5 Ways to Lovingly Support Someone With C-PTSD

I was watching Disney’s The Hunchback of Notre Dame when I felt myself starting to panic.

Right from the start, seeing Quasimodo be the recipient of so much gaslighting – being told that the world wasn’t safe, that he would never be accepted or loved, that Frollo had only his best interest at heart – struck a jarring but familiar chord with me.

Quasimodo’s isolation in the bell tower, unable to leave or connect with the outside world, eerily mirrored the control and entrapment I’d experienced years before.

“Hey,” my partner said softly, pausing the film. “Sam, you’re safe. It’s okay. But if this is too much, I’m more than happy to watch something else.”

In the midst of an emotional flashback, my fears were disrupted by my partner’s tender assurances. I could only nod. Without another word, my partner put on Steven Universe – my go-to show, having watched every episode at least three or four times, its familiarity and charm never failing to calm me down.

And I breathed (slowly and deeply) as I was lulled back into a sense of calm, my partner sitting quietly beside me. Sometimes seemingly “little things” can stir up something in survivors that becomes difficult to process in the moment.

But if I’ve learned anything over the years, it’s that sometimes our greatest healing can happen when we allow ourselves to love and be loved.

When my therapist told me that he believed I was struggling with C-PTSD, countless pieces of the puzzle rapidly clicked into place for me. The flashbacks, the fear of abandonment, the hypervigilance, the distrust, the dissociation, the deep and abiding emotional pain that I could swear I was born with – with one diagnosis, all of it seemed to make so much more sense.

Complex trauma, while not officially listed in the DSM-5, is still widely recognized by clinicians and survivors alike as a form of PTSD that occurs due to prolonged exposure to trauma – particularly interpersonal trauma, in which there was abuse and/or neglect that led to a significant imbalance of power.

Many culturally competent clinicians and survivors alike extend this framework to include the oppression that marginalized folks face, which can so often be traumatic.

My understanding of C-PTSD is largely influenced by the work of Pete Walker, a psychotherapist and survivor of complex trauma, whose words and affirmations helped bolster my own recovery (his book on complex trauma in childhood is a must-read).

While I am in a much better place with my trauma history, my loved ones – especially close partners who don’t share this kind of history – sometimes struggle to know how best to support me. I’ve had time to read, engage in trauma-informed therapy, and connect with community around these issues, but my loved ones haven’t necessarily done that work.

Friends and family of folks with C-PTSD don’t always have the same level of education and understanding that survivors do. That’s why I wanted to create this quick resource – to serve as a jumping off point to how to better support trauma survivors.

If you aren’t sure how to support a loved one with complex PTSD, here are some suggestions to start with.

1. Recognize That We Don’t Always Know Our Triggers, Either

Whenever I disclose to someone that I have C-PTSD, they often try to support me by asking, “What are the triggers I should know about?” I think this is a great question to ask if a survivor is aware of what can cause a flashback, but the reality is that many of us can be triggered on a level we aren’t even aware of.

That’s why it’s good to not only ask what triggers us but to ask what you can do if we find ourselves triggered.

What does your loved one find helpful? Is there something you can say, a kind of safe touch they want from you, or something else that’s comforting?

I use this guide to manage my flashbacks, and I think it’s a good point of reference for anyone who wants to help someone work through a particular episode. Give it a read, and invite your loved one to share what’s useful to them and what isn’t – assuming that this person is ready and able to have the conversation with you.

2. Encourage Us to Express Our Grief and Anger

A lot of trauma-informed therapists will say that survivors have a difficult time grieving the trauma they endured, and sometimes have difficulty expressing anger.

One of the best things a loved one can do is hold the space, then, for survivors to experience these emotions and express them in healthy ways.

Not sure how to do it? Here are some suggestions:

  • “I noticed that this conversation is bringing up a lot of anger for you. Do you want to share why?”
  • “What happened to you is absolutely unfair and unjust, and I’m open to hearing more if you want to talk about it.”
  • “If you need to cry, that’s okay. I can stay with you or I can leave if you need privacy. Just let me know.”
  • “Your feelings about this are absolutely valid. I hope you know that you’re safe now, and you’re allowed to feel those feelings.”

The key here is to (1) validate those emotions as real and understandable, and (2) open up a space in which those emotions can be felt and expressed more deeply.

Sometimes these conversations will happen when the trauma is referenced directly. Other times, a seemingly unrelated event can trigger a flashback. In both cases, it’s important to give survivors the space to navigate their feelings without judgment.

3. Let Us Vent Without Trying to Fix Things

One of the biggest mistakes that my loved ones made was that every time I tried to process aloud what I had been through, they would interrupt with advice on how to “fix” things.

In my recovery, I’ve found that coping with C-PTSD is not so much about fixing something. For me, a big part of the work has been about breaking through the denial of what I’d been through, and learning to love and protect myself in a way that I’d never believed I could.

I didn’t need to change or “fix” my relationship with the people who’d hurt me – more than anything, I needed to work through the ways I internalized that harm so I could, in turn, address the ways I’d been hurting myself.

More than anything, I’ve needed to be able to talk about what happened and feel seen when I did, so that I could begin to process what I’d been through and treat myself with more compassion.

And while every survivor’s recovery will look different, remember that when we want advice, we’ll ask for it – but what we need more than anything is your compassion.

4. Give Us Permission to Be Imperfect

For a lot of us with complex trauma, we struggle with perfectionism. Pete Walker calls this the “inner critic,” which so many survivors grapple with in recovery.

For some of us, perfectionism was a coping mechanism run amok, in which we desperately tried to better ourselves to “earn” the love or attachment that we lacked by correcting our supposed shortcomings. (Spoiler alert: No amount of perfecting ever changed this, but we continued trying anyway)

This “inner critic” can also be the voice we internalized, like when “you’re a bad child” suddenly becomes “I’m a bad child.” The external criticisms or neglect we endured suddenly became the mantras we took on as we were further and further traumatized.

Which is to say, a lot of survivors who are dealing with complex trauma really struggle with being imperfect.

For me personally, I believed for a long time that if people truly got to know me, they wouldn’t be able to love me. So I spent a good amount of time trying to make myself “better,” with the hopes that I would someday be “good enough” for the people in my life.

I think this is why it’s powerful when our loved ones give us permission to be imperfect. Some examples:

  • “You don’t have to be perfect for me or for anyone else. I’m going to be in your corner no matter what.”
  • “It’s true that you make mistakes. But you always work hard to make things right, and that’s what matters.”
  • “In my eyes, you’re already lovable and you’re already worthy.”
  • “Trust me. If something’s wrong, I’m going to tell you, and I promise we’ll work through it.”

An important thing to remember is that you’re responsible to your loved one, but not for your loved one – so their perfectionism, self-esteem issues, and unresolved trauma aren’t yours to fix.

