Masks

                “People don’t fake depression. They fake being okay…Remember that. Be kind.”

– Robin Williams

 

                  The above quote by Robin Williams means a lot to me. I remember where I was when I heard that Robin had died by suicide. I was in my psychologist’s office waiting for my appointment. A little television on the receptionist’s desk had the local news on and they announced that he had died. I remember being sad and wondering what had led this man who seemed so happy and spent his life making others laugh to take his own life. 

                  None of us ever really know the pain others go through. We all hold parts of lives inside of us. We all have things we do not share with others even those closest to us. I believe that at times we all consider putting a mask on so that others do not see what we are going through. That mask is often a false positive mask. In other words, we often fake being okay when really, we are struggling. I know I have worn a mask disguising my depression and anxiety often. As I have grown in my understanding and acceptance of my depression, I need that mask less often, but it is still nearby and at the ready. 

                  In the past I had to wear the mask in attempt to hide my depression so that I could function at work or get through family gatherings. Unfortunately, when we live with depression, sometimes we feel like we need to deny it to get by. I have masked my depression when people insinuated that I could “snap out of depression”. Many times, it was easier to escape under the mask than to explain that I could not just snap out of my depression. Of course, this was a bad habit to get into for many reasons. First, it forced me to deny what I was feeling and experiencing. It also gave others a false impression of who I am and what I live with. Another thing wearing a mask did was to perpetuate mental health stigma. Each time I put that mask on I am denying that depression is a legitimate illness. For the most part I no longer use that mask even though it is within reach. I am not ashamed of my depression. It is an illness. People can either accept me with my illness or they can move on. 

                  When we wear a mask to hide our depression, we are faking being okay. No matter how long we wear that mask or how hard we try to mask our depression, it is going to find its way out. The depression will become worse the more we try to hide it. 

                  Back to Robin Williams. Since his death I have read many stories about him. I have learned that he suffered, but did not want his suffering to affect others. He spent his life making people laugh with his movies and other entertainment ventures. What I like best about him is what he did when no one was watching. He would quietly go to hospitals and spend time making kids with serious illnesses smile and laugh. There were never any cameras when he did this. He did not want cameras. He wanted to be fully present for the children. Doctors, nurses, and parents knew the true gift of Robin’s visits. Yes, he was wearing a mask when he made these visits because inside, he was also suffering, but I think making people, especially children, brought him joy. Maybe these visits also brought him some healing. We likely will never know because he kept these visits quiet and did not talk about them. He didn’t need the attention. His sole purpose was to bring joy to children who needed it most. 

                  I have been affected by a few celebrities’ deaths by suicide. It is not the fact that they are celebrities. It is the death; the end of a life that didn’t need to end. We often don’t hear about a suicide unless it makes the news, or it is someone we know. When I hear about someone dying by suicide or struggling with suicidal thoughts, I feel a strange connection. Perhaps because I have been on that edge. Depression has taken me to that edge more times than I would like to admit. I know I have been lucky that I have not fallen off that edge. I think about that when I hear that someone has died by suicide. I wonder if they had worn a mask. I wonder if that mask prevented them from receiving help. 

                  Masks only help others avoid dealing with someone who is struggling. Masks do not help the person with depression. We may feel like we need to wear the mask to get by or to protect ourselves, but in the bigger picture masks prevent us from getting help. 

If others could find it in themselves to be kind to people living with depression life would be easier. More people could reach out for help. Just as important, more of us could be honest about what it is like to live with depression. If we do that, just maybe people could live an easier life with depression and not attempt to end their lives. 

Remember to be kind to others. You do not know what they are going through. Each of us deserves to be treated with kindness. 

Mental Health Maintenance

                   A lot of times when we discuss mental health we focus on the difficult times or the times when the struggle is intense. It is important to focus on these times, but there are other times we should also give attention to in our discussions about mental health. One important aspect of mental health that comes to mind is maintenance. How do we maintain our moods at a stable or good level? 

