The Power of Not Giving Up on Someone with Depression (Part 2)

“And I won’t give up if you don’t give up” – Train, from the song, “Calling All Angels”

 

In my last post, Choosing to Stay Alive When Depression Says to Give Up, I discussed not giving up when you live with depression or other mental illnesses. Today I would like to expand on that discussion. The lyric, “I won’t give up if you don’t give up” (Train), can also be applied to daily life with mental illness. We face constant challenges. Knowing that there is someone, or even more than one person, who won’t give up on us makes a huge difference in our lives. 

                  One of the challenges is remembering to take our medication or sometimes just being willing to take our medication. This can be difficult, especially if we need to take one at time when we are occupied with other things. It can also be difficult if the medication has side effects or makes a feel a way we do not like. Taking medication can be difficult if we are not seeing quick enough improvement. It is easy to give up on medications. Frustration can lead to giving up on the medication. We may need a mental healthcare provider to encourage us and not give up on us. That mental health provider can show they are not giving up on us by helping us set up a strategy to remember to take our medication. They can help us deal with side effects. They can listen when we explain how those side effects are impacting us and offer solutions. 

                  Another challenge might be wanting to give up on doing things that are healthy for us. This might include engaging with others, self-care activities, or coping strategies. It might also include going to work or going on a vacation. There are times, sometimes frequent, when we want to give up on these activities. For example, when I am struggling with my depression and/or anxiety I often give up on self- care activities. I may not want to get out of bed or may not want to take a shower. I may under- or overeat. In moments like these having a friend who won’t give up on me is important. A friend can show they are not giving up on us by reminding us to engage in self-care activities or by doing one of our coping strategies with us. 

                  Let’s look at some other things a friend or loved one can say or do to show that they won’t give up on someone living with depression or other mental illness. Here are some ideas:

What You Can Say

                  “I’m no expecting you to be okay right now. I’m here for you however you need me.”

                  “I care about you even on the quiet or hard days.”
                  “What can I do for you?”

                  “I may not fully understand what you are going through, but I want to understand.”

                  “You don’t need to earn my support.”

                  “I’m not going anywhere just because things are difficult.”

                  “Would you like to talk, sit quietly, or be distracted together?’

                  “Do you need me to talk or listen?’

What Can You Do

·      Follow through on promises, even small ones.

·      Sit with them during difficult times. Just be present. You don’t need to try to fix anything.

·      Learn about your loved one’s or friend’s condition. This will help you understand what they are going through and let them know you care enough to learn.

·      Treat them like a whole person, not only as someone who is struggling.

·      Engage in a coping strategy with them. For example, if going for a walk is one of their coping strategies, offer to walk with them.

·      Stay in contact even if they withdraw. Don’t disappear until they feel better. Send a check-in text or make a quick call or stop by.

·      Offer specific help. This might be something like:

o   “I can drive you to your appointment.”

o   “I can put a reminder on my phone and text you to remind you take your medication.”

o   Offer to help them with something that might be causing anxiety or a sense of overwhelm.

 

Those of us with depression or other mental illness are more likely to feel supported when we are believed, when we are not judged for our symptoms, when we are not punished for struggling, and when we are allowed dignity and autonomy. This is how you show you are not giving up on us.

                  As you can see the challenges facing many of us with mental illness are not always suicidal thoughts. Sometimes the challenges are the day-to-day things. When we are struggling we need to know that there are people in our lives who won’t give up on us. Believe me it is easy to give up on ourselves when we live with depression. The depression we live with often speaks negatively towards us. It might say that medication or treatment won’t work. We start to believe it and don’t take the medication. We might not go to a treatment appointment or therapy appointment, if we find ourselves giving up on it and believing it won’t work. If one of these are happening, we might need reassurance from our mental healthcare provider. That reassurance is being told they won’t give up, if we don’t give up. It might be the psychiatrist saying, “Let’s try this. What do you think about that?” These words let us know that our psychiatrist is still trying. If we see them trying, it can help us not give up. 

                  The same is true with therapy. It may be as simple as the psychologist/therapist/counselor saying, “Let’s talk about this.” That shows interest. When we see someone is interested in us, it lets us know that they have not given up on us, which encourages us to not give up on ourselves. 

                  It is not just the mental health professionals who can show that they are not giving up on us. As I mentioned friends and loved ones can encourage us and show us they have not given up on us. It might be that extra call or text to see how we are doing. Maybe it is an invite to do something together. It can also be asking, “Do you need me to talk or listen?” (See my post:  How to Support Someone with Depression: What to Sat and How to Help). Just knowing that a friend or loved one is there lets us know they have not given up on us. 