Instead, support your loved one as they do the work to untangle those issues for themselves. That begins with simply letting them be human – creating the kind of space where you can both show up as yourselves, without the “all or nothing” expectation that the only people worthy of love are perfect people.

5. Educate Yourself About C-PTSD

Not sure where to go? A great place to start is this FAQ about complex trauma. While it’s written with survivors in mind, it’s still extremely useful for loved ones who aren’t sure what this C-PTSD stuff is all about.

I also think that this Wikipedia article on C-PTSD is one of the better online resources, along with this book that I mentioned earlier on in this piece.

Ask your loved one if there’s a particular resource that they’d like you to familiarize yourself with, or if they’re open to having a conversation about how complex trauma affects their life and relationships. If they’re interested in a conversation, make sure that you’re committed to holding the space for whatever emotions might arise, and that your approach is validating and compassionate.

Pete Walker also has a great resource on the concept of “co-counseling,” which offers a nice structure on how to have these conversations in a productive and safe way. I’d highly recommend it. You can also reach out to a therapist to facilitate this conversation between you if more guidance would be helpful.

Part of supporting a survivor is being open to learning and realizing that this learning is an ongoing process, rather than a single event. There’s no singular article or resource that will give you the expertise needed to support someone – rather, in the process of building trust between you, you’ll teach each other how to create a mutually safe and supportive space.

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When my partner paused The Hunchback of Notre Dame, it was a simple but important gesture that said to me, “Your trauma is not a burden. I’m here to support you.”

More than anything, I think survivors withhold a lot of what they’re going through for fear of being “too much” – but when invited, we can find the kind of safety necessary to open up and allow our relationships to truly grow.

If you’re looking to support a survivor, it can be as simple as noticing. As simple as validating us. As simple as saying, “I believe you.”

All I really wanted was someone to believe me. And every time someone does, I can feel a part of me learning to trust again, learning to love with abandon and without fear.

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What I Wish My Loved Ones Understood When I’m Suicidal

My mother hit the nail on the head when she said that I didn’t come with an instruction manual.

If I did, I’d request that it include at least one chapter on suicide – because none of us, including me, were prepared for how to deal with suicidal thoughts and actions. As it turns out, mental illness would drive me to the end of my rope on more than one occasion.

The truth is that no one prepares you for that phone call, the one when your loved one is on the other end of the line saying, “I just can’t do this anymore.”

No one prepares you for that moment when they hang up abruptly, and you have to make a quick decision that might save their life.

I’ve been the person who both got the call and made the call – suicidee and suicidal, if you will – and I know what it feels like to be both on the ledge and the one trying to talk someone down.

But if you’ve only ever been the one on the ground, you might not understand what it looks like from way up there. It’s difficult to understand and even more difficult to empathize with a person who is suicidal, having never been there before.

And while I can’t give you an instruction manual, I can tell you what it feels like to be there.

Here’s what I wish you knew:

1. Please don’t pretend to understand what it’s like if you don’t actually get it.

I know that you’re just trying to connect with me, but I can see through the nonsense from a mile away. I know when you can’t actually relate to what I’m going through. I know when you’re just pretending.

In this moment, I just want you to be here for me. I want you to hold space for me to be vulnerable, to feel pain, to be afraid. Let me know that you’re here with me. Remind me that I have options, and ask me if I want to talk through them. Give me the chance to unpack what’s been hurting me. Remind me that you’re here.

Listen and don’t judge.

If you haven’t been suicidal before or if you haven’t experienced depression like this, that’s okay. I don’t actually need you to have some kind of insider knowledge. I don’t need you to be able to relate to everything I’m saying and feeling.

I just need you to be here with me right now. I called you, of all the people I could’ve called, for a reason.

2. I don’t need you to fix this.

If I’m at rock bottom, the reality is that my situation is one that won’t be fixed in a single night. Crises like these aren’t about fixing things – it’s about being my support, helping me to hang in there when it seems like there’s nothing worth holding on for.

By all means, offer resources and coping strategies with me, and be sure to ask if that’s helpful for me. But if you enter into this conversation with the expectation that you can fix all of my problems, it’s just going to create a whole lot of stress for us both.

If there were some kind of immediate solution to my crisis, believe me, I would’ve chosen that before I ever considered suicide. The reality is, it’s going to take a lot to pull through.

Rather than promising a solution, promise me that I won’t have to go through this alone — and mean that when you say it.

3. The fact that I told you what I’m feeling is a really huge deal.

Being suicidal is one of the most vulnerable positions a human being can be in. It’s also one of the most difficult things you can endure. It took a lot of courage to talk about what I’m going through. Honor that courage.

And remember: I chose you. Of all the people I could call in this moment, I trusted you. That means something.

Instead of ending my life, I called on you. You mattered enough to be the person that I picked up the phone for. You mattered enough to be the face that I looked for in my darkest hour. You mattered enough to be the voice that I wanted to hear.

Being suicidal doesn’t mean I don’t care enough about you to stay — the fact that I’m including you now means that I care very deeply about you. Please don’t forget that.

4. Take me seriously.

I wish I didn’t have to say this, but you need to take everything I’m saying very seriously. I need you to operate from a place of belief — believe that I’m in pain, believe that I’m in danger, and believe that this is urgent and requires your attention.

I say this for a few reasons.

For one, suicidal people can sound detached. They can sound resigned. There isn’t always desperation or urgency in their voice. We don’t always respond emotionally in the ways you might expect. That doesn’t mean this experience is less real or sincere.

Instead, ask questions, and pay attention to these factors: Is there a plan? Are there means to carry out that plan? Is there an intended time to carry out that plan? And do they intend to take their own life?

(This guide is a pretty important resource for understanding how to respond to someone who is suicidal. I wish all my loved ones had read it before I made that call.)

The other reason that I ask that you take me seriously is because, sadly, many people assume that when someone shares that they’re suicidal, they’re only doing so for attention. But the reality is, a person in this much pain needs attention.

When the mere suggestion of someone taking their own life comes into play, there’s no question of how seriously you should take them. Take me seriously, because this is serious.

5. Telling me that there’s hope when I feel hopeless isn’t always helpful.

Do tell me about concrete alternatives, resources, and options that I have in my position. But don’t give me empty promises of how beautiful life is or other poetic ideas that you think will inspire me to keep on living.

If I could comprehend that kind of optimism right now, I probably wouldn’t be in this position.

Remember: My depression doesn’t just affect my mood — it affects my thoughts. Sometimes, I’m just not capable of seeing the big picture, or I’m in too much pain for that big picture to matter.

I don’t want to hear about how great life is. Because for me, in this moment, it’s anything but. And you reminding me of what I can’t feel and understand will only make me feel more alienated and more alone.

