Mental Health: Get your FAQs straight

I appreciate people who ask questions about mental health struggles – it shows that they care enough to dig a little deeper and are trying to understand. I should clarify here that I know some people ask questions because they are fed up or at their wit’s end. I would argue that as long as they have the patience to listen to the answers, those are still valuable questions.

Why is it important to ask questions? Because mental illness affects everyone. It affects those on the inside, as well as those on the outside looking in. In 2017, 43.7 million adults in the US suffered from some sort of mental illness (MHA, 2018), which means that chances are pretty high that if you don’t suffer from one, you know someone who does. According to a journal article from World Psychology, “Many people with serious mental illness are challenged doubly. On one hand, they struggle with the symptoms and disabilities that result from the disease. On the other, they are challenged by the stereotypes and prejudice that result from misconceptions about mental illness” (Corrigan & Watson, 2002).


Misconception: “A conclusion that’s wrong because it’s based on faulty thinking or facts that are wrong” (n.d.)


You might argue that a journal article from 17 years ago isn’t relevant anymore. Coming from someone who suffers from depression and anxiety, I can tell you that statement is still incredibly relevant. Stigma is a toxic byproduct of misconception, which is the direct result of lack of education. The National Alliance on Mental Illness reports that “stigma and misunderstandings about mental illness prevent families from facing the problem and seeking help” (NAMI, 2019). On the other hand, “education provides information so that the public can make more informed decisions about mental illness” (Corrigan & Watson, 2002). How does education happen? By asking questions.


Question: “A sentence or phrase used to find out information” (2019).


With all this in mind, I thought I would share some of the questions that get asked of me. Some I hear on a regular basis…some I’ve only heard once or twice. All are welcome. I urge you, though, to always consider how you pose your questions. You know the old adage – it’s not what you say, but how you say it. Due to the stigma that surrounds mental illness, it’s easy for some people to get defensive. This is due to the fact that they have likely been bullied growing up or have experienced less than compassionate interactions with the public and health providers as adults. The uneducated masses can be horribly unkind. If someone doesn’t seem comfortable answering questions, don’t push the matter. It might be a trigger for them. I would like to think, though, that open minded people would be willing to share their experiences for the sake of education. As mentioned before…that is the only way to end the stigma. It can all start with one person asking one question and waiting to hear the answer.

These FAQs are in no particular order. I am typing them as they come to mind. Bear with my stream of consciousness.


Is it okay that I don’t know what to say?

This was asked of me very recently by two different women who mean the world to me (my mom and my aunt). It was striking to me how similar and genuine the sentiment was in each separate conversation. The answer is quite simple: Yes, it’s okay that you don’t know what to say. No, it does not add to my anxiety that you don’t know what to say.

One of the difficult lessons I have learned over the last few years is that if someone has never experience anxiety or depression (or any other mental illness, for that matter), they will never truly understand. By this I mean truly empathize. You can still try to understand what I’m going through from an education standpoint, without actually knowing how it feels to be depressed or so anxious you don’t even want to leave the house.

It’s okay to not fully empathize or understand exactly what I’m going through on an emotional level, which means it’s okay to not know what to say. Most of the time I don’t even know what to say, so how could I place different expectations on anyone around me? Compassion and a little grace are all I ask for when words fail. Don’t put pressure on yourself to come up with some Hallmark greeting card sentiment. And certainly don’t put pressure on yourself to say something that will make this whole thing better – that’s what medication and therapy are for!


Is it okay for me to laugh while reading your blog or is that insensitive?

Please laugh! I deal with stress, pain, and general unease with humor. I’m sure it’s hard sometimes to know exactly how to take some things I pen, especially if you don’t know me on a personal level. But if I’m making fun of myself, I am doing so to show the world that life is too short and too important to be taken seriously. Some days, poking fun at my own depression is all that gets me through the day. Laugh with me…just don’t laugh at me. There’s a difference.


Have you thought about seeing someone for this?

I get this one ALL. THE. TIME. Here’s the thing: therapy is expensive. If I could sit down and talk to a professional once a day, I would. We live in a society that doesn’t take mental health coverage seriously. We live in a society where 3 therapy sessions are considered adequate for many Employee Assistance Programs. For someone with chronic mental health, routine therapy sessions can be very unkind to the pocket book. Although I just started seeing a new therapist a month ago, I realized it’s not a financially viable option for me long term. This is the world that we live in. When therapists charge $100/hour (as they should…they have so much expertise and education backing them up), but insurance waves my high deductible in my face, guess who doesn’t go to therapy?

That was a long, somewhat bitter way of saying that yes…I have thought about seeing someone. I’ve thought about it a lot throughout some of my emotionally traumatic experiences in the last few years. When you think about bringing this up to someone, do so with sensitivity and keep in mind that it’s not as easy as finding a therapist you mesh with and having coffee with them. Oh how I wish it were that easy. Remember that there are often extenuating circumstances that prevent ongoing therapy. If someone isn’t going, don’t assume it is because they are lazy or in denial. Maybe someday mental health benefits will be where they need to be. Until that day, I fight my battles without the help of a professional counselor.


What do you do when you are stuck obsessing over something?

When I begin to experience obsessive anxiety, it can quickly spirals out of control. It sometimes gets to the point that I can’t focus on any task at hand. My mind goes into hyper-analysis mode and starts exploring all the worst possible outcomes to whatever situation has caught my eye so thoroughly. Often I know that I am being irrational, but by then it’s too late. Usually, the key for me is to pull someone I trust aside, explain to them what I’m worrying over, and let them talk me off the proverbial cliff. Sometimes it takes talking to a “normal” person (i.e. someone who doesn’t have irrational, obsessive anxiety) to realize that everything will be okay.

