I often find myself amazed and inspired in my work at a hospital. Seeing so many people come through the emergency room or intake offices struggling with suicidal thoughts, profound depression, substance use disorders and trauma who somehow find a way to carry on reminds me of the strength it takes to live with mental illness.

Living with mental illness can be debilitating, leaving one both mentally and physically exhausted. Depression can cause a lack of sleep or too much sleep, changes in appetite, trouble with concentration and memory. Substance use disorders literally can change the structure of the sufferer’s brain. Trauma can leave one with painful memories and flashbacks. The resilience of those living with these illnesses astounds me. To carry on takes courage and bravery.

Coming to the hospital to say you need help with mental illness can take a lot of effort. Many of the people I meet are at wit’s end and no longer can manage on their own. We try to get them the help they need, be it inpatient hospitalization, partial hospitalization, outpatient services or substance abuse treatment. Thankfully, many people follow our recommendations and get the help they need. Unfortunately, some people choose not to follow through on the doctor’s recommendations.

What I often see is people who come for treatment for only a short while and while they are in treatment, take their medications and speak with a therapist or counselor. Often, after leaving the hospital, patients choose not to carry on with therapy and medications. Frequently, these folks end up back in our emergency room wondering how things got so bad again. They fail to follow up with the doctor’s recommendation for continued care such as taking medications as prescribed, seeing an outpatient therapist and meeting with a psychiatrist for medication management. There are many reasons for this, but I urge you to follow your doctor’s recommendations following discharge from inpatient or partial hospitalization or substance use treatment. Believe me, you will be better off for it.

There should be no shame in seeking treatment and continuing to take medication and speaking with a therapist or counselor following hospitalization, but sadly there is stigma attached to treatment. Only you can decide to follow up with treatment. Only you can make the decision to move from mental illness to mental wellness. The future is up to you.

It pains me to see so many people stop taking their medication and stop talking to a therapist because they think they are “cured” of mental illness. Taking medication and speaking to someone about what troubles you is what gets and keeps you well. Please do not stop doing the things that keep you feeling better. Please take into consideration what the doctor ordered for you. We all want to see you get well and stay well. Medication and therapy, along with coping skills, exercise and proper nutrition, can keep you from sliding down the slippery slope back into mental illness. Follow the doctor’s recommendations and, more likely than not, you will continue on the path of recovery.

Every day at work I am reminded that you just never know what someone is struggling with, what challenges they face or what demons they battle on a daily basis. Every day, I am reminded of the courage it takes to rise to the challenge of saying to someone, “I need help. I cannot do this alone.”

I have said it before and I will say it again: It takes more courage to ask for help than it does to suffer in silence. This past week, I met several brave people who brought themselves in for treatment after suffering in silence with crippling depression and anxiety. I applaud them for doing so and hope I did right by them all. One of the amazing people I met was a woman who walked three days through the mountains of Mexico to come to the United States, only to find herself in an abusive relationship that has left her profoundly depressed. I reminded her how brave she was for bringing herself in for treatment.

Finding one’s way from mental illness to mental wellness is not easy nor does it happen overnight. The path to recovery can be a long one and taking the first step can be daunting. But there is hope in recovery and a promise of a brighter future if you are willing to do the work of recovery.

Recovery is work and one has to be all in for it to work. Recovery requires therapy and medication and proper nutrition and exercise and learning a new set of coping skills and practicing those skills when times get tough. One cannot simply take a pill and expect to be magically better. Talk therapy is necessary to work out problems that are at the root of mental illness, substance use, eating disorders and trauma. Proper nutrition is important to help your body work the way it should. Exercise releases ever-important endorphins that help you feel better. Coping skills are important for everyone to possess. It is okay to ask for help learning how to employ these things. There are people like me who care to listen and help you work through your problems.

I have had people tell me that they do not want to talk to a counselor or therapist because “they are paid to listen.” Yes, we get paid for our work but that does not mean we are not interested in hearing your story or in helping you write a better ending. We care and care deeply about helping you find your way to wellness. All you have to do is ask for help.

The woman I met last night who trekked through the mountains to come to the United States came here because she wanted a better life. Last night she climbed one more mountain to ask for help with depression. Her bravery astounded me, her courage inspired me. Can you find the courage to take the first step on your road to recovery? Are you willing to trek through the mountain of mental illness to find your way to wellness? Reach out today. There are people who very much want to help you succeed on your journey.

So often in my work, I see people desperately wanting to feel better, to be free of their mental illness, substance use, trauma and eating disorders. So often, I see people suffering in their symptoms, wallowing in misery and despair. I wish I could wave a magic wand and make everyone better.

