20 Mental Health Resolutions for 2017 (Because We Sure As Hell Need Them)

This time last year I wrote out some of my mental health resolutions for 2016. And I enjoyed – so much – the process of thinking through my resolutions, reflecting on the kind of precedent I wanted to set for my sanity, and then all the conversations we had together about what kind of year we wanted 2016 to be (this is a good time to mention our online Facebook community is a stellar place for dialogue).

And then, you know, 2016 actually happened.

For those following along at home, I kicked off 2016 with a psychiatric hospitalization and wrapped up 2016 with a relapse and a field trip to rehab. As far as mental health goes, it’s not been my finest year.

This doesn’t even touch on the fact that we’ve lost numerous pop culture icons – most recently mental health and addiction advocate/badass Carrie Fisher – and we elected an orange Voldemort to the highest office of the land after a grueling and painful election season.

I’m sure we can objectively say that this is not what we had in mind for a mentally healthy year. I’m also not going to be foolish enough this time around to suggest that 2017 will be your year or my year – it’s probably no one’s year, frankly, if a nuclear arms race breaks out, although, weird, Russia seems pretty stoked.

Do I sound bitter? Maybe I’m a little bitter.

Listen, it’s been a rough year. And my resolutions from last year by no means prevented the apocalypse from happening. They did remind me to focus on what’s important (i.e. keeping it together).

I believe if we’re going to survive this next year (and, y’know, the next four… or the next – ugh, I can’t say it), renewing our commitment to our self-care and sanity is never a bad idea.

I’m a fan of going into any transition in life with a lot of intention and mindfulness, so I’m bringing some of that intention into the new year.

That’s why, despite the catastrophe that was 2016, I’m going to once again share twenty resolutions I have for 2017.

Your mental health is more important than ever, and if there were ever a time to be vigilant about keeping all your marbles in the jar, it’s when apocalyptic headlines and subsequent panic attacks are always in abundance.

If resolutions are your thing, I hope that these inspire you to come up with your own (or steal mine, it’s all good!).

Sam’s 20 Magical Resolutions For 2017 To Be A Little Less Shitty

1. I want to go to more support groups. I know that what I need right now is community support. I have a tendency to isolate myself in my apartment and watch a lot of Law & Order, and while decompressing this way can be good, it can’t be the only way I deal with my shit.

2. I’m going to try opening up to someone that I don’t usually. I’ve already started on this a little early. I tend to unload on the same three or four friends when I’m struggling. Meanwhile, there are other new friends in my life who keep telling me that I can always count on them – yet I never do. Maybe it’s time to give other people a chance to support me, too, even if being vulnerable with a new friend is scary.

3. I want to find a new hobby. Someone told me that boredom is the enemy of sobriety. I’d expand that to say it’s the enemy of mental wellness sometimes, too. I want to find a hobby that makes me happy.

4. I’ll reconnect with an old hobby, too. There are so many things that I used to do that gave me a sense of fulfillment that I’ve lost over the years. Like music. I recently bought myself a keyboard and sheet music to try relearning piano. I tend to play the same chords and sing the same songs repeatedly. I’m terrible at it but you know what? I like it anyway.

5. I want to sober up, for real. If you’re wondering about sobriety or if you might have a lousy relationship to substances, please read this thing I wrote. Alcohol and I have a rough relationship and I think it’s time to break things off. I don’t think it will be easy, but I’ll try my best.

6. I’ll try to start going new places by myself. My agoraphobia has made leaving my apartment extraordinarily difficult. But I also know that the only way I can live a functional life is if I don’t give up. I think many of us with mental illness can withdraw in unhealthy ways. It’s time to step out of our comfort zone, little by little.

7. I’m going to unplug from bad news as often as I need to. Being informed about the state of the world is valuable, but not if it comes as the expense of your sanity. I’m going to take a break when I need to. Delete the Facebook app, turn off the television, and go the fuck outside.

8. No more counterproductive arguments. Period. If I’m arguing online when I know it’s accomplishing nothing, I’m going to hand my phone to my partner and go take a shower. It’s one thing to educate, engage, or intervene as a marginalized person or ally. But I need to try harder to see the difference between a teachable moment and a troll.

9. I’m going to (consensually) hug, kiss, and cuddle my friends more. Lord knows we need more of that in the apocalypse.

10. I’m working on accepting my limitations in 2017. I recently had to step down from my full-time job for my recovery, and I’ll be returning in a smaller capacity more akin to what I can handle right now. 2017 is going to be the year where I’m realistic about what I can do, and I’m not going to beat myself up because it’s not where I would like to be.

11. I’ll demand better of my clinicians, always. If I don’t feel like I’m getting the care I deserve, I’ll say so. If I don’t like the solutions I’m being given, I’ll ask for better ones. If I don’t like my clinician, I’ll get a new clinician. Therapists, psychiatrists, case workers beware.

12. I’ll stop using my friends to avoid being proactive. Sometimes I rely on other people to catch me when I fall, instead of making sure I don’t fall in the first place. If they’re going to do their part as friends, I need to do my part and take care of myself. Am I using all the resources at my disposal? Keeping in touch with my clinicians? Taking all my medications? My friends are responsible to me, but they aren’t responsible for me.