I’d like to quickly draw your attention back to the phrase someone I trust. I have learned over the years that not everyone is willing to talk you down. Not everyone is capable of understanding what obsessive anxiety is. They don’t want to acknowledge that, while I know my fears are unfounded and irrational, I can’t stop the invasive thoughts that interfere with just about everything except breathing. Sometimes even breathing is threatened! The trusted people in our lives are often family members, significant others, or close friends. It becomes easy to go to these people over and over, which can unfortunately become frustrating for them. In my experience, my significant others are the ones who become most hard on me and tell me to “just stop worrying” or that “obviously that won’t happen…forget about it.”

In those moment of blind panic, having someone say “you worry too much” is the most defeating answer to my cry for help. What I need is this: don’t point out how crazy I am. Instead, walk me through the reasons that the expired macaroni and cheese I just ate isn’t going to kill me. Walk me through the reasons why driving up over a curb unintentionally isn’t going to cause Armageddon to fall down upon us. Although my extreme anxieties may seem silly and irrational to you, please acknowledge that for me, they are very, very real. When everything is out to get me, a patient person who is willing to talk me off the ledge is the most helpful thing I can ask for.


Does it help to talk about it?

See above. For me, it helps for a number of reasons. 1) It gives someone the opportunity to talk me down, 2) it helps me feel like I am spreading education, and 3) it is an outlet when I have been bottling up emotions and fears.

One thing I will add here is that I am a much better communicator through the written word. Talking in person can be incredibly difficult for me. I fumble for the correct words, forget what I am saying mid-sentence, and trip over my own tongue. This generally triggers my social anxiety and things just go downhill from there. If I struggle to express my feelings to you verbally, don’t think it’s because I don’t know what I want to say. It’s usually because I need to write it down first.


Is all that medication really necessary?

For some people, medication works better than any other forms of treatment. If you remember that mental illnesses are due to genetic makeup and chemical imbalance in the brain, you have to view it as a physical disease, not just an emotional disorder. Would you go up to someone with cancer and say, “Do you really feel that chemo is necessary? Have you tried meditation instead?”

So my educational takeaway is this: I wouldn’t put chemicals into my body – chemicals that have almost certain side effects – if I didn’t feel it was necessary for my sanity and survival. My psychiatrist started me on a mood stabilizer a couple months ago. I can quite confidently say that it saved my life. I take antianxiety/antidepressants so that I can go out in public and function on a daily basis. I take sleeping medication so that I can get a decent night’s sleep, which raises my threshold for both anxiety and depression. There is a method to the madness. Instead of asking someone if all that medication is necessary, it might be better to ask what the medication is for. You might be amazed by how much you learn!


Are text messages an impersonal way to check in on you?

I hate talking on the phone. The awkward silences (most often caused by my verbal constipation) generate an insane amount of anxiety and distress for me. I most certainly do not consider it impersonal to reach out to me via text. Just the fact that you are reaching out is enough to bring some light to a potentially very dark day.


Can’t you just stop worrying?

Let’s talk about this one. I get it a lot. I mentioned earlier that it is usually the people who are closest to me – who live with me on a daily basis – who start to push this question to me. My very first serious boyfriend gave me a book on my birthday about how to stop worrying. Each significant other after him proceeded to tell me to just stop worrying so often that it got to the point that I felt I couldn’t talk to them about anything. I felt shut down inside a relationship that should be a safe place.

That being said, this can still be a valuable question…but only if you listen the first time or two it is answered. Try to keep in mind that I don’t choose anxiety for the sheer joy I get out of it. No. It is a devastating illness that spreads into every area of my life. If I could just flip a switch and turn it off, I would do that. As you seek to further educate yourself and ask more questions about your loved one’s mental illness, this question should answer itself. It is not a choice.


Does being around other people help?

It depends on my mental state, so that answer may change from one hour to the next. Sometimes I want to be in the company of people I care about for an afternoon or evening. Sometimes I want to barricade myself in my apartment and not come out for days. If you ask someone with anxiety or depression to come out with you and they say they aren’t feeling up for it, it doesn’t often help to say something like “Oh come on…it will make you feel better.” I can tell you that in my experience, depression and chronic anxiety are EXHAUSTING. There are times where the mere thought of going out in public brings me near to tears because I don’t have the energy. I’m not saying no simply because I’m feeling antisocial or don’t like you anymore. I’m saying no because my very sanity depends on it. The same applies if I come over and end up leaving after only an hour or so. I get overstimulated and anxious, even when I’m with people I know and love. If I suddenly stand up and say I need to get going, don’t try to change my mind. Instead, acknowledge that I know my limit and I have reached it. The only thing more exhausting than facing the world is feeling guilty for not having the energy to face the world.


How are you today?

I can never actually tell if people ask this because they genuinely want to know or if it’s just to be polite. I fall into the category of people who tends to say “Fine, how are you?” instead of being honest. It causes me a lot of anxiety to think about opening up to someone in the elevator when all they were doing was acknowledging my presence.

When it’s obvious that someone is asking because they genuinely want to know, sometimes it’s enough to make me cry. If you are honestly worried about someone and are concerned that they are a danger to themselves or others, try to press a little bit when they only want to give you the standard “I’m okay” answer. Don’t be bossy. Just encourage them that you are there for them. It may be the tree root that that person is able to grab as they plummet off the cliff.