Sadly, treatment does not work like magic. Treatment … recovery takes hard work and daily effort. Oftentimes, I see people who want to feel better but refuse to fully participate in their own recovery. Getting well takes more than simply wanting to feel better; it takes a commitment to doing the work of recovery. That could mean anything from inpatient hospitalization, participating in a partial hospitalization program, meeting with a therapist or counselor on your own and, more likely than not, taking medication. I have seen very few people living with mental illness recover without taking their medication.

What I do see frequently is people who stop taking their medication and then decompensating to the point where they no longer can function and must be admitted to the hospital for stabilization. People stop taking their medication for a variety of reasons. Perhaps they feel it no longer is working or they do not like the side effects. Some people in the throes of psychosis believe the medication is poison. Some people simply cannot afford to pay for their medication and stop taking it. I urge you to continue to take your medication as prescribed.

If you believe the cocktail of medication you have been prescribed no longer is working for you, instead of stopping usage, talk to your psychiatrist or primary care physician. Perhaps the doctor can try a different medication. It can take several tries to find what medications work best for you. It also can take several weeks for the medication to kick in. Do not stop taking your medication because you feel it is not working. It is possible it just has not started working for you yet. If you have concerns about your medication, please talk to your doctor instead of stopping usage. Your doctor can help you find what works best for you.

Recovery from mental illness, substance use, eating disorders and trauma is possible if you are willing to do the work of it. There is no magic trick to be performed. Recovery involves a combination of talk therapy and medication, as well as learning coping skills, exercise and positive thinking. Recovery works if you work it. Are you willing to take the steps necessary to find your way to wellness? Are you willing to take good care of yourself so that you can live the life you deserve?

I woke up this morning as the sun was rising from a dream that left me wishing there were less stigma surrounding mental illness.

In the dream, I was chatting with a stranger who asked how I was and of whom I inquired the same. He told me he was fine, and I said the same. But then, he said, something along the lines of that is what we are supposed to say when someone asks how we are doing. We are supposed to tell people we are fine, even when we are not. But why is that? What would happen if we who live with mental illness, substance use disorder, eating disorders or trauma were to tell people what we really are feeling? More likely than not, we would be met with surprised looks.

We are taught at a young age not to share our true feelings with others lest we somehow offend them. We are taught at a young age not to share our true feelings because most people do not know what to do with others’ feelings. So, we say we are fine, that everything is good. In my world of mental health, keeping silent about your true feelings is what helps perpetuate stigma.

I truly believe that if we start sharing our real feelings and our stories about our lives with mental illness and substance use and eating disorders and trauma, there will be less stigma surrounding these sicknesses. If more people could come to the understanding that depression, anxiety, substance use, eating disorders and trauma are illnesses that can be treated and managed like any other kind of illness, perhaps there would be less stigma surrounding them. If more people could understand that mental illnesses are treatable medical condition, perhaps more people would feel free to seek treatment and enter into recovery.

How do we go about sharing our stories? By being honest about our feelings. If someone who cares about you asks how you are doing, tell him the truth. Hopefully, that person will take a minute to listen to how you really are doing and offer an encouraging word or two. That can help open up a conversation about mental illness, one where you can provide information about conditions that affect some one in five people. The more we who live with mental illness, substance use, eating disorders and trauma can educate those who are not afflicted, the closer we come to ending stigma.

Naturally, my dream ended before that stranger and I could share what we both really were feeling. My hope upon waking was, though, that we both shared our true feelings and entered into a conversation about them. Wishful thinking? Perhaps, but I remain hopeful and confident that the more we share our true feelings and stories, the weaker stigma becomes. What can you to today to help end the stigma surrounding mental illness? Can you share your story? Can you tell someone who cares about you how you really are feeling?

I am reminded this week of the enormous strength and courage it takes to do battle on a daily basis with mental illness, substance use disorder, eating disorders and trauma. I am reminded of my own struggles with mental illness and eating disorders and the work involved in recovery.

In my work, I see people in the throes of illness and wanting desperately to stop feeling the pain of depression and anxiety, to stop using substances, to be free of eating disorders that plague them, to overcome trauma they have survived. I see people at their worst, at their most vulnerable. I want to applaud them for seeking treatment, for finding the courage to say they are ready to do the work of recovery.

So many people who live in the darkness of depression and anxiety, who live in the quagmire of substance use and who live in the profound aloneness of eating disorders feel ashamed of their illness. So many people feel the weight of stigma in asking for help, in admitting that they cannot find wellness on their own. I want to remind anyone who lives with mental illness, substance use, trauma or eating disorders that there is no shame in seeking treatment. It takes more courage to ask for help than it does to suffer in silence. Can you be courageous today? There are people who want to help you find your way from illness to wellness. There are people who want to hear your stories and help you find a way to write a happier ending.

