Mind & Body – BE BOSSY

The Window Sill

I had been out of my intensive treatment program for almost 6 months. I was substantially better. Yet, after a night out, I ran home, up to the top level of my apartment building, kicked out the window screen, and perched myself on the window sill. As I sat there sobbing, trying to catch gulps of air through my tears, I tried to work up the courage. I was going to jump.

But I didn’t.

If I had, this would have been my second attempt. And while most people think this is so crazy, or focus on how detrimental suicide is to the people who love you (I know this, and ultimately this is the reason I stepped off the ledge), what they don’t realize is what it is like to be in such tremendous pain that you don’t feel anything anymore. And for me, as someone who self-harmed, it was about trying to feel something, anything.

I am still here today, but I can’t tell you that I don’t still have those days, that I don’t still have the thought cross my mind. And my rational mind can still tell me that I’m being irrational, while my illness stubbornly still sees suicide or self harm as an option.

An Epidemic

A recent report from the World Health Organization (WHO) says that one person dies by suicide every 40 seconds. This means that close to 800,000 people die by suicide every year. This is more than those lost to malaria, breast cancer, or war and homicide. Today, suicide is the second-leading cause of death for 15-29 year olds, after road accidents.

Just thinking about this overwhelms me. The sheer amount of pain this represents is immeasurable. WHO also finds that for every suicide, there are many more attempts of suicide. Further, suicide rates are higher for vulnerable groups who tend to experience discrimination. For example, refugees, immigrants, LGBTQ individuals, indigenous peoples, and prisoners. This is a global public health issue, and is one that is having a disparate impact on the most vulnerable in our society. What frustrates me is that suicide is preventable. And there many low-cost interventions that can save lives.

I acknowledge the privilege that I have to be able to afford high-quality treatment and medications. I also acknowledge that as a white, middle-class, cis-gender, heterosexual women with a higher education, I am also privileged. Because of these things I do not face the level of discrimination that underrepresented groups do face. Because I am not isolated as a result of my identities, I experience a sense of connectedness – a major preventative factor against suicide. I am not othered by society, and I also know how to access helpful resources.

How Can We Help?

The majority of the conversation about World Suicide Prevention Awareness Month is often how to help a friend or loved one who is either displaying suicidal behavior or who has divulged suicidal thoughts. But this is a conversation of privilege. I was able to use my smart phone that night on the window sill to contact my therapist, I was able to take my emergency sedative that I could afford to pay for, I was able to seek safety in my apartment. I was able to seek support from other people who have an understanding and knowledge about mental health. And while my experience is important, as is every experience of someone with a mental illness, I know I am at an advantage.

This is why I have made the choice to highlight the groups that don’t normally get talked about when we discuss suicide prevention. And as weird as it sounds, I thought of these people when I decided to step off the ledge and close the window. I thought about how if I did not have all of those things I listed above, I probably would have taken my own life that night.

A part of my healing process has been using the energy and good days that I do have to help others. Whether this is by telling my story or attending mental health events in the community, I am able to make my pain have a purpose. And that makes me feel like I’m worth something. Like there is a reason for me to be here on this earth.

So I ask you to acknowledge your privilege. And understand that by doing so, you aren’t giving anything up. Instead you are recognizing that other people do not have the advantages that you have. It is accepting that any initiatives or programs to help these groups will only help to bring them to an equal position to that which you are standing in right now.

If you think you have nothing in common with these groups, think about the human brain. An organ thats structure is maintained in every person, regardless of race, gender, religion, sexual orientation, etc. An organ that can experience the same mental illness that you or a loved one may experience. That’s chemistry, anatomy, irrefutable scientific fact. Connect to their humanity. By supporting and giving back to these communities, we can help to alleviate many of the risk factors that contribute to their higher suicide rate. Equality isn’t just about laws, equal treatment, or financial wellness – it is also about deserving to live a life without pain. And personally, I think every human being deserves that.

General Resources

National Suicide Prevention Hotline – 1-800-273-8255
The Trevor Project LGBTQ Suicide Prevention Hotline: 1-866-488-7386
Suicide / Self-Harm Safety Plan Template
Download the My3 Safety Plan App
Black Girls Smile
Indigenous Suicide Prevention Toolkit
Refugee Suicide Prevention Training Toolkit
If you suspect someone is suicidal, ask them. Asking does not increase the chances that they will attempt. In fact it has been shown to reduce the likelihood that they will.

You’re Thinking About Me

I know exactly what you’re thinking about me – and it’s nothing good. Yep, you’re looking at me that definitely means you and your friends are talking about me – and it’s nothing good.

This is what my brain continually tells me when I interact with or even just come near people. The mechanism behind this is a cognitive distortion called mindreading. First let me tell you about cognitive distortions.

DISTORTED REALITY

Often described as irrational thought patterns, while they can be experienced by anyone, cognitive distortions are especially prevalent in individuals who have anxiety or depression. Crack the champagne, I check both of those boxes. Cognitive distortions can have really negative affects on our mood, and sometimes even lead to unhealthy behavior.

There is an array of different distortions, but my brain is most guilty of mind-reading. Those who mind-read assume that they know what others are thinking of them. Now a certain degree of this is helpful to us as social creatures. It is a large part of emotional intelligence – which comes in handy when we need to take cues from a person’s facial expression or body language.

SOME OF MY DISTORTIONS

Too much of this behavior can be miserable though. Let me give you a few examples of common mind-reading distortions that I have:

Say I’m tardy for work. I think that everyone is thinking about my tardiness for the whole entire day, and that they are thinking I lack commitment or am a bad employee.
From my other blogs, you know that I am working on body positivity. Related to that work, I am constantly thinking people are having negative thoughts about my body and how I look. I sometimes assume someone may not want to be in a relationship with me because of my body.
I have a group of friends that I met because of an ex-boyfriend. After the break up I always thought people were thinking negatively about me. I also then would tell myself that they didn’t want me around anymore.
If I have a mild disagreement with a friend, or have to cancel plans I think that the person doesn’t want to be my friend anymore.

Now, when I write it all out, I can see how it is irrational. But in the moment, by brain can’t distinguish that. Now you might say, “everything isn’t about you.” Believe me, I know that. For me, this distortion is more about my deep loyalty to the people in my life.