13. I’ll go to the hospital or rehab when I need to – even if I don’t want to. Sometimes a crisis calls for a response I may not like or enjoy. No one likes hospitals and no one likes rehab. But it may also be exactly what I need to get better.

14. I’ll be more communicative when I’m struggling. I tend to only convey how bad things are when it’s already blown up in my face. I did this at my job, I do this with my loved ones. But so much could’ve been avoided if I had been honest about where I was at, and done so sooner. There’s nothing wrong with being honest.

15. I’m going to start dealing with my actual feelings, rather than how I think I “should” feel. My boss (who is brilliant) emphasizes this often. An example of this in my life was when I felt like I should be happy because I had everything I thought I wanted, without acknowledging that, even so, I was falling apart. Sometimes we miss the red flags with our mental health because we’re not giving ourselves permission to feel how we really feel. For me, this begins with understanding that you don’t need permission or justification to feel depression.

16. I’ll treat my relationship with myself as a priority. Do you ever go through a period of really low self-esteem, and you kind of let it fade to the background because it doesn’t seem important? I do that all the time. And yet in real life, if I had a rough patch with my partner or friend, fixing it would be my priority. If I don’t feel good about myself, I’ll commit to self-care and support until I can start to feel more positively about myself again. Because caring about myself IS urgent.

17. I’ll practice healthy boundaries. This means inviting my friends to support me rather than imposing my crisis on them. This means asking for what I need rather than expecting it. And above all, this means checking in and making sure my needs aren’t exceeding someone’s emotional capacity. Not because I’m a burden, but because we’re only human, and I would want someone to do the same for me!

18. I’m going to be proud each day that I survive. Being mentally ill is difficult as fuck. Any day that I manage to hang in there is a terrific accomplishment, and in 2017, I want to make sure I keep that in mind.

19. Self-care. More self-care. And even more self-care. Never apologizing for taking care of myself – lighting new candles, taking long showers, writing to my heart’s content, and getting cozy with a heating pad and a good book. These things will always be necessary, especially in the coming year.

20. I will stop basing my value off of what I do instead of who I am. So much of what I thought made me valuable had to do with my job at Everyday Feminism, the success of my blog, the lectures I’ve given, and what I had managed to accomplish. In 2017, I want to look in the mirror and say, “You are valuable because of your empathy, your humor, your tenderness, your strength, and your determination.” Who I am. Not what I do. And I think all of us could afford to take a minute or two to reflect on the difference.

These are my mental health resolutions for the year. A lot of hopes, a lot of feelings. But that’s what this holiday is for, right?

I sincerely hope that in taking some time to reflect on what’s important to you and what you need this coming year, you’ll be as ready as you can be to take on all the challenges ahead, even the ones you don’t expect – because if 2016 is any indication, 2017 will probably have a lot of those.

5 Signs It Was Time For Rehab (Regardless of How Much I Was Drinking)

In seven days, I went from being sober for eight months to sitting in a chemical dependency center after a relapse, being evaluated for a potential outpatient rehab program.

I remember the bitterness and resentment that I felt as I exhaled into a breathalyzer until it clicked, sitting motionless as the nurse asked me what I meant by a glass of wine – big glasses? Small glasses?

I remember saying repeatedly – to anyone that would listen – that I couldn’t be an alcoholic because comparatively, I didn’t drink as excessively as an alcoholic should (whatever that means).

And no matter how many times I was diagnosed with a substance use disorder or gently told I needed help, I’d stamp my foot and insist that getting drunk with some regularity didn’t make it a problem.

And maybe it doesn’t. But there were a hell of a lot of other red flags that did make it a problem.

Substance abuse exists on a wide spectrum, and I’m a big believer that no two people struggling with it will look exactly alike.

But some narratives perpetuate the idea that substance abuse is simply using excessively and using often – and while these can be indicators of a problem, they are by no means the be-all and end-all of substance abuse.

I certainly got drunk and maybe more often than I should have, but that’s not why I made the decision to enter rehab. Here are five signs that helped me realize I needed support – regardless of how many drinks I had in a night.

1. My Drinking Became More Important Than The Consequences

In a single week of relapsing, I’d managed to jeopardize my employment, my relationships, my health and my sanity (including stopping my psychiatric medications because they didn’t mix well with booze).

And at the end of a night, sobering up, I was absolutely ready to do it the next day – even as I watched my job crumble, grieved as the people I loved distanced themselves from me, risked legal troubles (drinking in public, FYI, is a terrible idea), and lost my mind as my bipolar disorder started to seize hold of me again.

I had rapidly gotten to a point with my drinking where the potential consequences didn’t matter, even if it might kill me. Somehow, drinking had become more important – and I started to wonder why this substance had so much control over me.

When I talked about this with a therapist specializing in substance use, she simply looked at me and said, “I see what you’ve lost. What else are you willing to lose?”