6. My feeling this way isn’t your fault.

Please, please, please don’t blame yourself for how I’m feeling in this moment. Could’ve, should’ve, and would’ve scenarios will only make us both feel worse. Instead, focus on the here and now, and how to get us through this.

7. My pain is valid.

You may not understand my pain, but that doesn’t mean it isn’t valid. Don’t tell me that I don’t have a reason to be depressed or suicidal. Don’t tell me my life is too good to throw away. Don’t tell me that there are people out there with worse problems than mine.

I don’t deserve to be punished or made to feel guilty just because I’m having a difficult time in my life.

Validate my pain. Acknowledge my suffering. And know that, for me, it’s very real. Real enough to make me contemplate suicide.

8. I may not be ready for what you have to say (right now), but it could mean everything to me later on.

Talking to a suicidal person can sometimes feel like talking to a brick wall. The truth is, I’m not always ready to hear what you have to say. Your messages of support, love, and warmth may go right over my head. I’m in a dark place and I can’t always see the light from where I’m at.

But I’ll tell you what: I remember the people who talked me off the ledge years and years ago. I remember what they said to me to this day. And even though, in that moment, I couldn’t really grasp what they told me, it came back to me.

I remembered it in therapy. I remembered it the next time I was hurting. I remembered it in recovery. And those words that, at first, meant nothing to me eventually came to mean everything.

What you’re saying to me is never in vain. Because while it may not resonate at the time, it could be the affirmation that I cling to weeks, months, years down the line. Sometimes it takes a while before the message really sinks in.

Give me time. I’ll thank you later.

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Have a suicidal loved one and not sure what to do? Read this guide from the National Suicide Prevention Lifeline or, if you need immediate assistance, give them a call at 1-800-273-TALK (8255).

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A much shorter version of this piece that I wrote originally appeared at Ravishly.

My Beautiful, Borderline Mind

Not too long ago, I wrote an article about the misconceptions around borderline personality disorder.

“I reject the idea that people with BPD aren’t deserving of competent care and compassion that would allow them to thrive,” I wrote, “and if we dismiss them as being irredeemable, that support becomes more difficult to access.”

Writing that piece was painful. Recalling the ways that people misconstrue my struggles was a deeply emotional process for me.

It also brought to light the very real stigma that still exists around BPD.

I started getting emails.

“My husband has borderline, but he’s horrible,” someone writes. “How can I get him to be more self-aware like you?” (This is almost, word-for-word, a message I received.)

“My partner with BPD is crazy, she’s too much,” someone explains. “What pills are you taking? Do you think that they’ll make her normal?”

This wasn’t the first time I was being held up as some kind of psychiatric achievement. Sometimes even my clinicians viewed me this way. “Most people with borderline aren’t like you,” a clinician told me recently. When I asked what that meant, he told me, “Most of them are just… flailing around, deeply unstable.”

Flailing around. That’s what most people think. Even our clinicians believe we’re chaos embodied, helpless, disturbed.

And thus I was propped up as an ideal. I was the repentant borderline, the good borderline. The more I was perceived as distancing myself from the disorder, the more people applauded me.

This is because the borderline that the world likes the most is the “reformed” borderline — the one that will apologize for being too much, will cut themselves down to be accepted, be neurotic in “acceptable” and small doses, and most of all, disavow any and all traces of the disorder.

In other words, the self-hating borderline is the one that the world loves the most.

It’s an uncomfortable truth, then, when I tell people that I don’t really hate my borderline mind. For all the hell it’s given me — and by extension, the folks who’ve supported me in my recovery — BPD has given me a beautiful intensity that I appreciate.

The world asks me to reject my borderline mind, looking for some symbolic gesture to demonstrate that I hate myself as much as they hate people like me.

In me, they see the redemption of their “crazy” spouse, their unhinged mother, their unruly child.

Every time I apologize for my existence, they are comforted knowing that they don’t have to learn to love someone with borderline — they can wait for the day when their loved one with borderline finally hates themselves enough to be someone else, or hates themselves enough to die.

But there are parts of me that I so deeply love — parts of me that wouldn’t exist if BPD weren’t a part of me, too.

And so long as we view people with borderline in such a reductive way, we fail to appreciate what’s possible for people with BPD. We demand that they erase themselves or punish themselves, rather than coming into their own, realizing themselves fully, and perhaps even learning to love themselves.

It’s devastating to think that, as we characterize people with BPD as abusers that need to repent or as irredeemably lost, we create a culture that denies people with BPD the possibility of authentic healing and self-love.

In the process of my own healing, I’ve realized that BPD is not just a source of trauma, but in some ways, it’s been a source of unique strength.

That’s the conversation that’s missing. That’s the conversation I’m longing for, waiting for.

The love that I’m capable of feeling for others, when it’s no longer fueled by fear, is a remarkable thing. My capacity for seeing the best in others, my ability to love deeply and fully, my sense of connectedness to the folks that I care about — these are things I would never change, so long as it comes from a healthy and secure place.

While I can be reactive, my sensitivity allows me to tune in deeply to the feelings of others. My firsthand experiences of pain allow me to make intense and empathic connections to others who might be suffering. And knowing what it’s like to be left behind, the loyalty that I possess makes me a reliable and caring friend.

What people with BPD need isn’t the greatest possible distance from themselves and from their disorder. What they need is security, healthy attachments, support, and genuine safety, so that they can become someone that they’re happy to be.

My borderline mind can be frightening and self-destructive. Ask anyone who was along for the ride this last year (when I was hospitalized not once but twice) and they’ll tell you as much.

But this mind also has a capacity for intense love, connection, and empathy — a potential that’s so often ignored or missed in people with BPD because of a stigma that leaves no room for us to grow.

For me personally, living with borderline has been retraining my brain to recognize when I am safe, after having lived for many years without protection in the face of complex trauma and PTSD. It’s been a process, too, to create the safety that I lacked for so long, and to trust in it when I have it.

It’s also been important to understand that safety doesn’t have to come in the form of support from others — it’s safety I can create for myself.

But that’s a realization I never would’ve come to if I’d listened to the stigma that told me that having BPD meant I was inherently bad, spiteful, or dangerous, teaching me to fear myself rather than be kind to myself.

Nothing about this process has been “flailing around,” as a clinician once said — it’s been a desperate search to regain the safety I’d been denied. And nothing about that process has been “manipulative,” either. Any misdirection to meet my needs, especially during a struggle I wasn’t prepared for and never asked for, was an act of survival, however flawed or unskillful.

My borderline mind has embedded in it a propensity for chaos that I won’t deny, but just the same, it gives me an incomparable ability to love and be loved. I have a sensitivity that keeps me deeply engaged with my world, a vulnerability that gives me immense integrity and strength, and an intensity that makes me creative and dynamic and alive.

