Let’s get physical

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Fear can make you thin. Fear can make you thin as you tremble and shake at the idea of anything passing your lips. Fear can make you thin as your heart quakes with the first sign of you body needing to eat, needing to be fed, needing anything more than air to keep going. Fear can you make you thin as you snatch up the compliments, gobbling them up, terrified they will stop if you give up, give in, and eat something. Fear can make you thin as you slowly waste away, too afraid to be full, too afraid to be satisfied, quietly lying yourself down with your ever-present bedfellow – hunger. Afraid to start. Afraid to stop. Fear can make you thin.

Fear can make you fat. Fear can make you fat as you gorge and burst and bloat. Fear can make you fat as stuff and pile food into your mouth and body, no longer eating, simply consuming. Fear can make you fat as you open the fridge late at night, afraid to stop, afraid to start, afraid of what will happen if you don’t keep feeling the crunch, the soft, the smooth, the salt, the sweet on your tongue. Fear can make you fat.

Depression can kill you. Not necessarily because you get so sad that you can’t get up, too melancholy that you want to pack it all in one day. Depression can kill you by keeping you awake for years on end, never letting you sleep. Depression can kill you by stealing your energy, dragging your body down and slowing your movement. Depression can kill you by giving your endless headaches, brutal stomach pains, heart problems, Depression can kill you by making you so sick that you finally think it’s going to be a mercy to die. Because at least then you are not in this much pain, this much literal, physical pain. Depression can kill you by breaking your body down.

***

Anxiety is a very physical illness. This is something that gets a little bit overlooked in our assessment of mental illness. We spend a lot of time trying to explain that whilst a mental illness isn’t an illness you can necessarily see in the same way as other illnesses – the whole ‘if you had a broken leg you wouldn’t tell someone to just get up and walk’ comparison – that sometimes we go too far, and pass over the fact that for a lot of people, the reality of living with a mental illness is a very physical one. Yes, it is an illness that lives inside your head, but that doesn’t mean it’s all in your head.

It might be in your stomach, giving you severe gastric problems from constant stress and anxiety. Yes, the anxiety and stress are in your brain, but the inability to leave the house due to constant trips to the toilet is very much a reality.

It might be in your chest, giving you an increased heart-rate and breathing problems when a panicky situation occurs. Yes, the panic attack is happening in your brain but the dizziness that blurs your vision and threatens to make you pass out at work is a reality.

It might be in your immune system, as nights of broken sleep and worry chip away at your health. Yes, the worry is in your head but the constant colds and bouts of flu that keep you away from your friends and stuck in your bed are a reality.

I know from my own experience that mental illnesses are physical illnesses, not just because we want to get people to think appropriately about mental health, not just because mental illnesses can come from a physical discordance in your brain chemistry but because when you wake up every day with a mental illness you wake up sick. You wake up physically ill, and it sucks.

When I wake up with depression I wake up exhausted, lethargic, and the whole day feels like a fight against a deep cloudiness inside my head. I essentially wake up with the worst flu of my life, and I know other people with depression who wake up the same way.

When I wake up with anxiety, I wake up with a headache, heart palpitations, and sometimes a seriously upset stomach. I essentially wake up with a terrible hangover, and I know other people with anxiety who wake up the same way.

When I wake up with an eating disorder. I wake up hungry. I wake up to cramps. I wake up to stomach disorders and extreme fatigue.

And of course, there is medication,  but sometimes medication isn’t enough.I take medication for all of these things – I take anti-depressants that control my anxious impulses and my depressive thoughts, but sometimes they make me more tired, more fatigued. This is something to again bear in mind because like all physical illnesses, treating a mental illness is a process.

It took nearly ten years for my mother’s doctors to find medication for her arthritis that didn’t give her terrible side affects, and the same is true of medication for mental illness. It can take years or incorrect diagnoses, I had a friend whose anti-depressants gave him flop sweats that soaked through bedclothes, and then another that gave him a hideous rash. It takes time, and sometimes multiple other physical problems before it gets right.

