If your ‘suicide prevention’ isn’t talking about the mental health system, you’re missing the point.

As both a suicide attempt and loss survivor, I need to climb up onto my soapbox for a minute.

Suicide attempts, from a “preventative” standpoint, are rarely, if ever, as easily prevented as calling a hotline or a loved one. “Reaching out” — while incredibly important — is not the be-all-end-all of preventative strategies.

Especially considering the fact that many of us have a history of asking for help, and not getting the care that we needed.

I understand the impulse to ask, “Didn’t they know they could call me?” I asked myself that many times when I lost one of my best friends earlier this year. But this shows a very big misunderstanding of the emotional experience that many suicide attempt survivors have described.

Speaking from my own experience, when you are in a very acute amount of emotional distress, your thought process is not as linear or composed as you might assume.

The pain in that moment can eclipse everything else — past, present, future. It’s a sort of tunnel vision in which the pain becomes too great; in those moments, I’m cognitively incapable of stepping back to get the kind of perspective I might otherwise have.

This is why I always try to remind folks that suicide attempts don’t necessarily reflect a person’s overall state, as much as it does their level of pain in that particular moment.

To put it as a metaphor, suicide attempts remind me quite a bit of heart attacks, in the emotional sense.

After a certain point, the body’s resources can no longer fend off a very acute and painful event. It is so pronounced that your brain’s reaction is to scramble and do whatever is necessary to combat that pain, as immediately as possible.

We have some autonomy when we’re in that kind of pain. But so many of our actions are ultimately driven by the visceral agony we’re in. Our systems are flooded and overwhelmed, made worse by the adrenaline, the stress hormones, and for many of us, whatever substances we might be abusing — like alcohol — in a misguided attempt to cope.

But more often than not, unlike a heart attack, it’s also a pain that’s been building for weeks, months, or even years.

When we talk about “suicide prevention,” we focus too much on trying to understand the actual attempt, and not enough on accessibility of care.

We don’t do much to ensure that the pain doesn’t become that acute in the first place. We don’t focus enough on quality of life afterward. And most importantly, we rarely interrogate the systems in place that have failed to support them long before they reached this place.

It’s as though we’ve seen someone having a heart attack, but we start asking what they had for dinner the night before, or kicking ourselves for not offering them aspirin that morning.

When we talk about addressing heart disease, we’re not just trying to intervene in the mere moments before they happen — we know that isn’t enough, which seems like common sense in this context.

We talk about the whole person, and all of the ways in which their wellbeing needs to be prioritized well before they reach a crisis point.

But suicidality is still not viewed this way. We treat suicide attempts as very deliberate choices, rather than complex reactions that we know are better addressed sooner, not just puzzled over later.

The problem is, our mental health system isn’t set up to intervene at the moment when it’s needed.

Therapists and psychiatrists are still wildly inaccessible. And if you can find one that has availability and is covered by your insurance (assuming you have insurance), it often takes weeks, even months before you can actually see them.

If that clinician isn’t competent or a good fit? That’s additional weeks, months, and even years until you find someone who meets your needs. Which doesn’t include the months it takes for those treatments to start yielding real results.

I recently wrote a reported piece about a veteran with PTSD, for whom the nearest mental health provider that took his insurance was a staggering four hours away by car. And if he hadn’t had access to a vehicle? I’m not sure he would still be alive right now.

And all this assumes that mental health care isn’t so stigmatized in your community that you feel empowered to get help sooner rather than later, which is simply not the culture we live in.

This bureaucratic nightmare, combined with stigma, is why many people with mental health struggles often don’t seek help for nearly a decade (or more) after their symptoms set in, if they seek help at all.

And that’s why I bristle at the questions I so often hear after a suicide attempt. “Why didn’t they ask for help?” is the wrong question to ask. “What were they thinking?” is the wrong question to ask.

“What did WE do to help them, as a society?” is the question here. And more specifically, what were WE thinking, when we set up our mental health system to be so inaccessible?

I want to challenge us to think about what we’re doing to change this on a substantive, systemic level. This isn’t about reaching out. This is a call-to-action.

My own suicide note years ago simply read, “I’m sorry. I just can’t do this anymore.”

Not, “I don’t want to do this.”

Not, “I don’t have any other options.”

Not, “I don’t care about my loved ones.”

I simply said, “I just can’t.” I had reached a point at which I truly believed that I could no longer physically withstand the pain that I was in.

This led me to the emergency room and, even there, I saw people desperately trying to harm themselves by any means they could, being stopped only because they were restrained by hospital staff.

And this was not because they didn’t have “help” or “options.” It wasn’t even because they weren’t asking for support. They were in the hospital — they were surrounded by people who, in theory anyway, wanted to help them.

But their pain was that unbearable, that all-consuming.

How do you bring someone back from that? And more importantly, how do you make sure they don’t return to that place?

Beyond preventing the act of attempting suicide, I want to know how we can assure them that the life they’re returning to is one in which they are truly supported.

No one should ever get to a point of experiencing that much pain. And if they do, there should be no question of what resources are in place to guide them through recovery. But our system isn’t built to intervene sooner rather than later. Our system isn’t built to create a reliable, consistent safety net afterward.

It’s certainly not interested in establishing any real quality of life, so much as it focuses on simply preventing death.

We have a “worst case scenario” mental health system, and it’s failing. Its efficacy is a game of luck at best, a roll of the dice.

If you have insurance; access to transportation; the right combination of clinicians, inpatient or outpatient programs, and/or medications; the time to commit to recovery; the persistence to keep following up with providers; the support system around you to help you when this becomes overwhelming; and the sheer energy to navigate the system that is already overburdened — maybe, just maybe you’ll survive.

No one’s livelihood or quality of life should be left to chance.

I’m not trying to paint a bleak picture. People can and do thrive, and I’m absolutely an example of that.

But not because our system is actually successful at what it does — it’s because I am one of the lucky ones that eventually, after many years, found my way through it.

I can tell you why I attempted suicide years ago, and it’s simple: the amount of time it took to “recover” exceeded the amount of resources I had to cope.

It took eight years to get the proper diagnoses for my mental health conditions from the time I started therapy at age 17.

Which means it took eight years to find the right medications to treat my OCD, PTSD, and ADHD. And it took eight years to find a therapist that specialized in those areas — a therapist that I had to pay out-of-pocket for, because my insurance wasn’t taken by any therapists in the area who had openings for new clients.

I’m less interested in preventing the act of suicide itself, and more interested in knowing why our system is doing such a terrible job of caring for people who are struggling before, during, and after.

When we know earlier and more compassionate interventions are so critical, and when we know quality of life is exceedingly more important than simply keeping someone alive, we need to start asking why our system is set up the way it is.

We need to start demanding that something change — because our lives depend on it.

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Hey there, friend. Before you go, I want to share some resources with you.

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If you’re suicidal, call the National Suicide Prevention Lifeline at 1-800-273-8255, the Trevor Project at 1-866-488-7386, or reach the Crisis Text Line by texting “START” to 741741.

This isn’t just a generic “here are some numbers” plug, I promise. This is a “I want you to stay, we need you here, please don’t go just yet” plea.

Are you a loved one that wants to reach out to someone you think is struggling? Incredible. You totally should.

I have a guide here for how you can offer support in concrete ways.

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One more thing: I created this resource totally for free, but your donations help keep this labor of love going.

This blog is not sponsored by any fancy pants investors that are trying to sell you stuff.

It’s funded by readers like you via Patreon!

Every donation counts. Help keep resources like these accessible to everyone that needs them! And help buy me a cup of coffee, because I write a lot of these blogs after work, late at night, so I could definitely use the caffeine.