I think what compounds my distortion is the fact that I am highly emotionally intelligent, and am a total empath. I pick up on the emotions of others constantly. So sometimes it can be confusing as to whether what I am picking up on in a mind-reading situation is completely irrational or not.

DISRUPTING THE DISRUPTIONS

Here are some techniques to combat this cognitive distortion.

First, identify what you predict the person/people are thinking
Ask yourself what evidence you have to support that thought
Look for other possibilities, if your friend doesn’t text back after that disagreement they could just be preoccupied or cooling down before they continue the conversation.
Imagine that the thought is true, then ask yourself would it mean more about you or more about the other person?
Ask yourself if it is realistic to expect everyone to like you
Act counter to the thought

That last one can be scary. For example, with that group of friends I mentioned, I initially would leave get-togethers early because of the mind-reading I was doing. I convinced myself that I wasn’t welcome there. After awhile, and some positive reinforcement from a friend, I started to fight that urge to leave. I would stay even if my urge was to grab my purse and go.

What else can this look like? Say you’re in an unfamiliar social setting, and you’re thinking that the people there don’t like you or think you’re awkward. Instead of avoiding eye contact and babysitting the snacks, approach people and introduce yourself. Focus on the conversation and really listen to what that person is saying. It will distract you from the thoughts you were having, and also probably disprove them.

What about thinking about your body? Recognize that the majority of people have insecurities about their own bodies. And because they are focused on theirs, they don’t have the time to pay attention to yours. Also remind yourself that people don’t like you for how you look, they like you for how you make them feel. List out qualities that make you, you. Remind yourself of your value.

I will say this. Don’t just let these thoughts drift away. Distressing thoughts like these tend to recur, especially if you do live with a mental illness. By taking the time to think about them, or even write them out, you give yourself the opportunity to prove them wrong by finding the inconsistencies. Maybe you even work on a list of rational statements that you can use to reply to yourself in the future. By leaving these sorts of thoughts unresolved you are just leaving the door open for them to be disruptive again in the future.

MINDFULNESS TECHNIQUE

You can also use mindfulness after you’ve taken the time to do this work. Having come out of a cognitive behavioral therapy program, I went through the above exercises to challenge my distortions. Since I’ve done that, I now use a visualization technique to keep them at bay. It’s going to sound really cheesy, but it works for me.

As the disruptive thought comes up, I imagine it spelled out in the sand. After recognizing it, I imagine a wave coming up onto the sand and erasing it. In that visualization, I acknowledge the thought, but then allow it to pass without judgement. You can generate your own visualization to do the same, but I urge you to first do the work to address and disprove your most common distortions. Take your power back, and then focus on how to maintain it.

IF THE DRESS DOESN’T FIT

So recently I reached a tipping point. I got fed up, and I realized I didn’t want to feel how I was feeling anymore. I was tired of my constant awareness of how my body looked. Was the way I was sitting showing my stomach rolls? Is my arm pressed too firmly against my side making it look wider than it really is? Could my butt showing in these shorts?

I was tired of feeling like if I ate a cookie or skipped the gym that I was doing something morally wrong. Tired of associating living a successful life with working out everyday and eating different variations of salads for 2 out of 3 meals, 7 days a week.

I was tired of thinking that I couldn’t go to the beach or fall in love until my body was smaller. Tired of thinking that I could wear certain clothes, even though I love fashion. Tired of not having pictures of certain memories because I didn’t like I how I looked in photos.

Some background

Now let me tell you about that tipping point and how I got there.

In the winter of 2017, I had already been in a major depressive state for about a year. Exasperated by a breakup and the fallout from that relationship, and dealing with health issues and family problems I had hit rock bottom. As I have written about before, after self-harming I realized that I needed help. I took a medical leave from work and entered treatment.

During that time I also found out that I needed my now third knee surgery and that it was going to be the most intense yet. Complications during that surgery made my recovery time even longer than it was going to be at the outset.

Over three months later, I finally returned to work and life – still with more recovery to go. But when I got back, everyone started telling me how great I looked. Asking if I lost weight. I honestly didn’t know the answer to that question. I had been basically bedridden for three months. I didn’t have the energy to get up, or let alone weigh myself.

Size does not equal health

It took stepping on a scale after those comments for me to realize that I had lost 30 pounds. I felt great. Like i had accomplished something while I was away. Like that was my biggest accomplishment. Not that I had gotten through a major surgery or started to come out of my depression, but that I lost weight.

But it didn’t last long. Nine months later, I gained it back and then some. I was so frustrated with myself that I criticized and insulted myself almost everyday. What had I done wrong? I was working out, I always had a well-rounded diet…

Panic set in. In a frantic call with my mom, I was brought back to reality. She listened to my cry and talk myself down for a minute, and then interrupted me… “sweetie, you were really sick. You were depressed and not eating. You were on pain medication with no appetite.”

She was right. That weightloss was during a time I wasn’t healthy. Now, I was mentally stable and able to talk again. I was enjoying food again and taking care of my body. Now I was healthy.

The dress fitting

Despite that realization, I was still upset. Still felt like that failed. And that all came to head at a dress fitting for a bridesmaid’s dress.

I had had the dress hanging for a while in my closet. Unconcerned. I scooped it up one Saturday a month before the wedding and headed to Macy’s with my Spanx and strapless bra in my purse.

I got into the dressing room, stepped into the dress, put my arms through the sleeves and proceeded to reach for the zipper. It wouldn’t zip. At that moment, with the bride in the dressing room with me, my heart dropped into my stomach faster than I let out my next breath. Then, I noticed the dress was tight around my thighs and that the lining wouldn’ t go all the way past my butt.

“Do you expect that she’ll lose the weight?”

We walked out to the tailor and I stood up onto the pedestal in front of all the mirrors. The tailor came out and went straight for the zipper. He tried to zip me up, yanking at the dress as if no one was inside of it. “It doesn’t fit,” he said. He turned to the bride, and said as if I wasn’t right there, “do you expect that she’ll lose the weight.”