2. I Repeatedly Compromised My Values

I’m not a liar. At least, when I’m sober I’m not a liar. When I’m not sober, I’m willing to lie straight to my partner’s face as I’m walking out of the door to the liquor store.

I try to be fair, caring, considerate. I love my friends to pieces and would never want to hurt them. But like a tornado, I willingly create chaos and fear for my loved ones when I binge. Everyone in my path has to endure a lot of pain as they try to protect me or push me away.

I put them in an impossible position again, and again, and again.

I love my job. At least, sober Sam does. But drinking Sam will miss entire days of work and blow past deadlines with complete and total numbness, leaving others to clean up the mess.

I think about who I am when I’m sober, and I think about who I am when I’m drinking, and I see all the ways my values don’t line up. The ways in which I can be selfish, hurtful, and deceptive.

And even knowing all this, I desperately still want to drink.

That sounds like a problem to me.

3. I Dehumanized Other Addicts (Because I Wasn’t ‘Like Them’)

The stigma around addiction is so real, and I found that even as someone with social justice values and ideals, I treated other addicts like shit.

I may not have the healthiest relationship with alcohol, but I’m not like them.

I don’t belong in rehab, I won’t be able to relate to these people.

This place is for addicts, not for someone like me.

I continually employed an “us versus them” mentality, othering people who struggle with substance abuse in an attempt to elevate myself as being better than, above, or more enlightened.

In my denial, I treated addicts as categorically subhuman – people I could never relate to, understand, or have empathy for. The further I distanced myself from them, the more secure I felt in my substance use.

Ever heard the phrase “thou doth protest too much”? I spent so much time and energy defending myself as a “not addict” – and no time cultivating any kind of empathy for those who were.

Why did I feel the need to do that?

4. I Wasn’t A Social Drinker – I Was An Emotional Drinker

I remember going to my first AA meeting and explaining to someone that I didn’t really think I was an alcoholic. She asked me casually, “Do you ever have just one drink?” To which I blurted out, “What’s the point of that?”

“You tell me what the point is,” she replied. And then I realized I’d never really asked myself why I was drinking in the first place.

I drink for a lot of reasons, some of which I’m still working on understanding. I use it to cope with my mental illnesses. To self-sabotage when I can’t handle the pressures or stress of my life. To put me in another headspace when I don’t want to be in my own. To slow down time when I’m dreading something.

I drink to take the immense avalanche of emotions I deal with on any given day and subdue it so that I might survive it all.

Notice nowhere on my list does it say “to have fun with my friends” or “to get a good buzz.”

Alcoholic or not, addict or not – I don’t think these terms are necessarily useful for everyone – nothing screams red flag like “I use alcohol to deal with my emotional problems.”

5. Everyone Around Me Could See It But Me

This. Is. So. Common.

And it is no exaggeration when I say that I felt like I was losing my mind. Here I thought I didn’t have a problem, and an abundance of therapists, psychiatrists, friends, and loved ones told me numerous times that I did.

For my short time in AA, I refused to call myself an alcoholic and sat bitterly in the back row, murmuring about how none of this resonated with me because I wasn’t like them.

Instead of being open to recovery and community, I left AA, and tried to do sobriety alone, much to the dismay of everyone around me. It worked, until it didn’t work at all. And here we are.

I believe that only you can ultimately decide to take on a label like “alcoholic” or “addict,” but I also believe that when there’s writing on the wall – and on literally every inch of that wall – it might be time for a conversation.

About nine or so months ago, when people were trying to tell me I needed help, I wish I would’ve taken the initiative to find a therapist and talk through it. It didn’t mean I had to go to rehab, or AA, or commit to any kind of substance abuse support group or program.

It meant I would’ve gotten some support from a professional as I decided, for myself, what my substance use meant in the scheme of my life – and what I might want it to mean moving forward.

It can be hard to hear folks when they’re trying to impose a terrifying and life-changing label. Take it from someone who knows. The word “alcoholic” still makes me cringe (forever unpacking that stigma, even now). But these days I’m willing to accept that if everyone sees something except me, it might mean that I have something I need to work through.

***

It can be hard to see your own substance abuse when you’re in the midst of it, especially when the narratives around it can be confusing and limited.

I by no means drink heavily. And for varying reasons, I don’t drink every day. And I’m still working to admit to myself that I can be an alcoholic despite that.

When I took the time to honestly evaluate how drinking operates in my life, I finally started to see the red flags I had been missing while I was too busy counting the number of drinks I had.

It doesn’t always matter how much or how often. It never did. For me, so much of it was about the kind of person drinking made me, and the consequences waiting on the other side.

And that’s a good enough reason for rehab as any.

Mental Illness Doesn’t Care How Good You Are

It is six o’clock in the morning and I wake up suddenly. My body is trembling. My thoughts are beginning to spiral and my breath is shortening – every inhale becomes smaller, and smaller, and smaller until I fear that the oxygen in the room might run out.

I try to remember what my psychiatrist told me, about how breathing through a straw never killed anyone. I swear that this time it might.