 

Some credits & gratitude go to… Photo by rawpixel on Unsplash. Artwork by Jessica Krcmarik.

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10 Ways to ‘Reach Out’ When You’re Struggling With Your Mental Health

I’m a mental health writer and advocate, and a suicide attempt survivor. I’ve told people on this blog many times, “Keep reaching out.” I’ve written multiple articles preaching the importance of vulnerability, defying stigma, and owning your struggles.

This is my whole thing, okay? This is what I do.

So when one of my closest friends died by suicide a few weeks ago, I wasn’t just shocked — I was completely gutted.

I thought there was never a question of whether or not my loved ones could reach out to me. But the very person who I’d talked to so often about mental health… didn’t call me.

Not even to say goodbye.

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The last night I spent with them.

In the weeks following their suicide, my grief took me to dark places. I soon began having my own suicidal thoughts. And even then, when it was my turn to “reach out”? Even after losing my friend? I began to withdraw, too.

I watched, with painful awareness, as I did much of what my friend seemed to do leading up to their suicide. I wrote myself off as a burden. I isolated myself. I got lost in my own head. And despite knowing the danger of where I found myself, I said nothing.

After an especially scary night, I realized something: No one ever explained to me how to ask for help. No one told me what “reaching out” even meant.

As my grief began to snowball, I hesitated to tell anyone I was struggling, largely because I didn’t know how. I didn’t know what to ask for, and without knowing what to ask for, it felt too complicated and futile to ask.

“Why didn’t they tell me?” is such a common refrain when we talk about suicide or mental health challenges in general. It’s easy to make this remark, because “tell someone” seems like a simple request. But in truth, it’s vague at best.

“Reaching out” is this skill we’re somehow expected to know, yet it’s never taught and rarely modeled for us.

It’s this vague, hopeful sentiment that people throw around, without ever really defining it. What are we asking people to do or say? It’s not exactly clear.

So I want to get more specific. We need to be more specific.

I don’t know if an article like this could’ve saved my friend. But what I do know is that we need to normalize asking for help and talk about what that might look like, rather than pretending it’s a simple and intuitive thing to do.

Maybe then, we can reach people sooner. We can meet them more compassionately. And we can find better ways to support them.

So if you’re struggling but you don’t know what to say? I get it.

Let’s talk about it.

1. “I’m (depressed/anxious/suicidal). I’m not sure what to ask for, but I don’t want to be alone right now.”

Sometimes we don’t know exactly what we need, or we’re unsure of what someone can offer. That’s okay; that shouldn’t discourage us from reaching out. It’s perfectly fine if you have no idea what you need or want — especially when all you can think about is how much you’re hurting.

Let someone know how you’re feeling. You might be surprised by the ways they offer to support you. And if they aren’t helpful? Keep asking until you find someone who is, or seek out a hotline (I know it can be weird to talk to a stranger, but there are some awesome hotlines out there).

2. “I’m struggling with my mental health and what I’ve been trying isn’t working. Can we (meet up/Skype/etc) on (date) and come up with a better plan?”

Feeling helpless or exhausted is part and parcel for dealing with a broken mental health system. But a team approach can make it a little more manageable. Sometimes we need a cheerleader/researcher that helps us explore our options, especially when we’re having trouble believing that we have any.

One thing you’ll also notice is that, for almost everything on this list, I suggest setting a time.

This is important for a couple reasons. The first being that it helps the person you’re talking to understand the urgency behind your ask. It can also be helpful to know that there’s an event in the near future when you can expect to receive some support. This can help us hang in there when things get bleak.

3. “I don’t feel safe by myself right now. Can you stay on the phone with me/come over until I calm down?”

I know this is a hard one to say. Because we often fear telling someone just how much we’re struggling, and admitting that we don’t feel safe? That’s a biggie. Obviously you can replace the word “safe” if it’s not working for you, but I always encourage people to be direct, because it’s the surest route to getting exactly what we need.

Asking someone to be present might feel especially vulnerable. It might not even feel like, in the moment, it’ll make that much of a difference. But you’re more likely to feel better with support than without any.

And remember, from everything we know about mental illness, depression is more likely to be a liar than a truth-teller (I talk about that a bunch in this blog post).

4. “I’m in a bad place, but I’m not ready to talk about it. Can you help me distract myself?”

You do not have to talk about what’s bothering you if you’re not ready.

Opening up a whole can of worms might not be the safest or best thing for you in that particular moment. And guess what? You can still reach out for help.

Sometimes we just need someone to shoot the shit with, so we aren’t stuck in our heads, making ourselves a little crazy. This is a valid and healthy thing to ask for! And it’s a subtle way of making folks aware that you’re having a rough time, without needing to go into detail.

The sooner the folks around you are aware that you’re having a hard time, the quicker they can show up to help you through it.

Early interventions are so critical for our mental health. In other words: Don’t wait for your whole basement to flood before you fix a leaky pipe — fix the pipe when you notice the problem has started.

5. “Can you check in with me (on date/every day), just to make sure I’m alright?”

I cannot say it enough — do not underestimate the value of asking for a check-in. I am such a huge fan of this as a coping skill, especially because it can be super helpful for everyone involved.

If you take nothing else away from this article, it should be this: Please ask people to check in with you. It’s such a small thing to ask for in the age of texting, but it can help us stay connected, which is freaking critical for our mental health.

(If you’ve played The Sims before, remember the social bar? That’s you. You need to fill it. Humans need to connect with other humans. It’s not just about wanting to, it’s that we actually require it to survive.)

And this can happen in so many smart ways. A few of my favorites:

  • “I haven’t been doing well. Can you text me every morning to make sure I’m okay? It would really help me.”
  • “Hey friend. I’ve been kind of sad lately — do you maybe want to Snapchat/send selfies to each other before bed every night, just to check in? It’d be nice to see your face.”
  • “I’m in a funk right now. Do you want to be self-care buddies? Like text each other once a day something that we did to care for ourselves?”
  • “I’ve been isolating myself a little lately. Can you check in with me every so often, just to make sure I didn’t fall off the face of the earth?”

Add emojis wherever fitting if you want it to feel more casual (but really, you don’t need to, there’s nothing wrong with asking for what you need!).

Asking for people to check in with you when you’re struggling is just like buckling your seatbelt when you get in a car. It’s just one extra safety measure in case things get rough.

Both can actually save lives, too. Consider this a PSA.

6. “I’m having a hard time taking care of myself. I need extra support right now around (task). Can you help?”

Maybe you need help getting to an appointment or the grocery store. Maybe you need a cheerleader to make sure you took your meds, or someone to send a selfie to to prove you got out of bed that morning. Are your dishes piling up in the sink? Do you need a study buddy? It doesn’t hurt to ask for support around tasks like these.

Sometimes these things add up when we’re struggling with our mental health. But we forget that it’s okay to ask for a hand, especially at those times when it could really make a difference.

Being an adult is already challenging. If you’re going through a rough time? It’s even harder. We all hit a point when we need some extra support. Don’t be afraid to let folks know directly how they could support you.

7. “I’ve been feeling so low. Can you remind me about what I mean to you or share a favorite memory? It would really help me.”

I used to think that asking for something like this meant I was “fishing for compliments.” And what a lousy way of looking at it…

Sometimes we need reminders that we matter! Sometimes we can’t recall the good times, and need someone to help us remember them. This is true of every single human being on the planet.

It’s such a simple request, too. If you’re the kind of person that feels nervous about making a big ask (again, I’d encourage you to challenge that assumption — it’s okay to ask for help!), this can be a small step in the right direction.

8. “I’m struggling right now and I’m afraid I’m reaching my limit. Can I give you a call tonight?”