I could feel my chest tighten and my eyes begin to fill with tears. He began to say that they usually don’t hem dresses unless they fit. Still — not talking to me. I snapped, “we’ve established that it doesn’t fit, let’s hem the dress.”

He huffed and puffed, but got to work. I felt like I was standing there in front of the mirror for ages. Crying quietly and trying to avoid my own reflection right there in front of me. When he was done I walked as quickly as I could back into the dressing room and closed the door. I felt like I was suffocating.

When I doubt call your MOM

I took the dress off and immediately texted my mom. After that, I emailed the bridal shop where the dress was from and inquired about ordering a new dress. I was not about to ruin one of my best friend’s wedding — the people in my life are the most important thing to me. I didn’t care about how much money I would have to spend, I just wanted it fixed and I wanted it fixed yesterday.

It was all I could think about the next few days. And when I found out the bride was also contacting the shop I panicked. I had become a problem. An added stress.

For the next week I cried myself to sleep. I was exhausted. I was confused how this happened. But I knew that I didn’t want to feel this way anymore.

Freedom from Shame

Then I had a SnapChat memory from a year ago pop up. A mirror selfie at that 30+ pounds lighter time. And then I remembered. I hated my body then when I was thin, and I hated it now. It wasn’t all about the weight.

And it wasn’t my fault. I, just like you, have grown up in a society and culture that glorifies certain bodies and demonizes others. Now I may have a larger body, but my body at my size, and my skin color still put me in a place of privilege when it comes to the most marginalized bodies.

Regardless, I want to be free of the constant shame I have of my body. I want to walk around not focused on how I look and eat food without thinking people are watching me. I want to take a photo and not hate how I look.

Making new meaning

Personally, I knew I could not accomplish this all on my own. So because I have the means, I made the decision to work with a body image and intuitive eating coach.

Julie helped me to turn that negative bridesmaids dress experience into a story in which I decided to take the power back. For me, it is no longer a story about failure or sadness. It’s a story about me deciding that enough is enough.

I can tell you that I’ve begun to notice small changes. The day of the wedding, after alterations that cost more than the dress itself, I fit into it like a glove. I was comfortable, I got my hair done, my nails done, and I did my makeup. And not once did I have anxiety about that dress. Not once did I think about how I looked. I strut my stuff with my head high, and I was present. I ate the absolutely delicious dinner and dessert without shame. I enjoyed every moment of two of my dearest friends getting married. For one night I was free. And I hope to share the rest of this journey to freedom with you.

I’ve Been Stuck

So I’ve been stuck. Call it writer’s block, call it a depressive episode, call it what you want. I can’t describe how I feel more accurately than the word “stuck.”

But what I’ve realized is that feeling stuck, or like you’ve reached a plateau, doesn’t mean that you aren’t still making progress. I think that these days, with the presence of social media, there exists this pressure to always be doing something. You have to have something “interesting” to add to your Instagram story – and binge watching bad superhero shows on Netflix in your underwear doesn’t always cut it. The things that you do just to get by each day doesn’t cut it.

But isn’t that sort of messed up? Everyday of our lives should cut it. The nitty, the gritty, the seemingly boring and uneventful.

On a Personal note

I’ve been on this road of self-improvement and self-care for a little over a year-and-a-half now. There have been marked ups and downs. But what I wasn’t prepared for was the times of neutrality. The times where there’s nothing remarkably good happening and nothing disappointingly bad. Everything seems to have gone into slow motion. And that’s felt frustrating. Frustrating because I can’t identify the progress that I am making as easily as I would like to.

I’ve never felt like this in my life. And it sounds crazy to say — but I feel stable. Sure, there are days or spans of days where I can sink into a dark, depressive hole… But more often than not, I’ve just been floating in calm waters.

But what is important that I’ve realized is that that progress has not stopped. I’m just in a period where the changes are more incremental. And maybe that means I need to put in more work — but it could also mean that I need to be truly present in the person I am at this moment.

Socially Prescribed perfectionism

A study by a writer and activist from Inc. found that 67% of millennials feel extreme pressure to succeed, compared to 40% of GenXers and 23% of Baby Boomers. Millennials have this profound feeling that they “haven’t done enough yet,” and that time is running out.

I can definitely relate to that. With social media, you see so many more examples of young people accomplishing amazing things as artists, entrepreneurs, and even CEOs. Meanwhile, I struggle to pay my bills every month and make just enough to stay afloat.

A recent American Psychological Association (APA) study found that in comparison to prior generations, millennials are harder on themselves, and report higher levels of social pressure to be perfect. This has reached the point where the desire for perfection has become unhealthy. I often feel like I’m stuck in some sort of rat race. I couldn’t put it better than a writer from The Cut:

“And yet there is obvious risk to feeling trapped in an endless cycle of unreachable expectations and overly critical self-evaluation. Tying one’s sense of self-worth to achievement can make a person unable to hold on to the sense of satisfaction that comes with success, and has been associated with clinical depression, anorexia, and early death.”

don’t get distracted

Sorry – don’t mean to scare anyone with the “early death” part — but we all need to take a collective deep breath. And also we need to pause to recognize that we’ve already done some pretty great things in our life — even if there isn’t a trending BuzzFeed article out there about us.

That same APA study showed that this pressure can be even more damaging when we feel like that pressure to be perfect is coming from others. We’ve all become the victims of self-comparison. We live in a meritocracy that places huge importance on self-success – and then we’ve gone and made matters worse by comparing where we are in life to the highlight reels that everyone else is sharing to their social media. And heaven-forbid we have a day that isn’t worthy of sharing to our feeds. Because to us that means we haven’t accomplished anything that day.

So remember this. Progress is slow and life moves fast. Don’t waste the days you have worrying about if you’ve done enough, if you’ve accomplished enough, if you’ve made enough money, or lost enough weight. Be here now, even if that feels uncomfortable. Take that weight off your shoulders, and have a goddamn drink or a piece of chocolate. True progress is made through experience and interaction, and I think you’re doing pretty fucking great already.

Mindfulness Practice

I recently posted on Instagram about my mindfulness practice, and have had a couple of followers ask that I talk more about it. What better way than a blog post?