When I fall asleep, I dream that I live in a house on the beach. I am staring out at the ocean until I see the waves grow taller, and bigger, and louder. The tide is creeping up on me now. I run inside, waiting for the first floor to flood, then the second. I keep climbing the stairs, trying to get away.

I know that I need to get to higher ground. I abandon the house and start running up a hill. No matter how high I climb, there’s always water on my heels. Sometimes it’s up to my ankles. No matter how fast I run, it’s always at my feet. All I can do is wait for the water to recede and hope that it doesn’t take me with it.

I tell myself, “No one ever drowned in an inch of water, Sam.” I swear that this time I might.

When I wake up again, my partner is next to me. I tell them about my panic attack, and about my dream. “I think I know what it means,” I explain. “That sometimes all you can do is keep searching for higher ground.”

Neither of us needs to acknowledge out loud that we’re talking about my mental illness.

About how, for the last eight months since I was hospitalized, I have watched the waves come in and out, chasing me uphill and luring me back down. I have known the kind of grief of being small in the face of something that could eclipse you, could make you disappear effortlessly.

When I see my psychiatrist later that week, I tell him that I have something to say, and that it isn’t nice. He tells me that I don’t have to be nice, that I should say how I feel. I tell him that I feel broken. I tell him that I feel irredeemable. I tell him that I am ashamed. I tell him that I am tired. I tell him that six medications is too much and too little. I want to know –

“Why you are the way you are,” he says quietly. This is a tender wound that I try to avoid. 

I nod, choking back words – words like, this isn’t fair, I don’t deserve this, I only ever tried to be good, I only ever tried to be kind, I shouldn’t be here, I should never have been here, fuck this and fuck you.

I know that maybe he has asked himself this before, about me, about the others. Because when I look at him, I don’t see pity – I see pain.

The unspoken truth: There is a particular kind of agony that comes with the realization that you could be good in every way, and mental illness will still chew you up and spit you back out.

You can do everything right – take all of your pills, go to all of your therapy appointments, read every bit of literature, do all your self-care – and still be trapped between the incisors, gnawed to pieces in the aftermath of another episode.

Some days, I can be standing on the platform waiting for a train, or cleaning up my apartment, or having lunch with a friend – and like a sudden, unexpected punch in the gut, I want to weep because I know I’ve been good, I want to weep because I know I’ve tried, and here we are.

I’ve tried so hard.

When I tell a friend about my dream, I quietly comment, “The ocean doesn’t care about how good you are.”

They tell me, “I know.”

I keep looking for someplace safe, somewhere high enough, somewhere untouched. And when I think I’ve found it, all I can do is wait. All I can do is wait, overcome with bitterness, overcome with rage, weeping with the force of a hurricane, breathing through a straw.

Cis Writers: Do Your F#cking Homework Before You Write About Trans People

You tell me if this makes sense:

I know nothing about this topic, but I’m just going to wing it.

I think I have a vague idea what this word means? So I’ll just make up my own definition.

Lots of people are going to read this, but I’m not going to check this for accuracy.

It seems like no writer should ever utter those statements. In theory. And yet the number of cisgender writers taking this approach when they talk about trans people is truly astonishing.

Today was just one of those days. You could say I’m fed up. In this last week alone, I’ve come across countless articles that ranged from offensive to downright violent when discussing transgender people.

And here’s what I don’t get: Why aren’t cisgender writers doing their homework?

A quick Google search will reveal a Transgender 101 Guide that I personally wrote if you need to start at square one, and there are countless other resources, including media guides like the one from the folks at GLAAD and another from Trans Media Watch, that exist solely with the purpose of educating folks like yourself.

But let me be clear: A transgender person should not have to spell out where these resources are, because as a writer, being able to use the internet to get information is kind of in your job description. I am fairly sure if you don’t have a working knowledge of Google, you’re in deep shit.

Cis writers, it’s not often that I try to speak for all trans people. But I’ll take the liberty this once. On behalf of transgender people everywhere, if you can’t be bothered to put in a real effort to respect our community when you write about us, maybe you shouldn’t be writing about us at all.

I’m a writer and an editor for a living. I often talk about the struggles of marginalized people, either directly or indirectly. And with these roles, I understand the immense responsibility that I have as someone with access to a platform. I understand that it’s my responsibility to be truthful and accurate, and to not harm the communities that I write about.

If I do not have expertise on a topic, I ask myself two questions: Is this my story to tell? And if so, how can I do it respectfully?

Cis writers, I want to push back first on your impulse to cover stories on transgender people. Why is it your place? Is this article better told from the perspective of a transgender person? Hint: In many cases, you’re swerving out of your lane and you need to get a grip on your steering wheel.

But sometimes we are in a position where we feel we can take it on ethically (hopefully you’ve got a compelling reason, because I’m already suspicious), or we are trying to be trans inclusive on a piece within our usual beat (i.e. how can I make sure I’m being intersectional), and this requires us to talk about transgender people – sometimes for just a paragraph, other times throughout the piece.

More questions for you, then: Have you done enough reading to make sure you aren’t harming trans people with what you’ve said? Have you consulted a transgender person (or even multiple trans people) to review the piece? Are you compensating them for their time?