To be honest, it wasn’t until my friend died that I finally found these words in particular.

Up until that point, I’d never been sure exactly how to raise the alarm. You know, that moment when you’re not at the end of your rope, but you’re getting there? It’s a crucial moment.

Yes, you can and you absolutely should reach out then, even if you aren’t sure if it might make a difference (spoiler alert, people might actually surprise you). I think about how much pain I could’ve avoided if I’d saw that moment for the opportunity it really was.

Listen to that little voice in the back of your mind, the one that’s trying to tell you that you’re a little too close to the edge for comfort. Listen to that nagging feeling that tells you you’re in over your head. That’s your survival instinct — and it’s an instinct you should trust.

9. “I know we don’t talk much, but I’m going through a tough time and I feel like you’re someone I can trust. Are you free to talk (day/time)?”

I wanted to include this because I realize that not all of us have people we’re close to that we confide in.

When I was a teenager, everything changed for me when I reached out to a teacher at my high school that I barely knew. She had always been incredibly kind to me, and I had a gut feeling that she would “get it.” And she did!

To this day, I still believe that she saved my life at a time when I had no one else to turn to. She connected me with a social worker, who was then able to help me access the resources I needed to recover.

While it’s important to be respectful of people’s capacities and boundaries (and be prepared, of course, if someone can’t be there for you or isn’t helpful — it’s not personal!), you might be surprised by the responses that you get.

10. “I’m suicidal. I need help right now.”

Raise the alarm.

Raise the damn alarm, friends, and be as direct as you need to be. An emergency is an emergency, whether it’s a heart attack or a self-harm risk. Harm to you in any form is reason enough to ask for help.

I promise you, there’s someone in this world — an old friend or a future one, a family member, a therapist, even a volunteer on a hotline — who wants you to stay.

Find that person (or people), even if it takes time. Even if you have to keep asking.

Give people the chance to help you. It’s a chance that my friend deserved, and it’s a chance that you deserve.

(And if all else fails, I have this resource about going to the emergency room when you’re suicidal. I’ve personally been hospitalized twice, and while it’s not a ritzy vacation, it’s the reason I’m here today.)

Pick something from this list. Write it down, even if it’s on your hand or a sticky note. Reach out — because now you know how.

Hell, bookmark this article while you’re at it. I know I’m going to, because there are times when I need this advice, too.

If you’re struggling with your mental health, let me remind you that it’s never too soon or too late to let someone know.

And it’s never, ever too heavy, too messy, or too much to ask — even if you asked fifty times the day before.

I’d have rather had my friend “bother me” every day for the rest of my life than have to lose them forever. Their life was that precious.

And yes, so is yours.

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Hey there, friend. Before you go, I want to share some resources with you.

If you’re suicidal, call the National Suicide Prevention Lifeline at 1-800-273-8255, the Trevor Project at 1-866-488-7386, or reach the Crisis Text Line by texting “START” to 741741.

You can also go to the emergency room. If you’re not sure if you should or how to prepare for something like that, I’ve got an article for that, too.

This isn’t just a generic “here are some numbers” plug, this is a “I want you to stay, we need you here, please don’t go just yet” plea.

 

Screenshot 2018-03-03 at 10.35.49 AMAnd lastly…

There’s a memorial fundraiser in honor of my dear friend, Cris Alvaro. The funds raised will go to organizations that support trans mental health and racial justice.

This article is, of course, dedicated to them.

Topher, you’re still the brightest star in my galaxy. We couldn’t keep you safe. But I will never stop fighting for a world that could have.

 

Feature photo by Matthew Henry on Unsplash.

15 Mental Health Resolutions For The New Year

2017 was pretty momentous, as far as mental health and recovery goes.

I was finally diagnosed with obsessive-compulsive disorder (OCD), which was one of the most important realizations I’ve ever had. It’s also the year I finally said goodbye to alcohol and hello to online therapy (both A+ decisions). As far as personal growth goes, it was kind of a banner year for me.

It wasn’t easy, though. 2017 was also an important reminder that healing takes hard work. The combination of political and personal turmoil landed me in the hospital last January, and a series of unchecked compulsions finally led me to seek professional help for my OCD after it tore through my life like a relentless tornado.

That’s because, my dear internet pals, healing isn’t linear. When you think you’ve got a plan in place, the universe often laughs in response.

So why make resolutions at all? Well, I believe it’s powerful to begin a new year by saying, “I’m choosing me.” 

Every year for the past few years, I’ve shared my resolutions with the internet with the hopes of inspiring folks to choose themselves, and to be thoughtful about how they’ll care for themselves in the new year.

These resolutions are affirming our right to commit to and prioritize our wholeness; they’re the map that reminds us that to give to others, we have to first nourish ourselves.

These are fifteen resolutions that I have for 2018. I hope that you’ll steal them, throw them up on your vision board, tattoo them on your body, whatever — if you feel inspired, I hope you’ll carry them with you as you navigate the new year.

1. I will stop looking for permission to be happy.

I’ve noticed that I shy away from things that make me happy in favor of the things that make… literally everyone but me happy. I’m a people-pleaser by nature, but in 2018, I want to start unapologetically seeking out things that bring me joy, even if I’m the only one enjoying it.

2. I’ll think twice before I do something out of a sense of obligation.

I have a very difficult time saying “no,” especially as someone with a strong sense of empathy and loyalty. In the new year, though, I want to reconsider just how often I’m doing things because I feel obligated to — especially from people who could be taking advantage of my generosity.

3. I’ll focus less on what my life “should” look like.

Instead of living a life that looks good on paper, 2018 is going to be the year that I focus on self-reflection and building a life that makes me happy, regardless of how it compares to anybody else. Because sure, there are people in their late twenties that are traveling the world or working themselves to the point of exhaustion. But neither of those things actually appeal to me — so why should I measure myself against them?

4. I’ll commit five minutes to doing things that make me anxious.

I’m a chronic procrastinator. One of the antidotes I’ve read about is setting aside five minutes to Do The Thing, and giving yourself permission to stop after that if you don’t want to continue. Why? Because getting started is the difficult part, and it’s easier to commit to doing something for five minutes than trying to tackle the entire task. So this coming year? I’m going to do my best to commit five minutes to the stuff I’m dreading.

5. I’ll embrace being “too much.”

I’ve worried a lot about loving too hard or having too many feelings, or otherwise being “too much” for people. But what I’m realizing is that my intensity and depth of emotion are an intrinsic part of who I am. It’s a part of me that doesn’t need to change.

6. I’ll set boundaries even if it’s difficult for me or the other person involved.

I’m a pushover. I’ll admit it. When people demand my time or energy, I often cave immediately. And when I try to set limits, the faintest sign of disappointment or resentment will send me into a tailspin. But this next year, I’m setting boundaries and sticking to them. My heart is worthy of protection.

7. I’ll savor the time I spend alone.

This past year, I talked about how difficult I found it to be alone. But more recently, I’ve started to really enjoy it. In the new year, I want to take myself on more dates, embrace long walks for daydreaming, and give myself the space and time to reflect without interruption.

8. I’ll try to ruminate less on what I could be doing and enjoy what I’m actually doing.

How often do I worry about what I could or should be doing instead of just being present? Easier said than done, but rather than feeling guilty for how many hours of Netflix I’ve watched, I want to get in the habit of simply asking myself, “Is there something wrong with what I’m doing now?” And if there isn’t, maybe I can just freaking enjoy it for once.

9. I’ll let myself tap out if I feel like I can’t support someone emotionally.

There are people I’d literally fall onto a sword for. That doesn’t mean that I should, though. And if I find myself depleted, I want to make sure I’m taking care of myself instead of burning out.