                  Maintenance of a stable mood is important. Afterall, that is one of the goals of treatment. We receive treatment so that our symptoms improve. Many treatments can get us to this level. So, let’s take a moment to discuss how we can maintain our moods at a stable or even good level. 

                  First, it is important to recognize when we are stable or even in a good place. Sometimes it can be hard to recognize this state because we can get caught up in the bad times. We can even become so used to the hard times that we do not notice a change. That is where mental health providers or loved ones can help us. They might notice a change in us before we do. 

                  Once we acknowledge that we are doing better it is important to create habits that support our mental health with respect to our emotional, psychological, and physical well-being. Let’s look at some strategies we can try.

                  First, we should prioritize sleep and eat balanced meals. Lack of sleep can negatively impact our mood and how we regulate our emotions. Most recommendations I have read say that we should get 7-9 hours of sleep each night. I know this is not easy when we have other responsibilities, but it is a goal to strive towards. Nutrition affects our brains. It is important to eat healthy foods, avoid processed foods, and stay hydrated. These help our brain health, which in turn helps with our mood and emotional regulation.

                  Another area that we should include in our wellness routine is exercise or movement. Depression and anxiety are improved by exercise. That would indicate that when we are stable, exercise can help us maintain that state.  There are many types of exercise we can engage in to find benefits. It can be as simple as walking or stretching. Maybe aim for 20-30 minutes a day a few times a week. I know walking helps me. I feel at my best when I incorporate walking into my daily routine. Is there a type of movement that makes you feel better? Try making it a part of your routine. 

                  Meditation or breathing exercises can also help maintain a positive state of mental health. I struggle with meditation. I have never been able to free my mind in that way. My psychologist taught me a form of self-hypnosis that I find helps me. Self-hypnosis allows me to focus on my breathing and relax my body. There are many mindfulness activities that can help with maintaining our mental health. Maybe there is something you can try.

                  Along the lines of meditation and breathing, I find that journaling and making art also help maintain my mental health. These activities give my brain something else to focus on. Even when I am journaling about my thoughts, I find that written in my journal the thoughts are more concrete and less painful. There is a lot of research that demonstrates the benefits of writing and art on our mental health.

                  Setting boundaries is another way to maintain our mental health. For example, if work is a stressor that impacts our mental health, we can set work time boundaries. Maybe we set a boundary that keeps us from working outside of our contractual time. Or perhaps, we leave work at work and do not bring home work-related tasks. We might also need to set boundaries with the people in our lives. Think about what boundaries will make you feel the most comfortable. Try to set those boundaries. 

                  It is important not to isolate. This is a tough one for me. If left without support, I will self-isolate. I am not great in social situations. Consequently, I will avoid these situations. I know I need to reach out to others to maintain my mental health. As much as I struggle with social situations, I do not do well when I isolate. Isolation can lead to depression. Not isolating is a delicate balance. Despite my difficulties with self-isolating, I know that human connection is important, and we need to be connected to others to maintain our mental health.

                  Another thing that is important is monitoring our mental health. This can be through journaling, discussions with our mental health provider, and/or mood-tracking apps. These are important because they allow us to be on the lookout for changes in our mental health. We need to recognize when our mood is slipping, or our anxiety is increasing so that we can address these changes as soon as possible. We do not want to wait for the crash in our mood to seek help. We should seek help at the first signs of a downward turn. 

                  Here is a step that can be hard in today’s world. We need to limit overstimulation from tech devices. Whether it is social media or television, too much tech can damage our mental health. Too much input from technology can increase anxiety or decrease mood. One way I know my mood is slipping is I start doomscrolling on my phone. When I recognize this is happening, I know it is time to reach out to my mental health team and reach for my journal. I try to take tech breaks by grounding myself in my senses. Sometimes it is lighting a candle and focusing on my breathing. Other times it is listening to music. Another way to disconnect is to create art. You can also go for a walk in nature. I keep telling myself that I am going to get a membership to the Arboretum, so I have a place to head to when I need to disconnect from technology and connect with nature. I also need to make more trips to the beach.