Yes, even for that paragraph you’re using to cover your ass so you don’t seem trans erasive (which, when it’s done right, I totally appreciate). If you’re talking about trans people, even for a sentence, you need to be diligent and responsible.

Learning By Example: We Need You to Do Better Than This

The article that broke my damn back wasn’t even explicitly about transgender people. It was a single paragraph in an article about something else:

Before I go any further down the rabbit hole, let me clarify that when I say "men," I'm not referring to all people who identifies [sic] as male, but rather cis-gender men – men who have been anatomically male since birth, free of any and all struggle that many other people who also identify as male have gone through. This one is about you, biological men. HELLO to you!

This was written by @GigiEngle – I won’t link it here – and unfortunately, a well-intentioned attempt to acknowledge trans people turned into a total nightmare. This writer fell down a totally different rabbit hole that many cisgender writers fall down. It’s what happens when you don’t educate yourself about trans issues, and start using whatever language seems right without checking it for competence and accuracy.

I’m going to break this down, so other cis writers (and yes, editors too) can get an idea of what exactly I’m talking about when I emphasize the importance of research. Because these mistakes are easy to make when you aren’t putting in a genuine effort to responsibly write about trans folks – yes, even for a single paragraph.

Let’s look at this paragraph for a bit.

If you are talking about cisgender men, talk about cisgender men. Using the word “men” to exclude transgender men is a shitty way of revealing that you don’t actually see transgender men as men – they’re secondary to you, not inherently a part of the word “men” but instead a detachable part.

That’s garbage. And this is easily avoidable if you just say what you mean: Cis men.

Or at the very least, if your editor is resistant to modifying the word “men” every time you use it, at the beginning of your work you should explicitly state that you’re focusing on cisgender men – and state why you’re doing this, instead of starting an irrelevant, sideways conversation about genitals.

Because really, penises had nothing to do with it. Cis men are not “biological men” because the category of man (and men) have nothing to do with biology. “Anatomical male” does not mean cis man either, because the biology of cis and trans men exists on a spectrum, and there’s nothing inherently male (or female) about it.

If you’d done your research, you’d know that phrases like these are not only unnecessary to your point, but have been used to oppress trans men (and trans people as a whole).

Cis folks, I want you to sit down and look at the terms you’re using, and really ask yourself what you mean when you’re saying it. Spell it out. And you’ll likely find that underneath those words are some really icky and problematic ideas about transgender people.

(And if you’re still confused, read this.)

You had it at “cisgender men” in this paragraph but lost it when you fell into essentialist rhetoric that harms transgender men and is downright inaccurate. And all of this has been written about – again, and again, and again. If you want to be inclusive, there are better ways to do it. Read up.

The really puzzling part about this article as a whole (which again, I won’t link, not interested in driving traffic there) is that it’s an article about toxic masculinity in relationships, particularly the trope of the “fuckboy.” And believe me, I love bashing manchildren and fuckboys and all the other bullshit ways that patriarchy encourages men to behave.

But notice how I said men, not cis men. Somehow transgender men are deemed exempt in that paragraph, as if they don’t perpetuate these behaviors? It suggests that you really, really don’t see transgender men as men at all, like they are a special breed that is untouched by misogyny and privilege.

If you’re a cisgender writer writing about gender and gendered norms especially, you really should be asking yourself: Am I being inclusive of transgender people? If so, have I done my homework? If not, what are my reasons for not including trans people? Have I stated that clearly, correctly, and responsibly at the beginning of my writing?

And as always, whenever possible, if it’s writing that impacts transgender people, involving a trans person or two to review the piece (for compensation) is critically important.

I’m going to need cisgender writers to do a hell of a lot better than this – and I know that they can.

You Aren’t Just Offending Us – You’re Harming Us

I get asked all the damn time why I’m so angry when I encounter writing that doesn’t get the whole ~transgender thing~ right. I’m told about how the writer is trying, or they meant well, or that no one is perfect.

I mentioned this on Facebook, too, but it bears repeating: Why is every fucked up article about transgender people deemed a teachable moment for cis people, rather than violence towards trans people?

Why are transgender people thrown under the bus and spoken about in ways that harm us, uphold our struggles, and outright oppress us, and cisgender people aren’t held accountable because “no one is perfect”?

To me, that sounds like a really awesome (read: shitty) way to dismiss any responsibility we have as writers for what we put out into the world, and the impact our words really have.

As a writer, I know that when you have access to a platform that people read, what you say on that platform has the potential to uplift people. But it just as easily has the ability to disempower people – we can fall into narratives and stereotypes that make people’s lives a whole lot harder.

And in the case of transgender people, who are already so often victimized and brutalized in our society, when we speak about trans people in ways that are dehumanizing, we literally encourage people to view us and treat us as less than – which far too often leads to violence.

Cis writers, you should care about how you talk about trans people. Your words are the microaggressions that make us feel like the “other.” Your words are the hostility that shatters our psyche and self-esteem. Your words are the battle cry for those waiting for an opportunity to bully us, assault us, or even end our lives.