Have you considered [insert diet or health trend here]?

I think even the most sane and mentally healthy people would tell you that diets are difficult to follow. They would also tell you that if you stick to it, they can be wonderful stepping stones to a healthier you. I’ve considered a couple different diets recently, based on the positive results people experience on a physical, mental, and emotional level. While I am of average build and don’t necessarily need to lose a lot of weight, it’s the lifestyle change that appeals to me. So why didn’t I do it? I realized that the diet plans I was looking at involved strict self-control, a ton of meal planning, and denying myself some of life’s simple comforts. Pretty much describes any diet, right? Exactly.

What I realized is this: my perception is that I have failed at so much leading up to this point, so why would I set myself up to fail something else? One of the diets allows no alcohol, but I’ve learned that every now and then a glass of wine is exactly what I need to take the edge off. I am not an emotional eater, so why should I put so much added pressure on myself when I am in such a delicate emotional state? It was an important lesson is acknowledging and respecting the fact that there is a time and a place for everything. Maybe in a year or two I can say goodbye to alcohol and carbs for 30 days. Until then, my self-care inner voice is telling me to enjoy a piece of cheese, savor a Dr. Pepper, or nibble on an Almond Joy if I need to. All good things in moderation, right?


You know you can call anytime, right?

Depression does not foster a proactive mentality. I understand that I am surrounded by people who are only a phone call away. However, usually when I am in a bad enough place that I truly need to talk to someone, I have become numb to that option. If I am in a bad place, I don’t deny that I can call people. What my mind and body deny me is the energy to do so. The idea of explaining my mental state seems like too much to bear. Just picking up the phone seems exhausting.

On top of that, I don’t want to be a burden. I know that everyone has their own struggles. I often don’t feel that I am worthy of placing more to their list of worries. That does nothing but make me feel guilty, which pushes me deeper in depression and higher into anxiety. Sometimes it is easier to just curl up in a ball and cry my way through it.

Thank you to everyone who remains just a phone call away, though. I hear you.


How do you put yourself out there like you do in your blog?

It’s all for the sake of education for every player in this elaborate story that is mental health. I don’t do it for attention or pity or accolades. One of my new favorite quotes is this: “I hope that if you read yourself in my story, it will hold up a mirror for you” (Hollis, 2018, p. 53). If putting myself out there for all the world to see – the good, the bad, and the ugly – helps one person realize that they have worth because of their unique struggles (not in spite of them!) or helps one family member better understand what their loved one is experiencing, then it is worth it. Ending stigma and misconceptions are worth it.


 

References

Corrigan, P. & Watson, A. (2002). Understanding the impact of stigma on people with mental illness. World Psychiatry. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1489832/

Hollis, Rachel. (2018). Girl, Wash Your Face. Nashville, TN: Nelson Books.

MHA. (2018). 2017 State of Mental Health in America – Prevalence Data. Mental Health America. Retrieved from http://www.mentalhealthamerica.net/issues/2017-state-mental-health-america-prevalence-data?gclid=EAIaIQobChMIyvvR-I-A4AIVj8DACh0BhAzkEAAYASAAEgILffD_BwE

Misconception. (n.d.). Vocabulary.com. Retrieved from https://www.vocabulary.com/dictionary/misconception

NAMI. (2019). Family Education and Support. National Alliance on Mental Illness. Retrieved from https://www.nami.org/Learn-More/Mental-Health-Public-Policy/Family-Education-and-Support

Question. (2019). In online Cambridge Dictionary. Retrieved from https://dictionary.cambridge.org/dictionary/english/question

Anxiety and Depression: What’s the big deal?

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Trigger warnings: anxiety, depression, suicide

There’s a reason two of the most common things I hear are “You worry too much” or “Just stop worrying about that.” There is a deep level of ignorance in this society regarding mental illness. I would love to be asked “Why do you worry about that?” or “Are you able to stop worrying about that?” instead, but until people learn more about anxiety or any other mental illness, they will never understand what kind of questions to ask or things to say. I don’t believe most people are ignorant because they choose to be ignorant – the problem is a direct result of stigma, shame, and people being afraid to be open about their struggles because they will be… [insert whatever appropriate word here: bullied, not accepted, labeled, shunned, embarrassed, etc.].

So how do we fix this ignorance dilemma? In my mind, the answer is simple – if not easy – because it starts by looking in the mirror. Sometimes I doubt the fact that the world can start to change with just one person, but in this case, I think it’s true. If I do what I can to educate myself and a few others, then if each person I reach out to works to educate themselves and a few others, we have a ripple effect that might change the world as we know it. So what do you think? Do you want to change the world with me?


“We all experience emotional ups and downs from time to time caused by events in our lives. Mental health conditions go beyond these emotional reactions and become something longer lasting. They are medical conditions that cause changes in how we think and feel and in our mood. They are not the result of personal weakness, lack of character or poor upbringing” (NAMI, Learn More, 2018).


I absolutely love the above statement from the National Alliance on Mental Illness (NAMI). It does an amazing job of succinctly stating not only what mental illness is (a medical condition), but also what it is not (weakness, cries for attention, or the result of being a bad person). The stigma, and subsequent deep-seated shame, come as a result of people clinging to incorrect ideas of mental illness.