I should start this off by saying that I am not a licensed health-care professional. I do identify as a mental health advocate, though, based on my own personal experiences with my own and loved ones’ mental health.

After hitting the lowest of lows of my major depressive episode a little over a year ago, I started intensive therapy that involved meeting three times a week in a group therapy setting. The curriculum of these sessions was based on Dialectical Behavior Therapy (DBT). The goal of this form of therapy is to provide individuals with concrete skills to manage painful emotions and conflict in relationships. There are four overarching components of DBT: mindfulness, distress tolerance, emotion regulation, and interpersonal effectiveness.

But what really is DBT?

Four components of Dialectical Behavioral Therapy - mindfulness, emotion regulation, distress tolerance and interpersonal effectiveness.

DBT is a cognitive-behavioral treatment that was developed by Dr. Marsha Linehan in the 1980s to treat individuals with borderline personality disorder. It is now become an effective treatment for depression, eating disorders, substance abuse, bipolar disorder, and PTSD. As Psychology Today states, “DBT is influenced by the philosophical perspective of dialectics: balancing opposites. The therapist consistently works with the individual to find ways to hold two seemingly opposite perspectives at once, promoting balance and avoiding black and white—the all-or-nothing styles of thinking. In service of this balance, DBT promotes a both-and rather than an either-or outlook. The dialectic at the heart of DBT is acceptance and change.”

The way that I would explain this is that I can have an emotion driven, “irrational thought,” but also can identify it as such. Think about how sometimes you can give your friend advice that you can’t give yourself. Even though I know the thought is irrational, it still causes me emotional distress.

Today I’m going to talk about mindfulness, and in the coming weeks will explore the other components of DBT. So – here we go!

What is mindfulness?

At its core, mindfulness is about being present and self-aware. To take it a step further, it is doing those things without being judgemental, without overthinking, and without invalidating your own experience in any way. Mindfulness is acceptance.

In the world we live in today, we really don’t spend a lot of time being mindfully present. We tend to disconnect from our actual experience to either live through someone vicariously on instagram, or just engage with our own thoughts rather than reality. Now, according to DBT theory, there are three states of mind that are in at varying times: emotional mind, logical mind, and lastly wise mind being the ideal state of mind. Wise mind is the combination of emotional and logical mind.

We use logical mind when we are doing concrete tasks, like math or putting together furniture from Ikea. Emotional mind, unsurprisingly, is the state of mind in which we feel our emotions and act from our emotional state. So things like acting out of anger or just plainly being impulsive.

Wise mind is somewhere in the middle. In wise mind, we are aware of our feelings in a non-judgemental way (mindfulness) and act in a way that is cognizant of our emotions and goals.

So what are the core skills of mindfulness?

Observe

Observe your thoughts, emotions and feelings without trying to change them. Recognize how you are responding to an event, and allow yourself to feel what you are feeling.

Describe

Whether just to yourself in your head, or using pen to paper – describe your experience. What physical manifestations did you experience? Rapid heart rate, crying, chest tightness? Where were you when this happened? What was the prompting thought? How did that thought make you feel? By describing in great detail your experience, you are able to show yourself a bit of empathy as well as later have a more firm grasp on your emotional response. Remind yourself here that feelings and thoughts are not facts (wise mind).

You might feel alone for example, but if you sit down and truly think about it there are people and support services that you can reach out to.

Participate

Be present. Experience things with all five of your senses. All the emotions to pass, and then engage with the present moment. This sounds easier than it really is, but that’s where a couple of techniques come into play.

Being more mindful

Being mindful involves being non-judgemental, practicing one-mindfulness, and being effective. Below are a couple of specific exercises to strengthen your practice of these things.

Body Scan

This is one of my personal favorites as it is very meditative, and engages your whole body. A typical body scan runs through each part of the body starting with the toes and working upwards. You pay attention to how each part of the body feels, focus your breathing to that area, and imagine the muscles of that area relaxing. Just search “body scan meditation” on YouTube and you will find many options. Below is one of my favorites. A body scan can be done at any time of day, but as it is really relaxing – it is most commonly practiced before sleep. This practice has really helped me with my insomnia.

One Mindfully

Identify situations in your life where you are trying to do multiple things at one time. For me, my biggest problem area is mornings. I try to do my hair and makeup, pick out an outfit, maybe change the load of my laundry, make my lunch and make my breakfast all at the same time. Doing so is usually chaotic and just anxiety-provoking.

You may find that you also do this after work. Many times I come home and look at my apartment and realize all the things I need to do: make dinner, empty the dishwasher, fold my laundry, take the trash out… And I enter a fury of doing all things at once.

Another situation you may do this is when hanging out with loved ones. Now that most of us have smartphones, we feel the need to constantly to attend to the information that we have access to.

One mindfully means concentrating on one thing at a time, and completely experience it by engaging all of your senses. When you are eating, eat. When you are walking, walk. When you are worrying, worry. When you are remembering, remember. Observe and listen quietly, and then reflect on your experience afterwards. Below are a couple of things that you can do one mindfully. One of my favorites is making coffee. My therapist taught me to approach it like it’s a scientific experiment – which really helped me to think of how to approach one-mindfulness. I really honed in on my observation skills.

watch rain falling
watch a campfire
listen to music
fold your laundry
make your dinner
make your coffee 🙂
listen to a loud clock
listen to the sound of the wind
pick a place in your home, or a chair that will be your “worry space,” when ever you are worried about something, sit there and worry. Observe how you feel for 30 minutes, then allow yourself to go about the rest of your day.
go for a walk to a park. sit, close your eyes, and try to identify 3-4 sounds you can hear. Can you identify from what direction they came from? Try to make out 2-3 smells from the air. Do those smells remind you of anything? Reflect.

Mindful Creating

Remember play-doh? Well go get you some play-doh. It is one of my favorite mindfulness mediums. Sit and play, create. Focus on how it feels and what it reminds you of. You can also practice mindful creating doing any sort of activity or craft that you like. I find crocheting to also be a super mindful activity.

