to see other people’s contributions. The more informed you are, the better you will be able to address the topic of mental health both personally and publicly.

Why do you speak up about mental health? Or what stops you from doing so? Join the discussion in the comments.

100 ways to improve your mental health

We’ve reached a milestone today – this is my 100th post! To celebrate, I decided to make a list of 100 things. The most helpful idea that came to mind was ways to improve mental health, so here it is. I have broken the list down into categories so that you can find the ones that are the most relevant for what you are working on. (Another milestone: Happy birthday, A. You’re my favorite.)

  

Stockimages/FreeDigitalPhotos.net

Emotionally

1. Honor your emotions for what they are and accept them fully.

2. Do something that makes you happy every day.

3. Remember that feelings are temporary; they will always change.

4. Express your emotions creatively.

5. Ask for help when you feel overwhelmed.

6. Know when to back out of a situation.

7. Stop your thinking and ask yourself what you are actually feeling and why.

8. Use a feelings chart to identify what you are experiencing.

9. Surround yourself with little things that make you happy – flowers, art, scented candles, etc.

10. Find positive and uplifting entertainment.

Keerati/FreeDigitalPhotos.net

Mentally

11. Stay in the present.

12. Deal with stress as it comes up.

13. Eliminate bad habits. 

14. Set realistic goals and work towards them.

15. Stop using negative words to describe yourself.

16. Reward yourself for doing difficult things.

17. Take a break when you need it.

18. Find new ways to do things.

19. Stop and consider other perspectives on what you’re experiencing.

20. Use good common sense.

                                                                                              Physically

Stockimages/FreeDigitalPhotos.net

21. Exercise regularly.

22. Take time to relax.

23. Eat three meals a day.

24. Take your medication as prescribed.

25. Stay at a healthy weight. 

26. Get enough sleep.

27. See a doctor when you need to.

28. Choose healthy food.

29. Stay away from harmful substances.

30. Love your body as best you can.

Photostock/FreeDigitalPhotos.net

Socially

31. Rely on your support system.

32. Spend time with other people regularly.

33. Be a helpful friend.

34. Respect the needs of others and expect that they do the same.

35. Engage in volunteer work.

36. Eliminate negative influences in your life.

37. Set and keep healthy boundaries.

38. Make time for yourself.

39. Be clear in your communication.

40. Be considerate.

Sira Anamwong/FreeDigitalPhotos.net

Intellectually

41. Be educated about your disorder(s).

42. Learn something new every day.

43. Study things you genuinely find interesting.

44. Study something you know absolutely nothing about.

45. Do mind exercises like sudoku, crossword puzzles and word games.

46. Talk to other people about what they do.

47. Take an evening or community course.

48. Think up funny jokes and witty responses.

49. Take notes when you are learning about something. Refer to them later.

50. Do calculations in your head instead of using your phone.

Spiritually

tiverylucky/FreeDigitalPhotos.net

51. Practice mindfulness

52. Meditate and/or pray.

53. Eliminate unhealthy beliefs.

54. Rely on a higher power.

55. Learn about the beliefs of others.

56. Journal about your spiritual experiences.

57. Share your spiritual experiences with open-minded loved ones.

58. Forgive.

59. Find or decide on your life’s purpose and live it.

60. Stay true to what you believe.

                                                             Environmentally

                                                             61. Surround yourself with beautiful things.

marcolm/FreeDigitalPhotos.net

62. Hang up motivational posters.

63. Spend time in nature.

64. Keep your home clean.

65. Use sticky notes to post affirmations where you’ll see them frequently.

66. Support any environmental causes you believe in.

67. Use your resources well.

68. Take basic safety precautions.

69. Repair broken things so they don’t continue to frustrate you.

70. Stay organized.

Occupationally

71. Do things you love.

Ambro/FreeDigitalPhotos.net

72. Know your limits when it comes to work.

73. Develop schedules and routines.

74. Simplify your work.

75. Get support from colleagues when necessary.

76. Keep good boundaries between your personal and professional lives.

77. Compliment coworkers on a job well done.

78. If you are unhappy in your job, look for a new one.

79. Multitask less.

80. Take a day off when you need to.

stockimages/FreeDigitalPhotos.net

Self-care

81. Journal regularly. 

82. Go for a walk.

83. Make your favorite meal.

84. Use grounding techniques.

85. Have a list of coping skills.

86. Be patient.

87. Keep a gratitude journal.

88. Go easy on yourself.

89. Respect yourself.

Other

Gualberto107/FreeDigitalPhotos.net

91. Stand up for yourself.

92. Believe you can get better.

93. Keep a beginner’s mindset.

94. Learn from every experience.

95. Keep some money in savings.

96. Have alternatives for self-destructive behaviors.

97. Be prepared for change.

98. Have a safety plan.

99. Stay progress-oriented.

100. Make a list of personal reasons to recover.

Do you have any tips to add? Please do so in the comments!