For me in particular, I have the exhausting combination of Generalized Anxiety Disorder (GAD), Social Anxiety Disorder, and Depression. I once had a primary physician (yes, a medical doctor) tell me that anxiety and depression are the same thing and should be viewed and treated as interchangeable. Ummmmm…no. Anyone who thinks anxiety and depression are the same has obviously never experienced either. It is frustrating when even medical professionals don’t take it seriously or don’t even try to understand the difference. What makes this scenario even worse is that this is someone who was prescribing a psychiatric medication. How could they possibly be trusted to know what or how much to prescribe when they don’t even acknowledge the difference between illnesses? There’s a reason I don’t have my PCP manage psych meds anymore! This is an example of why it is critical to find a good psychiatrist for medication management and/or a good therapist for behavioral therapy or psychotherapy – not all medical professionals are created equal when it comes to psychiatric care.

Every person’s story is unique. Every person’s experience with mental illness is different. In order to hopefully shed some light on and reduce ignorance about mental illness, I want to share a little more about my own demons. Please remember that my story is just one of thousands. My experience with a specific disorder may be completely different than someone else’s. It’s dangerous to generalize when it comes to mental health – each illness is so incredibly specific to each individual. Please keep that in mind as you continue reading.


Generalized Anxiety Disorder

What is it?

According to the Mayo Clinic, Generalized Anxiety Disorder is characterized by “excessive, ongoing anxiety and worry that are difficult to control and interfere with day-to-day activities” (Mayo Clinic Staff, 2017). A more detailed list of symptoms include “persistent worrying or anxiety about a number of areas that are out of proportion to the impact of the events; overthinking plans and solutions to all possible worst-case outcomes; perceiving situations and events as threatening, even when they aren’t; difficulty handling uncertainty; indecisiveness and fear of making the wrong decision; inability to set aside or let go of a worry; inability to relax, feeling restless, and feeling keyed up or on edge; and difficulty concentrating, or feeling that your mind ‘goes blank’” (Mayo Clinic Staff, Generalized Anxiety Disorder, 2017). I have yet to see a more accurate list of mental and emotional symptoms. This doesn’t even include the physical symptoms one might experience on a day-to-day basis.

What causes it?

If I asked some Joe Schmoe off the street what causes an anxiety disorder, he might say, “It’s caused by someone worrying too much.” I use this example because that is what I have gotten time and time again from people who know me, yet don’t want to take the time to understand me. It is unfortunately not so simple – oh, how I wish it was…it would be easier to “get over it” if it was! Instead, it is caused by “a complex interaction of biological and environmental factors, which may include differences in brain chemistry and function, genetics, differences in the way threats are perceived, and development and personality” (Mayo Clinic Staff, 2017). As much as people don’t want to admit it, anxiety can (and often does) have a biological source. In fact, more than one part of the brain can play a role in anxiety disorders (NIMH, 2016). Although overthinking and worrying are symptoms of anxiety, they are not the cause or sole factor.


Social Anxiety Disorder

What is it?

NAMI defines Social Anxiety Disorder in the following way: “More than shyness, this disorder causes intense fear about social interaction, often driven by irrational worries about humiliation (e.g. saying something stupid or not knowing what to say). Someone with social anxiety disorder may not take part in conversations, contribute to class discussions or offer their ideas, and may become isolated. Panic attacks are a common reaction to anticipated or forced social interaction.” (NAMI, Anxiety Disorders, 2017).

Speaking from my own experience, what seems to be irrational to other people is extremely debilitating. I went to therapy for several months to try and prepare myself for my own wedding because I was so terrified of all the social interactions and expectations. I often lay awake at night thinking about my various social interactions throughout the day, wondering if people think less of me because of how or why I said something. I hyper analyze every aspect of my behavior before, during, and after social situations. It is not uncommon for me to ruminate over other possible responses months or even years after the fact. I acknowledge that I likely invent perceptions that others have of me, which in turn influence how I perceive myself. I allow these perceived opinions of me to directly influence my own self-worth and self-confidence. At times, it makes it impossible for me to participate or even attend social gatherings. When I do attend social events, you will most likely find me sitting in a corner by myself observing the other event goers, hoping no one feels the need to come keep me company, yet wishing desperately for someone to rescue me from my misery. It’s really quite awful. If you have someone in your life with social anxiety, I would highly recommend sitting down with them and having a heart to heart conversation about ways in which you can help them manage their anxiety and even ease some of their suffering while in the midst of social interaction.

What causes it?

As with GAD and most other mental illnesses, there are many different factors that come together to cause Social Anxiety Disorder. Genetics and brain structure play a big part. According to the Mayo Clinic, “people who have an overactive amygdala may have a heightened fear response, causing increased anxiety in social situations” (Mayo Clinic Staff, Social Anxiety Disorder, 2017). The theory of nature versus nurture plays a big role with Social Anxiety Disorder sufferers. We may have been classically conditioned to exhibit a fear response due to some bad experiences in the past, but there also “may be an association between social anxiety disorder and parents who either model anxious behavior in social situations or are more controlling or overprotective of their children” (Mayo Clinic Staff, Social Anxiety Disorder, 2017).

I find the last one factor incredibly interesting, especially in my case. Anxiety does run in my family, but I was also homeschooled from kindergarten all the way through high school. Whether we like to admit it or not, homeschoolers have a pretty bad reputation for being socially challenged at best. This stems from having little to no social interaction beyond that of our siblings and parents. Some homeschoolers are more involved with extracurricular activities than others. In my case, we really only had social interactions outside of the home when we would attend church functions. I would argue that this kind of protective environment can backfire because a lack of social interaction comes with the heavy cost of non-existent coping mechanisms for awkward or uncomfortable social situations. Although I have been told that I don’t come across as the stereotypical homeschooler and that I seem to do okay with social interaction, the turmoil going on under the surface in indescribable. You may not see the anxiety, but oh is it there. It makes me wonder if greater social interactions growing up would have aided in development of appropriate social coping mechanisms.