If you’re a writer, you don’t need me to tell you how powerful words are. You already know that. And you wouldn’t be a writer if you didn’t believe that.

What trans people are asking of you isn’t hard. We’re asking you to think deeply about your choices as a writer. We’re asking you to be critical, to stay sharp, to be responsible. But more than anything, we’re asking you to view us as human beings worthy of dignity, respect, and truthful representation.

And frankly, we don’t deserve anything less.

 

How Many Mental Disorders Is Too Many?

How many is too many? This is what I asked myself when a psychiatrist – who I was seeing temporarily while my usual was on paternity leave – looked up from a stack of books and a database on his computer and said to me, “This is really complicated.”

When I asked him what he meant, he seemed a little worried when he said, “Your diagnoses and your medications are very… complex.”

I knew that. Every clinician that opened up my file knew that. Every pharmacist that ever filled my prescriptions. Every friend that finally realized how much energy goes into being a mostly-assembled Sam Dylan Finch.

With my bipolar diagnosis reinstated after a hypomanic episode triggered by Zoloft, it could now rejoin my growing list of neuroses: borderline personality disorder, obsessive compulsive disorder, agoraphobia, substance use disorder, and generalized anxiety and/or ADHD depending on which clinician you ask.

This doesn’t even capture the psychotic and dissociative features of a few of the illnesses I deal with.

Some people would call these “co-occurring diagnoses” on a good day but I would actually just call these a straight up clusterfuck.

People like to tell me that “it’s all just labels” and that the words are ultimately unimportant. But they weren’t there ten years ago,  when I was a teenager that fantasized about ending my life, tormented by obsessive thoughts and deep depression. Back then, the only thing I wanted was to understand what was wrong.

My psychiatric diagnoses have given me that understanding, and affirmed that it wasn’t just in my head, that it wasn’t made up, that I wasn’t alone.

People can tell me that my diagnoses are just words at the end of the day, but those words are important to me, and that’s what makes them important. And the impact of these disorders is something that I have to live with every minute of every day – so why wouldn’t it be critical to name something that’s so pervasive in my life?

(Honestly, when people tell me it’s just words, I laugh. If you woke up to the sound of a chainsaw every morning with no explanation, would you ignore it altogether in favor of just saying, “Well, it’s just noise”?)

But I would be lying if I said my psychiatric diagnoses always make me feel empowered. The truth is that while I am glad to have a name for a once invisible battle, I’m also afraid.

I’m very afraid. I’m afraid because, like many clinicians have told me, this is complicated. Complicated to understand. Complicated to treat. Complicated to manage. I’m afraid that maybe there’s such a thing as “too mentally ill” or “too many mental disorders,” and that there will never be a “normal” for me – that I’ll always be swimming upstream.

I’m afraid of being hospitalized again. I’m afraid of being hospitalized again and again, because statistically this is likely. I’m afraid of attempting suicide again. I’m afraid of attempting again and again, because this, too, is possible and maybe even likely.

People often tell me that I’m not a statistic. I know this is true. But we can’t also pretend that statistics have no bearing on what my future might look like. I can’t ignore the fact that I am vulnerable. And I go to bed every night knowing this – knowing that I have a lot of good reasons to feel unsafe, even on my best day.

The more diagnoses I’m given, the more overwhelmed I feel.

I am mistrustful and fearful of my own mind – how it seems to always be working against me, how even my best efforts are sometimes not enough to stay in control. I never seem to know what’s real and what’s part of an illness.

I don’t know where each illness stops and I begin. I’ve spent a lot of the last two months confused, feeling claustrophobic in my own head, like I need to get out of here because there’s no room for me, like the wind is constantly being knocked out of me.

In conversations about mental health, we often talk about people who have one or two disorders. And I’m usually somewhere on the sidelines, wishing people like me were more visible – people who have so many diagnoses, they sometimes lose track of themselves, sometimes lose themselves to the fear of what they’ve become and could become.

I am an optimistic and determined person on the whole, and I still lose myself to that fear from time to time. When my psychiatrist quietly acknowledged the complexity of my trauma, I wondered if it’s possible to be so mentally ill that you become impossible to care for, impossible to help, impossible to love.

I spend a lot of time worrying that I can’t be loved.

In a society that tells us we’re broken if we have one mental illness, what happens when you have six?

Can you ever really be honest about who you are and what you’re going through without seeming too crazy? Too hopeless? Too much? This is the perpetual question for me, as someone who is both a person offline (go figure) but also an activist and writer online, who wants to create the space for people to be authentically themselves, but has to navigate the same stigma, too.

I think with all of the fear that I’m experiencing lately, I’ve finally gotten to a point where I’m tired of being isolated like this. I want to create a space for all of us to own how terrifying it is to be told we’re “complicated.”

Being complicated sucks. Being complicated hurts.

I remember that when I was initially diagnosed with just depression as a teenager, I was told by clinicians that my depression was very treatable, always emphasizing a positive prognosis and long term goals.