10. I’ll give myself permission to ask “ridiculous” questions.

I’m a little embarrassed to admit how often I don’t understand something or pretend to know what people are talking about, just because I’m afraid of looking uncool or clueless. But what would happen if I just asked more questions? In 2018, I guess I’m going to find out.

11. I’ll practice naming exactly what I need from the people that I love.

I’m pretty sure this has been a resolution for me three years in a row now. But that’s because it’s so, so important. I want to keep practicing being direct when I need support. It’s the best way for folks to know what to offer me when I’m struggling.

12. I’ll curate my social media more intentionally.

I’ve started spending most of my online time on Instagram now. Why? Because I (purposefully) follow accounts that are positive and affirming, so it’s basically my only safe haven at this point. I highly recommend being thoughtful about who you follow and what you expose yourself to. It’s important to be informed, but it’s also important to take care of your mental health, too. (I talk a bit more about this in this blog.) Next year, I want to continue curating all of my social media accounts to be more balanced.

13. I’ll pause sometimes and make sure I’m doing what I actually want to be doing.

How often did I go along with someone else’s plan just because they were more assertive than me? How frequently did I default just because it was easier to? While it’s totally fine to go with the flow, every so often, I want to check in with myself and make sure I’m spending my time in ways that feel fulfilling for me, too.

14. I’ll ask the folks I care about what makes them feel loved.

I want to get in the habit of asking the people that I love what makes them feel appreciated. It’s different for everyone, right? Some people want to be showered with encouraging words. Some folks want physical touch or a thoughtful gift. So why not ask the people that are meaningful to me what makes them feel cared for?

15. I’ll resist letting shame control me.

Remember when I mentioned being diagnosed with OCD earlier? It took this long because I was so ashamed of my intrusive thoughts and bizarre rituals that I kept it to myself. Not anymore, though. This next year, I’m not going to let shame discourage me from getting the support I need. Often times, the things that make us feel like monsters or weirdos are actually common and very human experiences. No more shame.

So, readers, here’s to a brand new year.

After what was a difficult year for many of us, I hope these resolutions inspire you to invest more deeply in your own mental health and happiness. A year of honesty, authenticity, and self-care — in other words, the year that each and every one of us deserves.

You’ve got this!

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Appreciate the blog? Please consider becoming a patron! A dollar a month might seem small, but it helps keep this labor of love going.

Need a therapist? If you follow this nifty link, you can get $50 off your first month of therapy with Talkspace. Not a bad deal! ¯\_(ツ)_/¯ Read more about online therapy with Talkspace here.

Looking for some extra resources to make 2018 a better year?

I’ve got a few to recommend!

If you need to get organized: ADHD Survival Guide: How I Stopped Procrastinating and Got My Sh!t Together

If you’re thinking of getting some extra support: 7 Signs That Online Therapy Might Be Right For You

If you’re looking to incorporate more self-care into your life: 5 Awesome, Immediate Self-Care Resources For When You Feel Like Actual Garbage

Happy New Year!

Photo by Inna Lesyk on Unsplash

For The Mentally Ill Folks Who Didn’t Think They’d Make It This Year

The year had only just begun when I heard my psychiatrist, his voice quiet on the other end of the phone, telling me to go to the emergency room. “Will you go?” he asked me.

And I remember in that moment feeling like my cells were crawling and clawing in my body. The mere state of “being” was painful. I wanted to ask that doctor if he knew what he was asking me to do. How could he ask me to stay when everything hurt this much?

Last January, I couldn’t think of one good reason not to jump in front of the next train.

It’s December.

There were a million reasons not to.

Here’s what I would have missed: Trying my first veggie burger at Burger King. Learning I had obsessive-compulsive disorder. Eating sushi for the first time. Getting the first job that I’ve ever loved. Finding the best therapist I’ve ever had. Adopting a cat named Pancake that makes my heart so much fuller. Discovering how much I love yoga and learning more about astrology.

Buying the best pair of boots I’ve ever owned. Listening to Lorde’s best album and witnessing Kesha’s… everything.

Holding a dear friend’s hand while they waited for an ambulance. Crying with my partner when their father died. Learning a best friend’s new name. Trying out the word “no” for the first time. Looking in the mirror at my body and feeling gender euphoria for the first time. Figuring out (finally) that I actually am an introvert. Remembering what it feels like to believe in magic (and making a little magic of my own).

All the times I picked up the phone when someone needed me. All the times I said the right thing to someone that needed to hear it. All the times my being here made someone else feel like they should stay. All the times I said “I love you” and had the honor of hearing back, “I love you, too.”

All of the many, many moments this year when I woke up and thought, “I’m so glad I’m still here.”

It wasn’t easy. I relapsed spectacularly. I had to leave (what I thought was) my dream job. I almost lost my apartment along with it, and came within inch of losing everything else. I had to watch Trump celebrate his inauguration on a flickering screen in a psych ward, next to a poster from 1995 with “stress-busting” tips like, “Stop worrying so much.”

I was in that hospital for a week. In the last two days, it rained so hard that my ceiling leaked, drenching my group therapy handouts on the shelf below. You know, the handouts that were supposed to teach me how to be well again. And for a moment, I remember being flustered, thinking that maybe I should just throw them away.

I laid them out carefully to dry.

When I was discharged, I brought them home with me. And I started to rebuild, day by day.

If you’re reading this, it’s probably safe to say it wasn’t easy for you this year, either. I won’t presume to know why and I won’t tell you how to feel. But from one survivor to another, there were a couple things I wanted to shout out into the big internet void, hoping maybe the right person will read them.

Because you and I? We got through it. And the mere act of being here is a tremendous thing.

1. You are remarkably strong.

How do I know that? I guess I don’t exactly. But I have a hunch. Because it takes real strength to keep yourself alive, especially when your brain isn’t cooperating. You’ve had years now to throw in the towel, and yet, here we both are.

And yes, I suspect there were setbacks and close calls and tantrums, even, and all of that is valid. There was rage and grief, because if life is anything, it’s definitely not fair. I don’t doubt that it took everything in you, maybe even things you aren’t proud of, to keep going. And looking at where you are now, you may feel scared that you don’t have what it takes to rebuild.

But you’re here. Holy shit. You’re still here. And of all the jobs you have, staying alive is the most important one. You had the guts and resilience it took to survive this year. That was you.

Sometimes it was recklessly running into battle because, fuck it, what do I have to lose? Sometimes it was having an impulse, and choosing the less destructive one instead. And sometimes it was swallowing the pills you didn’t want to take, dragging yourself out of the bed you didn’t want to leave, or slowly sipping that nutritional shake to make sure your body had something, anything to sustain itself.

Whatever you had to do, you did it. And you should be so, so proud of that.

2. You belong here.

There have been more moments than I can count when I wondered if I ever should’ve been born. If there was really a place for me in this world. If someone like me could exist someplace like this.

That’s been an open wound from the moment I realized I wasn’t like most people (though, to be truthful, I have to wonder if there was ever a time I didn’t feel that way). I was queer, I was transgender, I was traumatized, I was sensitive, and by most accounts, I was crazy.

I certainly wasn’t the kid my parents were expecting. And I was never going to be the kind of person this world was built for.

I was lucky to find people, though, who taught me that while this world wasn’t built for us, it doesn’t mean there isn’t a place for us here.

And we might be a little rough around the edges. We might be a little wild, a little unsteady, and a little weird. But we find ways to grow no matter where we’re planted. Some of us make art, create zines, speak in poems. Some of us throw our bodies on the line for shit that matters. We speak truth to power, we stare down our fears and our demons, we exist despite everything that tells us we should not.