                  I consider myself lucky to have mental healthcare professionals who believe in me and who won’t give up on me. In all honesty, that is probably the main reason I am still here. It is the reason I have continued with therapy and treatment. Their suggestions and support are the reason I have so many coping strategies available when I am struggling. They let me know that they won’t give up on me. That encourages me to not give up. 

                  The way a person communicates with us both verbally and nonverbally can let us know that they are not giving up on us. Words matter. Words can encourage us. Unfortunately, words can also push us down. We need people in our lives who will encourage us whether they are mental healthcare providers or friends and loved ones. This does not mean that they need to agree with everything we say or do. Sometimes showing that they won’t give up on us means saying or doing the hard things. We may need to be told that we are hurting ourselves in some way. We may need to be told that taking our medication or being in treatment or going to therapy is non-negotiable. That is not to say that we do not have input, but sometimes we need to be reminded that we have an illness and require certain things to heal.

                  I have found that most mental healthcare professionals are going to be there saying “I won’t give up if you don’t give up.” As I said, I know that the mental healthcare professionals involved in my care and treatment won’t give up on me even when I am at my darkest points. While not every mental healthcare professional is as dedicated to their patients as mine are, I believe most are. Have I experienced ones that are not as committed to not giving up on us? Sadly, the answer is yes. I have experienced this with a former psychiatrist. I have also experienced it with an oncologist who didn’t give me much of a chance at survival So, it happens in physical healthcare, too.

                  One thing I have learned through having great mental and physical healthcare providers is that I have a right to that type of care. It should be the norm that they don’t give up on us. I had to learn this the hard way. When I discovered that a former psychiatrist had basically given up on me and was just overmedicating me, I struggled. I had to learn that there are psychiatrists who won’t give up on me. Luckily, after a couple of years I found one. The same with my psychologist, I know he will never give up on me. He may tell me things I don’t want to hear at times, but those words are shared to show me he is not giving up on me and to guide me in the right direction. I am lucky to also have two psychiatric nurse practitioners who I know won’t give up on me. 

                  I have a few friends and loved ones I now know I can turn to who won’t give up on me. That means the world to me. I wish that for everyone. That is why I talk to family groups and why I work to spread this blog to all who are willing to read. At some point in each of our lives we will encounter someone with depression or other mental illness. I hope I can educate people on what it is like to live with a mental illness and encourage them to not give up on those living with a mental illness.

As I said before, I know I am lucky to have all the care I have. I share my story in the hopes that it will help others. I hope others will see the type of care I have and understand that there are mental healthcare providers who won’t give up on us. I hope readers will take that understanding and reach out and demand the care I have.

I also hope that people understand that I won’t give up on them. You can always come to this blog for information, comfort, and understanding. My mental health is far from perfect. It is not where I want it to be at this point. Knowing this, I am working hard to keep myself from giving up on getting to where I want to be with my mental health. This requires me to not give up. Sometimes I need support in not giving up. When my mood drops or I have an anxiety attack, I often want to give up. In those moments I sometimes feel like I have done all I can do. In these moments I need to hear from someone on my mental health team or a friend or loved one that I am okay. I need them to say, “I won’t give up, if you don’t give up.” They may say this in different words or in actions, but the message is clear. I am not alone in this battle. And my friend, neither are you.

 

For part 1 see the May 25 post: Choosing to Stay Alive When Depression Says to Give Up https://depressionbentnotbroken.blogspot.com/2026/05/choosing-to-stay-alive-when-depression.html

 

 

 

 

 

Breaking Free from Self-Criticism in Depression: Practical Strategies That Help

     One aspect of depression that I find myself struggling with even at times when my depression is otherwise in a manageable state is self-criticism. Often, my mind fixates on my perceived faults. It does not take much to trigger these thoughts. Sometimes it is not even something that happened. My self-criticism can be triggered by a random thought. It can be triggered by something that does not go right. Whatever the cause, self-criticism worsens my depression. It does this for many people.

                  According to the Oxford Language Dictionary, criticism is “the expression of disapproval of someone or something based on perceived faults or mistakes.” It defines self-criticism is “criticism of oneself or one’s actions.”  Anyone can experience times of self-criticism. That is normal. Most of us experience self-criticism at times. When a person has depression thoughts of self-criticism can become persistent and harsh, worsening the depression.  

                  Self-criticism turns into an inner voice carrying on a negative dialogue. This dialogue is often cruel and shaming. Instead of saying “I made a mistake”, the dialogue might be “I am a mistake.”  The mistake is seen as a reflection of our whole self. With self-criticism we judge our self-worth based on one incident or mistake. We experience a setback and then believe that we always fail. 