Note: I know my mom reads this blog, so I’ll make a note here that I don’t blame my parents for my struggles with mental health. It is no more their fault than mine. It is no one’s fault! Although environment plays a key role in cognitive development, I believe I have a genetic predisposition. I am who I am for a reason and no one should be blamed for the good, the bad, or the ugly!


Depression

What is it?

The Mayo Clinic describes depression as “a mood disorder that causes a persistent feeling of sadness and loss of interest… it affects how you feel, think and behave and can lead to a variety of emotional and physical problems. You may have trouble doing normal day-to-day activities, and sometimes you may feel as if life isn’t worth living” (Mayo Clinic Staff, 2018). If you take nothing away from this, take away the fact that depression is more than just feeling sad that your favorite TV show was just cancelled or that you went for ice cream and they were out of your favorite flavor. Depression is a life altering, sometimes life ending, illness. It is serious.

Speaking from recent experience, depression can be both devastating and terrifying for both the sufferer and their loved ones. I personally live several hundred miles from my immediate family and from my very best friend, so they felt helpless to do anything while I tried to deal with significant depression and even suicidal ideation. What made the biggest difference in attempting to pull myself out of my depression were three things:

  1. Emotional support system: Although my immediate family and best friend do not live in the same state as me, I have identified several key players in my local support system. I opened up to them about the ugliness going on in my life. Making others aware of what you are going through can be the game changer you need. It is a way to hold yourself accountable to seek help and treatment. It also provides an outlet when you need to talk out some feelings, as well as someone to reach out to when you are in over your head. I also adopted a dog, who provides companionship and a level of emotional therapy I never imagined possible.
  2. Medication management: I recognized that I was in trouble and scheduled an appointment with my psychiatrist. We have been working diligently to adjust and modify my medication regimen to enable greater success in my recovery.
  3. Therapy: I am realizing that I can only process so much on my own or with the help of friends. Considering what I have been through the last few years and how volatile my emotional and mental states have been, I am finally realizing that I need to get a professional involved in helping me process everything correctly and in a productive manner. Hopefully some hard work with my new therapist will help me avoid future run ins with depression.

What causes it?

NAMI states that “depression does not have a single cause. It can be triggered by a life crisis, physical illness or something else – but it can also occur spontaneously” (NAMI, Depression, 2017). Emotional, mental, and physical trauma can be a major player in depression. Losing a loved one, going through a divorce, or experiencing abuse can really change the way we view ourselves, expect to be loved, or even love ourselves.

Physiological causes of depression seem to be better understood than the causes for the two anxiety disorders I discuss above. NAMI explains that “the frontal lobe of the brain becomes less active when a person is depressed. Depression is also associated with changes in how the pituitary gland and hypothalamus respond to hormone stimulation” (NAMI, Depression, 2017). These are some crucial bits of brain anatomy being mentioned.

  • Frontal Lobe: “Carries out higher mental processes such as thinking, decision making, and planning” (brainmadesimple.com, Frontal Lobe, n.d.).
  • Pituitary Gland: “It’s main function is to secrete hormones into your bloodstream” and one symptom of pituitary gland issues is “changes in psychological state, including mood swings or depression” (Seladi-Schulman, 2018).
  • Hypothalamus: “Controls the pituitary” and “influences the functions of temperature regulation, food intake, thirst and water intake, sleep and wake patterns, emotional behavior and memory” (Pituitary Foundation, 2018).

I mean, holy moly. If you look at just those three things, not to mention environmental stressors and traumatic life events, see what functions are influenced? My psychiatrist told me recently to “not make any big decisions while you are depressed because you are not thinking rationally.” I can see why! Think about that small list of brain anatomy next time you are tempted to think that depression is simply someone being sad, lazy, or “just” emotional.


Now….take all three of those and put them together!

“Having anxiety and depression is like being scared and tired at the same time. It’s the fear of failure, but no urge to be productive. It’s wanting friends, but hating socializing. It’s wanting to be alone, but not wanting to be lonely. It’s feeling everything at once, then feeling paralyzingly numb.” – Unknown

There are so many other mental illnesses and so many stories that are similar and vastly different to my own. I hope sharing a combination of objective facts and subjective experiences can help others understand a little bit more of what I and countless others go through on a daily basis. And I hope that having the courage to open up and be vulnerable about my own experiences inspires some others to open up about theirs. Yes, stigma exists, but it should not. So many of us suffer from mental illness. Let’s join together and fight this fight proudly. We are all survivors! As a dear friend of mine reminds me continually, “You have survived 100% of your days up to this point. You will survive today as well.” (love you, Steph!)

Come on…let’s be the ripple that causes a tsunami of understanding.