And with the right support, I’ve been able to nurture that empathy and depth in incredible, unexpected ways.

I don’t believe that a diagnosis of borderline personality disorder is a statement of finality, of futility, of hopelessness, and I resent any suggestion that it is. I think for many, it can be an opportunity — a chance to grow, and to take everything we were taught to fear, and find the strengths hiding just underneath.

I wouldn’t be who I am without BPD. And I’m tired of the world demanding that I be anybody else.

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7 Things I Wish People Hadn’t Said After My Psychiatric Hospitalization

It took four weeks for my breakdown to happen – like a slow spiral, my sanity slipped out from underneath me. But in my memory, it doesn’t feel like such a long time. It’s as if I blinked, and suddenly I was in the emergency room with an IV in my arm and a security guard watching me sleep.

From there, I was committed, and driven an hour and a half by ambulance to a hospital in some city I’d never heard of before.

It took seven days before I was deemed fit to return to the “real world” – a world I was not prepared for, a world that I did not assimilate back into so easily.

Everything was the same as when I left it – yet none of it felt familiar. My bed felt too soft, like it could swallow me whole; my apartment felt like I was visiting someone else’s place; and my friends felt distant, like I hadn’t seen them in years. I could never seem to relax, waking up five, six times a night and greeting the morning exhausted, as if I hadn’t slept.

For a long time after, there was almost constant anxiety when I was with the people that I loved. Spending time with friends was unnerving; knowing that they’d seen me at rock bottom made me feel exposed, like there was nowhere to hide, nowhere to go.

I couldn’t be myself or let my guard down. I used to feel at ease socially, but for a while, I felt safer when I was alone.

There are reminders of my pain, even now. Every so often, there are flashbacks of the breakdown that sent me to the ER. The voices, the suicide note, the delusions, the alcohol, the intervention, the doctor’s disappointment (“I’d hoped this wouldn’t be necessary”), and the IV stuck in my arm – a blurry haze of shame and despair and fear.

To say that being hospitalized changed things for me doesn’t even begin to scratch the surface – I spent half a year after as a visitor to my own life.

Going back home after my psychiatric hospitalization was one of the most alienating experiences I’ve ever had, and like many people who have been hospitalized, finding the support I needed to feel secure during that transition was difficult.

There’s a lot to be desired when it comes to supporting folks who were recently hospitalized, especially when that hospitalization, like mine, is traumatic for them. And that support begins with how we talk about the experience.

To start, here are seven things that were said to me after my hospitalization that didn’t feel so supportive – and why you really shouldn’t say them.

1. (Nothing)

A lot of people didn’t know what to say, so they didn’t say anything at all. To be honest, I didn’t know how to ask for their support, so I didn’t say anything, either.

In our own ways, we were both just scared. We didn’t know how to process or where to begin. We didn’t know how to be vulnerable around each other. There was no cultural script for how to have these conversations. And for many people, I think they were afraid that if they said the wrong thing, I might fracture and break.

And yet, even though I understood this, I think the silence is still what hurt me the most.

Everyone is different in how they deal with emotional pain. Some people will explicitly ask their loved ones not to ask or talk about the experience. That’s a very valid reaction to trauma. But for others, saying nothing can suggest that you don’t care, that you’re pretending it didn’t happen, or that their hospitalization has scared you off – any of which can be very painful.

I think it’s important to ask your loved one what they need, so you can act accordingly.

If you want to say something but you don’t know how to approach it, here are some suggestions that might be helpful:

“How can I help support you?”

“Would it help if you talked and I just listened?”

“It sounds like you’re going through a lot, let me know if you need a friend.”

“Do you want me to bring some food over?”

“Can I send you a care package in the mail?”

It’s also true that after supporting someone through a mental health crisis, you may need to take some time apart. I was just as appreciative of the friends who stepped back, but still took the time to say, “I need some space to take care of my own mental health, but I want you to know that I’m proud of you for committing to your recovery.”

Your response doesn’t need to be perfect. All we need is some indication that you care.

2. ‘I’m Glad You’re Better Now’

One of the most common things people said to me when I left the hospital was telling me how relieved they were that I was “better.” Never mind that I’d never said things were better; never mind that I’d never said that I was recovered.

I could tell that the people in my life were relieved to see me, and glad that I seemed steadier than before. So they expressed it the only way they knew how – with gratitude.

I completely understand the impulse. Because I was glad to see them, too.

But it still doesn’t feel good to have everyone around you assume that you’re okay, especially after something that might have been traumatic. I found myself swallowing my grief, feeling like there wasn’t any space to not be okay – and when post-hospital life became more and more difficult, I didn’t feel like I could talk about it.

Many people assume that being out of the hospital means that we’re cured. But in reality, hospitalizations are often just the beginning of our healing, and much of the work we do to regain mental wellness happens outside of the hospital.

Recovery is not simple or linear, and mine certainly wasn’t. It took so much emotional strength to cope with the nightmares, flashbacks, panic attacks, and not to mention, the intensive therapy program that I attended three days a week when I returned home.

I don’t think anyone knew the burden I was shouldering, and just how brave I was to face it all.

So the idea that I should be “back to normal” – without understanding how hard I was working to stay afloat – only made me feel more distanced from my loved ones. I felt like there was an unspoken expectation that I would be stable and untroubled from here on out, which was impossible with all that I was still dealing with.

I felt like I had no permission to express what I was actually feeling – because there was now an assumption about how I should be feeling.

Everyone deserves the chance to recover on their own terms; try not to assume that someone is “back to normal” if they haven’t told you so.

3. ‘This Could’ve Been Avoided If You Had Just…’

It’s understandable that our loved ones, who presumably care very much about us, find themselves wishing that the hospitalization hadn’t happened, or feeling scared about what we went through.

It’s also understandable if there’s anger about the hospitalization, because sometimes it’s traumatic for more than just the folks who end up hospitalized.

So trust me when I say that I get it – fear, anger, and sadness were just a small slice of the spectrum of emotions my loved ones were feeling, too.

In the bigger picture, we are a part of a culture that so often blames victims for their own suffering – that tragedy or violence could be prevented if we had only made different choices. We blame rape survivors for having drunk too much, we blame poor folks for not spending wisely, we blame victims of police brutality for not “following orders.”

This kind of attitude is ingrained in our everyday lives.

With all of the emotions that you might be feeling, and the cultural script of blaming the victim, you may find yourself wanting to tell someone how their hospitalization and subsequent trauma is their fault, a result of poor choices that they made.

And I know that that assertion might feel very true, very real, and very justified.

But the truth is that it’s too late. What’s happened is done. When people pointed out that it was my choices that led to my hospitalization, they resurrected the pain, the memories, and the self-blame that had already been tormenting me.