                  Having something to look forward to is another way to maintain our mental health. When we look forward to something we feel good. Looking forward to something gives us hope. When I was looking forward to my trip to Italy, my mood improved. It does not need to be something big. Just looking forward to little things can make a difference. Something as simple as looking forward to a concert or lunch with a friend can help me. Think about what you can look forward to that will help lift your mood.

                  Maintaining our mental health is as important as improving it when we are struggling. As you have read, there are things we can do to maintain our mental health. If you are unsure how you can incorporate these things into your life, talk to a mental health professional. Just as importantly, remember if your mental health starts to slip, reach out for support and help.

 

                  

 

                  

You Can’t Pour from an Empty Cup

                 Today’s post is a bit selfish. In all honesty I am writing it for two reasons. One, I need the reminder that I cannot pour from an empty cup. Two, I need the distraction writing provides me. I ask that you indulge me in this post. My hope is that even though I am writing for myself, the post will also help others.

                  The phrase “You can’t pour from an empty cup” popped into my head the other day when I was sending an email to someone I know has a lot on her plate. I included the phrase to give her a reminder to take care of herself, too. Since then, the phrase has been in my head. I looked online and couldn’t find anyone to attribute it to. From what I read, it may come from ancient times. 

                  This phrase breaks down to an important message: You can’t take care of others if you don’t take care of yourself first. That is a powerful statement. So often, we get caught up in what we are doing for others that we forget to take care of ourselves. I would guess that parents often get caught up in taking care of their children and forget to take time to care for themselves. The same is likely true for other caregivers. 

                  I am reminded of when a flight attendant tells passengers flying with young children that in the event of an emergency, they need to put their oxygen mask on first. Then they can tend to their child. It is the same idea. Our cups need to be full before we can help others. We need to be functioning well. We need to be healthy, both mentally and physically when we are faced with caring for others. 

                  You can’t pour from an empty cup is a reminder to practice self-care, to set boundaries, to allot time to rest and recharge, and prioritize your own well-being. When I was teaching, I struggled to do these things. I was always focused on what my students needed. I was working more than I was not working. Long hours and little reward, led to burn out. I was not taking care of myself. I was not setting boundaries. I was not resting and recharging. I was not prioritizing my own well-being. Burnout was the result. My cup was empty. I reached a point where I hated teaching. Now, as I am considering whether it is time to go back to teaching, I need to ensure that I if and when I go back, that I prioritize myself. My own self-care must be a central to all I do.

                  I think the same is true when caring for a loved one who is ill. The tendency is to place all our focus on the one who requires care. That will likely not end well. You can’t do it alone. You need to take time to rest and recharge. You need to accept help and understand that you can’t do it alone. Just as importantly, you can’t put your life on hold. I think this is true in any situation where you are assisting or caring for others, such as parenting, teaching, caring for an ill family member, or being in charge in the workplace. 

                  There are some simple things you can do to “fill your cup”. These include getting enough sleep, eating nourishing meals, moving your body (i.e. go for a walk), setting and respecting boundaries, doing something you enjoy or that relaxes you, spending time with people who uplift you, and unplugging form technology and the news. These are simple things that can be done to fill our cups. Whether we are in a helping or healing profession or we are responsible for loved ones, it is important that we fill our cups. We cannot be of service to others if our cups are empty.

                  This is a difficult lesson to learn. I think I have struggled with it all my life. I poured from an empty cup too often in my teaching career and now I am struggling to return to it. I am dealing with it in other ways, too, but they are too difficult to share here. Perhaps we all are in some way. I think it is easy to get stuck with an empty cup in today’s world. Let’s all take some time this weekend to try one or more of the steps above to fill our cups. It can’t hurt to try, and it just might lay the groundwork for healthy lives. 