                  Another characteristic of self-criticism is rumination. We keep replaying a mistake on a loop in our mind. I experienced this today. A lesson I taught didn’t go the way I planned. Instead of just moving on to the next lesson and allowing myself not to be perfect, I kept going over what I felt I did wrong in my head. Something that my students probably did not even notice became a siren in my head. I questioned my worth as a teacher. Despite the fact that I have taught for over 28 years, my mind fixated on a perceived bad lesson. It was not even the whole lesson, it was just a little part of it. That was enough to trigger self-criticism in my head, which led to my mood dropping and depression creeping in and reaching a level that was difficult for me.

                  So, how do we cope with self-criticism when we live with depression? First, we need to recognize that we are not likely to be able to force that voice of self-criticism to be completely silent. Instead, we need to change our relationship with self-criticism. In doing this we can reduce its power over us. Let’s look at some strategies we can employ. 

                  A powerful strategy for coping with self-criticism is to name the voice. A common statement made by self-criticism is “I am a failure.” We can rename this by saying “I am having the thought that I am a failure.” This allows us to notice the thought and create distance between ourselves and the thought. We can even label the thought. Maybe we say, “That’s my depression talking” or “That’s my inner critic.” Naming or labeling our self-criticizing thoughts allows us to take away its power. This takes practice. So, we cannot beat ourselves up when we struggle with it. As we practice doing this, we will be better able to employ this strategy. 

                  Another coping strategy is to talk back to the self-criticism with evidence. We can ask ourselves what the evidence is. Then ask ourselves what evidence contradicts it. We might even say something like, “If a friend said this about themselves, what would I say?” Then gently say that to ourselves.  Talking back to our self-critic requires practice. 

                  When self-criticism is attacking us, we can try to shift the thoughts to specificity. For example, instead of saying, “I’m no good.” We can say something like “I didn’t prepare enough for that.” When we do this, we are shifting from a shaming thought to something that is behavioral and specific. In doing this the overarching self-criticism is replaced with problem-solving. 

                  Self-compassion is an important practice for many aspects of depression including self-criticism. There are three parts to self-compassion. The first is mindfulness. When we are mindful, we acknowledge what we are feeling. For example, we can say, “This hurts.” The second part is common humanity. We need to remind ourselves that other people struggle like we do. The third part of self-compassion is kindness. When  we are kind to ourselves, we acknowledge that we can be gentle with ourselves in this moment.

                  When we struggle with depression we can be paralyzed by the combination of depression and perfectionism. To combat this, we can define in advance what good enough looks like for a particular task or we can define what is enough effort for the day. When depression has us in its grasp, our best effort might only be 20% of our capacity. We can allow ourselves to recognize that we do not need to give 100% or be perfect. 

                  Self-criticism is tied to rumination. Maybe we need to give ourselves an opportunity to “hear” those thoughts. We can set a criticism window by telling ourselves that we are only going to listen to those thoughts for five minutes. In that time, we might write those thoughts down to get them out of our head. Then when the period is over, we should physically shift activities. We can do this by standing up or walking into another room. As with the other strategies, this can take practice. Be gentle with yourself as you are working on this strategy. 

                  Another strategy is to collect counterevidence. Keep a log of compliments you have received, tasks you have completed, and/or times you handled something well.  Depression likes to choose what we remember. Usually, it remembers the negative. This log can help balance out those negatives with real positives. 

                  We can also take small actions in contradiction to the self-criticism. If self-criticism tells us we are not good at something, we might take a small step toward doing a part of that task. In doing this we are letting our self-critic “see” what we can do. 

                  These strategies are not always easy. As I mentioned, I struggle with self-criticism. With that comes a struggle implementing these strategies. One of the things I have learned is that trying is half the battle. There are going to be times when self-criticism feels heavy. Maybe I need to sit with it. That can be part of the strategy in which we give ourselves an opportunity to “hear” the thoughts. Once I have done that, I need to select a strategy to focus on. I wish I could tell you that I am successful every time. The important thing is to keep trying.

The struggle might require the help of a therapist. With the help of therapy with a trained therapist or psychologist we can target self-criticism patterns and learn to the strategies that work best for us. 

                  It is important to recognize that if the self-criticism is constant, cruel, tied to hopelessness, or connected to thoughts of self-harm, we need to seek professional help. It is okay to reach out for support. It is necessary to reach out for help. If you do not have a mental health provider to reach out to, you can call or text the 988 lifeline.