 


References

Brainmadesimple.com. (n.d.). Frontal Lobe. Retrieved from http://brainmadesimple.com/frontal-lobe.html

Mayo Clinic Staff. (2018). Depression. Retrieved from https://www.mayoclinic.org/diseases-conditions/depression/symptoms-causes/syc-20356007

Mayo Clinic Staff. (2017). Generalized Anxiety Disorder. Retrieved from https://www.mayoclinic.org/diseases-conditions/generalized-anxiety-disorder/symptoms-causes/syc-20360803

Mayo Clinic Staff. (2017). Social Anxiety Disorder. Retrieved from https://www.mayoclinic.org/diseases-conditions/social-anxiety-disorder/symptoms-causes/syc-20353561

NAMI. (2017). Anxiety Disorders. Retrieved from https://www.nami.org/Learn-More/Mental-Health-Conditions/Anxiety-Disorders

NAMI. (2017). Depression. Retrieved from https://www.nami.org/Learn-More/Mental-Health-Conditions/Depression

NAMI. (2018). Learn More. Retrieved from https://www.nami.org/Learn-More

NIMH. (2016). Generalized Anxiety Disorder: When worry gets out of Control. National Institute of Mental Health. Retrieved from https://www.nimh.nih.gov/health/publications/generalized-anxiety-disorder-gad/index.shtml

Pituitary Foundation. (2018). What is the pituitary gland? Retrieved from https://www.pituitary.org.uk/information/what-is-the-pituitary-gland/

Seladi-Schulman, Jill. (2018). Pituitary Gland Overview. Retrieved from https://www.healthline.com/human-body-maps/pituitary-gland

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Merry Christmas to the misunderstood and the lonely

It’s Christmas Eve. So many familiar songs of the season fill the air as families and friends gather to exchange gifts, eat good food, and enjoy each other’s company. In particular, the words by Noel Regney stand out to me today: “Do you see what I see… Do you hear what I hear… Do you know what I know…Listen to what I say…” (1962). Although I know mental health awareness was probably not on his mind when he penned those words, I can’t help but feel that countless people with mental illnesses can relate as we are struggling to “fit in” or simply survive this Christmas.

Seeing those bits of the song pulled out and pieced together, I see a plea for understanding. Experience truly is a brutal teacher. Those who have never experienced mental illness can sit next to someone with anxiety, yet have no notion of how consuming the illness can be. Those who have never experienced depression can sit next to someone with depression, yet have no understanding of the hopelessness that accompanies the illness. The same can be said of all mental illnesses. Unless you have walked in my shoes, you unfortunately will never understand just how deeply these issues influence every aspect of my life, including holidays with family and friends.

With this in mind, I thought I would write this short Christmas post to say “I get it” to those people out there who are struggling through Christmas feeling misunderstood or alone in their struggles. You are unique, as are your individual struggles, but you are not alone. I’m right there in the thick of it with you. There are a few things I try to do or to keep in mind at social events. Whether I am with a group of strangers or with people I have known my entire life, sometimes one or all are necessary. 

  1. Enjoy the little things – focus on how delicious your food tastes or the sound of Christmas carols in the background.
  2. Think about what is happening right now, rather than what could happen or what might have happened.
  3. Escape to a quiet area when a group setting becomes too overwhelming
  4. Establish an ally – someone you can pull aside if you need help getting out of an endless anxiety loop.
  5. Don’t be afraid to leave early if you need to do so for the sake of your mental health.
  6. Set boundaries – don’t participate in activities that make you too uncomfortable.

Finally, if anyone is reading this and is struggling to survive this Christmas, reach out to me. My email is tealmhawareness@gmail.com. You are not alone. I am happy to commiserate or talk about shared or different experiences or coping mechanisms. Christmas is about love and acceptance, not pain and loneliness.

References

Regney, Noel. (1962). Do You Hear What I Hear? Lyrics retrieved from https://www.lyrics.com/lyric/1449506/Star+Bright/Do+You+Hear+What+I+Hear-The+Little+Drummer+Boy

Confessions of a Drowning Social Moron

drowing

I was curious about common definitions of Social Anxiety Disorder (SAD) – a disorder I live with each day. According to all-knowing Google (2017), SAD is “a chronic mental health condition in which social interactions cause irrational anxiety” (para. 1). This comes across as a bit obtuse and vague. If I tell someone I have SAD, do they think I walk into a party and am afraid all the party goers will turn into pink dinosaurs and eat me alive? Because that seems like an irrational anxiety to me. In my world, in my head, my anxieties surrounding social situations are not so easily explained by just labeling them irrational. To me they are very real and very scary. I found a much more accurate description on the Anxiety and Depression Association of America (2010-2018) website:

“The defining feature of social anxiety disorder, also called social phobia, is intense anxiety or fear of being judged, negatively evaluated, or rejected in a social or performance situation. People with social anxiety disorder may worry about acting or appearing visibly anxious (e.g., blushing, stumbling over words), or being viewed as stupid, awkward or boring. As a result, they often avoid social or performance situations, and when a situation cannot be avoided, they experience significant anxiety and distress” (para. 1).

THAT. That is what I experience every single day when we step foot out of our front door.  It’s not irrational anxiety…it is just anxiety. I am not afraid of other people. I am, however, afraid of how other people see me. What if I say the wrong thing? Why are those people whispering…are they talking about me? What if I mispronounce a word? What if I trip over nothing? What if I have an allergic reaction to something I’m eating in public? What if I get in a car accident while someone else is in the car with me? What if I call someone by the wrong name? What if I have an upset stomach and can’t make it to the bathroom in time? What if I run into one of my ex’s friends? What if I run into a wall? What if I drop food down the front of my shirt? What if I’m asked to play a sport and can’t do it? What if I choke on my drink and cough all over the person next to me? What if I fall down the stairs at the Brown Palace? What if I don’t have enough money to pay for my lunch? What if…? What if…? What if…? What if…?