 

 

 

Men’s Mental Health Month

                  In June 1994 was established as Men’s Mental Health Month in the United States. The purpose was to raise awareness about mental health issues affecting men as well as to encourage open discussions about mental well-being. Organizations involved in Men’s Mental Health Month promote access to resources, support, and open conversations. 

                  Men’s Mental Health Month is especially important due to concerns about high rates of suicide among men, untreated depression and anxiety in men, substance abuse and addiction, and the reluctance of men to seek help due to stigma, cultural norms, and lack of access. Each one of these increasing rates is cause for concern on their own. Combined they show a serious need to address mental health in men.

                  The stigma surrounding mental health in men starts when they are just boys. Too often boys are discouraged from showing their emotions. They often hear that “boys don’t cry.” This statement is so damaging. It discourages boys from showing emotions, especially difficult or painful emotions. 

                  Boys and men frequently hear the phrase “man up”. This is another damaging idea taught to boys. They are taught that men don’t show their emotions. Again, this is damaging and can lead to mental health issues later in life.

Boys who grow up afraid to show their emotions become men who do not know how express their emotions in a healthy way.  Often these boys learn to deny, ignore, or bury their emotions, especially emotions like sadness, fear, or vulnerability. This can lead them to become disconnected from their own feelings. They may also be unable to name or express their emotions. When emotions are repressed in this way, it often results in numbness or outbursts. When sadness, shame, or fear are repressed, they may resurface as aggression, irritability, or violence toward themselves or others. 

When boys are taught to suppress their emotions, they do not develop the skills to understand or regulate those emotions. This can lead to a lack of ability to emphasize deeply with others. 

Boys and men need permission and encouragement to feel all emotions, even emotions that they have traditionally been taught to repress. They need role models who demonstrate that strength includes vulnerability. (See my last post "Being Vulnerable" for a discussion on vulnerability.) Boys and men also need safe environments in which they can express emotions without judgement. Another important thing to provide boys and men with is access to mental health education and support from a young age.

As you can see there is a definite need for Men’s Mental Health Month. Since the needs for mental health education and support are developed early and boys often are faced with stigma in comments such as “Boys don’t cry” or “Man up”, perhaps we should call it Men’s and Boys’ Mental Health Month. Both men and boys need to have access to help.

Let’s take a moment to understand the goals of Men’ Mental Health Month. One is to break the stigma around talking about emotions and mental struggles. A second goal is to encourage men to seek help when they experience mental distress. Promoting preventative care is another goal of Men’s Mental Health Month. A fourth goal, which is similar to the promoting preventative care is educating communities about the signs of mental health issues in boys and men. As someone who has spent close to three decades in education, I believe we need to do more in the school system. I think there should be a mandatory mental health class at both the later elementary and high school levels. In addition to this, mental health lessons should be part of the middle school health curriculum. It is not enough to teach it once. Our young people need to learn about mental health often. Another goal of Men’s Mental Health Month is to support marginalized groups, such as BIPOC men, LGBTQ+ individuals, and veterans. These groups might face additional barriers to mental health care and need the additional support. 

While June is a month dedicated to men’s mental health, we need to be focused on the mental health needs of men all year long. Mental health needs of all people need to be addressed year-round. When we dedicate a month to something like men’s mental health, the purpose is to draw increased attention. The focus of this month should shift into our everyday lives. It should be a part of overall mental health advocacy. 

Everyone should feel safe expressing their emotions. It is okay to cry, no matter who you are. It is okay to seek help. It is okay to be vulnerable. Emotions are a part of who we are. We need to give our emotions an outlet. Don’t stifle your emotions or force someone else to repress theirs. These are important steps to ending the stigma surrounding mental health in men and in everyone. 