My wounds were still fresh – and prodding at them only made things worse.

It made me feel like I deserved to go through the traumatic experience – like I should be punished for having a mental illness.

I had already spent every night in the hospital, thinking about what I should’ve, could’ve, or would’ve done. I already knew what choices were the wrong choices, because I’d replayed them in my mind a hundred thousand times. And I was not in the emotional state, when I left the hospital, to hash it out all over again.

No matter what the circumstances are, it’s triggering to blame someone for their own trauma, effectively forcing them to relive it.

It’s important to remember that mental health is far more complex than just individual choices. There are so many factors – psychological, biochemical, and even political – that can steer someone’s mental health in one direction or another.

Maybe there’s a conversation in the future which can involve prevention strategies and reconciliation. But for now, a person recovering after a hospital stay has one priority and one priority only: themselves.

4. ‘Please Don’t Tell Anyone’

A number of people discouraged me from writing about my hospitalization. Friends told me to reconsider how openly I’d posted on social media about it. Family members told me not to tell other family members. The underlying message, while not explicit, was that I should be ashamed of what happened to me, and that I should keep it a secret.

I chose to write about it on the internet instead. Because frankly, as a queer person and as a mentally ill person, I’ve spent most of my life in the closet and I’m not about to go back in.

The reality is, it’s up to the person who was hospitalized to disclose or not disclose. It’s up to them to decide what they feel comfortable sharing and what they don’t. And it’s up to them to tell this story on their terms – because what happened belongs to them, and not to anyone else.

It’s true that there’s a very real stigma around psychiatric hospitalizations. And when my loved ones asked me not to share, I know they only wanted to protect me.

But frankly, I never asked to be protected – and their attempts at shielding me only revealed their discomfort with my hospitalization, not mine.

There are always potential consequences when talking about mental health struggles. But it’s up to the person who was hospitalized to weigh those risks, and decide what makes sense for them.

Instead of telling people how to navigate their disclosure, it’s more important to support people in whatever choices they make – because it’s about their safety, their comfort, and their needs… not yours.

5. ‘What Was It Like?’

I think that the people who have asked me this wanted to be supportive and give me a space to process the experience, but they failed to acknowledge that I might not be ready to share.

(For the record, this goes for “what got you hospitalized?” and “did you hurt yourself?” inquiries, too. Ugh.)

Many people felt entitled to details about what happened to me in the hospital – entitled because they were family, or because we were close, or because they were curious. They seemed to suggest that what happened wasn’t mine, to process on my own time. That, instead, it belonged to everyone else but me.

And as people pushed and pried for details, I felt violated – I felt like they were exploiting my suffering because they had a morbid curiosity about being institutionalized, not about my healing or well-being.

It started to feel dehumanizing.

The reality is that many of us leaving psychiatric facilities may not feel safe sharing, aren’t in a place to relive what happened, or just don’t want to talk about it. And that should be respected – we should never be putting anyone on the spot, as if their hospitalization is just an entertaining story instead of a very personal experience.

6. ‘When Are You Going Back to Work/School?’

Being asked when I was going back to work was by far the most stressful question I was asked.

I promise, every single one of us wants to go back when we’re ready, so this is a question you don’t even need to ask. And if we need to go back sooner, it’s a decision that’s ours to make.

What many people don’t understand is that hospitalization is often the beginning, not the end, of recovery.

It will take its own course, on its own time – there’s no absolute formula for knowing when a person will start to return to their baseline mood and functioning.

If you want to support someone’s recovery, it’s far more important to be patient and understanding than to push someone to do something they may not be ready for.

And it’s critical to understand that going back to school or work when we’re still trying to recover may make things worse, not better.

I’ve known people to end up right back in the hospital because they returned to a toxic work situation or stressful semester at school before they were truly equipped to handle it.

The question shouldn’t be “when are you going back?” The right question is, “How are you feeling? How can I be supportive?”

Because if you’re really that interested in their return to work or school, you should be focused on how you can support them in getting better – valuing their humanity and wellness first and foremost, instead of their productivity. Pressuring them won’t get them back to “normal life” any faster.

7. ‘Try Not to Dwell on It Too Much’

A lot of well-intentioned people told me that instead of ruminating about what happened, I should “try not to dwell on it,” stay busy, go out, and keep it off my mind. But it felt like such a careless thing to say – that if I ignored what happened, it would just disappear.

I knew that their mindset was something like, “I can see that you’re in pain when you think about this, so maybe you should find a way not to think about it.” Logically, I can see why it would feel like this is sensible advice.

But the reality is that for many of us, we couldn’t ignore it even if we tried. Sometimes we’re dwelling on it even if we desperately don’t want to be. And being told not to think about it sounds a lot like saying, “Why can’t you just move on?” or “Why are you making such a big deal out of this?”

I developed some post-traumatic stress after my hospitalization – and the sheer tension that my body carried at every moment made my trauma not just an emotional experience, but a physical one, too. This wasn’t just a train of thought I needed to redirect. It was anguish and fear that I held in every cell of my body.

I wish people would’ve just asked, “How can I be helpful right now?” rather than instructing me on how best to deal with post-hospital life, especially when that advice didn’t resonate with me.

It’s better to never assume that you know what’s best for someone – especially if you haven’t experienced hospitalization firsthand.

Truthfully, as much as we don’t want to dwell on it, so many of us who were hospitalized are not “over it.” But it’s okay not to be over it – and letting people know that can be a powerful way to support them, affirming their right to take this recovery at their own pace.

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Most days that I was in the hospital, I had spaghetti and veggie meatballs with green beans for dinner. It was one of the more edible of the few vegetarian options, I was told, and with experience I quickly realized they were right.

Every so often, it comes back to me. I can be with a friend or sitting at home and suddenly taste it. Unexpectedly, its texture and smell and stale flavors will overtake me without warning.

It takes me back to the meals I stared down, remembering the way the nurses would inquire about how much I ate and write it down, clipboard in hand, like I was a specimen under observation. I’ll recall the faces of the other patients, waking me up with a jolt when they threw their bodies against the doors in the middle of the night, screaming LET ME OUT, desperate to escape.

And if I close my eyes, I’m being escorted to a room, I’m throwing punches, I’m being handed a cup of pills that I can’t name, I’m disappearing involuntarily into a wave of dreamless sleep.

So how do you explain that the panic all over your face came from phantom spaghetti?

How do you explain you can’t see an ambulance without flashing back to your body in restraints? That you have nightmares about the night you spent alone in the emergency room, in a drug-induced haze, bombarded with questions you can’t answer by people in white coats, tormented by voices only you can hear?

How do you tell someone that most days you still don’t feel real? That you feel robbed of something that you can’t define? That something – your identity, your safety, your connection to the world – was taken away and you’re afraid you’ll never get it back?