It is exhausting. These thoughts are racing through my head at work, school, social events, big group outings, one-on-one meetings. It never ends. I have found what makes or breaks a social situation for me is the support I receive from those closest to me. I am a firm believer that people don’t know how to support those with mental illness because we are afraid to reach out and tell you exactly what that support might look like.

With that in mind, here are a few “what not to say” tips for anyone who has someone in their life who suffers from debilitating social anxiety.

  1. Stop worrying so much!

As soon as you start to tell me I’m being irrational or that I am worrying too much, I will become frantically anxious about how anxious I am. It is a vicious cycle and making a big deal out of it helps in no way, shape, or form.

  1. Just do another shot!

Yes, sometimes alcohol helps to take the edge off, but unlike what some people from my past thought, getting drunk before any social gathering is NOT the way to cope. If anything, it makes anxiety grow as the day/evening/event goes on because now I am worried about all those other things PLUS being completely drunk and talking too loudly, saying even more ridiculous things, or puking all over myself.

  1. I can’t talk about this again!

If I bring it up multiple times, it’s because it is my life and sanity on the line. It is meaningful to me. I know you don’t necessarily understand…and that’s okay! I don’t expectyou to understand. But I need you to be sensitive to this very real disorder that plagues me every day.

  1. But you know everyone there!

I am just as terrified, if not more terrified, of making mistakes and looking like a fool in front of people I know. Being around friends and family can at times be exhausting. It is not a reflection on you, but rather on me. Don’t get offended if I don’t want to hang out or if I cancel at the last minute. Sometimes I just can’t do it.

  1. But you had fun last time!

That was last time. It may have been last night, last week, last month, or last year, but it was still last time. Maybe I had an exhausting day today. Maybe my anxiety was extra high because of that project at work, so now I’m already too worn out to face another small or large group of people. If I do well in a social situation once, don’t be disappointed in me if I don’t do well the next time. I hate to suggest you should “lower your expectations,” but sometimes it may be necessary.

  1. You drive me crazy!

That only makes it worse. I can’t speak for all people with general anxiety or SAD, but I have a very healthy guilt complex that pairs better with my anxieties than a fine red wine pairs with filet mignon. Please don’t guilt trip me. I’m not fragile…I just ask that you be considerate and patient with me. This is very real to me whether you understand it or not.

  1. I can’t help you!

Oh, but you can. All you need to do is sit down with me, listen to some of my fears, and see what you can do to help. For example, one of my biggest fears is not being able to locate a bathroom in a restaurant, private residence, or larger event venue. I felt like I had a breakthrough in a previous relationship because he realized this was a huge source of anxiety, so all I had to say was, “I need to use the bathroom” and he would point out its location. It’s little things like that that make a huge difference. Even if you don’t understand, figure out how to help put my anxiety at ease so I am better able to navigate a social gathering.

  1. Can’t you just be normal?!

Listen. This ismy normal. I’m not going to get over this like a common cold. If you can’t accept me and love me for all of me, including this side of me, then I may need to step away from our relationship for my sake and yours – it’s not healthy for either of us.

There are alternative phrases that would work for every single one of those above. Also note that saying the words and meaning the words can make a huge difference.

  • What can I do to help you get through this evening?
  • Am I introducing you to too many people?
  • Are you okay with me leaving to go spend time with that group over there?
  • Would you rather stay home? *if the answer is yes, don’t make me feel guilty about it*

Please remember that just because you have never experienced something or don’t understand something, that doesn’t mean it is not a valid struggle for someone else. Keep an open mind. Be patient. Show empathy. We are strong in our own way, whether you see it or not. Help us pull that strength out and make it shine. We can do it alone, but it is so much more difficult.

social moron

Resources:

Anxiety and Depression Association of America. (2010-2018). Understand the Facts: Social Anxiety Disorder. Retrieved from https://adaa.org/understand-anxiety/social-anxiety-disorder

Google. (2017, Sept. 11). Social Anxiety Disorder. Retrieved from http://www.google.com/search?q=Social+anxiety+disorder

Chronic Anxiety: A day in the life…

1:15 am – Sits up straight in bed. What an awful dream! Are the sheets drenched in sweat or did I pee the bed?

2:09 am – What was that noise? Did I lock the door? Better go check.

3:29 am – Go. To. Sleep.

3:41 am – Bolts awake. Am I late for work?

3:52 am – I only have a couple more hours to sleep.

3:59 am – My side hurts. Is it appendicitis? I need to check my temperature.

4:04 am – What if I never get back to sleep?

4:15-5:40 am – Listens to audio book.

5:40 am – Finally dozes off

5:45 am – Alarm goes off. Snooze.

5:54 am – Snooze.

6:03 am – Snooze.

6:12 am – I’m going to be late for work! Quick! Make the coffee.

6:30 am – Falling asleep in the shower. I forgot to make the coffee!

6:45 am – Forgot to make lunch, but made coffee. Priorities.

6:48 am – Where did I park when I got home last night? And where are my keys?!

6:59 am – Was that a pot hole or did I just run someone over?

7:00 am – Turning around to make sure there isn’t a person dead in the road.

7:04 am – Where did I put my parking pass? Do I have change for a meter if I can’t get in to the parking garage?

7:06 am – Did I hit the car next to me with my door? I don’t see any marks and didn’t feel the door hit anything, but what if I did?

7:09 am – I’m half way into the building, but I better go check one more time to see if I door dinged that car.