We show up for one another. We take up space. And we keep trying, knowing that there are kids like us growing up in the world that are going to need us to look up to.

We keep trying for them, the way we wished someone had been there for us.

…one of them was probably born, just now. (Let’s hope they find themselves a little faster than it took for us to find ourselves.)

This is the legacy we’re here to build, the legacy we’ll someday hand down to them.

3. Please be gentle with yourself.

Be gentle. Be soft.

There is an inner child within all of us, I think. Someone who’s doing their best in a scary world they were never prepared to enter. Someone who, every day, is hanging on tight as life does what it does best — changes.

And just when we think it’s settled, it changes some more. Sometimes for the best, but often for the hell of it, and almost never in the ways that we expect.

You are allowed to make mistakes. You are allowed to be messy, emotional, unsure. You are allowed to be afraid (in fact, I’d be surprised if you weren’t). And being human in all of these ways? That doesn’t make you “too much,” no matter what anyone else says.

You deserve compassion. You deserve patience, understanding. You deserve all the space and support you require to grow.

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It’s easy to ruminate on what you wish you’d done, or the ways in which you disappointed yourself or someone else. That’s a feeling I know all too well; I think everyone, especially folks with mental health struggles, knows how that feels (which isn’t exactly comforting, but hey, at least you’re in good company).

I hope that when you find yourself going there, you remember what I’m telling you now: You are worthy of kindness and care. And whenever you can, I hope you’ll give yourself permission to receive it.

4. You aren’t alone.

I don’t say this to you as an empty platitude or promise. I say this because it’s the truth.

Mental illness and trauma can so easily cut us off from our connection to the outside world, making everything and everyone feel like it’s a million miles away.

But feeling lonely is not the same as being alone. And I can almost guarantee you that someone out there has walked in those same shoes before — or at least wears the same size.

This year, I was finally diagnosed with “pure obsessional,” a very difficult form of obsessive-compulsive disorder. I spent a lot of years with painful and confusing obsessions that I couldn’t control — and it convinced me that I was some kind of monster, the sort of monster that no one could ever understand.

When I got my diagnosis, a whole new world slowly opened up to me. I started to learn just how many people in the world were a lot like me, even people that I knew and talked to every day.

Shame and stigma are like a fog sometimes. We can see ourselves and our struggles so clearly, but it’s difficult to see anybody else. But that doesn’t mean other folks aren’t out there.

And if you keep searching, keep reaching out, the figures in the distance will become clearer. There is someone that’s been waiting for your story.

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I know it’s terrifying to venture out into that fog, not knowing who’s out there. I know it’s scary to be vulnerable, to ask for help, or to share a piece of yourself with someone else. More than once, I’ve wished I could gather up the words I just said and shove them all back into my mouth.

But then someone says those words — “I thought I was the only one,” “You feel that way, too?” or my personal favorite, “YES!” with a bunch of frantic hand motions or snapping — and it suddenly feels worth it. Or at the very least, it gives us just enough courage to keep venturing out.

So here’s to this year and everything it took for us to survive it.

And the next one, too, whatever it may bring. Here’s to another year of stumbling through the fog. Here’s to all the people who waved their flashlights, giving us something to follow; here’s to all the shoulders we cried on, and the right words that came at the right time.

For what it’s worth — and I really hope it’s worth something — some very tender boy in California (hello, that’s me!) sends his love. You survived. And I, for one, am so glad that you did.

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You can care about social justice and care about your own happiness, too.

It feels strange to write a headline like this.

On the one hand, maybe it should be obvious — we all deserve to have joy, pursue meaningful connections and experiences, and invest in our own mental health. But somewhere along the way, I think I forgot what it meant to be happy just for the sake of it. And based on the burnout I’ve seen, I don’t think I’m the only one.

I was talking to my online therapist recently about how (yet again) a post about sexual assault on my Facebook feed had triggered my obsessive-compulsive disorder. When he gently suggested I take a deeper look at my social media usage, the conversation that ensued drudged up a lot of intense realizations about how I view happiness and self-care.

Namely, that I wasn’t giving myself permission to unplug, because I viewed that as betraying my values.

I realized through this process that very rarely do I do much of anything just for my own happiness. Blogging was an opportunity to support folks in my community. Self-care was a chance to “fix” my mental health so I could do more work. Most of my correspondences online had become me trying to support folks through crises or trauma. My social media was an endless stream of injustice and calls to action.

Every single thing that I did — what I read, what I watched, what I said, what I wrote — became an endless pursuit of doing better, doing more. 

If it wasn’t in service of other people, it simply didn’t have much value, and I didn’t prioritize it.

Last year, I noticed a number of things about myself. For one, I was lonely and burnt out. When I wasn’t working my day job at Everyday Feminism (which involved deep dives into the trauma of marginalized folks), I was either consumed by the news cycle, writing about social issues, opening my own wounds to educate others, or working really f*cking hard to support other folks in the community who were burning out for all the same reasons.

For a while, it was a running joke that I didn’t know how to have fun. “What’s fun?” I used to laugh.

Because when you understand the full extent of injustice in a system like this, fun can feel selfish, trivial, useless. It never seemed important enough. Meanwhile, I bounced in and out of intensive psychiatric programs, with my clinicians shouting after me, “Wait! Slow down? Maybe take more time?”

Even as I write this, I’m riddled with guilt. How many folks get the privilege of uplifting folks in their community on this kind of scale? How many folks get the chance to devote themselves to world-changing work? And most importantly, as an editor, I’ve had the privilege of holding space for so many experiences, stories, traumas… how could I take that for granted?

To be clear, I’ve found so much joy, meaning, and fulfillment in the work. But I have to wonder: When did I decide that my own happiness and wholeness — just for the sake of it, and just for myself — was too self-involved? When did I decide that taking care of myself was not just selfish, but unnecessary?

I’ve shared the “self-care isn’t selfish” memes countless times, and yet here I am, struggling to give myself permission to be happy.

After my second psychiatric hospitalization in the beginning of 2017, it became clear that my time working at Everyday Feminism was done. Walking away from that work was gut-wrenching. I had a lot of late night conversations with my partner, wondering how I could’ve “ruined” an opportunity like that.

Rather than listening to my body — which had been telling me for months, unequivocally, that the work wasn’t sustainable — I spiraled. I began questioning my dedication, questioning my investment, questioning my values. What kind of person has an opportunity to do such important work and, instead, loses their mind, drinks to excess, winds up institutionalized, and then walks away?

For a long time, I thought that my breakdown was my own fault, some kind of indication that I was ungrateful or selfish or incompetent, or that I wasn’t committed enough to my activism.

Here I had an opportunity to make an impact and I’d come undone. It was a dedication issue, I thought, I’m just not trying hard enough.

There’s a larger conversation to be had about the ways in which we fail to support folks doing this work. Structurally, so much social justice activism in underfunded, underpaid. And things like call-out culture can skirt the line, at times, between being necessary vehicles for accountability and being outright dehumanizing. This is all made worse with harassment and doxxing for those of us who primarily do this work online.

All of that makes it challenging to do this work and remain whole, to say the least.

But it also comes down to a very prevalent idea: that we must dedicate ourselves to this work at all times, and that joy is an afterthought, certainly not a priority.

There’s a level of perfectionism in the work that can be toxic. The reality is, there will always be more to do. There will always be more to read. There will always be more pain, more work, more need. And caring deeply about everything and everyone, you can get caught up in this unhealthy cycle of prioritizing everyone else at the expense of yourself.

This year it finally reached a point where I felt like digital activism was the only thing I really knew how to do. It eclipsed my entire identity, my entire self.