At this point in my life, when I meet clinicians, we only ever talk about today – we never talk about the future in any capacity. I think because neither of us knows what to say.

And that’s what my psychiatric journey has looked like: a lot of subtle ways in which it was communicated to me, with each new doctor and each new name, that being “complex” means difficulty – difficulty treating, much less supporting or affirming.

But I’m tired of apologizing to clinicians, to friends, and even to readers for being messy. For having more issues than National Geographic. For giving “certifiably insane” a whole new spokesperson. And I know so many mentally ill people with countless diagnoses who are equally exhausted, trying to package things in a more presentable way so people will accept them.

Sometimes people have three, four, five, six, seven, eight, you-name-it diagnoses and if we aren’t making room for those people to show up authentically, we are failing the mental health community as a whole.

This work isn’t about making spaces for some of us. It’s about making room for all of us.

Having co-occurring diagnoses is a scary place to be. Sometimes it’s a hopeless place to be, especially when your clinicians seem a little defeated themselves and the people in your life don’t know how to help you.

Sometimes (often) people don’t even believe me. Sometimes they see it as a chance to write me off as beyond repair. Sometimes my mental illnesses go from being a concern to being a joke. Sometimes I’m dehumanized and pathologized to the point where I’m seen exclusively as a case study. In my life, I’m consistently reminded of how people have no idea how to treat other people with co-occurring diagnoses, especially as they increase in number.

If we can’t create support for folks like me, where else are they going to go? When else can they be themselves?

Psychiatric labels can be important to us, scary to us, even empowering to us – for me, it’s been all three. But one thing they’ll never be is the sole determiner of our worth. We are whole people with value, no matter how few or how many diagnoses we have.

That’s the truth. And it’s a truth we need to make sure everyone – especially mentally ill folks – know.

Mental Illness Has Impacted My Transgender Identity

Once upon a time, I wrote an article about how I wasn’t completely happy with my hormonal transition. Unsurprisingly, I got a lot of shit for it – because dog forbid I have complicated feelings about my body completely changing.

One commenter, I guess in an attempt to insult me, told me to get a therapist and that I was INSANE (emphasis theirs). What they didn’t realize was that they were correct about one thing – my feelings about my transition were absolutely informed by mental illness.

Frankly, I’m annoyed with neurotypical trans people judging my experience of transition – because comparing our experiences completely ignores the reality that I struggle in a way they never will.

What I didn’t mention in that article is that I was diagnosed with OCD after a spiral of obsession that all but drove me to the edge. And what was I obsessing about? My gender identity.

Some folks with OCD – particularly those with the pure obsessional form – find themselves obsessing about sexual orientation or gender identity. Imagine a straight person completely tormented by the idea of being gay (or a gay person obsessed with being straight), or a transgender person, like me, spending hours and hours in a panic, obsessed with the idea of being cisgender (and, yes, vice versa).

The thing about these obsessions is that there’s no concrete evidence that the obsession is grounded in reality.

I’d identified as transgender for four years, and up until the obsession started, felt secure and happy in my identity. I didn’t want to detransition – the thought of doing so horrified me. I was unbelievably opposed to living as a cis woman, which had never felt right in the first place. And my dysphoria was improving slowly but surely with my transition.

The obsession didn’t make any sense. It was just a track on loop that said, “What if, what if, what if?” But it felt like I couldn’t stop thinking about it, no matter what I did.

My therapist said that the obsession was triggered when I was supporting a friend through detransition (which I was happy to do – I love this person, and I support folks making whatever decisions they need to, including detransition!).

The fear that I might experience the despair that they were experiencing had set off an obsession – and it’s an obsession I still battle with months and months later.

When the obsession started, I was initially afraid to disclose to anyone that it was happening. I was afraid that they would invalidate my transgender identity, question the sincerity of my gender, or ostracize me from the community.

And I felt like I couldn’t tell clinicians, because I was afraid they would impede my access to top surgery, which I badly needed.

But imagine my relief when my therapist, who specialized in caring for the transgender population, recognized that my OCD was impacting my transition. I was able to access medication to help manage it – and from there, I connected with another transgender person with OCD, who had endured the same kind of obsessive spiral that I had.

Nowadays, the obsession comes and goes, and I feel more secure knowing that it isn’t a reflection of my identity but rather, an aspect of a disorder.

To be honest, when people commented on that previous article, telling me that I was less of a trans person because I had mixed feelings about my hormonal transition, I was angry. Angry because they had no idea the kind of hell that OCD put me through, making me irrationally obsess about the most fundamental part of who I am for nearly every waking hour of my day.

Lucky you, I wanted to say, that you’ve had nothing but positive transition experiences. Good for you?

The reality is that mentally ill trans people like me have a distinctly different experience of transition.

I’ve talked to trans people with generalized anxiety, who overthink and worry about every aspect of their transitions. I’ve talked to (and personally experienced) the detached, unstable sense of identity that trans people with borderline have coped with. I’ve talked to trans people with depression who, in the midst of an episode, felt too empty to connect with their transness. I’ve talked to mentally ill trans people who have had their gender identities completely written off as a delusion.