It’s also true that in mental illness just as physical illness, sometimes meds aren’t enough. It’s taken my mum years to come to terms with her arthritis, just as it’s taking me time too. It’s taken us both down different paths; counselling, religion, medication, and there are so many divergent ways that people manage whatever illness they have.  The point is though, she will sit down and say ‘My arthritis is playing up.’ If I need to lie down in the afternoon because I feel like crap I often say ‘I’ve just got a stomach upset,’ 

or ‘I’ve just got a headache.’

Why do I do that?

Is it just because I have a hang up? I have a fear or identifying myself in another way? Of letting people know the truth?

Perhaps partly, and I know there are plenty of people with non-mental illnesses who would also hate to identify their own cancer, or arthritis, or heart condition in front of a group. But mostly it’s because as a society we don’t think mental illnesses mean a physical disorder. If I said that I was taking a sick day due to anxiety, my boss might have some questions where she wouldn’t have if I had tonsillitis. As a society we associate mental illness with words like sadness, morose, melancholy, or worse: Crazy. Unstable. Dangerous. What we don’t do is associate them with words like acute pain. Extreme fatigue. Chronic insomnia. Intense migraines. So we often see a lie, rather than the truth.

The truth is I have depression and anxiety and an eating disorder. The  truth is that they are physical illnesses, affecting my body physically, and today I need to treat them physically.

Depression isn’t just sadness. Anxiety isn’t just worry. It isn’t all in your head.

I encourage you that if you are struggling with your own problems to not be ashamed of the fact that you are physically afflicted by a mental illness, and not to belittle it. What you experience is real, it is what is happening as part of your illness, and it should be understood by more people and you should not have to be embarrassed by that. Discuss what you are experiencing with a medical professional, see if they have some help to give. And if you need someone to ask questions to or talk to, please message me or get in touch.

I also encourage you if you have friends or family who you know are struggling, to try and be aware of the physical reality they might be facing. You might know about their mental illness and be in good habits of checking in on them about it, but are they managing a physical reality that you don’t know about? Do they seem tired all the time? Do they seem to struggle to eat sometimes? Maybe they are exhausted, maybe they are having digestive problems, maybe they are experiencing these painful things in silence, with no one to talk to about them. Maybe they just need to be told it’s okay to miss that dinner party, or it’s all right to stay at home on new years eve and take it easy. Maybe they just need to hear from you that you understand the physical strain they are experiencing. That you don’t think it’s all in their head.

Because what is more comforting, affirming, and kind than hear that that from someone you trust or respect?

It’s not all in your head.

 

The Christmas Blues – how to help

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There are beautiful things to look forward to this holiday. Precious time spent with family. Wonderful lie-in’s from days off work. Reunions with old friends. The giving of specially chosen gifts that have been lovingly bought, craftily hidden, and delicately wrapped. These are beautiful things to look forward to, and what gives me hope in the dark winter days. But it wasn’t always this way. When I was a teenager I dreaded the coming of Christmas and wished for it to pass quickly.

My depression had always worsened in the winter; for many years I had never even heard of SAD (Seasonal Affective Disorder) and just thought that I hated Christmas, that I was the teenage Scrooge and doomed to ruin Christmas for my family.  It wasn’t until I went to University and met people similar to me, (one of whom had a SAD lamp which she used for study in the winter) that I started to put two and two together – my own picture of my mental health diagnosis began to come into focus. Then when I was young I feared the Christmas season because it only served to draw attention to my eating disorder – it’s pretty hard to claim that you just ‘don’t feel like it,’  every single time your friends or family offer you chocolate over the 12 days of Christmas, and to fight with your family at every big meal. By the time I made it to University I started to enjoy the actual Christmas celebrations and could manage the food side of things well, but the idea of spending a week cut off from my normal routine and my support system was downright daunting, if not terrifying. And these were all feelings I had to hide – because being depressed at Christmas means you are a grump. A Grinch. You might as well be kicking Tiny Tim whilst you’re at it. And that’s all before we have got to the crushing social anxiety and emotional pressure that is New Years Eve.