Play a mindfulness game

I have an excellent support system, and sometimes when I’m in a bad place I just really need to be around people. There are a couple of games that we used in play in my group session that are really fun. They are mindfulness games because they require a lot of attention. Here are some examples:

Categories – pick a category and list as many items from that category as possible.
The alphabet game – pick a category and go around circle (or back and forth) listing items from that category starting with A-Z. So for fruit it would go, Apple, Banana, Cantaloupe…etc.
Play catch! You can also integrate playing catch to either of the games above. Throw a ball back and forth while you name items.
Play 20 questions with a friend
Play Jenga or complete a puzzle

Half-Smile

This exercise can feel a bit weird, but it has been shown to improve mood. But basically, sit in a chair or somewhere comfortable. Take a couple of deep breaths. Close your eyes if you wish. As you continue to breathe, make a small smile with your lips. Then relax your face. Continue to alternate and notice whether your emotions begin to change as you communicate feelings of acceptance to your brain.

Go forth, and live mindfully!

I hope that this post has been moderately helpful. I would love to hear about your experiences with some of these exercises. Lookout for future posts on DBT techniques.

Mental Illness, Stigma, and the Dangers of Not Getting Help

So I’ve been putting this one off. And even as I sit here and begin to write I feel uneasy. Even though I am very open about my mental health, I still experience internally imposed and externally received stigma. I fully believe that it is part of what makes me who I am. Yet, I know it can make people uncomfortable and cause them to trust you less. And sometimes others even dismiss you as just being, “crazy.” This is the first blog about my mental health (cue the deep breathing exercises).

I myself had a very public major depressive episode, and eventual break. I know this still colors the perceptions that those around me have of me. And I still experience blame. There are people who say it is my fault and that I could have controlled it if I wanted to. I know that much of this stems from ignorance and lack of knowledge. But what I honestly must say to those people is, “kindly, fuck you.”

In this post I argue that my expletives are warranted. I know what can happen when you ignore your mental health – when hide that you are in pain. Today I’m not going to present you with my full story. Instead I will discuss the dangers of not getting help and the hindering role stigma plays in that process.

Stigma & Unconscious Bias

A CDC study found that 57% of adults believed that people were caring and sympathetic to persons with mental illness. But, only 25% of adults suffering from mental illness believed that people were caring and sympathetic towards them. Something called the Dunning-Kruger effect could explain this gap. This is the cognitive bias where people who are incompetent at something are not able to recognize their own incompetence.

As humans, I think we would all like to say we are caring to people who have a mental illness. But unfortunately, there is a deeply ingrained, unconscious bias at play. Take the following example. In the media, people are reduced to just being, “mentally ill” far too often. Instead, they should more respectfully be referred to as a, “person with a mental illness.”

By calling someone “mentally ill, you are not acknowledging that they are a person and not just that mental illness. That is a manifestation of bias. How often have you seen a news story about a, “mentally ill” person who has committed a crime? And how often do you independently associate mental illness with other behaviors that you would identify as “bad?”

A Single Story

Photo of Chimananda Ngozi Adichie with a quote that reads, "The problem with stereotypes is not that they are untrue, but that they are incomplete. They make one story become the only story."

Let me tell you about a concept called the “single story,” created by author Chimamanda Ngozi Adichie. She uses this term to describe the overly simplistic, often stereotypical, perceptions that we form about individuals, groups, or countries. A lot of her work serves to complicate and disrupt the single stories that many people have about Africa. I think that there are also many single stories that people have about those who live with mental illness.

Let’s do an exercise. Picture a person with depression. How would you describe them? How do you know that they’re depressed? What type of person do you think that they are?

You can keep the answers to yourself, but I hope that you see a bit of what I’m getting at. I had a single story of mental illness, and because of that story, and the stigma I saw associated with it, I did not get help for almost ten years. Let me tell you why.

I was “high functioning.” I was always an “A” student, overly-involved in extracurriculars, and friends with a wide variety of people. Out of college I had a stable job, paid my bills, and was involved in my community. But I was living all this time with almost no quality of life. Six out of seven of the days of the week having thoughts of death and self-harm. This does not mean that I did not have happy moments, but that the pain I was experiencing kept me from truly valuing those moments.

So I hid what I was going through. On the one hand, I didn’t look or act like what I thought people with depression looked like. On the other hand, I didn’t want to make the important people in my life feel unvalued because of my lack of interest and extreme pain. And being in a family in which others suffered from mental illness, I didn’t want to add to any heartbreak. At one point early on I did seek help, but continued to minimize my symptoms to my doctor and to the people I cared about. I didn’t want to put my life on hold and I didn’t want to scare anyone.

The stigma of having a mental illness and stigma of taking the necessary time to treat one kept me from doing so. I didn’t see myself as sick enough to get help and I didn’t want to change what people thought of me. Eventually, I sunk into a major depressive episode. An episode that lasted over a year and a half, and that culminated with me self-harming.

Effects of Delaying Treatment

The longer that one waits to treat their mental illness, the more complicated it becomes and the harder it becomes to treat. Various preclinical studies have shown that delaying treatment of mental illness can cause untreated disorders to become more frequent, spontaneous, severe, and resistant to treatment.

Additionally, a single disorder will most likely progress to more complex comorbid disorders that are harder to treat. You will most likely begin to experience chronic physical problems such as insomnia, gastrointestinal issues, and even chemical changes to your brain and other organs.

Outside of affecting one’s health, leaving a mental illness untreated is correlated to school and job failure and early, unstable, and sometimes violent marriages. At the extreme, some experience bankruptcy or homelessness. Further, there is an increased risk of substance abuse, incarceration, accidents, and suicide.

For those with major depressive disorder, like myself, only 35% are treated within a year of first developing symptoms. For others it can take 4 years or more. Going over a decade without treatment has left me with a lot more challenges to overcome. In addition to Generalized Anxiety Disorder, I also battle PTSD, and now have been classified as having medically-resistant depression as a result of long-term chemical changes in my brain.

Creating Conversation

This isn’t meant to scare anyone, but rather underscore that both stigma and lack of conversation are detrimental to those with mental illness. By othering those who have a mental illness, we push them into a state of fear when it comes to talking about and seeking help for what they are going through. If we can make mental health a part of everyday conversation, then we will create an environment that empowers people to take care of themselves and supports them throughout that process.