And I’ve written about survivors of trauma and mental illness who don’t even realize they are transgender until much later in life, because survival was their first priority – and because trauma can delay many aspects of self-actualization.

To be clear, being transgender is not a mental illness. But I absolutely believe that mental illness can impact our experiences of being transgender.

When neurotypical transgender people judge my experience of transition, I can only roll my eyes. What a privilege, to not live through the complexities, the complications, and the anguish of trying to manifest your truth through the trauma of mental illness, not to mention the actual barriers that prevent us from accessing care.

If we are acknowledging that things like race, class, and gender impact the oppression that transgender people have been dealt, I’m asking that neurotypical transgender people recognize that perhaps their experiences are different from mentally ill trans people – and that mental illness does not invalidate our identities, or make us less valid as transgender people.

I’m just going to say it, straight up: I think it’s ableist and fucked up to tell mentally ill transgender people like me that if they aren’t happy about transition or secure in themselves, they aren’t transgender at all.

I believe that we need to hold space for mentally ill trans people to navigate their identities. To stop saying that questioning, doubting, or fearing their transness makes them inherently less than – because that experience is not only normal for any and all trans people, but especially real for many trans people with mental illness.

We need to make room for mentally ill trans people (and really, all trans people) to be stressed about transition, fed up with transition, exhausted by transition – because we don’t always have the capacity to deal with these kinds of changes when we’re just trying to survive.

We also need to recognize that mentally ill trans people are some of the most vulnerable in our community, because struggling with any kind of dysphoria (emotional, social, physical), transphobia, or erasure only jeopardizes our health even further, endangering us.

And we absolutely need to acknowledge that there are mentally ill trans people who can’t transition or don’t want to – full stop.

So yes, irritating commenter, I’m insane. Har har, you got me. Mental illness has undoubtedly shaped my sense of self and my experience of transition, as it has for many trans people.

Chances are, with the prevalence of mental health struggles in our community, if you aren’t struggling with mental illness yourself, you know and love a trans person who is.

But if we continue to marginalize mentally ill trans people, I’d venture to say that we aren’t much better than the cisgender people who marginalize us.

BREAKING: Local Resident Comes Out as Non-Binary, World Doesn’t End

Originally published at Wear Your Voice Magazine and republished here with permission.

OAKLAND, CA – Residents are profoundly underwhelmed today after an Oakland resident, Tyler May, announced their non-binary gender identity. What was expected to be the literal end of times, residents say that they were shocked to find that the event has had little to no impact on their daily lives.

“I said over and over again that acknowledging more than two genders would signal the apocalypse,” a local cisgender man explained. “But then nothing happened. Literally. Nothing.”

“I had designed a bomb shelter and stocked it up with canned goods for the next five years,” another resident said. “Come to find out, all Tyler wants is for us to switch pronouns.”

Many locals had believed that by in any way challenging the gender binary, it would spontaneously combust, resulting in widespread fires and a complete breakdown of the social order.

But to the surprise of residents, some are beginning to speculate that someone else’s gender may actually be none of their business, and that when identities are mutually respected, the lives of residents may actually improve.

“This might sound wild,” one resident said, struggling to grasp the words coming out of his mouth. “It’s almost like… if we treat others the way we want to be treated, things are… better?”

Still, some residents are disappointed, seeming to prefer conflict.

“I’m a real transgender person, a transgender man,” one resident exclaimed proudly. “I don’t believe in this non-binary thing. I think it’s just a ploy for attention. I’ve talked about this at length on my blog, YouTube channel, Snapchat, Twitter, and Tumblr!”

Pulling the microphone closer to him and smiling, he added, “Is this being broadcast? Is this going to be online?”

Other transgender residents felt similarly. “I find it insulting that they can just identify with a gender they weren’t assigned,” a transgender woman explained. “Like, who do you think you are?”

“It’s almost like someone’s gender has no bearing on my life,” another cis resident complained.

Cisgender and transgender residents alike agreed that they had hoped for more chaos or at least something to live tweet about.

“Tyler tweeted that they were non-binary,” a cisgender resident recalled with horror. “And then everything stayed the same. No pyrotechnics, no street fighting, nothing.”

With tears streaming down his face, a cis man quietly explained, “They said who they were, and nothing happened to me.”

“Naturally, I started to wonder about their genitals, how they have sex, what bathroom they go in,” a cis woman explained. “But then my friends told me I was being inappropriate.”

Pulling a pocket mirror out of her purse and gazing into it, she whispered, “Am I… a creep?”

Perhaps the most devastating part of this experience was the introspection that transpired after Tyler May explained their identity. Many residents were visibly distressed after reconsidering the idea that two genders could really encompass the complexity of the human experience.

“It’s too much, it’s just too much,” one cisgender man explained, tearing at the hair on his head. “What’s next, telling me that I’m my own individual, not defined by the presence of a penis?”

Asked what they thought of their neighbors’ reactions, Tyler May looked bewildered. “Why do they care how I identify?” Shaking their head, they added, “People are so weird.”