Handling mental illness

Hey there, readership.  I apologize in advance for being super serious in this blog in general, and I realize that I may lose your interest the second I start talking about things that aren't sassy Twilight commentary or weird running stories.  This post is probably even worse, because I get both serious and personal.  I'm doing this because I'm attempting to improve the world through my experience.  You can stop reading here and I won't blame you even a little bit.  Whole heap of trigger warnings in this post for pretty much any mental health issue.

Some of you may have noticed that I did not graduate from law school last May.  Without going into too much detail, I had a very serious battle with depression last fall, and took time away.  I'm currently doing quite well, my medication has been consistent for about ten months, and I attend therapy regularly, both to help prevent a relapse and also to treat my generalized anxiety disorder, a problem I had been treating long before depression decided to show up uninvited.  My anxiety manifested itself in many terrible ways, some that I'm not yet comfortable sharing.

Currently, I can actually sleep through the night, something that was refusing to happen last fall, and my medication switch seems to have helped.  I was on an SSRI for several years before switching to an SNRI.  The drug I currently take is called Pristiq, and seems to be doing me good, despite having a name that sounds like a nightclub you don't want to go to, with cocktails that focus heavily on their use of blue curacao.  School starts up again on Monday, and I kept my scholarship.  

I don't mean to act as if this isn't a big deal, because it is.  My life was put on hold for a year, and I spent several months hating myself, not being able to do anything, and not even really knowing why.  While I can talk about it more easily now, it took me a very long time to NOT feel that this was somehow my fault; that all I needed to do was try harder and I could just beat depression.  I understand now that I was sick, I am still sick, I am privileged to have had access to treatment, I was a rockstar for getting that treatment, and this was not my fault.  I'm disclosing this information to help alleviate some of the stigma surrounding mental illness, but also to take some control: no one can force me to disclose this background not on my terms if I've already disclosed.

So, if you've stuck with me this far, thank you, but what does this mean for you?  I have some general things to keep in mind if you are in any way involved with people who are struggling with mental health issues.  That is, of course, if you don't already know them!  You might already be an all-star and not need this stuff.  Carry On with your bad self, Wayward Son.

1. Talk about it
If you're concerned about a loved one, don't just "let it go" in the hope that it will resolve itself.  You are probably just fine talking directly to the person you care about, but if you're not sure that's the best idea, talk to a professional about how to approach them.  A simple "how is everything, no REALLY" goes a very long way.  Also feel free to ask them how they'd like to talk about what's going on.  Open communication is key.  If they say they don't want to talk, then they don't, but asking that one time is a good call.

2. Don't suggest treatment options
Unless someone asks for them directly, please do not offer things that you think would help.  Yes, there are exceptions here, but very few of them.  Treating mental health is an imperfect science at best, and different things work for different people, but please do not offer solutions.  Your intention is good, absolutely: you care about this person and want them to get better!  Really, it is awesome that you want this person to feel better.  But if you start telling them that going gluten-free is way better than the meds they're on for treating their bipolar disorder, or that they really SHOULD be on meds for their anxiety when cognitive behavioral therapy seems to be doing the trick, it comes across as "I know better than you do about your own health."  Also please, please, PLEASE do not tell people to just calm down, or cheer up, or focus of the positive, or go to yoga, or any direct commands.  If it were that easy, they'd do it.  I heard this at least once a week, and it was so difficult to handle, because the person was well-meaning and kind every time, but it made me want to punch them and cry.  It made me feel like my own mental health was yet another thing I wasn't doing properly.  Don't be the nice, well-meaning person who just got punched.    

3. No comparative health issues
My lovely friend Adrienne called this playing "the suffering Olympics," and no one wins.  People with mental health issues frequently already feel guilty about their conditions, and saying "well, you don't have cancer!" just makes them feel worse for feeling bad.  It just turns into a terrible feedback loop.  Ranking suffering does no one any good, and we should try to alleviate it regardless of its perceived severity.

4. You can get help yourself
If you're dealing with someone who is struggling, you are not legally or ultimately or responsible for their well-being (unless they are your children), and their illness may put stress on you.  If you are feeling overwhelmed, or even angry at someone you care about for being sick, this may be an indication that you should find support as well.  It is not their fault they are sick, but it is also not entirely on you to make them better.  Mental health disorders can make people not be very nice to their friends and family, and while that may not be their fault (it's the fault of the mental illness!), it does not mean that you have to sit there and take it.

5. Please don't toss around mental health phrases
"Oh my gosh, I was so depressed!" is not a good way to describe that a movie you wanted to see was sold out.  You're not "super OCD about that stuff" because you like to clean.  You're not "like, so bipolar" because you had two different moods in reaction to things that happened in one day.  This is really hurtful to those who actually suffer from these issues, and just because your friend who goes to therapy said it's okay to use them, doesn't mean it IS okay.  And speaking of tossing around therapy as a concept?  Please stop using the expression "exercise: it's cheaper than therapy."  How about "exercise: sometimes an excellent addition TO therapy?"  Sick people aren't deliberately staying sick because they don't want to spend half an hour on the elliptical.  This is serious stuff.     

6. No jokes or brush-offs
I realize I may be asking people to completely restructure their thinking about this whole concept, and I get a little angry here, but please hear me out.

Therapy is not "trendy."  It is more common now than ever because people have more access to mental health treatments, and this is a GOOD thing.  Psychiatrists (the good ones) aren't just "paid to listen to you talk."  They try their best to help their patients function in the world, and even potentially no longer need them.  I personally get homework from mine.  Think of therapy sessions as a weekly physical for your brain.

Meds aren't inherently "big pharma bullshit."  Some people with a diagnosis are like Zach Braff's character in Garden State, but many aren't.  (Also his dad is a terrible therapist for thinking there wouldn't be any issues with your dad being your shrink because whaaaat.) If you need a debate about the problems with R&D development and patent law in pharmaceuticals, and depression medications with black box suicide warnings, and why meds are marketed more to women, go ahead and have one (really! do have one!  that stuff is important!), but not at the expense of those who may credit the medication with saving their lives.  My several years on my SSRI helped me calm down, and my current medication allows me a normal baseline of emotions. 

Those who are suicidal and/or self-injurers are not "cutters" or "emo kids" and don't need to hear "I wish my grass was emo so it would cut itself" or "remember, down the road, not across the street" for the best way to slit your wrist.  This isn't a political correctness issue.  This isn't about being able to take a joke.  This is unacceptable behavior.  And if you're about to say that the people who self harm do it for attention, please think about this: just how awful is their life that they think making themselves hurt is the best or only way to get that attention?     

Perhaps most importantly, mental health issues aren't stupid.  They aren't bullshit.  They are real illnesses and disabilities and they hurt and kill people.  The fact that we're more comfortable talking about heart attacks than we are about depression doesn't mean depression isn't real: it means our comfort level is wrong.

There's zero chance that you don't know anyone dealing with a mental health issue.  You probably know several.  I'm one of them, and I'd love it if you took this information to heart.