                  

 

 

 

 

 

 

                  

Asking for Help with Depression When You Don’t Have the Words

Often, when we are struggling with depression it is hard to ask for help. It can be difficult to find the words to let someone else know we are struggling. Many times, I have struggled to find the words to ask for help. When the depression leaves me in the dark, words often fail me. I find myself unable to explain to someone else the pain I am experiencing. There are times when I cannot even write what I am experiencing in my journal. 

So, what do we do when we do not have the words to ask for help? The pain of depression can mute us. Wanting to ask for help even when we do not have the words is a sign of strength. The first thing to remember is that we do not need the “right” words to reach out for help. Just saying we cannot explain what we are feeling is an important step. We might tell a trusted person or a healthcare provider, “I’m not okay, and I don’t have the words for it.” We might say, “Something’s wrong, and I don’t know how to talk about it.” Another way to let someone know we are struggling is to say, “I’m struggling more than I’m letting on.”  These words are enough to open the door to receiving help.

We do not need to say a lot to communicate that we are struggling with depression. Just letting someone know that we are not okay can be enough. A few simple statements we can make might include:

 

“On a scale of 1-10, I’m a 3 right now.”

“Today is a bad mental health day.”

“I’m functioning, but barely.”

 

                  Even these statements can be difficult to say. That is okay. It takes strength just to try. When communicating our struggle, it is okay to keep it simple. We do not need to tell the whole story. It can help if we have a few of the above sentences ready. Maybe we write a few of these sentences on a page we create in our journal or a note that we keep somewhere we have easy access to. Then when we need help, we can refer to that page or note. We can even read the sentence if we are struggling to get it out. 

                  Another idea is to borrow words from someone else. Maybe we read something that someone else wrote. It might be an article or words from a song.  We might say, “I read/heard something that describes how I feel.” This is a way to explain how we are feeling without having to find our own words. We could also say, “This article/post/video/song sounds like me.” By doing this we are letting someone else know what our struggle feels like. This can open the door to support. 

                  Some of us can get the words out in writing even when we cannot speak the words. We might send a text saying we are having a hard time but do not know how to talk about it. We might write in our journal and then share that page with someone. I have done this at times. Sometimes I share something I have written with my mental health team. This lets them know I need support. Even a simple email to a therapist or doctor saying that we are not okay can lead to the support we need.

                  We do not always need to explain why we need support. I have a friend who knows I struggle with depression. Sometimes it is enough to just tell her I need her to sit or hang with me for a bit. This is enough for her to know I am struggling, and I just need someone with me. I do not need to explain what I am experiencing. Silence might be part of the support at times. We might not have the words, but we just do not want to be alone with our depression. 

                  It is common for those of us living with depression to struggle to find the words to explain what we are experiencing. Depression steals words from us. It robs us of our ability to tell others how we are feeling or what we need. If you are feeling this way, know that you are not alone. Just because the words elude us does not mean our pain is unreal or invalid. Depression is real. Depression is painful. It is important to remember that depression does not always carry with it the words to make sense of it. Even though I write every day, and writing is an important aspect of my healing, there are times when I cannot find the words to explain to someone that I am suffering. In these moments I tend to become quiet and isolate myself. I have learned that even if I can say, “I am not okay,” to someone on my mental health team, it is enough for them to understand that I need support. They can often guide me to find the words to share what I am going through. That explanation does not need to be detailed. We can rely on our mental health providers to support us in these moments.

                  Not everyone has a mental health provider. If this is the case it is important to have a trusted family member or friend to turn to. In our better moments we can share with this person that depression is a part of our lives and that there may be times when we need support and cannot ask for it. Having a plan for these times is good idea. I wrote an article about having a safety plan (Creating a Safety Plan for Times of Suicidal Crisis). This article addresses when the depression is leading to suicidal thoughts, but a plan can also be created for when we are struggling and need support. I think that might be an upcoming post. 

                  One thing that has helped me is being part of a support group. Most of my experience with support groups has come from a cancer support group, but this group assisted me in dealing with the mental health aspects of my cancer battle. When I first went to the group, I did not have the words to say much. I did a lot of listening. Through listening, I learned from how other people were sharing their struggles and needs. Slowly, I became more comfortable talking. Being in a support group helped me find the words to talk to others. If you are interested in joining a mental health support group, I would recommend NAMI Connections support groups. The link can lead to groups throughout the country.

                  There is a simple sentence that is extremely powerful. “I am not okay.” When we struggle to find the words to let a loved one or mental health provider know that our depression is bad and we need help, we can use this sentence. The loved one can guide us to professional support. Our mental health provider can lead us into a conversation that provides a picture of what we are experiencing. They can then provide the proper support.