And when you determine that your only value is in what you can provide other people, you lose yourself.

After my hospitalization, I had to begin rebuilding my life. I started to wonder who I was in the absence of the work. What did I like? What did I enjoy? What interested me, excited me, energized me?

I have to wonder, how many of us working towards social justice don’t actually have answers to those questions outside of activism? Because my answers before would’ve all circled back to one thing: helping people. But if everything I do is for someone else, it can only be sustained for so long.

So I changed careers and found an unexpected joy in telling a different kind of story. I blogged when I felt called to, about what felt meaningful in the moment, instead of repeatedly opening my own wounds every week. I let myself blog about things that made me happy, too. I enlisted some help in managing my growing Facebook community, and gave myself permission to unplug.

And I started doing a heck of a lot of therapy. Because when we confuse total self-sacrifice for social justice, that’s a wound we immediately need to tend to.

I’ve started going outside. Drinking coffee. Laughing. Reading books. Letting myself get lost in articles about interior design and street style. I got a cat (he’s perfect). I meditate sometimes. I’ve started picking up the phone and calling friends. I completely overhauled my social media (I’ll write about how next week, if you’re wondering) to be a lot less triggering.

Through this process, I’ve realized that by abandoning my own happiness, I had also destroyed my capacity to meaningfully support others.

The reality is, social justice isn’t an all-or-nothing equation of either being committed or complicit, informed or uninformed. It’s all a process, and one that we can invest in while also investing in ourselves.

And if there’s no room for joy? It simply isn’t just. We all deserve to be well, to be whole. And if we don’t protect our own heart when we do this work, we deny ourselves the very thing we’re fighting for.

There are very good reasons to be angry. There are very good reasons to be furious, devastated, even unhinged in light of the world that we live in. But that makes it all the more pertinent, I think, to take care of ourselves, and to ensure that we’re prioritizing joy.

We can’t let injustice consume us to the point where we’ve lost everything that makes life meaningful and worth living.

Being joyful in the face of injustice is not a betrayal to the movement or to those who are struggling. It’s a loyalty to yourself, affirming your right — and by extension, everyone’s right — to wholeness.

Human beings need connection, fulfillment, and joy. So I ask you very sincerely: When’s the last time you gave that to yourself?

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7 Signs That Online Therapy Might Be Right For You

There wasn’t anything wrong, really, with my last therapist. He was smart as a whip, caring, and thoughtful. But after more than a year of working together, I had this nagging feeling that I wasn’t getting out of this what I needed to be. Something wasn’t clicking.

As someone with agoraphobia, it was already challenging to get to another city just for therapy. The financial impact of a copay, transportation there and back, and the time taken away from work had already added up. If I was already spending that money, why couldn’t I just sign up for online therapy, and get the care I needed without leaving my apartment?

So (shrug emoji) I decided to give Talkspace a try.

I chose Talkspace in particular because I knew from talking to other folks that they are especially mindful of their queer and transgender clients (of which I am both).

They didn’t ask me to review their services, or offer me any kind of incentive to talk about them. This is not a paid advertisement, friends, so you can trust that everything here is my honest opinion!

(This was actually an article requested and funded by my patrons, who were interested in online therapy and wanted my perspective. Hi there, patrons!)

If you’re intrigued by online therapy but not sure if it’s for you, I wanted to create this no-nonsense resource to help you decide.

While Talkspace is the platform that I use, this is advice that I suspect will apply to other platforms as well.

As with any therapy experience, you ultimately get out of it what you put in. That being said, there are definitely some signs to look for when deciding if online therapy could work for you:

1. Paying out of pocket isn’t prohibitively expensive for you.

Between my $15 copay and the Lyft ride to and from the office, paying for online therapy wasn’t actually that much more expensive for me. For $39 dollars a week, I can send unlimited messages to my therapist (text, audio, or video, as lengthy as I want) and get two thoughtful responses per day.

If I need a video call for a face-to-face experience, I can pay extra for that, either as part of my plan or on an as-needed basis.

But I want to acknowledge upfront that not everyone can afford this.

If you have insurance and your therapy is already sufficiently covered, online therapy will not be cheaper. However, if you have travel expenses and copayments (like me), or you’re already paying out of pocket, online therapy might actually be cheaper or at least fairly reasonable.

I still think this is the best $39 bucks I spend every week. But for folks who are low-income, this isn’t necessarily accessible to you.

2. You find yourself wishing you could process in the moment.

One of my biggest issues with face-to-face therapy is that, by the time my appointment rolled around, a lot of the more intense situations or emotions had already passed, or I couldn’t remember them once it was time to talk about it.

I often walked away from my sessions thinking, “Jeez, I wish I could just talk to my therapist when things came up, instead of having to wait until our next appointment.”

I felt like I was wasting time, like our appointments were basically me trying to remember what was bothering me or just filling up our time.

If this sounds familiar, online therapy might actually be an awesome option for you. With Talkspace, I’m able to write to my therapist at any moment, so when situations or emotions come up for me, I can articulate those things to my therapist in real time.

I’ve noticed a difference, too — we’re actually talking about the issues that are most present and important for me, instead of what I happened to remember during a scheduled time.

It’s important to note: If you are the sort of person that needs an immediate response, online therapy might not feel as gratifying at first. It took a period of adjustment to get comfortable with spilling my guts, knowing that I would have to wait to hear back from my therapist.

But I did get used to it! And it’s a format that’s working much better for me.

3. You know or suspect that writing is a great outlet for you.

A lot of my best emotional work happens through writing (this probably doesn’t come as a shock, seeing as I’m a blogger). Online therapy has been like having a diary that actually talks back, compassionately and competently guiding me through my process.

If you know that you’re the kind of person that finds it cathartic to write everything out, online therapy can be an awesome platform for you. There aren’t time constraints or character limits, so you’re given permission to take whatever space and time that you need.

If writing isn’t your thing, you can always just monologue with an audio or video recording. Sometimes you just need five minutes to ramble uninterrupted, and online therapy is great for that, too.

4. You find it easier to be emotionally vulnerable in digital spaces.

I grew up in the age of AOL Instant Messaging. Some of my deepest and most vulnerable connections have happened digitally. For whatever the reason — maybe it’s social anxiety, I’m not sure — I find it much easier to be vulnerable online.

I think online therapy is the best possible platform for folks like me, who simply find it easier to be honest when there’s the safety of a computer or phone screen between us and our therapists.

In just a couple of weeks, I disclosed more to my Talkspace therapist than I had with my previous therapist that I’d worked with for over a year. Being online helped me access emotions that I found it difficult to tap into in a face-to-face appointment.

(I think it helps, too, that this is therapy that can happen in the safety of my apartment, whenever I’m ready, while I’m hanging out in my pajamas and hugging my cat and eating nachos…)

5. You feel like you’re texting your friends a little too often.

I’m the kind of person that, when I’m overwhelmed with my life, I find myself texting or messaging my friends, sometimes with a frequency that makes me feel a little annoying.

And to be clear: It’s absolutely okay to reach out to someone when you’re struggling, as long as those boundaries are negotiated between you!

But what’s great about online therapy is that I now have a safe space to express myself at any moment, without the fear that you’re “too much” for that person.

If you’re an “external processor” like me, where nothing feels resolved until you’ve actually gotten it off your chest, online therapy is actually awesome.

I feel like there’s more balance in my relationships across the board, because every single day, I have an outlet for what I’m thinking or feeling that doesn’t rely exclusively on my friends and partners. That means I can be more thoughtful and intentional about who I reach out to and why.