How do you explain to someone that realizing you weren’t invincible made you lose any trust in yourself you ever had?

That every moment inside your mind is like walking through a cluttered room where everything is breakable?

That you’re still breakable?

I’m not over this. But sometimes, the things that people have said about my psychiatric hospitalization made me feel like I was supposed to be.

It felt like there wasn’t any room for my pain when I emerged on the other side. It felt like I wasn’t allowed to be shaken, to be lost, to be shattered. I don’t think they realized the impact their words had on me – in fact, I think most people had the best of intentions when they said what they did – but I walked away feeling like I had to carry this burden alone.

That’s why I wrote this. Because if our loved ones really do care, they can and should do better.

There’s something to be said for holding the space for someone’s struggles, giving us permission to feel whatever it is we’re feeling. In a world that wants us to be silent about what happened to us, acknowledging that we’re hurting and bearing witness to it is an incredible gift.

I wish I had a triumphant conclusion for this article – about how, against all odds and with the loving support of my community, I have healed.

In some ways, I have. But there are days when I still hurt, still remember.

But each time someone reaches out to me – saying something caring, something sensitive, something thoughtful – it feels like there’s a stitch that wasn’t there before, helping to hold me together.

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This piece that I wrote originally appeared at Everyday Feminism.

7 Signs Your Psychiatrist Is a Keeper

“I’ll defer to your judgment on this one,” I said to my psychiatrist, shrugging.

“You defer to me a lot,” he pointed out, laughing. “You’re allowed to have an opinion.”

I was?

As a mentally ill person, I was so accustomed to having decisions made for me that I was baffled when my new psychiatrist was giving me the final say on my treatment – not just once but consistently.

That’s when I realized: No one ever told me what a good psychiatrist looked like, let alone the kind of treatment I deserve.

And this is nothing short of tragic because the relationship that we have with our psychiatrist can make or break us. When our mental health impacts every aspect of our lives, having a positive and trusting relationship can be the difference between surviving and thriving.

It took seven years of navigating psychiatry to finally find a clinician that I felt safe with. Seven. Years.

This is due, in large part, to the fact that I simply accepted whatever treatment I was given, rather than advocating for myself.

I didn’t know how to recognize when a clinical relationship was working for me, and when it wasn’t – and I was convinced that it didn’t matter as long as I could fill my prescriptions at the end of the day.

But it does matter. And as both a mental health advocate and a patient, I know now that a caring and competent psychiatrist can make a huge difference.

My current psychiatrist is the-bomb-dot-com. And I’ve been reflecting lately on why that’s the case: What exactly does he do differently? And what should we, as mentally ill folks, start to expect from our clinicians?

There are positive signs that I think we should all look out for in our clinical relationships – not just to help us find a good fit, but to give us the language to advocate for ourselves with every psychiatrist that we meet.

Here are seven signs to get you started.

1. They Look at You

When my psychiatrist came out from behind his desk, pulled up a chair across from me, and grabbed his laptop instead of hiding behind his desktop computer, my first thought was, “What the hell is he doing?”

He had a desk and a computer – why did he need to relocate right across from me?

But there was something about his relaxed posture, his complete attention, and most importantly, his consistent eye contact that totally disarmed me.

I immediately felt more trusting of him – something I hadn’t experienced with previous psychiatrists.

My last psychiatrist back in Michigan seldom looked at me, only to greet me and say goodbye. She stared at her computer, rapidly typing as I spoke, saying very little to acknowledge what I had said.

In hindsight, I realize this is why I always found our interactions to be cold and why I always held back on the details when speaking to her.

Something as simple as direct eye contact can change the entire temperature of a room. I went from feeling invisible to being seen.

I can’t emphasize enough what a difference this has made.

2. You Don’t Feel Rushed

In my work as an advocate, the most common complaint I come across is that folks feel their appointments are always cut short, or that they never have enough time to say what they need to.

The pace of the conversation and allotted time ultimately makes them feel like a burden, and they ask fewer questions, share less information, experience significant anxiety, and ultimately receive subpar treatment because they feel rushed.

I realize this varies widely depending on the clinic and clinicians you have access to, but I encourage folks to explore their options as much as possible.

It’s critical that you don’t feel like you’re always running out of time – this can absolutely impact your interactions and treatment.

I’m always blown away by how long my psychiatry appointments are now, and the fact that my psychiatrist always asks at the end if there’s anything else I’d like to talk about, no matter how long the appointment has already been.

We decide together when everything has been said – I’m never pushed out the door.

And if I open a (non-urgent) can of worms right at the end of an appointment, we make another appointment to discuss it, so I’m assured that it will be addressed and I know exactly when it will be.

Check in with yourself during your appointments. Do you feel rushed? Do you feel like you’re always running out of time? If you do, don’t be afraid to mention this.

3. They Respect Your Agency and Give You Choices

When I was struggling with binge drinking, my psychiatrist didn’t tell me what I should and shouldn’t do.

He made a few recommendations about resources that I could choose from, but then went on to tell me he trusted that I knew what I needed.

He believed in my self-determination, and affirmed that I was in charge. He didn’t criticize me for relapsing, or tell me that he knew what was best for me. He gave me choices.

Not once has my psychiatrist made a recommendation for me without giving me other options, and asking me how I felt about the options I was given.

My psychiatrist told me that he strongly believes in collaboration and self-education. In other words, he believes in my agency. I can’t emphasize enough how critical this is for mentally ill folks who – far too often – aren’t trusted to make competent decisions and are talked at rather than talked with.

This approach is both humanizing and, yes, anti-oppressive, as it upholds the belief that mentally ill people are truly the experts on their own lived experience. And we are.

So ask your psychiatrist what the word collaboration means to them in a clinical setting. This is far and away one of the most important signs about what kind of relationship you can expect, and what your treatment might look like.

4. Your Input Is Valued, Not Discouraged

My psychiatrist is always asking me for my opinions and for feedback, encouraging me to be an active participant in my treatment.

And I’m baffled that this isn’t the status quo.

As an advocate, I hear time and time again, “My psychiatrist was annoyed by how many questions I was asking” or “My psychiatrist was bothered by how much I was pushing back.”

Just recently, someone told me that their psychiatrist actually said to them, “You don’t get to call the shots. I do.”

This is a big, ol’ red flag, and you should head for the hills if a psychiatrist ever discourages you from being invested in your own treatment and wellbeing.

A good psychiatrist wants you to stay engaged. A lousy psychiatrist wants you to be seen, not heard, and to swallow your pills dutifully.

Don’t be afraid to seek out a different doctor if you feel that your psychiatrist isn’t listening. Newsflash: A big part of their job is listening – and if they aren’t, they’re failing you as a clinician.