                  I understand how difficult it can be to talk about our struggle with depression. We fear others may not understand. The words do not come easily. It is okay if all we can do is utter those four simple words, “I am not okay.”  Long explanations are not needed. The important thing is to reach out in whatever we can. “I am not okay,” is a simple but powerful statement. It is a statement that we can use when other words fail us.        

 

 

Signs You Need a Mental Health Break

                  Living with mental illness is tough. Often, it is necessary to take a mental health break. Even people who are not diagnosed with a mental illness can benefit from a mental health break. I would like to share some signs that it may be time for that break.

                  We can break down the signs that it is time for a mental health break into a few  categories. The first two categories are emotional signs and mental and cognitive signs. There are also physical and behavioral signs. Work or school related signs may also be present. In addition to these categories, there can also be serious indicators that you need a break. It is important to recognize these signs whether you have a diagnosed mental illness or not.

                  There are several emotional signs to be aware of. One is irritability or impatience over small things. Feeling overwhelmed by tasks that are normally manageable is another sign. If you notice an increase in anxiety, worry, or dread, it might be time to take a break and reach out for support. You might need a mental health break if you start having mood swings or emotional numbness. Feeling disconnected from people or things is another indicator. We can all experience emotional signs that we need a break at times. So, it is important to pay attention to these indicators and give yourself the grace of a break.

                  We can also experience mental and cognitive signs that we need a mental health break. If you experience difficulty concentrating or a sense of brain fog, it is a good idea to take a step back. Memory loss or forgetting simple things can be a sign that your mental health needs attention. A person in need of a mental health break might have trouble making decisions. Sometimes when we need a break, we feel drained even after sleep. You might also notice reduced creativity or problem-solving ability. Again, if you notice these signs, you need a mental health break.

                  Often, we do not realize that physical symptoms can be related to our mental health. Constant fatigue despite resting is a sign of mental health struggles. You might experience headaches, muscle tension, or stomach issues. Changes in appetite or sleep patterns can be an indicator. Sometimes frequent colds or lowered immunity is related to our mental health. Unexplained aches or tightness in the chest can be a sign of mental health issues. Of course, with chest pain or tightness, it is also important to be checked for physical issues.

                  Sometimes we do not recognize behavioral signs, but it is important to be aware of them. One behavioral sign might be withdrawal from social interactions or responsibilities. Procrastination or inability to complete tasks can be an indicator that you are struggling. Dependence on food, alcohol, caffeine, or social media and other screentime is another sign. If you start to lose interest in hobbies or self-care, it is important that you pay attention to your mental health. 

                  The above signs can be present in our work or school lives. In addition, a drop in productivity despite your efforts is an important sign to address. Sometimes you might feel on edge or resentful at work or school. When you dread tasks you once enjoyed your mental health is telling you to pay attention. This is also true when you feel like you are constantly behind or notice mistakes that are not typical for you.

                  Most of these signs can be addressed with simple strategies. These might include taking a day or more to rest. Do not be afraid to use sick time to tend to these signs. Mental health is a legitimate reason to use sick days. Even if you do not have sick time, it is important to give yourself time away from a job, school, or whatever else is resulting in the need for a break. Another important thing is disconnecting from screens and social media. While technology has provided us with a lot of benefits, it also causes a lot of unnecessary stress. 

Spend time outdoors. Nature can be an amazing healer. Check out my post on forest bathing for more information on allowing nature to bring healing. You can also do something that you find nourishing or grounding. Some examples might include: a slow walk in which you notice each step, holding something with texture, lighting a calming candle, listening to ambient sounds such as rain or nature sounds, a warm shower, walking barefoot on sand or grass, gardening, watching clouds, journaling, crafting, playing an instrument, listening to calming music, talking to a supportive friend, meditation, light exercise, or watching a comfort show or movie.

                  Another important activity that can provide a mental health break is doing a reset. This might include a reset on sleep habits. Setting new boundaries is also important. Rethinking responsibilities and establishing a doable pattern can be helpful. 

                  You do not need to do these things alone. You can reach out to a mental health provider or even your primary care provider for assistance. You can join a support group. Organizations such as NAMI (National Alliance on Mental Illness) can provide support. Some people find support in peer groups or religious groups. You can search online for a group involving an activity you find nourishing. 

                  There are also serious indicators that you need more than just a mental health break. The signs that follow indicate that you need break immediately and need support.  If you experience panic attacks or constant high anxiety do not try to deal with it alone. Thoughts of self-harm or hopelessness are another serious indicator that you need help. In these instances, you should reach out to the 988 Lifeline either by phone or text or call 911.  You also should reach out for immediate help if you experience emotional breakdowns or uncontrollable crying. If you feel completely disconnected from yourself you should reach out to 988 or 911, too. 