6. You have other clinicians on your team that can help during a crisis.

A lot of reviews I’ve read talk about how online therapy isn’t designed for folks with severe mental illness. But I don’t actually agree with that — I just think that folks like us have to be mindful of what support systems we put in place, and when we use them.

Every person with severe mental illness should have a crisis plan. This is especially true for those of us who use online therapy, which means we won’t always get an immediate response when we’re in crisis.

I use online therapy to explore my trauma history, manage my OCD and depressive symptoms, and navigate the daily triggers and stressors in my life. However, I don’t use online therapy exclusively.

I also have a psychiatrist that I see regularly, support groups that I attend on an as-needed basis, and I can also contact my previous therapist if I’m suicidal and need to be referred to local crisis resources (like outpatient resources or hospitalization).

My Talkspace therapist knows that I have a history of suicidality and self-harm, and we’ve talked about what steps we would take if I were in crisis again.

I think online therapy can be a great option for folks with severe mental illness. (For me personally, I feel much more supported checking in with my therapist ten times a week online, as opposed to seeing them just once a week, if that.)

The key is that online therapy should never be the only option, and you and your therapist should work out a crisis plan upfront.

7. You have very specific therapeutic needs that you’re having trouble meeting.

My therapeutic needs were a bit… complicated.

I’m a queer and transgender person with a history of complex trauma, struggling with depression, OCD, and borderline disorder. I needed a therapist that can handle all of the above, but trying to find one who was up to the task was daunting, to say the least.

When I signed up for Talkspace, I first talked with a consultation therapist (kind of like a clinical matchmaker) who would help me find my ideal therapist. Upfront, I gave them as much information as I could, and they gave me three therapists to choose from.

One of them was a trauma-informed therapist who was also queer and transgender, who was well-versed in the disorders I was dealing with. We also came from a similar perspective, valuing a social justice-oriented and sex-positive approach.

Talk about a perfect match!

I think that one of the benefits of online therapy is that you have more options. Rather than searching for someone within a reasonable distance, you can connect with any therapist that’s licensed in your state. This widens the pool of available clinicians, and ideally connects you with a therapist that meets more of your needs.

(The great thing, too, is that switching therapists on apps like Talkspace is super easy — and those therapists will have access to your previous conversation logs, so you won’t feel like you’re starting all over again.)

If you’re a marginalized person that needs a therapist from your own community, your odds of finding the right therapist are much higher with online therapy. To me, this is by far the best part of the process.

There are definitely some valid criticisms to keep in mind, though.

I’ve loved my online therapy experience, but I’d be remiss if I didn’t mention these. Some of the common issues that people encounter with online therapy, summarized for quick reading:

  • You need to be 18 or older: As far as I know, for legal reasons, it’s not available to folks under the age of 18. Be sure to investigate this before signing up if this applies to you.
  • It’s a different pace: Responses are “asynchronous,” meaning your therapist responds when they’re able to — it’s a little more like email rather than instant message. For folks who like instant gratification, this will take some getting used to. If you’re in acute crisis, this shouldn’t be your primary support system.
  • There’s no body language: If you’re someone that is a little more withholding, and therefore you need a therapist to be able to “read” you, this can be an obstacle. If you’re someone that has difficulty interpreting emotion and tone through a text, this can also make things tricky. (Video calls and audio recordings are still options, though, so don’t hesitate to switch things up if you’re finding the text-only format to be tricky!)
  • You have to spell things out (literally): Your therapist won’t know if something isn’t working if you don’t tell them directly (they can’t exactly see if you’re uncomfortable, or bored, or annoyed, for example), so be ready to advocate for yourself if you aren’t getting what you need.

Alright, so what should I know before I get started?

Online therapy is really like any form of therapy, in that it only works if you show up. Here are some quick tips for the best possible online therapy experience:

  • Be as specific as possible when looking for a therapist: Better to tell your “matchmaker” too much about yourself than too little. The more you advocate for yourself, the better your matches will be.
  • Disclose, disclose, disclose: Be as open, vulnerable, invested, and honest as you can possibly be. You will only get out of the experience what you invest into it.
  • Talk about therapy in therapyTalk with your therapist about what’s working and isn’t working. If something is helpful, let them know. If something isn’t, be sure to say so. If something needs to change, it’s important that you communicate that to get the best possible experience!
  • Customize it: Online therapy has a little less structure, so be sure to talk with your therapist about how you can create accountability and a format that works for you. Whether it’s homework assignments, assigned readings (I like to share articles with my therapist on occasion), scheduled check-ins, or experimenting with formats (text, audio, video, etc), there are tons of different ways to “do” online therapy!
  • Set some goals: If you’re not sure what you want out of the experience, take some time to think about it. Creating goal posts can be helpful in guiding the process, both for you and your therapist.
  • Be safe: If you have a history of suicidality, substance abuse, or self-harm — or any kind of disordered behavior that could lead you to harm yourself or someone else — make sure your therapist knows this, so you can create a crisis plan together.
  • Anticipate an adjustment period: I felt weird about online therapy at first. It feels distinctly different, especially in the absence of body language and the delayed responses. Give yourself time to adjust, and if things feel off, be sure to let your therapist know.

So is online therapy a good option for you?

Obviously, not knowing you personally, I can’t say for sure! But I can say with certainty that there are definitely folks out there who have benefited from it, myself being one of them.

While I was skeptical at first, it turned out to be a great decision for my mental health, though I recognize its limitations. Like with any form of therapy, it largely relies on finding the right match, disclosing as much as you’re able to, and advocating for yourself throughout.

Hopefully this guide gives you all the right information to make a decision that’s right for you. I’d also encourage you to research more on your own (I am by no means the ultimate authority on therapy!). As the saying goes, knowledge is power!

Hey, fun fact (added some time after I published, once I found this out): If you sign up with Talkspace using this link, we both get $50 dollars off. ¯\_(ツ)_/¯ If you’re on the fence, give it a whirl!

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4 Ways Mentally Ill People Are Blamed For Their Struggles

The first time I told someone that I was mentally ill, they reacted with disbelief.

“You?” they asked. “You don’t seem that sick to me. Be careful not to play the victim.”

The second time I told someone that I was mentally ill, they invalidated me.

“We all get depressed sometimes,” they replied. “You just have to power through it.”

Countless times, I’ve been made to feel like my mental illness is my fault. I wasn’t trying hard enough, I needed to change my perspective, I wasn’t looking at all of my options, I was exaggerating how much pain I was in, I was only looking for sympathy.

If I wasn’t mentally well, they implied, it was obviously an issue with me that had nothing to do with the systems that fail mentally ill people each and every day. My “failure” to live a functional and happy life had nothing to do with the biological, psychological, and sociological factors that contribute to mental health. Instead, it always seemed to circle back to me and an apparent lack of willpower that kept me down.

For a while, this kind of gaslighting – the denial of my struggles that made me question my own reality – had convinced me that my mental illness wasn’t valid or real, and what was intended to be “tough love” from the people around me only made things worse by leading me to blame myself instead of advocating for the kind of treatment I desperately needed.

Like many mentally ill folks, it was impossible for me to move forward in my recovery until I stopped blaming myself and started seeking out the right kind of support. But it can be impossible to do this when the people around you are convinced that you’re doing something wrong.

A culture that routinely traumatizes mentally ill people by interrogating the severity of our illnesses and the sincerity of our efforts – effectively blaming the victim – is a form of psychological violence that keeps us from accessing the care that we need.

And yet it’s the norm in this society. People seem to have a lot of opinions on the choices that mentally ill people are and aren’t making while staying silent about the systems that force us to make less than ideal choices in the first place.