25 reasons to recover

On tough days, it’s important to remember why you are working on your recovery at all. When steeped in negativity, it’s hard to think of what you have to gain. But it is important that you do. Motivation and hope can get people through a lot. 

So what keeps you going? I suggest that you make a list of reasons why you want to recover. There is always something. Even if your list has a single item, you can turn to that one reason you have when you are feeling discouraged. You can do your list all at once and add to it as you think of new ones, or you can decide to write down one a day for as long as you can. To get started, here are 25 examples.

Stockimages/FreeDigitalPhotos.net

1. So you can feel confident in your own skin.
2. To truly be there for your loved ones.
3. To understand yourself better.
4. So you don’t have to worry about keeping up appearances. 
5. To think more clearly.
6. So you don’t have to be scared of going outside.
7. To be a more empathetic person.
8. So you can get out of bed in the morning with a smile on your face.
9. So you’re not afraid of food.
10. Because you deserve the best life you can live.
11. To be honest when you say, “Fine,” when others ask how you are.
12. So you can wear whatever you want without being uncomfortable.
13. To show your loved ones that you care about them.
14. So you don’t always compare yourself to others.
15. To concentrate better.
16. So you can actually enjoy celebrations. 
17. To feel motivated and inspired.
18. To improve your physical health.
19. To become a more accepting person.
20. So your dreams can become realities.
21. To show others that it is possible.
22. To feel like life is worthwhile.
23. Because you believe in second chances.
24. To show that you love yourself.
25. Simply do it because you can.

What are your reasons? Add to the list in the comments.

Have hope – it will change

  

Jeanne Claire Maarbes/FreeDigitalPhotos.net

Mental illness has a way of trapping you into thinking that you are stuck in it forever. A depressed person doesn’t lay in bed for three weeks and say, “Two more and I’m good.” Someone doesn’t think, “I’ll have five more panic attacks and then I’m done.” It’s pervasive. And even if you can logically convince yourself that it isn’t going to last forever, it’s hard to believe it enough to get the accompanying feeling of relief. It’s like a kid the week before Christmas. It drags on forever. 

The point is, though, that it isn’t forever. Like I said, it’s hard to believe. Really hard. But it’s true. There is an end to it. Even if you are suffering from a lifelong condition, the way it manifests will change. There will be variation. The pain you are feeling won’t feel the same way for the rest of your days. 

There is always change. If you aren’t changing, the world around you is. You might not be capable of changing yourself at the moment. That’s okay. Some days/weeks/months/years/decades are like that. But others aren’t. An acquaintance might transform into a good friend. A family member might have a burst of inspiration that results in him being more helpful. Your therapist can learn something new about your diagnosis and apply it to your treatment. You have to believe in change.

Change happens on larger scales, too. Psychologists do studies to find out which treatments are more effective and why. Scientists invent new medications. People learn to become more sensitive to mental health issues. You never know when the next breakthrough is around the corner.

That is why you have to believe that change is possible. It’s happening around you all the time. But it is possible for change to happen to you as well. It might take a really long time, but it does happen. I tried several different medications of a certain class before we found one that worked. Did it suck until we found it? Yeah. Did some of them make me worse? Yes. But when we did find it, it made my life easier. I was in therapy for seven years before I decided to take a chance on a new treatment approach and it transformed my life. I’ve had bad relationships. If I had given up on people, I would not have a boyfriend that makes me better every single day.

You never know how long it will take to change and that’s scary. It really is. I spent over a decade almost constantly fighting with a certain terrible feeling before it subsided. If you’d told me at the start that that’s how long it would take, I might have given up before even trying to get better. That amount of time is overwhelming. But it is a lot shorter than the rest of my life.

Stockimages/FreeDigitalPhotos.net

I’ve asked myself if it was worth it. How long can you endure misery before the chance of getting better is no longer worth it? There were times when I would have said not another day. Sometimes, I would have said that ridiculously many days in a row. But part of me didn’t let go. And eventually, things did turn around. 