                  We live in an increasingly stressful world. It is normal to need a mental health break. If you have a mental health disorder this need increases. However, it is important to remember that you do not need to be diagnosed with a mental health disorder to need help. If you are struggling, please remember that it is okay not to be okay and it is absolutely okay to reach out for help. 

                  

Do I Deserve Support?

                  A question I have often asked myself is “Do I deserve support with my mental health?” Living with mental illness is not easy and I often cannot do it alone. I need support. Is it fair for me to reach out for support? Am I too needy? The simple answer is that everyone deserves support no matter what struggles they are facing. The question then becomes can I allow myself to feel okay asking for support?

                  Even though I can understand that everyone, including me, deserves support, sometimes I start thinking I should be able to get through things on my own. The reality is at times my depression and anxiety prevent me from getting through things on my own. I need support.

                  No one would deny me support for my cancer diagnosis. The same should hold true for my mental illness. Sadly, many people are forced to face their mental illness alone whether because they believe they are not worthy of support or because they do not have access to support. How do we handle it when we do not believe we deserve support? Sometimes I reach for my journal as if it could provide actual support. I know it provides a release for my thoughts and emotions, but it does not respond. What should I do then? 

                  Fortunately, even though I do not always believe I deserve support, I have learned to reach out. I am lucky to have mental health providers I can reach out to when I am struggling. That privilege is not lost on me. I am grateful for every one of them. I know that they are going to be there when I struggle. Sometimes I feel like a burden. I feel like I should just hold on until my next appointment. Unfortunately, depression and anxiety, as well, as other mental illnesses, do not always cooperate with the wait time. I may need support at inconvenient times. This is hard. I may know I am spiraling, but I do not want to be that burden. 

                  I know that even when I do not feel worthy, I need to reach out for support. Sometimes that support is a phone call. Other times it is an email. There are times when that support comes after I have let loose all that I am struggling with during an appointment. By its very nature, mental illness requires support. Even after a lifetime of living with depression and anxiety, I am still coming to terms with needing support and whether I deserve that support. Part of that is the negativity that depression and anxiety fill my mind with so often. Depression tells me, and many others, that I am not worthy. It berates me and causes me to internalize negative thoughts. 

                  I hope that I do not burden my mental health team. I always think about it before I reach out. I question if I really should be reaching out. Sadly, sometimes the depression wins, and I do not reach out. The message I would like to leave others with is that we need to allow ourselves to believe that we deserve support even if our minds our telling us differently. So, reach out when you need support.  

The Importance of Support and Connection

                  Living with an illness, whether mental or physical is difficult. Despite our best efforts we often cannot get through it alone. We have doctors, therapists, family, and friends to help us. Sometimes that is not enough. There is something missing. We need the support of those who understand what we are going through. While family and friends will try, and many are there for whatever we need, there is a sense of understanding that is missing. This is where support groups can be valuable.

                  A support group is an organized group of people living with the same condition or situation. I have gone to support groups for my mental health and for cancer. These groups and the people in the groups have helped me and I hope I have helped others.  A support group is a safe space to talk about what we are going through. It is a place where we find understanding and connection. 

                  Currently, I attend a cancer support group for people with stage 4 cancer. It is led by two therapists. We are on Zoom, which makes attending easier. I have been struggling with something related to my cancer. I was hesitant to share what I had experienced and how it had affected me because I thought it was insignificant compared to what others are going through. I forced myself to share. I was met with understanding and connection. I was able to talk about the situation and hear the perspective of others. It was helpful for me. Perhaps understanding and connection are the gifts of support groups. 

                  The therapist who leads the group said that every story matters. That struck me. I think our stories are all connected in some way. In this group maybe it is that we all know the struggle to keep living despite our diagnoses. Maybe it is that we are all battling an illness and still need to deal with everything else life throws at us. Our stories are connected in some way. That connection is our humanity. 

                  I have felt similar connections in mental health support groups. I have attended support groups facilitated through NAMI. They have a group called Connections (NAMI Connections). These groups are for individuals living with a mental illness and are facilitated by trained peers who have a mental illness. These groups also thrive on connection. I feel safe in these groups. I can share what I am going through and listen to the stories of others. Together we can thrive. 