Personally, I did not start to get better until I independently made the decision myself to get the real help that I needed. I sometimes think that if our culture was more open and inclusive of people with mental health issues, that I would have sought help sooner. That I would have saved myself years of being numb. But I also had to come to terms with the fact that depression was going to be a companion to me for the rest of my life. It is something that I need to work each day to address. And with that I’ve slowly started to become less ashamed. I wouldn’t be who I am today without my depression.

Irish musician Niall Breslin said something about his depression that resonates with me. Breslin said: “It’s always given me an edge, over everybody else. I truly believe it’s given me an edge, because with depression, nothing can be as bad as that day when you’re stuck in your bed and you can’t get up, and you cannot look at anybody in the eye. So that’s how it’s given me an edge.”

Getting Help

If you are struggling with any kind of emotional distress or mental illness and need to seek help, please utilize one of the resources below:

Psychology Today – Find A Therapist, Counselor – https://www.psychologytoday.com/us/therapists

National Suicide Prevention Hotline – 1-800-273-8255

National Alliance on Mental Illness Helpline – 1-800-950-NAMI (6264) or info@nami.org

Body Positive Movement

The body positive movement is starting to catch steam in the retail industry. This week I got really excited, and a tad emotional when the retail company I work for released their new arrivals online. There were two new “plus sized” models. And by “plus sized” I mean around size 8 / 10. Which, yes I’m going to out myself, is my size at the moment.

It was a bit comical to suddenly become aware of the fact that I was smiling from ear to ear at my computer screen in our work café. I definitely got a couple looks like “why is this girl so happy to be working right now?” But that’s the reality. I haven’t seen many girls that look like me at most of the brands that I like to shop.

I do think that it’s a bit crazy to be regarded as “plus size” – as of June 2018, 68% of American women wear a size 14 or above. At a size 8, or a size ten after I’ve ate too many tacos, I think to myself, “I’m still am a medium goddamnit.”

I’ve heard both sides of the sentiment surrounding the body positive campaigns out there. For one, there is the perspective that they celebrate people who are unhealthy and encourage those individuals to maintain their current lifestyle. And in contrast, the view that retail companies are becoming more inclusive of the diversity of body types that really exist in the world. That just because you are a higher number in sizing doesn’t mean that you’re unhealthy.

Positive or Negative?

Someone close to me who has struggled with an eating disorder for a large part of their life recently asked my opinion on body positivity. She wondered why it was okay for bigger women to be body positive, but not girls who are extremely thin.

In my perspective, we live in a double bind. You can’t be “too small,” or “too big.” There is one body type that has prevailed as being “beautiful,” and therefore that body type is featured in marketing, popular media, and film. And that body type “sells.” People buy products and services that are advertised with women who fit the beauty ideal.

The problem that I see deals with visibility. Disproportionately, we are making bigger women invisible. We don’t celebrate their body type, and we don’t tell their stories. We are making 68% of our American population invisible. Hence my excitement of finally seeing myself reflected in the plus sized model at a brand that I work for, and like to shop.

I had never felt like I have the right to label myself as beautiful. And I often find myself feeling that I am invisible because of my size. Invisible to potential male suitors and therefore impossible to love. It was hard not to think that my size contributed to a partner cheating on me in the past once I knew who they had been with.

I placed my worth on my size, because that is what I have been taught to do. Girls my size play the “fat friend,” or the “fat girl” that gets ridiculed, laughed at, and left out in movies. I still struggle with this. It often feels like if you aren’t in the stereotypical version of being, “in shape,” then you can’t be successful in your life. Feeling invisible, I start to impose that on myself. I don’t order the dessert that I want, because I feel like I can’t be seen eating it.

Facebook, Instagram, and Twitter… oh my!

This is further emphasized in social media. Women report that social media, followed by TV and movies are the most impactful factors in how they view their bodies. And we can’t forget that this is starting at a very young age. The more time that young girls spend on social media, they are up to 24% more likely to want to change their appearance. They don’t think that they’re good enough or beautiful enough. And 27% will delete an Instagram post if they feel like it didn’t get enough likes.

Similarly, new research this past year revealed that 88% of women report comparing their bodies to images in the media, and 51% of those individuals think that they compare unfavorably. At this doesn’t just affect women. Sixty-five percent of males report the same behavior. And in general, overtime both men and women become less confident about their bodies.

Being Body Positive

Back to those who believe that the body positive movement is contradicting. Yes – obesity is the leading risk factor for disease and death in the U.S. But the body positive movement is not about “denying science.” We’ve been trained to think of “fat,” as “bad.” And we often either pity those of a larger size, or think of them as “lazy.” We think that they could, “try a little harder,” even while we may simultaneously applaud their confidence.

What the body positive movement is about is loving the body that you have, and treating it with love and respect. Outside of that, it isn’t preaching that weight loss is the answer to someone’s presumed unhappiness. People can be overweight and healthy. People can be overweight and happy. And people can be body positive and want to lose weight. None of these things are mutually exclusive.

But if we continue to make this group of individuals invisible, and “bad,” their self-worth will dwindle. And with it their motivation – their motivation to treat their bodies with respect and love.

Let me show you my stripes.

Has this ever happened to you? Last week I established care with a new primary care physician here in Columbus. We couldn’t finish everything that we needed to do in one appointment, so we had to schedule a follow up for less than a month later. The last thing he said to me was, “wow, you’ve got a lot of medical history for someone your age.”

Trust me sir, I know.

I’ve grown to hate doctor’s appointments, and really want to know why – at every single appointment – I need to verify my laundry list of medications? Especially when I’m usually met with a questioning glance from a nurse who says, “are you sure allllllll of these are current prescriptions?” Yes Janet, I’m sure.

I also hate the fact that all the pharmacists and pharmacy technicians at my CVS know my name, and don’t even have to ask my birthdate anymore. But, I mean, Cinco de Mayo isn’t too hard to remember.

Being 23 and living with a rare genetic condition often seems extremely contradictory to me. And I can’t say that I haven’t held a lot of resentment about that, because I have. I get frustrated that sometimes I’m too tired, or my body is in too much pain to go out on a Friday night with everyone else my age. I get embarrassed when I can’t do things other people can in the gym and that I start basically keeling over because of heart and lung problems. And it’s been hard having to realize that I don’t relate to many people in my own age cohort.