 

Being Vulnerable

                  When you live with illness whether mental or physical, life can be difficult. I have struggled my whole life with depression and anxiety. A couple years ago cancer joined the fray. As a result of these illnesses, I think I have a fairly good idea of what it is like to live with illness. Most of my life I have tried to deal with my illnesses, especially the depression and anxiety, mostly alone. I have had my psychologist for quite a while, and I have leaned on him. I have had the same psychiatrist for several years, which has been helpful. A work with a psychiatric nurse practitioner and have a primary care provider and oncologist who are always there. But it has taken time to learn to trust all of them. 

                  There is one thing that I have learned more recently that I think is vital to living with illness. I have learned that it is okay to be vulnerable. The Merriam-Webster Dictionary defines vulnerable as being “capable of being physically or emotionally wounded”.  When dealing with illnesses being vulnerable means being open, honest, and exposed, often in deeply uncomfortable ways. Vulnerability can manifest emotionally, relationally, bodily, and in terms of identity.

                  With emotional vulnerability, a person often faces fear and uncertainty. It can be uncomfortable to admit when you are in pain, scared, or not coping well. This vulnerability means acknowledging things like feelings of depression, anxiety, or intrusive thoughts. It also means admitting limitations and acknowledging a fear of mortality. 

                  With respect to relational vulnerability, it is necessary to let loved ones and/or friends see you struggling. It also means being honest with doctors, therapists, and caregivers about symptoms. We need to be honest even when we are feeling stigmatized or embarrassed. This is not easy.  We need to learn to rely on others. Many of us are not used to that. I know I wasn’t. 

                  When our bodies are affected, we may need assistance with basic tasks or need to undergo invasive procedures. Accepting this loss of privacy can be embarrassing and difficult to accept. 

                  Being vulnerable can also impact our identity. With mental illness we might fear the labels that are so often placed on people with mental illness. We don’t want to be seen as unstable or crazy.  If it is a physical illness, we may be faced with feeling weak or disabled. 

                  Vulnerability is important because if we deny our illnesses, whether mental or physical, we cannot be treated. Even though it may feel like we are being weak, expressing vulnerability is a sign of personal strength. Vulnerability allows us to accept the help we need. 

                  As I think about my own illnesses, it wasn’t until I learned that it was okay to be vulnerable that I started to heal. My mental health improved when I was vulnerable enough to share that I lived with depression and anxiety. When I allowed others to know what I was going through, I discovered compassion. I was also better able to work with my mental health care providers. This vulnerability was the first step toward getting the treatment I needed to improve my mental health. It hasn’t always been easy, and there are still times when I hesitate to admit I am struggling with depression. Being able to tell a member of my mental health team that suicidal thoughts are entering my mind requires me to be vulnerable. I have learned that it is safer for me to let them know what I am experiencing. If I want to get through those times, I need to speak up. Fortunately, I have learned that I am stronger when I allow myself to be vulnerable.

                  Being diagnosed with stage 4 metastatic breast cancer forced me to be vulnerable. There were a lot of things I could not do for myself. I had to be vulnerable to accept help. I am lucky that my aunt stepped in made it safe for me to be vulnerable. I had to accept that I could not take care of myself on my own. I needed help. I was probably most vulnerable with my aunt. I could admit my fears to her, and I could accept her care. Being stripped of my ability to care for myself was scary. My mental health journey had taught me that it was okay to be vulnerable. I was able to cry when I thought about my mortality. Early on I didn’t know how my fight would turn out. Would I live or would I succumb to the cancer raging within in me? I had to turn myself over to my medical team. I had to allow my aunt to care for me. In short, I had to be vulnerable. That vulnerability led to an ability to fight cancer. I learned that it was okay for me to be scared. It was okay for me to need help. 

                  Vulnerability means been willing to be seen as you are. What you are might be a mess. It might be painful and scared. It might be a person on the edge of life. But when we are seen as we are, we can be ourselves. We can accept the help we need. Most importantly, we can heal. 

 

                  

 

The Practice of Journaling

                 Today I thought I would focus on the practice of journaling.  I know I spend a lot of time sharing how important writing is in my life. That’s just it. Writing is a critical part of my healing, and I hope that I can share its impact with others.