Sometimes you need to be ready for a support group or you might have to try a couple to find the right one. I remember years ago I attended a support group for depression. I was not in place where I was ready for that kind of sharing and connection. It wasn’t a good fit for me at that particular time. Maybe it was the group. Maybe it was me. Either way I wasn’t in a place where I could share with others. I was closed in, which isn’t healthy.

 Luckily, in time, I found NAMI and later the cancer support group I am a part of. I am able to be a part of the connection now. It benefits me even on the days when I don’t say much. Just listening helps me on some days.

Support groups don’t always have to be formal. I think about when I was teaching. Lunch time was our support group time. Of course, we thought we were just having lunch together. We were all teachers. We went through similar experiences. During this break in our day, we shared our stories Our day-to-day struggles as teachers were discussed and understood. This was our time for connection and support. My experiences lie in teaching, but I imagine there are similar experiences in other careers.

Finding connection when we are faced with struggle, especially illness, is crucial. It helps us maintain a sense of power over our struggle by letting us know we are not alone. Connection allows us to work through our struggles with the support of others who understand. I am grateful that support groups are a part of my healing process. While each of our journeys is unique, we all face similar challenges. Together we can work through them and live our best lives. 

 

Physical Versus Mental Illness

                  Most of my life has been spent living with mental illness.  I know the ups and downs well.  The loneliness of mental illness is something I have felt intensely.  I have often hidden my mental illness to protect myself from stigma.  The platitudes that are spoken when someone finds out I have depression are seared into my mind.  Living with mental illness has frequently been a solitary battle.  Many times, I have feigned a physical illness to hide my mental illness from people who just don’t understand. 

                  I shouldn’t need to hide my mental illness.  No one should. Unfortunately, the society we live in still doesn’t understand that mental illness is an illness.  I will acknowledge that society has come a long way.  It is easier now than it was 30 years ago.  Still, it is a challenge to live with mental illness.

                  People understand when you have a physical illness.  When you are in bed with the flu, people will text you and tell you to feel better.  People are quick to assist someone in a cast or on crutches.  Sometimes flowers are sent, or a meal is brought to you.  These things usually don’t happen with mental illness. Often, people who know exactly how to empathize with someone who has a physical ailment, lacks the words to say to someone struggling with a mental illness like depression.  

                  I have experienced this discrepancy firsthand.  When I was diagnosed with cancer, I heard from so many people.  People rushed to help me.  People asked what they could do to help me.  Don’t get me wrong. I am very grateful for this.  I just wonder why the reaction was so different from my depression. Cancer and depression are both debilitating illnesses.  They both have left me fighting for my life.  Yet they are treated very differently.  

                  Maybe some of the difference lies in the visibility of the two illnesses.  Both are inside of me, but the cancer has outward signs like my hair loss, my weakness, and the changes to my skin.  Depression’s outward signs can be mistaken for me being quiet.  These two illnesses present themselves differently.  People know that cancer is a killer.  The mere mention of the word scares people.  The ability of depression to kill is often misinterpreted as a choice.  That couldn’t be further from the truth.  As someone who has struggled with suicidal thoughts, I can attest to the lack of choice I have over those thoughts.  

                  People hear that you have cancer, or another physical illness and they want to help.  When people hear that you have a mental illness, they often turn away because they don’t understand.  For us to reach a point where mental illness is treated with as much empathy as physical illness, we need to increase knowledge about mental illness.  In my case, I accept some of the blame.  I am guilty of hiding my mental illness.  I have covered it up by blaming something physical.  That doesn’t help grow understanding.  Over the years, and especially this past year, I have learned that I must be open about my mental illness. There is no reason to hide it.  As I have fought depression and cancer side by side, I have learned that both need attention; both require treatment. I know that both cancer and depression can take my life.  Some people in my life understand that I am battling two illnesses. They have been by my side and supported me in both battles.  My wish is that all people who are struggling with mental illness receive the support and understanding they need.  

                  People send cards and flowers when you have a physical illness.  It is time we normalize sending tokens of encouragement to people living with mental illness just as we would when they are living with physical illness.  For this to happen, people living with mental illness need to be willing to be more open.  They don’t have to share every aspect of their illness. It is enough to just acknowledge it.  I don’t tell people everything about my mental illness just as I don’t tell people everything about my cancer diagnosis, but I do acknowledge both.  Acknowledgement can go a long way towards encouraging support and understanding.  Illness, whether physical or mental, does not need to be battled alone. 

                  If you know someone who is living with illness, whether physical or mental, reach out to them.  Send them a card. Offer to help them with something.  Maybe just sit with them and be present. Ask them how you can support them.  Knowing someone cares will go a long way for someone living with illness. 