I understand being stuck in depression and anxiety and eating disorders and feeling so weighed down that even the idea of asking for help seems too hard. I understand not being able to fathom the idea that anyone wants to listen to your troubles, that anyone cares to help. I understand the feeling of being so tired of feeling sick and tired that the idea of doing the work of recovery seems exhausting. Believe me when I say this, though. There are people who do care. There are people who do want to help. Reach out. You do not have to suffer in silence. You do not have to fight this battle on your own. You can assemble an army of mental health professionals to help you win the war against mental illness, who can help you develop an arsenal of weapons in your fight against substance use, who can arm you with tools to be free of your eating disorder. Can you find the courage to seek help? Can you find the courage to fight for yourself, for a better life? You deserve to be free of your demons. You deserve happiness and a life worth living. What better day to start living that life than today?

 

 

 

How often in our lives do we not do something because of the things we keep telling ourselves? How often do we tell ourselves we cannot do this or that because we are not good enough, smart enough, pretty enough, thin enough … enough at all? How often do we let the stories we have been telling ourselves for years stop us from doing something we likely would enjoy?

I recently saw something that said, “Underestimate me … that will be fun.” I then saw something that said, “Your only limit is you.” To some extent, that is true. What would you do today if you told yourself you are enough? What would happen if instead of telling yourself you are not good enough or do not deserve something, you told yourself you are good enough just the way you are?

What stories have you been telling yourself that keep you stuck where you are? So many times in my work, I see people who believe they are unworthy of love and belonging and understanding because they live with mental illness or substance use disorder or eating disorders. The story they have been telling themselves keeps them stuck in their illnesses. They put limits on themselves and their lives by staying stuck in the story that tells them they are not worthy of happiness, of a better life. What happens if instead of repeating that story, they start telling themselves they are worthy of happiness?

Who has been telling you that you are not worthy of love? Likely more than not it is not your family or friends. Perhaps that story developed in your mind because of childhood emotional neglect or abuse, but hopefully that is not the story people in your life are telling you now. Yet, we hold onto that story from our past that keeps us stuck in feelings of sorrow and sadness. Perhaps we do that because we feel it is easier to believe we are unworthy of love and belonging than it is to believe we are beautifully and wonderfully made and worthy of love and all life has to offer. What stories do you tell yourself that put limits on your life?

Perhaps it is time to start telling yourself a new story, one where you are worthy of happiness and love and belonging and a life worth living. Perhaps it is time to stop putting limits on your own life. You deserve to be happy. You deserve to be loved simply because you are a human being. Start telling yourself that and a whole new world will open up to you. Your only limit is you. Time to get out of your own way.

It has been a rough week. News of the suicides of Kate Spade and Anthony Bourdain and several patients living with suicidal ideation have left me shaken. I am constantly reminded that you just never know what people are struggling with.

Suicide is on the rise and currently is the 10th leading cause of death. So often, people living with suicidal thoughts want less to die than they want the emotional pain and turmoil they are in to simply stop. People living with suicidal ideation often see death as the only way for their pain to stop. They simply cannot see another way to be free of the often overwhelming feelings of hopelessness, helplessness and worthlessness that plague them.

In recent days, I have heard people say that suicide is selfish, that those who attempt or complete suicide fail to think of how their actions will affect others. To some extent this may be true, but more often than not people who attempt or complete suicide are feeling so alone they think everyone in their life will be better off without them. So often, people who are feeling suicidal feel as though they are a burden on those around them. They feel isolated and alone in their pain.

What we as care givers, friends, loved ones must do is frequently remind those living with profound depression, crippling anxiety, substance use disorders or eating disorders or other mental illness that they are not alone, that there is hope and that more likely than not tomorrow will be better. Those living with suicidal ideation often find it impossible to believe that their lives or situations can get better. We must remind them that it can. We must work to instill hope.

Living with mental illness, substance use disorder and eating disorders is not a choice. Mental illness is not a flaw in character; it is a flaw in chemistry. Please, if you or someone you know is struggling with suicidal ideation, seek help or encourage your loved one to seek treatment. There is help; there is hope. Anyone feeling as though they want to commit suicide may call the National Suicide Prevention Lifeline at 1-800-273-TALK or text the Crisis Text Line at 741 741 to speak with a counselor.

You are not alone in your illness. There are people who care. There are people who are willing to talk to you and remind you that there is hope. You may feel as though things will never get better. If you are willing to seek treatment and participate in your own recovery, you will get better. Tomorrow can be better. Tomorrow will be better.