It seems easy to say that, well, in retrospect it might be worth it. When you’re not in the midst of it, you can say it was possible to overcome. But my life is still affected by mental illness every single day. There are things I want to do that I can’t. Sometimes, I still get set off and have to spend a few days under the covers. But I have also found many things that are worth it. I have found relationships I could not have been healthy enough to manage before. I have come across new interests and started new hobbies that I would not have had the energy or concentration to learn about before. Even running this blog gives my life some sense of meaning. 

No one was more annoyed with the whole, “It gets better,” attitude than me. I felt like an exception. But the fact is that despite feeling hopeless, I still kept trying to get better. That effort pays off eventually. It will be small victories at first. It might be forgetting you’re suicidal for an hour or going a single day without drinking. But every bit of progress is still progress and it’s moving you forward. It might take you a thousand steps to get to somewhere when it takes someone else only 10, but you can still get there. 

With time, those steps do add up. Every day that you do your best matters. Everything is constantly in motion and you are becoming a new person minute by minute. Making the choice to recover helps you become a happier and healthier person. So love yourself for trying. That is one thing I always hold on to: I never stop trying. Knowing that alone has a powerful impact.

What gives you hope? Share stories in the comments.

13 theoretical orientations (and what that means)

This post is part of an organized reader request series. Stop by at the beginning of each month to make your requests on the designated post. This topic was suggested by reader Julie.

Ambro/FreeDigitalPhotos.net

There are as many different types of therapies as there are therapists. Maybe even more. Everyone has their own style and finds particular techniques or ideas to be helpful. Even so, there are general categories of therapy. These are called theoretical orientations.

A theoretical orientation is a theory about what causes mental illness and what can be done to heal it. In graduate school, future therapists are exposed to a variety of these and find what works best for them. There isn’t one that’s inherently better than another; research has shown that theoretical orientation doesn’t significantly affect therapy outcomes. 

But some therapies will work better for some people. When looking for a therapist, you can ask about his theoretical orientation in order to assess whether he might be helpful to you. You can also ask your current therapist about hers, as it might help you understand your treatment better. Here are 13 of the more common ones.

Cognitive-behavioral therapy (CBT)

This type of therapy focuses on beliefs and behaviors. With your therapist, you look at your thoughts, feelings and actions and look for maladaptive patterns. You might receive homework to track these things. They can then be worked on using specific techniques. CBT is commonly used to treat anxiety and depression.

Humanistic therapy

This orientation posits that people naturally strive for self-actualization. It encourages self-exploration and creativity. It emphasizes that everyone can be the center of their own healing. You will look at your values and help you find your inner wisdom. The focus is on positive adaptive traits rather than pathology.

Existential therapy

In this type of therapy, pathology is seen as stemming from internal conflicts with the givens of existence. These include death, freedom and its accompanying responsibility, isolation and meaningless. The present and future is focused on more than the past. The goal is to find out how to fully live.

Psychoanalysis

This therapy was developed by Sigmund Freud, but has been built on ever since. It believes that early childhood significantly impacts ones development and that we are driven by unconscious, irrational drives. Unconscious material causes us distress, which can be handled by bringing the material to consciousness. Sessions occur multiple times a week.

Psychodynamic therapy

Psychodynamic therapy is closely related to psychoanalysis, but is less intensive and focuses more on the therapeutic relationship. Psychodynamic therapy still addresses unconscious material and internal conflicts. It acknowledges maladaptive behavior and seeks to find its root. By bringing it to light, resolution can be achieved. 

Gestalt therapy

In Gestalt therapy, the focus is on being able to fully experience each moment. It also acknowledges the interconnectedness of everyone and everything. Relationships, including that with the therapist, therefore become important. It emphasizes personal responsibility and teaches one to have a higher level of awareness.

Feminist therapy

This therapy acknowledges the difficulties one might face due to sex, gender, race, ethnicity, religion, sexuality, level of ability, age and other traits that influence one’s position in society. By recognizing these forces, one can find ways to become more empowered. A lot of emphasis is placed on the therapist and client working together as equals.

Relational therapy

Relational therapy stipulates that reality is found in relationships. A relational therapist believes that a client’s problems stem from his relationships. Psychopathology comes from disconnection or dysfunction in one’s relationships. There is, naturally, a lot of focus on the therapeutic relationship, which can serve as a corrective experience.

Family systems therapy

This type of therapy will look at families and relationships as a unit and aims to treat it. The goal is to improve relationships and the family as a whole. It takes note of different patterns in the family and offers new alternatives. It is usually practiced by bringing in the entire family, but might also be used in individual therapy. 