                  

 

Struggling with My Illnesses

                 I am having a rough time.  I don’t feel well.  In the past not feeling well physically would not be a problem.  I would have just taken an over-the-counter remedy and moved on with my day.  Now, I can no longer do that.  My head, or rather my anxiety, won’t allow me that luxury.  Cancer changed my world in so many ways.  It has required me to relearn how to live.  I have learned to fight a terrible illness.  Cancer has made me more vulnerable both physically and mentally.  As a result, I have learned to accept help.  I now understand that my life has worth.  Those are just a few of the lessons I have learned on this journey.

                  What hasn’t changed is the control anxiety has over me.  The anxiety has increased in some ways.  The last several days my stomach has been upset and I have been somewhat nauseous.  I also have pain in my abdomen near my liver.  This is the same way I felt right before I was diagnosed with cancer.  So, of course my anxiety has latched onto that fact.  I know Dr. St, my oncologist, who I really do trust, has said the liver pain is not likely to be more tumors.  She examined me just last week.  My bloodwork is good.  She has explained all of this to me.  On an intellectual level, I believe her.  I can understand that she is right.  I know I have a pet scan coming up that will likely confirm what she has already told me.  Still, with every twinge of pain and every second of an upset stomach, my anxiety screams in my head.  It tells me the cancer is spreading.  

                  I find myself trying to believe my doctor. I know she is right, but still, I am anxious. I can reach out to my mental health team, to my oncology team, to my primary care provider and her nurse, to Aunt Holly, and to other family and friends.  The problem is none of them have had cancer.  As well-meaning as they are, they have never experienced what I am going through.  Part of me says that shouldn’t matter, but on some level that I don’t understand, it does matter.  Not only do I have cancer, but I also have depression and anxiety disorders.  Each of these three illnesses is difficult enough on its own.  Combined they are hell.  

The anxiety triggers the depression and vice versa.  Worrying about the cancer triggers both the depression and the anxiety.  Not feeling well physically is picked up by my mind, which jumps in and makes me feel worse.  I hate this. 

                  The nurse practitioner in my oncologist’s office called me last week.  She told me how to handle my upset stomach.  I am trying to follow her directions, but my mind wants immediate results.  That is not going to happen.  As I write this, my mind is questioning why the antacids I took ten minutes ago aren’t working.  Of course, I need to give them time.  I know that, but the anxiety that fills my mind tells me it is not going to work.  

                  The worst part is that I have not yet gone to bed.  That is when my mind loves to attack me.  As I lie in bed, I feel the pain over my liver.  My mind shrieks, “More tumors!”  Even though, Dr. St has assured me that is not the case, my mind’s argument is compelling.  I try to replay Dr. St’s words over and over in mind.  I focus my thoughts on hearing her voice.  Despite my efforts, I struggle.  

                  This is the part of being sick that doesn’t get as much attention.  The mind games. I know it happens to some degree for everyone who has cancer.  My depression and anxiety intensify everything.  I need constant reassurance, which makes me feel guilty.  I feel like I am reaching out for help too often.  I don’t know what else to do.  That reassurance is necessary for me.  I need a lot of reassurance.  It is something I cannot control.  I try to talk myself into being calmer.  I tell myself to focus on what Dr. St said.  It is a battle in my head that I can’t seem to win.

                  I am doing what I need to do to improve my depression and anxiety.  Every day I receive TMS treatment.  I believe it will help, but again, I need to be patient.  Every week I talk to Dr. Klein.  I talk to Stephanie weekly.  I have regular appointment with Dr. S.  My mental health is being addressed.  Depression and anxiety are powerful.  They overtake my mind making it harder to fight the cancer.  

                  I wish I could sit down with someone who has experienced what I am going through and just talk.  I attend an online support group for patients with stage 4 cancer.  It helps, but it is not enough for me at this point in my journey.  I am left with the question, “What can I do?”  Right now, I am not sure I know the answer to that question.  I’ll keep searching for the answer. I’ll try to keep reaching out to my mental health and physical health teams.  I know they are willing to help and that it is okay for me to reach out.  I need to remind myself of that.

Cindi, Dr. St’s nurse navigator understands what I am going through.  I find myself reaching out to her more often.  However, I can’t do that in the middle of the night when my anxiety is at its worst.  I struggle more at night, but the days are not easy.  

                  As for the physical ailments I am experiencing, I will follow the advice I was given.  I will eat soft foods when I can actually eat and take antacids and nausea meds.  For my mental health, I’ll keep going to TMS and trust my team to guide me through all of this.  I know that overall, I am doing fairly well.  It is never going to be easy, but I need to believe it can improve.