And yet we know now that it is incredibly common for people to feel depression around the holiday time. Even the cheeriest person can be brought to the lowest sloughs of sadness after seven solid hours of Christmas shopping. So why do we put harsh labels on something that so many of us struggle with? Why is it worse for a person to be depressed over the holidays than it is in February, and why does our compassion adjust accordingly?  After years of struggling, my depression still intensifies at this time of year, and I know it is very similar for other friends with depression and anxiety disorders. And yet I am often more afraid to reach out to people at this time of year, which makes the moments when they reach out to me and offer their understanding and compassion even more valuable.So what can you do to provide those moments of relief for your friends and family who struggle? How can we contribute to removing the stigma of depression in the holidays? How can you help make someone’s holiday easier to get through, and maybe even festive?

Here are some of my thoughts:

  1. Dial back the Pressure

Sometimes it’s just all too much. The parties, the people, everything. In the past it has been so great just having someone in my life who actually says, ‘well, we don’t have to go,’ rather than ‘Oh you’re not coming? But it’s CHRISTMASSS!’ (response: I know it’s Christmas, but I’m still gonna have a panic attack in your bathroom if I come to your party, Kay?) I love my friends, and I don’t want them to think I don’t value them or the plans they make, but sometimes I can’t manage my mental health well enough to meet their expectations. On those occasions, it is so amazing to have friends who will respond with kindness, or extend invitations that let me know they understand. Saying, ‘Hey, I’m having this party and I would love to see you, but I know you’re really tired and stuff so if you can’t make it, it’s totally fine,’ is amazing. It takes all the pressure off, and if you can follow it up with ‘perhaps we can have coffee sometime, just the two of us?’ then that’s even better.

2. Make new traditions 

Traditions can be a real stresser – the idea of having to go somewhere and be a particular thing can be incredibly pressurising, especially if a person has a disorder or a mental illness that means they can’t really partake of traditions in the same way other people can. Maybe they have a serious eating disorder and the idea of a rich, full-on, holiday of eating gives them a total melt-down. Maybe their depression is so inhibiting that they can’t get out of bed, can’t go to church, can’t make it to the annual carolling session by the big tree. Maybe their social anxiety is so crippling that the idea of that office party is keeping them awake at night. In these cases, think about what might make them feel included, not excluded. One of the biggest pressures of Christmas is the idea of not being able to join in when you feel like you should. Mental illness pushes you away from the people you love, and sometimes it can feel like the traditions are actually pushing you even further away from those people. We can battle it by making new traditions to pull people together. I can assure you, they don’t want to miss out, or miss out on important time with you.  Maybe you make Turkey sandwiches instead of turkey roast, or assure your friend that they should only eat what they feel comfortable with. Maybe you take a some crafts round to your friend who is having trouble getting out and spend some time making Christmas decorations together. Which brings me to –

3. Talk to them

The question ‘How are you?’ when asked over Christmas seems like it can only be answered one of two ways: ‘I’m amazing! Happy Christmas! WOOO!’ or ‘I’m so stressed I still need to decorate/shop/cook etc…’   There isn’t much space for a person to be very honest, and confess that actually they are really riding a down-swing into depression. Part of the reason this is so difficult is due to the threat of being told you are un-festive, or ‘bringing everyone down.’ If you can acknowledge to your friend that it is possible to feel down in the holidays, then they might be able to feel safe enough to be open about their mental state. Saying, ‘hey, I know you get down sometimes, how are you coping at the moment?’ might open them up to a place where they can tell you some of things that are making things difficult, or some of the things that could help. Which leads quite nicely to ….

4. Work out what they need.

Do they need company? Do they need time alone? Do they need you to pick them up and take them to the cinema where they can sit in the dark for a couple of hours and not talk to anybody but still not be alone? What do they need to keep their mental health in good balance?