7:13 am – Dang it. Did I lock the car? Better go back again and check.

7:20 am – I can’t remember my computer password. How am I going to clock in?

7:24 am – I’m so tired already! What if I fall asleep at my desk and get fired?

7:30-11:09 am – Is everything good enough? Which task did I do wrong? I can’t believe I just said that to someone – I am such an idiot! Later I need to analyze the conversation more to see what I should have said and how they might have interpreted what I did say. I can’t remember that person’s name. I need more caffeine. Did I shut off the coffee maker? What am I going to do for lunch? I can’t keep going out to eat…I’m going to gain too much weight and spend too much money. I was just zoning out in the meeting and missed what the person said. I told someone the wrong thing and now I’m so embarrassed that I want to crawl under the table and die. I think I just closed the wrong case. Did I lock my computer before I stepped away? What if someone gets on my computer and does something malicious? I just spilled coffee on myself! What if someone thinks I’m lactating and have been hiding a baby all this time. Who’s hair is this in my yogurt….I definitely can’t finish this now. Hair…did I unplug the hair dryer this morning? What if my pen runs out of ink during the next meeting? Where is that conference room again? What if I get locked in the stairwell and no one realizes I’ve been missing all morning?

11:11 am – make a wish! Omg. It’s already 11:12. Now what do I do? Can I still make a wish?

11:30 am-12:00 pm – this lunch was too expensive and has way too many calories. Remember to check weight in the morning. What time did I clock out for lunch again? What if I’m late going back? Did I have a meeting at 12:00 or was it 2:30?

12:06 pm – Don’t forget to put bread and string cheese on the grocery list.

12:08-4:00 pm – Carb coma…can’t keep my eyes open. More caffeine? No, I won’t sleep tonight. What if that pasta gives me an upset stomach and I’m not able to make it to the bathroom in time? Did I turn the coffee maker off this morning? What did I do with my phone? If that amazon package gets delivered today, will someone steal it off my porch? Did I remember to submit s refill request for that medication? What if it goes to the wrong pharmacy? Where do I find more toner for the color printer and how am I supposed to find the correct toner for that machine? What if I put the wrong size in and it gets stuck and breaks the printer? That manager was supposed to call me back an hour ago. What if the company was hit by a hurricane and he died?

4:08 pm – I need to go to the store on the way home. Wasn’t I supposed to put something on the grocery list earlier? I think it was maybe laundry detergent and salsa. Adds them to list.

4:18 pm – Throws a chicken pot pie into my cart. Realizes after checking out that I forgot to check my grocery list. I didn’t get laundry detergent or salsa, let alone bread or string cheese.

4:19 pm – Walks out to car and leaves. No way I’m going back in there for the things I actually needed. Someone will notice that I walked out and walked right back in. Surely someone would think it’s suspicious and report it to security or the police. I can’t go to jail for a jar of salsa. It’s just not worth the risk.

5:10 pm – So mentally exhausted. I don’t even have the energy to eat the pot pie.

5:30 pm – Determined to journal or read or craft.

5:34 pm – Dozing off

6:00 pm – Takes medication and goes to bed.

6:19 pm – Wide. Awake. Why?!

6:20-8:42 pm – How am I going to pay for school? Why am I not good enough for anyone? Is that pot pie in a metal pan or can I take it to work and put it in the microwave for lunch? Did I lock the car when I got home? Is the front door locked? Need to go check. Remember to add toilet paper to the grocery list….only have six rolls left. Did that person look at me funny when I sneezed at work today? Did I have a booger hanging out of my nose after sneezing? When I recommended a different method to Bob, he got upset and walked away. Did he complain to his manager? Should I have kept my mouth shut and not offered suggestions? If he complained to his manager, will that manager tell my manager I should no longer be employed there? What if I did actually hit a person driving to work this morning and they just crawled off the road before I could turn around? When will the police show up to arrest me for leaving the scene of an accident? I think I just heard a rattlesnake under my bed. How would a snake get in the house?

8:43 pm – I need to pee. Don’t use too much toilet paper….I’m running low and need to get more. Don’t forget to add toilet paper to the grocery list.

9:02 pm – Finally starts falling asleep.

9:05 pm – Did I feed the dog? Wait…I don’t have a dog.

9:21 pm – Sweet sleep oblivion.

10:37 pm – Need to pee again. It’s cold, though. If I try to hold it until my alarm goes off, will my bladder explode? Better not tempt fate.

10:40-11:12 pm – Listens to audiobook.

11:13 pm – Falls asleep.

11:59 pm – Still asleep….for now.

———————————

Believe it or not, this is a picture of my internal chatter every single day. And usually it is much worse.

While some thoughts may seem funny or ridiculous, my brain truly sees them as things worthy of the time and energy it takes to worry so extensively. I obsess over things that the logical part of me knows to be irrational, yet I am unable to stop worrying about them.

Imagine how exhausting it is to have your brain going like that all day…every day….all the while trying to participate in daily activities like work, school, social outings, etc.

For those of you who have never experienced anxiety but know someone who has, show some kindness. Don’t tell them to just stop worrying. Believe me….if we could, we would. Telling us we worry too much makes us feel worse. I personally feel shame, which causes me to internalize my fears and worries. Sometimes all we need is someone to listen to our concerns. I don’t need answers or fixes or referrals to a good psychiatrist. Just listen. And ask what we need. Often just verbalizing my irrational worries out loud helps me release myself from the vicious cycle that is constant, chronic anxiety.