5. There’s Mutual Trust Between You

During my last bout of depression, I sent an online message to my psychiatrist describing how suicidal I was and what plans I had.

I was truly at the end of my rope, and I didn’t know what else to do.

My psychiatrist didn’t call 911, though. He called me.

He calmly checked in with me, convinced me to go to the emergency room, and when I said I was on my way and that my partner was with me, he believed me. He then called the ER, filled them in on my situation, and told them to expect me.

This completely shocked me. But because I had trusted him and shared my suicidal thoughts, he trusted me to do the right thing. And you know what? I did.

admitted myself voluntarily – which anyone will tell you is preferable to being involuntarily committed and traumatized.

That kind of trust has been critical in my treatment. I feel respected and believed – and in return, I feel that I can open up and be honest about what I’m struggling with.

If you can’t trust your psychiatrist and the treatment they are recommending, how can you sustain the hope that things can and will get better? And how can you confide in them if you’re closing yourself off?

Trust is foundational in any clinical relationship. Do you trust your psychiatrist? If the answer isn’t “yes” or “we’re working on it,” then it may be time to find someone else.

6. They Acknowledge Your Identity and Trauma History

I’m transgender. And I’ve had so many psychiatrists who have pretended this isn’t the case.

Many psychiatrists have ignored the fact that my hormones do impact my mood. And almost every clinician has misgendered me, referred to me as “female,” or asked me questions that were completely inappropriate.

This is shit that I don’t put up with.

Weirdly, my current psychiatrist is the most trans competent psychiatrist I’ve ever had, despite never advertising himself as such.

I also have a significant trauma history, something that I’ve noticed many psychiatrists feel that therapists are exclusively responsible for knowing about in any detail.

But my psychiatrist has been very open to hearing about that history, and taking it into account when diagnosing and making treatment recommendations.

Which is all just to say, if your psychiatrist isn’t interested in the big picture – the aspects of your identity and history that have contributed to your mental health – they may not be a good fit.

If these things are important to you, they should be important to your psychiatrist as well, at least to some extent.

7. They Are Open to Alternative Diagnoses

When I was eighteen, I met with a psychiatrist who accused me of looking for an “easy way out,” being too young for medication, being too dramatic, and who – after all this – shrugged and said to me, “Which pills did you want?”

(I picked Prozac because I saw it on TV. She prescribed it without question or concern.)

She diagnosed me as bipolar after about ten minutes of yelling at me. And that label has followed me around since then, not being challenged or questioned by any of my clinicians until my most recent psychiatrist revisited it.

And guess what. I may not be bipolar after all. Borderline, ADHD, complex PTSD, OCD – these are labels that I only considered after my most recent psychiatrist had a real conversation with me, and these are labels we continue to revisit and explore.

Diagnoses are markers that can determine the entire course of treatment. Which therapies and medications are recommended can rely on these labels, and how we come to understand our struggles can be framed around these labels as well.

For the last seven years, it’s possible that I was receiving treatment for a disorder I might not even have. This is a huge deal.

This is why it is so incredibly important that we have psychiatrists that don’t take these diagnoses for granted. If something doesn’t feel quite right, don’t be afraid to ask for a reassessment.

If there’s a label that might fit better, don’t be afraid to introduce it to the conversation (because yes, there’s a place for self-diagnosis in psychiatry).

A good psychiatrist is open to new possibilities, and those possibilities can ultimately impact your mental health in big ways.

I don’t know at what point I started accepting whatever treatment I got. But I can tell you that now that I’ve had positive psychiatric experiences, I’m unwilling to go back to the days where I was a passive and jaded patient.

I can see the difference a good psychiatrist can make.

The sense of agency, trust, and validation I feel is absolutely priceless – and with each new success, I’m grateful for the amazing clinicians out there who make it a point to respect and uplift us, not perpetuating the harm and abuse that psychiatry can so often enact on mentally ill people.

I expect and demand much more now. And I believe we all should.

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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 Everyday Feminism.

Am I ‘Traumatized Enough’ For a Complex PTSD Diagnosis?

Crazy Talk is a mental health advice column, getting real about life with a mental illness. While I’m not a medical doctor, I’m living the good life with depression, OCD, and complex trauma, unapologetically owning my “crazy.” We’re talking all things mental health — trauma, happy pills, mood episodes, and whatever else you tweet me about! Check out last week’s column here.

Hey Sam! How do you know whether or not you have complex PTSD/trauma? I worry that what I went through wasn’t “traumatic” enough to warrant a diagnosis, and I don’t want to claim something that isn’t mine to claim. Where is the line drawn? And is it wrong to say I have C-PTSD if it’s a helpful label to me?

I’m really glad that someone asked me this question.

I’m glad because, too often, survivors diminish their own suffering — as Pete Walker, a trauma survivor and psychotherapist specializing in C-PTSD points out, the inner critic of a survivor is particularly strong.

I think when we combine this with a culture of invalidation (one which, generally speaking, does not believe or affirm survivors), it doesn’t surprise me in the slightest that coming to terms with trauma is such a challenge.

Before we go any further, let’s define C-PTSD. Complex PTSD is a condition that results from ongoing, chronic trauma, usually involving harm or abandonment within interpersonal relationships, particularly where there is an imbalance of power.

This is different from PTSD, which is usually the result of a particular event. C-PTSD is chronic in nature, meaning it was ongoing for some time.

The most common example is a neglectful or abusive caregiver, though that’s not the only kind of chronic trauma that exists. I would add that systemic oppression (like racism or ableism) is inherently imbalanced as well, which is why I think there’s such an abundance of trauma survivors in marginalized communities.

Complex PTSD, then, describes a very specific reaction to ongoing trauma.

Those symptoms can include difficulty regulating emotions; suicidality and self-injury; forgetting the trauma and/or reliving it through rumination or emotional flashbacks; dissociation or a sense of unreality; struggles within interpersonal relationships, like withdrawal or mistrust; intense helplessness, guilt, and shame; a sense of being distinctly different from other people; and even paranoia and psychosis.

I would encourage you to read the full list of symptoms on Wikipedia. As with any form of trauma, no two survivors will react the same way — C-PTSD, then, is an umbrella term that describes a dysfunctional reaction to prolonged trauma, a lot of which survivors may not even be consciously aware of.

Notice how the definition and criteria does not “draw the line” on whose trauma is severe enough to warrant a diagnosis. That’s because complex trauma is typically defined by a power dynamic, the chronic nature of the harm, and the resulting reaction to that harm.

Put another way: prolonged helplessness and harm, with a dysfunctional reaction to that state, is the recipe for complex trauma.

