25 Things I've Learned in 25 Years: Mental Health Edition
It's beautiful outside and warm, warm as early summer, even though spring has just started. I've been meaning to write a post about twenty-five things I've learned, one for every year of life I've lived. My birthday was last month, and twenty-five has been good to me so far. My mom has always said that she feels twenty-five in her head. It feels like the right age to make this kind of list: a quarter-century's worth of knowledge.
The past couple of days have been challenging for my mental health; I'm used to managing my anxiety on a daily basis, but depression has decided to stop by for an overdue visit. So, since writing is the best therapy for me, I thought I'd give this list a fun (hah) theme: The Mental Health Edition. There's no better time to remember these lessons than when I'm struggling, so here goes. Also, this goes without saying, but I am not a mental health professional, and this list does not constitute mental health advice - it's just a few things I've learned for myself over the years.
- Not everybody has mental illness, but everyone has mental health. A conversation card from the Canadian brand Wear Your Label taught me this lesson. I used to carry it displayed in my translucent phone case: "1 in 5 people have mental illness, but 5 in 5 have mental health."
- Similarly, you don't have to be mentally ill to benefit from mental health services. We go to the doctor for physicals, we go to fitness teachers for exercise, and we go to dietitians for nutrition advice, so why don't we go to therapists for mental health tune-ups? I firmly believe that everyone can benefit from some sort of mental health services, whether that's psychiatry, individual psychotherapy, support groups, art therapy, or any number of other possibilities.
- There's no such thing as "not mentally ill enough." You don't need to be at rock bottom to need treatment.
- That said, there's no shame in hitting rock bottom. I've been there twice: the first time right before I sought treatment for my eating disorder, and the second when I was suffering from suicidal ideation during a period of deep depression. Both times, I got out by admitting that I wasn't okay and telling people about it so that they could help me.
- Mental illness is (at least partly) hereditary. You probably didn't need me to tell you this, since the scientific community has already published findings to this effect, but it bears repeating. I've always known that certain mental illnesses (depression, addiction) run in my family, but for some reason I didn't make the connection when I first started experiencing anxiety and depression as a young teen.
- Not all doctors screen for mental illness. In fact, most of mine didn't. I had to seek out online tests to find out that I was dealing with depression in my first year of college, though I'd seen the doctor plenty of times.
- Mental illness, and mental health, manifests in the body. When I am struggling with my mental illness, I feel it in my body. Stomachaches for anxiety, lethargy and exhaustion for depression, and headaches for my eating disorder. Conversely, when my mental health is good, I tend to feel physically good. And if I become physically ill, even with just a cold, my mental health declines.
- Finding the right therapist is worth the time and energy it takes. I was unbelievably lucky with my first therapist. I went to my school counselor for an intake, we decided that I needed more intensive treatment than they could offer, and I walked out of the office with a list of therapists and dietitians who specialize in eating disorders. I called the first PsyD and RD on each list, and they were both perfect fits. In the years since, I've learned that this almost never happens. We don't have lists of pre-screened candidates floating around most of the time, and it usually takes a few tries to find the right person for you.
- Shitty therapists exist. Maybe this was just naiveté on my part, but for a long time I really didn't think bad therapists existed. How could a selfish asshole want to go into the mental health profession? I thought to myself. Well, then I met a woman in DC who spent forty-five minutes of our fifty-minute session talking about her senatorial clientele and kids' GPAs. They exist. Watch out for them and run away if you encounter one.
- Not everyone can afford therapy. This might seem obvious, but never tell someone who is struggling that they should "just go to therapy." They might not be able to afford insurance, their insurance might not cover mental health services, or they might not be able to take the time off work.
- Therapy isn't passive. TV shows seem to think therapy is lying down on a couch and being prompted gently about your dreams. In reality, a lot of my therapy sessions consisted of my therapist staring me down across a tissue box until I started the hard process of unearthing whatever fucked-up stuff I needed to talk about that week. Therapy is work, and both you and your doctor put in a lot of emotional labor.
- Therapy can suck, but it shouldn't make you feel bad. Therapy doesn't always feel good in the moment. I didn't love ugly-crying to my therapist about my relationship with my dad, or recounting to my psychiatrist how many times I need to check the stove to satisfy my mild OCD. That said, I always came out of sessions feeling, at worst, wiped out but satisfied with some amount of progress. If you walk out of the office feeling like shit, ashamed or worse, then there's something wrong with the situation.
- You don't have to go to therapy. I am living with mental illness, but I'm not in therapy right now, and I don't think I need to be. Sometimes I need therapy to manage my mental health; sometimes I don't. Ideally, I'd live close to a therapist I already know and trust so I can go as needed, but sometimes that's not possible.
- Talking about mental illness is painful. Not necessarily in the sense that it's hard for me to talk about, but when I talk about my mental illness I am choosing to be vulnerable. Not often, but sometimes, people react badly. That hurts.
- Talking about mental illness feels fucking amazing. For me, there is nothing more freeing than speaking openly about my mental health. It's an important part of who I am, and being my authentic self, mental illness and all, feels great.
- Talking about mental illness is a personal choice. I've decided to be open about mine, but there are so many reasons not to be, and there is no right or wrong decision.
- Not everyone deserves to know. I used to think that I could and should be open with everyone, but I've learned when and how to disclose my mental health IRL in a way that protects my emotional and psychological well-being.
- If possible, find an employer who cares about your mental health. And I don't mean an employer who just talks about "self-care" at staff retreats. I mean find an employer who offers a benefit plan that covers mental health services, who allows you to take time during the workday to go to therapy, who gives you the PTO you need to preserve your mental health. I know this is largely determined by class privilege, but if it's possible, try to get a sense of these metrics during your job search.
- Mental health exists on a spectrum. Sometimes my mental health is excellent, sometimes it's terrible, and a lot of the time it's in between. The dichotomy of mentally ill/not mentally ill is tricky, because while it's been important for me to claim mental illness, having it doesn't mean I'm "sick" all the time.
- Flexibility is key to managing your mental health. By this, I mean that what works for you one day might not work the next. It will change depending on how you're feeling and what your circumstances present to you.
- Privilege is hard to think about, but it's important. As someone who basically won the privilege lottery, it can be difficulty for me to reconcile my mental illness and my privilege. On the one hand, my mental illness is no less valid or real just because I have privilege. On the other hand, it's important for me to recognize the ways in which my mental illness is treated or recognized because of my identities, and how others' mental illnesses get erased.
- On that note, don't let guilt keep you from caring for your mental health. You can't pour from an empty cup, put your own oxygen mask on first, blah blah blah. In this age of political galvanization, there's a lot of talk about "self-care" for those involved in activism. The Internet has been so saturated with it that I've been tempted to tune out, but I have to remind myself that I have to take care of my mental health not just for the sake of my activism, but for my survival. Having privilege doesn't mean that I can neglect my mental health.
- Mental illness is more common than you think. I'm always surprised at the number of people who say "me, too" when I talk about my mental illness.
- Healing isn't linear. I learned this from the artist FrizzKid, who creates beautiful affirmation art. Case in point: I've been stable in my ED recovery for a long time, but I skipped lunch today. The path is not straight up.
- But healing is worth it. Sometimes the work of managing my mental health feels like too much. I get resentful towards my mental illness, pissed off that I have to deal with it, and contemplate just pretending it doesn't exist. First of all, that never works, and secondly, the healing work is the good stuff. It's makes me who I am. That's worth it.