My mom has always joked that when I was a little kid I was like a forty-year-old in a toddler’s body. Ironically, today I feel like a twenty-three-year-old in a sixty-year old’s body, so that tracks well. (Moms are always right. Call your mom.)

What do you have?

You’ve probably never heard of it. Most doctors haven’t either. But I have a connective tissue disorder called Ehlers-Danlos Syndrome, hyper-mobility type (hEDS), that is caused by genetic defects in collagen. hEDS affects approximately one in every 10,000 – 20,000 people. What is even more exciting is that my mom and I have a novel gene mutation that has never been seen before for this classification. So, we’re one-of-a-kind mutants. (Marvel, DC, where’s my movie?) For those with EDS, or who have other rare diseases, that means that we had to fight all the harder to get the diagnosis – a common issue experienced by many living with the condition. An issue that makes it all the more difficult to get the care needed to manage the many symptoms of EDS.

Here’s a couple of symptoms of hEDS that I experience. Unfortunately, this list isn’t exhaustive.

Joint hypermobility affecting large and small joints (the funniest thing that has ever happened to me was having to go to the ER for a dislocated pinky toe)
Frequent joint dislocations and subluxations (as a result I’ve had three knee surgeries)
Soft, smooth skin which easily rips, tears, bruises, and scars
Chronic muscle and bone pain
Early onset osteoarthritis
Osteopenia
Gastrointestinal issues
Dysfunction of the autonomic nervous system
Dysmenorrhea and dyspareunia
Acrocynaosis
Insomnia
Arrhythmia
Intermittent migraines
Gingivitis
Scoliosis
Postural orthostatic tacchycardia

Being classified as a rare disease, there isn’t much awareness around EDS. And like I said earlier, many doctors are unaware of the pathology. This makes treatment hard. Instead of a holistic approach, those with EDS often must see several different specialists to treat the symptoms – not the root cause. This can be extremely frustrating in a health care system that doesn’t do a great job communicating across specialties. And it can be extremely

I found out that I had hEDS when I was eighteen, after my second knee surgery. And for awhile I felt like my body was working against me. I had been dancing since I was five years old, and my dream was to move to California to become a professional dancer. I wanted to be on So You Think You Can Dance, and then hoped to tour with a musician or land a gig on Broadway.

So at eighteen, I was crushed. I felt defective, and being in competitive dance, I had fallen so far behind after my surgeries, that I couldn’t catch up to the rest of the girls my age – not to mention there were certain things that my body just wouldn’t allow me to do.

As I’ve gotten older, and went through my third surgery this time last year, my perspective has definitely changed. Now I see my body as incredible for having the ability to get back up time and time again. I began working with a personal trainer to learn how to weight lift, because I want to see what I am truly capable of. But it took me a really long time to get to this place.

And the battle isn’t over.

As I’m nearing my mid-twenties, my mind is starting to think about what’s next in life. I’ve always wanted to have a family. But I know that many with EDS struggle with infertility, and many have complications during birth. I also want to be able to be active with my children. And for me that all means having a family sooner rather than later. And let me tell you, my body knows it – hello baby fever!

And in a time where people are getting married and having children later and later in life, here I am again feeling out of place with people my age.

But despite always feeling out of place, and occasionally being frustrated with my genetic makeup, I’ve learned a couple of great things being a mutant – things that I think all people would benefit from:

1. Be present.

I’ve come to really appreciate life and the time that I have with the people that I love the most. It’s painfully cliché, but you really never know what life is going to throw at you. Put down the phone, turn off the TV, don’t worry about taking pictures. Just soak it all in.

2. You have the power to choose your obligations.

Our most valuable commodity is time. Don’t spend it doing something that you don’t want to be doing. Don’t feel like hanging out one day, that’s okay! Be honest about it. Sometimes you just need to lay on the couch with no pants on eating ice cream out of the container.

3. Toxic people are toxic, no matter the relation.

Unhealthy relationships aren’t good for your physical health either. The ones I’ve experienced, actually make my pain worse. Either make less space for, or get out of toxic relationships. And that extends to family, too. If a relationship is unhealthy, it’s unhealthy. Period. Don’t feel guilty about needing to set boundaries, most likely your guilt doesn’t fit the facts. (See number two)

4. You are stronger than you think you are.

Sometimes things feel and sound like the end of the world. But they aren’t. So many times I thought that I was done dancing, but every time I have found a way to keep it a part of my life. I just needed to expand my understanding of what dance was and my understanding of what I was capable of.

5. Humility can move mountains in relationships.

When you’re 23 years old and your mother has to help you shower after surgery, this is what you learn. Being able to ask for help and being able to admit when you are wrong is not easy. But doing so builds connection based on shared humanity.

I must be getting better at this, five points is a more presentable number than the 9 tips I gave in my blog post two weeks ago. Thanks for noticing.

All of this is to say that today, I wouldn’t trade my lengthy medical history for anything. It has made me into the person I am today, and taught me to take control of my life. It doesn’t define me, but it lifts me up and pushes me forward.

The official mascot for rare diseases is the zebra. And today I can say that I am proud of my stripes.

Help me to raise awareness by sharing this blog post and tagging #EDSAwareness.

Ehlers Danlos & Being Rare

What is Ehlers-Danlos? Don’t worry – we’ll get to that.

First – Has this ever happened to you? Last week I established care with a new primary care physician here in Columbus. We couldn’t finish everything that we needed to do in one appointment, so we had to schedule a follow up for less than a month later. The last thing he said to me was, “wow, you’ve got a lot of medical history for someone your age.”

Trust me sir, I know.

What does Ehlers Danlos look like?

So, we’re one-of-a-kind mutants. (Marvel, DC, where’s my movie?) For those with EDS, or who have other rare diseases, that means that we had to fight all the harder to get the diagnosis – a common issue experienced by many living with the condition. An issue that makes it all the more difficult to get the care needed to manage the many symptoms of EDS.

Here’s a couple of symptoms of hEDS that I experience. Unfortunately, this list isn’t exhaustive.