                  I write in many different forms including poetry, journaling, blog writing, letter/email writing, memoir, and article writing. Each is helpful for me in its own way. What is it about journal writing that is so beneficial? A quick online search will produce many benefits of journaling. These include stress reduction, improved mood, enhanced clarity, self-awareness, emotional regulation, gratitude and positivity, memory improvement, problem-solving skills, creativity boost, progress tracking, accountability, time management, improved immune function, better sleep, and pain management. That is a lot. Of course, not everyone is going to experience all these benefits. Journaling is an individualized practice, and the benefits often match the need of the person journaling.

                  Enough of what the internet says. Let’s look at personal experience. I have been journaling for close to 40 years. I started in my early teens. At that time, I did not know what I was doing. Writing was an escape for me. It allowed me to get dark thoughts out of my mind. It gave those thoughts a place to go. A lot of that early journaling was in the form of poetry. Some poems were quite long, sort of like a typical journal entry. As time passed journaling became my safe space. It was the place where I could let my emotions and thoughts loose. Looking back, I think writing in journals saved my life. It allowed me to rid myself of dark thoughts and gave the self-harm and suicidal thoughts a place to go.

                  Journaling isn’t always dark. Often, it is a place where I can sort things out, a place where I process my thoughts. As I have developed coping skills through years of therapy, I have leaned on my journal as a place to further develop ideas discussed in therapy. I also use it to help me process difficult times. When I have been frustrated in my career, I have journaled. That practice has allowed me to find clarity. It also allowed me to vent when I needed a place to scream my frustrations into the world. It has also provided space to share the good times and the positives I have experienced.

                  Without journaling my mental health journey would look quite different. In fact, I believe it may have ended tragically years ago, if I hadn’t had journaling. That is a testament to how powerful journaling can be.  It is also the reason journaling will always be a part of my mental and physical health toolkit.

                  When I was diagnosed with cancer journaling took on an enhanced role. My relationship with depression and anxiety became complicated by cancer. New fears and anxieties developed. I needed a place for all the thoughts about my illness to go. Early on in my diagnosis, death seemed like a real possibility. Outside of my oncologist, my mental health team and my aunt, I couldn’t really talk to anyone about the very real possibility that cancer could take my life. So, I journaled. I wrote every feeling and thought in journals. I had a lot to write. So, I went through a few journals. Journaling lifted the fears. It allowed me to seek understanding and provide some of it on my own. Journaling loosened up the thoughts and fears in my head. Perhaps more importantly, journaling provided a space for my thoughts to reside. Once made concrete in my journal I was able to share some of those thoughts and fears with people who could help me. In this way journaling provided healing. Sometimes I wonder if I would have made it to the other side of cancer if I hadn’t journaled. I will likely never know the answer to that question, but I have a pretty clear idea as to what the answer is. 

                  Journaling also provides a space to tell our stories. Even if we don’t realize it, each one of us wants our story to be heard. It may just be a part of our story, but we all have something to share. I learned a lot about this from Sandra Marinella’s insightful book, The Story You Need to Tell. I had first read it a couple years before my cancer diagnosis. After I was diagnosed, I found myself returning to her book with an even greater understanding. My whole life I have been journaling my way through illness. At times it has been mental illness. Other times it has been physical illness. Through it all I have been telling my story. Mostly the story has been for my eyes only, but at times I have shared that story. I hope what I have shared has helped others. I know telling my story through journaling has helped me immensely. 

                  Journaling has led to other opportunities for me. This blog grew from my journaling. My five published books stemmed from my journals. I have written articles and published poems. A lot of what I write starts in my journal. I know I will journal my way through the rest of my life. My journal will be there in good times and in tough times. It will be there when I am healthy and when I am battling illness. The practice of journaling is just that, a practice. Journaling is something I need to keep doing. It is something that you might find healing and I encourage everyone to give it a try.