Today is World Mental Health Day. I've talked a lot about mental health here in the past, but I think continuing to talk about it is so important to help reduce stigma. When I sat down to write this post, there was a knot in my stomach and I almost rejected talking about it because I don't want people to think I'm damaged or not stable. That is how deep the stigma runs – I'm still fighting it within myself after decades of managing it.
Note: My conditions are managed, I'm well-supported, and am not in any danger. If you are or know someone who is struggling with depression or a mood disorder, you can contact the NAMI HelpLine at [email protected] or at (800) 950-NAMI for information and tips. And if you or someone you know is in a crisis, contact the Suicide Prevention Lifeline at (800) 273-TALK (8255). You can also text NAMI to 741-741 to connect with a trained crisis counselor and receive free, 24/7 crisis support via text message.
I have depression (diagnosed at 16), anxiety (dx at 18), binge eating disorder (dx at 27, no binges for several years), and ADD (dx at 37). I also have insomnia (dx at 18). I work with a medication management provider (either psychiatrist, physician's assistant, or nurse practitioner) to help manage these conditions, and also go to regular therapy. I'm thankful that I have the appropriate support in place to be able to manage these conditions, and realize this is a privilege.
While these conditions co-exist within me (and are deeply related to one another), there are some times when one condition surfaces more than others. Right now depression is at the forefront, and it feels both situational (pandemic) and chemical, but also tied up with ADD, which I've not been able to treat successfully with medicine. Brain jumping around or inability to focus leads to feeling inefficient or lazy, which leads to feeling inadequate, and then negative self-talk about all the things.
In 2018, I wrote a post called “Lies Depression Told Me.” When I read it back today, so much of it sounded familiar to the lies that my depression has been telling me recently:
- You don't have friends you can confide in
- You aren't a great wife
- Things aren't ever going to feel less heavy
- No matter what you achieve, you'll never be happy
It's really uncomfortable to write those things out because 1: I know they're not true; and 2: the last thing I ever want is to appear like I don't have everything “together.” I'm an enneagram 3, have always been a high achiever, and care deeply about what others think about me. Still, I've come to learn that what I really want is for people to acknowledge and accept me for who I am at my core – not just the good stuff people might see because I've masked what others may perceive as the messy bits.
Even though things are a little bumpy right now with my mental health, I'm so grateful for care and coping strategies that help me manage these conditions. For me, this looks like:
- Stress management
I also acknowledge that access to many of these things requires:
- Time – researching providers, going to appointments
- Money – even with insurance, mental health care can be ridiculously cost prohibitive
- Access to providers – within network, in a convenient location, available for appointments, good fit with your personality
- Transportation or technology – Thankfully, telehealth has helped open up greater access to care so we're less reliant on transportation, but you still need stable internet and sufficient technical skills to participate in telehealth, navigate patient portals, etc.
- A social environment that does not shame someone for seeking treatment
There is a lack of mental health providers in this US right now, and insurance can be incredibly difficult to navigate. Even though I've dealt with these conditions for decades, I still regularly right with insurance and have had to jump medication management providers too many times to count because of people leaving the profession, frequently moving practices, etc. There's also a lot of consolidation of offices which has made it hard to get local contacts for scheduling, asking questions, finding a good fit. Also, many providers are limiting the prescriptions they allow because of regulatory obstacles.
I share all of this for a few reasons:
- The mission of World Mental Health Day is to make mental health care a reality for all.
- Talking about the importance of mental health and also the importance of ACCESS to mental health support is critical to creating change.
- If you've tried to get care in the past and have felt frustrated, it's not you – it's the system. I hope that you've continued to seek treatment because you're worth it!
- If you have people in your life with mental health struggles, understand how hard it might be for them to navigate getting help, and offer gentle assistance with research, making calls, and just listening to them. Don't try to fix them, but offering your presence and assistance is incredibly helpful. And make the offer more than once. Many people with depression feel like a burden, and asking for help might not feel like an option they have.
If you didn't think you knew someone with mental health conditions, now you do! Let's work to reduce the stigma, encourage and empower people to get help, and push for greater access to care.