I’d encourage anyone who’s worried about whether they are “traumatized enough” to not compare themselves to other survivors but, instead, ask themselves the following questions:

  • Do the symptoms of C-PTSD describe my experiences? Does this language resonate with me? Do I feel affirmed when I read about it?
  • Does the framework of C-PTSD help me better understand myself? Could claiming this diagnosis help me gain more self-insight and support?
  • Is my reaction to what I endured dysfunctional? Meaning, has it had some negative impact on my life, and would I benefit from addressing that impact?

Finding a trauma-informed therapist to explore these questions with you is, in my opinion, a really great place to start. Given how often survivors downplay their struggles and how often they are gaslit into thinking their perception is wrong, getting a second opinion from someone who deeply understands trauma can be an important part of healing.

I personally tend to depart from conventional ideas about diagnosing mental illness — I think that the most important part of any diagnosis is not that a clinician has given it an official stamp of approval, but rather, that it helps the person who’s diagnosed. This is why I think self-diagnosis, while imperfect, can be a very important tool for neurodiverse people.

(Sian Ferguson wrote a great article breaking this down over at Everyday Feminism, if you’re interested in the merits of self-diagnosis.)

To me, a “valid” diagnosis is one which helps that person access support, resources, and tools that aid them in recovery. So if claiming a complex PTSD diagnosis helps you to that end, I see no problem with it.

If only the most clinically severe cases of PTSD (or any mental illness) were diagnosed, we would be leaving out millions of people who can benefit from support. I see literally no benefit in doing that. I would rather see those people get the help that they need, rather than imposing some kind of “purity test” or gatekeeping that doesn’t actually serve anyone.

If trauma is affecting your mental health, you deserve compassion, care, and support. Full stop.

It’s important to note that while complex PTSD is becoming a popular framework in clinical settings, it hasn’t yet made it into the DSM (Diagnostic and Statistical Manual, a tool typically used by clinicians to diagnose mental illness — it was a pretty contentious decision to not include it, for what it’s worth).

That doesn’t mean, however, that a trauma-informed clinician can’t help you navigate recovery (there are well-established treatments for this form of PTSD). Many survivors are dissuaded from treatment believing that just because it isn’t in the DSM, there’s nothing that can be done and it can’t be diagnosed.

But this isn’t true — some clinicians, for example, will flag the existence of complex trauma by noting it as a “history of psychological trauma,” and offer resources accordingly. This is worth discussing with a trusted clinician who can help you decide next steps.

The bottom-line? The mere fact that you’re wondering if you’re traumatized indicates that you could benefit from some support. Interrogating yourself won’t help you to this end, but seeking out resources will.

I hope that we eventually live in a world where survivors don’t feel that they have to “prove” themselves to be worthy of care. But until then, please take this advice column as a permission slip — your trauma matters. And getting support for that pain you’ve been carrying is long overdue.

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I’m Not Settling For ‘Good Enough,’ And Your Psychiatrist Shouldn’t Either

Crazy Talk is a mental health advice column, getting real about life with a mental illness. While I’m not a medical doctor, I’m living the good life with depression, OCD, and complex trauma, unapologetically owning my “crazy.” We’re talking all things mental health — trauma, happy pills, mood episodes, and whatever else you tweet me about! Check out last week’s column here.

Recently, I wrote a Twitter thread about what it’s been like to finally find the right medications. “Finally getting the right psychiatric medications,” I wrote, “was like realizing I’d been playing my life on ‘expert’ mode with a broken controller.” 

The response? Overwhelming. And one question that popped up a lot in that thread and in my inbox was something to the effect of, “Is ‘good enough’ with my mental health a good place to settle? Or should I not be settling at all?”

To answer this question, we have to dive into my history a little bit.

In 2016, I was in and out of psychiatric hospitals and outpatient programs. For years, I was misdiagnosed as having bipolar disorder, which meant I was put on countless medications that weren’t very effective for what I was actually dealing with. Back then, my philosophy had always been, “If I’m not suicidal, I’m fine.”

This resulted in a pretty well-established pattern. I’d struggle for a while, I’d coast. My medications sedated me, but a lot of my symptoms were always beneath the surface. I wasn’t totally miserable, but I was never truly happy.

Then something would trigger me — next thing I knew, I’d be flung into a complete crisis.

After one too many breakdowns, I found my current psychiatrist. He took one look at the seven or eight medications I was on and said to me, “Something isn’t right.” I explained to him that despite all the pills, I was never really more than just okay. And he was the first doctor I’d ever met that told me that “just okay” isn’t actually okay.

Let me repeat that: “Just okay” isn’t actually okay, especially if it doesn’t last.

Thus began the long process of reassessing all of my diagnoses and completely transforming my medication regimen. The process was so involved, I had to be hospitalized so I could be closely monitored while coming off of four medications quickly and simultaneously. And while it wasn’t exactly fun, it was the beginning of getting my life back.

Because with a real advocate in my corner, the goal was no longer survival. The goal was recovery. The goal was becoming my best self. The goal was finally living.

Here’s the thing: If you’ve been depressed and anxious for your whole life like me, you may not actually know what it feels like to be mentally healthy. This makes it easy to settle. This makes it easy to say, “If I don’t want to kill myself every second of every day, this is probably fine.”

The bar is set so low, we accept a quality of life that doesn’t have a whole lot of “quality” to it at all.

And our clinicians don’t always help in this regard. If we’re willing to settle, sometimes they are, too. I once saw a psychiatrist who said to me, “If your grades in school are fine, I don’t know what you need from me.” (Spoiler alert: I needed antidepressants, Doc.)

Sometimes when we aspire to be “okay” or “functional” — get decent grades, hold down a job, be able to shower and comb our hair — we forget that there’s more to life than just being okay.

There’s being able to appreciate a piping hot cup of coffee in the morning. There’s doing work or finding a hobby that’s meaningful to us. There’s enjoying the company of our friends. There’s having passion, ambition, and investment in something more, something bigger. It’s a good thing to be able to survive, and it’s important, too. But I’d like to believe we all deserve more than that.

Do you remember the last time you laughed deeply, maybe even until you cried? Do you remember the last time something good happened, and you couldn’t wait to call your friend and blather on about it? Do you remember the last time you actually gave a fuck about your life? Felt excited? Felt interested? Felt curious?

I spent most of my life going through the motions. I may not have always felt empty, but it took a long time to ever feel full. And while surviving is your top priority, I don’t want to live in a world where mentally ill people give up on thriving, with clinicians that enable us to.

Sometimes we do need to coast. Pace is everything, and this mental illness thing is a long freakin’ haul. But coasting should be a pit stop, not a final destination. This is especially important to remember, because too often while we’re coasting, we miss some of the warning signs (like boredom, for example) that can evolve into full-blown depression.

While it’s not reasonable to expect a dramatic shift overnight, it’s not unreasonable to say, “Actually, I want to be more than just okay. I want to be well.”

You deserve to be well. And you deserve a clinician who believes that you can be.

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