Joint hypermobility affecting large and small joints (the funniest thing that has ever happened to me was having to go to the ER for a dislocated pinky toe)
Frequent joint dislocations and subluxations (as a result I’ve had three knee surgeries)
Soft, smooth skin which easily rips, tears, bruises, and scars
Chronic muscle and bone pain
Early onset osteoarthritis
Osteopenia
Gastrointestinal issues
Dysfunction of the autonomic nervous system
Dysmenorrhea and dyspareunia
Acrocynaosis
Insomnia
Arrhythmia
Intermittent migraines
Gingivitis
Scoliosis
Postural orthostatic tacchycardia

My Journey

Image of dancer with text that reads "Born this way? do tell." Hypermobility is a major advantage when dancers first take to the barre. For many, this is a gift. For others, hyper mobile joints are the beginning of a lifetime in pain.

And the battle isn’t over.

As I’m nearing my mid-twenties, my mind is starting to think about what’s next in life. I’ve always wanted to have a family. But I know that many with EDS struggle with infertility, and many have complications during birth. I also want to be able to be active with my children. For me that all means having a family sooner rather than later. And let me tell you, my body knows it – hello baby fever!

And in a time where people are getting married and having children later and later in life, here I am again feeling out of place with people my age.

1. Be present.

2. You have the power to choose your obligations.

3. Toxic people are toxic, no matter the relation.

4. You are stronger than you think you are.

Image of girl pulling the skin on her face that read: Ehlers Danlos means we are fragile but unbreakable.

5. Humility can move mountains in relationships.

I must be getting better at this, five points is a more presentable number than the 9 tips I gave in my blog post two weeks ago. Thanks for noticing.

Illustration of a photo of Diana Muzina, with a shadow made of zebra stripes.

The official mascot for rare diseases is the zebra. And today I can say that I am proud of my stripes.

Help me to raise awareness by sharing this blog post and tagging #EDSAwareness.

A Love Letter to January

I find humans to be exceptionally endearing in January. The influx of people at the gym, the total clearing of shelves at Trader Joe’s, the table of untouched desserts at work, and the friendlier faces. It’s a time of year when you can see the good in people. Everyone earnestly wants to better themselves in some way. Faced with a new year — we see an abundance of opportunities to do something and be something different.

People believe in themselves, and genuinely wish to make concrete changes to their life. I know that most people laugh at this, or get frustrated that they can’t use the leg press at L.A. Fitness because of all the “new year, new me” people. I on the other hand, find it quite beautiful.

This is my love letter to all those with a resolution for the new year. You are a badass. And there is no failure, because the fact that you took the first step to try to make a change is a huge accomplishment.

I think that this is where most people take the wrong turn. They set lofty goals that are not humanly-possible to achieve, and when they don’t see tangible progress, they get dejected. I’ve been there. The next thing you know you’re eating raw cookie dough out of that Toll House cylindrical tube. Which honestly, girl eat cookie dough whenever you want to. (Here’s a safe to eat cookie dough recipe – don’t get salmonella!)

So, as a girl with two therapists, two failed bullet journals, and an Fitbit with an uncharged battery, let me give you some unsolicited advice about maintaining your resolutions. As I am obviously the expert.

Well not to totally shit-talk myself — I have made huge changes to my life this year (yay for my two therapists) – but it’s because I learned something new. So here’s a couple tips that helped me to begin turn my life around.

1. You have to start incredibly small.

Seems simple, right? About those bullet journals – I had been creating monthly habit trackers. But I wasn’t tracking habits, I was evaluating my self-worth based on goals. In one day I wanted to walk 10,000 steps, drink 70 oz of water, sleep a perfect 8 hours, do a mindfulness activity, practice yoga, read for 30 minutes, take all my vitamins, not spend any money for once…

Most of this was trying to correct habits I already had, but didn’t like, by setting a goal to do the opposite. Here’s the secret: you can’t go straight from sitting for 8 hours a day at work to miraculously finding time and motivation to walk 10,000 steps. First just tell yourself that you’ll take a 15 minute walk after work, or stand up for five minutes every hour you’re at your desk.

2. Pick one.

Yeah, also very hard for me. Being a perfectionist, I wanted to correct it all. And I wanted to fill in all the pretty boxes with my new set of gel pens. But I wasn’t getting anywhere, and my progress was sporadic. In the book The Power of Habit, author Charles Duhigg discusses the origins of habit research, the mechanisms of habits, and how to form new ones. The most important thing I took away is that you need to focus on a single habit. Yes, just ONE.

First work on the 10,000 steps, and once you’ve made that behavior consistent, work on the water consumption. By successfully changing the first habit, you will create momentum for addressing further behaviors.

3. Reward yourself.

I’m all about the positive reinforcement. If you are successful at staying consistent with the new behavior you are trying to create, rewarding yourself will teach your brain that good things will come from that habit. Say if you talk that 15 minute walk for five out of seven days of the week – you can splurge on dessert on Sunday, or take an extra hour to relax over the weekend instead of running errands. Just make sure that the reward isn’t something that you have easy access to all the time. Otherwise, it isn’t as salient of a reinforcer. I eat chocolate everyday, so I’m not going to choose chocolate as a reinforcer.

Now let me rewind a minute. I don’t hate bullet journals. In fact I still have one. But when it comes to the habit tracker, be careful. Either use it to identify which habit you think you should attempt to change or instead create a mood tracker. It is exciting to see that as you improve or create a new habit, your mood will increase. (Another reinforcer)

~Interrupting this blog with an important message~ Check out the end of this post for some links to layouts I like, as well as a PDF I created for you to use! And if you’re interested in more layouts, follow my friend @nat.ur.ally on Instagram!

Now take all this with a grain or two of salt. I’m not an expert. The last time I took a behavior modification course was in 2016. But take this to say that if you need a cheerleader, I am more than happy to root for you.

We are more powerful than we think, we just have to outsmart ourselves.

Bullet Journal Layouts

https://goo.gl/images/ScfjtA

https://pin.it/arzansdv6vbx4g

https://pin.it/cdkd2pc3r4gyhc

Moodtracker – made by me!Download