 

In my line of work, I often hear people struggling with substance use disorder, mental illness or eating disorders say that they will start treatment in a week, a month … later. I often wonder, why not now? More often than not, they are not ready or do not recognize there might be a problem.

We in social work often speak about the stages of change. People sometimes know there is a problem but are not yet ready to do anything about it. People usually come to treatment when there is a crisis or when remaining the same is more painful than the possibility of changing. Sometimes, people come to treatment at the behest of a loved one or other person who cares about them. But change does not happen unless one is ready to stop performing the behavior that keeps them sick. And so often, we become so used to performing a certain behavior or feeling a certain way, the idea of changing is so overwhelming we opt to stay right where we are.

Sometimes, people stuck in the quagmire of substance use or mental illness or eating disorders do not even realize there might be a problem. They seem to be functioning well enough, making it to work or school. What they possibly do not realize is the damage they are doing to their bodies, minds and souls by continuing to use or stay stuck in sadness. There is so much more to life than being comfortably uncomfortable. Do you not deserve more?

Change takes work. But it is so worth it. Do you not deserve to live a healthier, happier life? Do you not deserve to become the person you always were meant to be? Why not start today? What is the worst that could happen?

So often in my work, I see people coming to treatment expecting to be healed in just a few sessions. For some people, that is true. For most, however, there is more work to be done. So many people come to treatment not fully understanding that the road to recovery likely will be long and arduous.

Finding one’s way to recovery takes work and persistence. There likely will be setbacks and times when one wants to give up because recovery is hard. Recovery takes daily effort and persistence. Recovery is not just about wanting to find your way from mental illness, substance use or eating disorders to wellness, it is about doing the work of recovery every day. You have to fight for it. It is not a fight won easily. But it is so worth it.

Living in the quagmire of mental illness or substance use or eating disorders can render one feeling helpless, hopeless and lost. But, believe me, there is hope for recovery. Once you become so tired of feeling sick and tired, recovery begins. Once the fear of changing becomes less so than the fear of remaining the same, recovery begins.

Recovery is not an event, it is a process. Recovery does not happen overnight. Where are you on your road to recovery? Are you stuck feeling comfortably uncomfortable in your illness? Has your illness become a constant companion? Perhaps it is time to move on from that particular relationship. Do you know that there is a problem that needs attention? Perhaps it is time to consider treatment. Are you ready to fight for the life you deserve? Are you ready to fight to become the person you always were meant to be? Perhaps it is time to find your strong and call a hospital or treatment facility, if even just to inquire about what types of programs they offer.

There is a beautiful life for you waiting on the other side of fear. There is more to life than feeling low and lost and unwell. Wellness and recovery are waiting for you. Are you ready to fight for your life? Are you ready to find your way from illness to wellness? Are you ready to fight for you?

So often in my work I see people who are unhappy with their lives, their jobs, their significant others, their situations. People come to treatment seeking solace, seeking an end to their sadness, their pain, their loneliness. People come to treatment wanting their therapist or counselor to make them happy. I wish I could wave a magic wand and make that happen, but unfortunately, I cannot.

As a mental health professional, I can help you find the tools that will help you make yourself happy, but as an outsider, I cannot make you happy. Happiness comes from within. Happiness and joy in your life comes from making the sometimes difficult choice to be happy, to make yourself happy, to do things that bring you peace and love and joy. You will never be happy or content with your life until you first decide to be happy and then choose to do things to make yourself happy.

Can others make you happy? Certainly other people can contribute to your happiness, but choose those people wisely. So often we find ourselves in toxic relationships with significant others, family members, even friends. It is okay to rid yourselves of those people who bring negativity into your life, who make you feel less than or unworthy of love and belonging, of those people who do not value you as a person.

I often say that your life is a series of choices and the choices that you have made thus far have helped create for you the life you currently are living. Are you happy in your life right now? If not, perhaps it is time to start making better choices. You can choose to bring happy into your life by making better choices. There is no law that states you must continue doing the things that no longer bring you joy simply because you are used to doing them.

What keeps you stuck in a life that leaves you unhappy or unfulfilled? More likely than not it is the choices you make, the people with whom you surround yourself and the situations in which you find yourself. If you find yourself feeling unhappy, perhaps it is time to make a change. Easier said than done, right? You do not have to change everything all at once. Start with something small. Set a new boundary with someone in your life who makes you feel unhappy, perhaps spend less time with that person. Update your resume and start looking for a new job if you are unhappy in your work. Stop using the substances that leave you feeling low about yourself.

Change starts with you. You can bring happiness into your life by making decisions that will improve your chances at creating for yourself the life you deserve. You are the architect of your life. Build something you can enjoy and of which you can be proud.