Personally? I believe that any choice made in an effort to survive is not necessarily a “wrong” choice, and if we care about mentally ill people, it’s our job to expand those choices by increasing their efficacy and accessibility rather than punishing mentally ill folks for doing their best to navigate their illnesses in circumstances that will never allow them to thrive.

As a mentally ill person, I have struggled within a culture that compulsively critiques the choices that I’ve made rather than advocating for the availability of better choices. And these critiques leveled against me, perhaps with the intention of motivating me, have ultimately hurt me.

I want to unpack those criticisms. The reality is that they harm not just me, but the millions of people that grapple with these illnesses every day.

And unfortunately, it’s a conversation that is increasingly necessary as support and resources for psychiatrically disabled people are only disappearing under the new administration, fueled in part by these prevalent beliefs about mentally ill people.

Here are four ways mentally ill folks are blamed for what they’re going through and what we can learn from these harmful assumptions.

1. We’re Expected to Pull Ourselves Up By Our Bootstraps

I remember when my old therapist told me, “If your mental illnesses were just an attitude problem, wouldn’t you have changed it by now?”

When I hesitated, she added, “I don’t think you’d make yourself suffer this deeply and this much if the solution were that simple.”

And she was right. I was doing everything that I could. My struggles were not due to a lack of effort on my part. I would’ve done anything if it meant finally getting better.

People who haven’t experienced mental illness personally often buy into the idea that if you try hard enough, mental illness is something you can overcome. With one brushstroke, it’s depicted as a lack of willpower and a personal failing. Myths like this disempower mentally ill people because they take the focus away from creating resources to help us and instead place complete and total responsibility on the person who’s suffering to make solutions appear out of thin air.

But if we could single-handedly ease our suffering, wouldn’t we have already done it? It isn’t fun, and for many of us, it disrupts our lives in significant and even unbearable ways. In fact, it’s the leading cause of disability worldwide.

When you place the burden on mentally ill people rather than advocating for a system that supports us, you put our lives in danger. Not only are we less likely to seek out help if we’re expected to go it alone, but legislators won’t think twice about slashing funding if it’s treated as an attitude problem rather than a legitimate public health issue.

No one wins when we abandon mentally ill people.

2. It’s Assumed That Treatments Will Be Accessible, Quick, and Effective

It took me over a decade from when my symptoms first appeared to get the right treatment.

And that bears repeating: over 10 years.

My case is exceptional, too. Most people will take at least ten years just to seek out help for the first time, and many will never receive treatment at all. This gap in care can account for the significant rates of drop-outs, hospitalizations, imprisonment, and homelessness that are a staggering reality for people with mental illness in this country.

It is incorrectly assumed that if you’re struggling with mental illness, a good therapist and a pill or two can easily remedy the situation.

But that’s assuming:

  • The stigma and cultural norms have not discouraged you from seeking out help
  • You have geographically and financially accessible options
  • Treating neurodivergence as an illness is a framework that serves you OR alternatives that resonate with you can be accessed
  • You have adequate insurance OR access to resources designed for folks without it
  • You understand how to navigate these systems and can find what you need
  • You can safely take medications and you respond to the medications prescribed to you
  • You were accurately diagnosed
  • You have the necessary self-insight to recognize your triggers and symptoms and can convey them to a clinician
  • You have the stamina and time to endure years of testing out different treatments to figure out what works
  • You have trusting relationships with the clinicians directing your recovery

…which only happens after you are willing to sit on a waiting list for weeks and even months to see those clinicians in the first place or can seek out crisis services (like the emergency room) sooner.

Does it sound like a lot? That’s because it is. And this isn’t even a complete list by any stretch.

Of course, if you’re multiply-marginalized, forget it. You not only have to wait for a clinician to see you, but you need a culturally competent one that understands the context of your unique struggles.

This is damn near impossible for many of us, as psychiatry as a profession is still dominated by clinicians who hold a lot of privilege and can replicate these hierarchies in their work. Instead of addressing the laundry list of reasons why mentally ill people don’t get treatment, it’s just assumed we’re not trying hard enough or that we don’t want to get better. This is a fallacy designed to prevent us from accessing care and perpetuates a broken system that does not serve us adequately or compassionately.

3. We’re Not Allowed to Feel Discouraged or Defeated

Behind all of the pressure to “keep trying” and all the suggestions that we’re never quite doing “enough” to get better is the implicit message that mentally ill people are not allowed to feel defeated. We’re not allowed to momentarily give up, hang up our gloves and say, “This isn’t working, and I’m tired.”

If we aren’t constantly “on” and working at recovery, it’s suddenly our fault that things aren’t improving. If only we’d just put in the effort, things wouldn’t be this way. Never mind that we’re human beings, and sometimes it’s just too overwhelming or painful to keep going.

A culture that treats mental illness as a lack of effort is a culture that says mentally ill people aren’t allowed to be fully human and vulnerable. It dictates that the effort is our sole and constant responsibility, and that we aren’t allowed moments in which we can grieve, give in, or be afraid.

The expectation that mentally ill folks are doing something wrong if they aren’t constantly in motion is an unrealistic and unfair burden to place on us, especially because the level of dysfunction that mental illness can present can make it nearly impossible to advocate for ourselves in the first place.

Feeling discouraged is valid. Feeling afraid is valid. Feeling exhausted is valid. There is a full spectrum of emotion that comes with recovery, and part of humanizing mentally ill folks requires that we hold the space for those emotions.

Recovery is a discouraging, scary, and exhausting process that can wear down the most resilient among us. This has nothing to do with mentally ill people’s personal failings and everything to do with the fact that these illnesses can be difficult to live with.

If you blame us for not trying harder or trying enough – demonizing those moments when we feel most vulnerable or defeated – what you’re saying is that if we aren’t superhuman and invulnerable, our pain is deserved.

This is untrue. We don’t deserve this. And we certainly didn’t ask for it.

4. We’re Either Too Functional to be Sick or Too Dysfunctional to be Helped

Here’s one of those ways in which mentally ill folks can’t win: we’re either too “functional” by appearances and therefore making excuses for our shortcomings, or we’re too “dysfunctional” and we’re a burden on society that can’t be helped.

Either way, rather than acknowledging the impact mental illness has on us, people tell us that in both scenarios, the problem lies with us.

It personalizes our struggles in a way that is dehumanizing. We’re seen as either dishonest or insane, and in either case it’s our responsibility to deal with it rather than society’s collective responsibility and ethical obligation to set up systems that allow us to heal.

And as with all of the myths we’ve broken down in this article, this is how oppression operates at its most insidious level: by decentering the systemic origins of human suffering and instead placing the responsibility and blame on the individuals who are suffering. If we categorically write off mentally ill people by either invalidating the authenticity of their struggles, or pushing them off to the margins as irredeemably lost, we no longer have to be accountable for what happens when our systems fail them.

Though attitudes like these remain the status quo and might initially seem benign, they create a protective shield that obscures what’s really at play.

It’s ableism, plain and simple.

Victim-blaming folks with mental illness is not just a matter of stigma, though we can easily recognize it as such. It’s also a form of violence; it directly upholds a system that harms the psychiatrically disabled and deflects accountability for that harm.

We can all do better than this, and it starts by putting the blame where it really belongs – not with mentally ill folks who are only trying to survive, but with the systems that fail us, a society that gaslights us, and the violent attitudes that embolden them both.

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PLEASE CONSIDER DONATING AS LITTLE AS $1 PER MONTH TO MY PATREON CAMPAIGN TO HELP FUND MORE FREE RESOURCES LIKE THESE, AND ACCESS EXCLUSIVE CONTENT WHEN YOU DO!This piece that I wrote originally appeared at Unapologetic Feminism.