Solution focused brief therapy (SFBT)

SFBT is a very structured and goal-oriented approach to treatment. It doesn’t delve into what the problem is and try to analyze it, but rather focuses on what the solutions are. By looking at times when the problem isn’t present or is less severe, successful practices can be identified and utilized in the future. 

Dialectical behavioral therapy (DBT)

DBT isn’t exactly a theoretical orientation, but it is a specific type of therapy. It is usually done as a group, but therapists will pull from it in individual work, too. The focuses of DBT are mindfulness, interpersonal effectiveness, emotional regulation and distress tolerance. It was created to treat borderline personality disorder, but has proven useful for other conditions, too.

Expressive therapies

Expressive therapies are a group of therapies that use creative expression to promote healing. This might include using art making, music, dance, drama, writing and recreational activities. The focus is on the process on creation. It is often used in conjunction with psychotherapy, but can also be used as the primary treatment when appropriate.

Eclectic therapy

Eclectic therapists take elements of different theoretical orientations and put them together in an individualized way. This could, for instance, mean combining the structured techniques of CBT with a good look at existential concerns in order to address feminist issues. A large number of therapists identify themselves as eclectic, so feel free to ask which modalities are an influence.

What types of therapy have you tried? What did or didn’t you find helpful? Share your experience in the comments.

A note on productivity

A lot of our sense of self comes from what we do. Our jobs, our skills, our hobbies – they all make up a big part of who we are. That is why mental illness’s interference with productivity can be so devastating. 

Stockimages/FreeDigitalPhotos.net

It’s tough to keep up with everything in our lives and mental illness makes it that much harder. It’s difficult to be a good employee when you can’t even get out of bed. When leaving the house is terrifying, you are restricted to what you can do at home. This toll on productivity can really affect self-confidence, which in turn can further damage mental health. This is why it’s important to reassess how much productivity is worth.

I’m currently in school. I started the semester with what I thought was a manageable class load – and I did keep up. I was doing well in all my classes, but it was very stressful. It started making my symptoms worse. I decided to withdraw from half of my courses. It was a difficult decision and it made me feel incompetent. Instead of letting my limitations get to me, I try to focus on the fact that I saw what I needed
                                                                                                                and chose to take care of myself. My health (both
                                                                                                                mental and physical) is more important than how soon
                                                                                                                I graduate.

It’s hard not to place your worth on how well you do. But self-care and managing your needs is so important. Without it, your productivity is going to suffer further in the long run. Check in with yourself every day and see how you are doing. Assess what your stressors are and how you can reduce them. Know when something becomes too much to handle and back off. Your needs are worth more than your output. When it comes down to it, a lot of the things we think we need to do are actually things we prefer to have done. 

You are more than what you do. You are your beliefs and your aspirations. You are the way you treat the ones you love. You are someone who keeps trying, and that in and of itself is admirable.

Why should I listen to you?

While this blog is not about me, I can understand why some readers might want to know what exactly qualifies me to write about this topic. In order to justify my endeavor, here is a summary of the relevant aspects of my experience for those who are interested.

Like many high school students, I felt depressed. Unfortunately, it's a relatively common phenomenon. Being a teenager includes moodiness, right? I had some other major factors in my life that could easily be seen as contributors, so I partially wrote it off. I was told that high school was not the best environment for me and that in college, I'd thrive and be happy. Even crushing suicidality was another thing that just happens.

My first semester of college, I was excited to be in a setting where I would finally fit in and succeed. That's not what happened. I had always gotten top grades, but I couldn't finish – or even start – easy assignments. It was not that I was not prepared for university-level work. It was the ever-growing melancholia that was taking over every aspect of my life.

At the time, I had started dating a doctoral student who was going into counseling psychology. Seeing me deteriorate, he told me that my experience was not just a normal phase and that I needed to get help. He referred me to the campus counseling center and that is how I entered therapy.

I have read countless memoirs concerning mental illness, looking for answers. They generally seem to end along the lines of, "And then I took Prozac/got an awesome therapist/met my significant other/moved/found the meaning of life/grew out of it – and lived happily ever after." This is not one of those stories. While taking that first step of reaching out to get help is a vital step in growing, there won't always be a magic pill, brilliant counselor or lifestyle change that will solve everything.

You will stumble along the way. There is no "intro to handling your mental illness" orientation meeting. No one will sit you down and explain how exactly you go about "getting better." I thought that a few weeks of therapy would cure me. Over six years later, that depression is still a part of my life.

While that sounds discouraging, it's actually amazing. I have a chronic condition, but I can function. I still struggle, but I know what my resources are. I continue to feel broken, but I don't feel despondent. Well, I have my days. I always will.

But reaching this point has been a hard-won battle. I went from thinking I was a sulking teenager to believing I had a depressive episode to a journey that, at times, is much stranger than fiction. I have met all sorts of characters who all had their own "interesting" takes on what was going on with me. There were times when I was being hurt more than helped by mental health professionals. During a particularly painful experience, I made a promise to do my best to make it so others would not have to endure that kind of suffering. It's hard enough to struggle with yourself; having the people who are getting paid to support you do damage of their own can be crushing.

Looking back, I could have many "if-only" wishes. If only someone had told me how to find a therapist that is a good fit. If only someone had explained psychiatric pharmacology better. If only those close to me understood the warning signs and intervened. If only someone had even told me how to properly ask for help… well, things would be different. But I don't regret it.

I did end up dropping out of college, then going back and forth for a while. That actually is normal young adult behavior. I diligently tried to improve myself through whatever means I could find. I found a few that help. Now I am working on a combined degree in psychology and communication in order to have the skill set necessary to guide others through a confusing world that, in and of itself, could drive someone "crazy."

I knew it was worth it when I got a 2 a.m. phone call from a distressed friend I hadn't heard from in a long time. Her younger sister had been admitted to a psychiatric unit and my friend was the only family member anywhere close enough to be of use. What was she supposed to do? How should she talk to her sister? Should she try to get her out of there? What could she expect? What would she need to do after discharge?

I didn't know all the answers. I still don't. But I knew where to point her. I knew which local agencies might be of use, as well as a few people she should avoid. Through both personal experience (including that of those around me), intense research and formal education, I have figured out a thing or two.

My aim here is to fulfill that promise I made to myself when I was at my worst. I can't fix your problems, but I can tell you how to get started.

So whether you are concerned for a loved one or feeling like you need some help yourself, welcome. It's a difficult but worthwhile journey you are embarking on. Let me show you the ropes and give you a map. I'm here as a friend. If I don't know the answer to your question, I will do my best to find it. I may not be the one who has the skills to ease your pain, but I have walked this path. I know the ditches and the shortcuts, as well as some beautiful places of reprieve.

I am here because I understand how confusing and overwhelming mental health issues can be. Let's figure this out together.

An incomplete education

There are certain challenges every adult is expected to know how to respond to:

Photo courtesy of @norwigger on Instagram.

How do I do laundry?
Where do I take my car for an oil change?
How do I fill out taxes?
Which stores have pants that fit me?
What do I do if my kid breaks her arm?

But then there are the ones that the average person is ill-prepared for:

What do I say to a friend who has suddenly lost interest in all his friends and hobbies?
Where do I go if I can't remember significant stretches of time?
Who can help me when I'm afraid to even leave the house?
Is there a supplement or medication that can make me focus better?
When do I seek treatment for my father's increasing disconnect with reality?

Mental health topics are given a cursory nod in high school health class and suicide hotlines are a small news item – sometimes – because of underfunding.  There's always the crazy aunt, but no one really cares to get involved because what can you do? A broken bone is met with sympathy while a diagnosis of
schizophrenia is unmentionable.

And yet the general population has a fascination with the functions (and dysfunctions) of the mind. There are movies about escaping mental institutions, TV characters with personality disorders and songs on the radio about bipolar lovers. Although cases of mental illness usually do not involve violence (at least not towards others), it suddenly becomes a temporarily real issue when a school shooting or suicide from bullying occurs. College students live on Ritalin and at any given workplace, you can be sure that there is someone on anti-depressants.

People manage their weight, check their blood pressure, get mammograms and visit doctors with complaints of the common cold. Is something hurting? Get it checked out. While you're at it, it's a good idea to get preventative care. Yearly physicals are a standard recommendation.

But when it comes to matters of the mind, hurting actually impedes getting help. How is someone bedridden with depression supposed to seek treatment when he doesn't even have the motivation to shower and get dressed? How is a student supposed to confront her roommate when she is becoming dangerously thin?

There are so many questions. There are also so many answers. So consider this blog the orientation you never got. The mental health system is complex, but a little street savvy advice and dissection of jargon can go a long way.

Health care – including that of the mind – is a business. Become an informed consumer.