By talking to them and asking them you can work it out together. It is easy for a person to offer suggestions about what you can do to feel better, but saying ‘Well maybe you should get out of the house more,’ is harmful. Saying something like ‘well, can I come and pick you up tomorrow and we can go to coffee, or wherever you feel comfortable?’  might be the life-raft they need to survive the holiday. It’s the difference between someone telling you what you need to do to make yourself feel better, and someone offering to make you feel better. Which would you prefer? My husband has become very good at knowing when I need to sleep away my anxiety, when I need to leave a party early, when I need to climb into bed and not get out for a little while. Like other people with mental illness, I have a pretty good sense of these things for myself, of my own limitations and needs, but it can be exhausting. It makes a huge difference having a person step in and offer to help you like this, even if it is just suggesting that you meet for a cup of tea and a chat.

5. Remember, you don’t have to compromise your own holiday spirit!

If you are a super positive and happy person around Christmas time, I know it can feel a bit awkward around people who are struggling and feeling low. Sometimes it can feel as if you shouldn’t be positive and happy in their presence, like you’re not taking them seriously. But you should be! You should be who you are. I have some incredibly positive and excitable friends who LOVE Christmas and relish every moment of the festive season and when I’m having a terrible day and wish Christmas was over I still want them to be who they are. Sure, we’re not the same, but it’s not as if I wish they were more laid back, I just really wish I had the energy to keep up with them. My friends help me do this by bringing all that joy that they have, all that energy, but just containing it within a context that is helpful for me. Whilst a giant party wouldn’t be good for someone like me, watching a festive movie together would be great. Everyone’s different, but a friend who shuts themselves off from you because they think their cheer won’t be helpful for your depression is just cutting you out. Bring your Christmas spirit into my dark little space, if you are willing. It might even raise my spirits, and make me feel included in your celebrations.

Those are my tips, and they are based solely on my experience and the experiences of my friends. Everyone is different and needs different things, but one thing is for sure – friendships keep people going.  I don’t want to feel cut off from my friends, or like we can’t celebrate together because I struggle with my depression and anxiety around the holiday season. We have new traditions, we try to make things less pressured for me and for them, and we talk about it and work it out. You can too.

The holidays can be difficult, but by understanding where we are at in our mental health and understanding the mental health of our friends and family, we can go a long way to making them a lot easier.

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Article about holiday depression: http://www.healthline.com/health/depression/holidays#2

Information and tips about how to cope over the holidays: http://www.health.com/health/gallery/0,,20550695_2,00.html

Information about Seasonal Affective Disorder (SAD): http://www.nhs.uk/Conditions/Seasonal-affective-disorder/Pages/Introduction.aspx

 

When all I had was You

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I’ve been thinking and writing a lot about mental health recently, and the response I have received has been incredible. My whole reason for becoming more direct with my blog about mental health was so that people felt they could have discussions, have someone to talk to, find a starting point, and I’m totally open to that here if you want to get in touch. It’s been great to see so many people have come out of the woodwork of my life and begun to ask questions, tell their own stories, but also wonder how they can help. Sometimes me, but often time people in their own lives who they find are suffering from a mental illness.

I came across this post on buzzfeed – a list of 18 ways you can help someone going through a hard time submitted by readers -and I began to think about the things that had meant so much to me.

The time my house-mate set up a den in our living room, made delicious pancakes and put on my favourite disney movie. Because ‘disney makes everything better.’

The time my friend gave up her tuesday morning once a week to drive me to therapy, sit in the car and wait, and then drive me home whilst I cried.

The friend who committed to meeting me for coffee after every therapy session to make sure I was okay.

The same friend who established a sunday morning breakfast tradition at her own house so that I wouldn’t feel anxious about going to church alone.

The friend who watched endless episodes of Dr. Who with me in the small, darkness of his living room.

But one thing on this list really stood out to me. Number 10.

‘Have a sleepover.’

As soon as I read that,  I was taken back to the times at University when I was too terrified by my awful anxiety to sleep alone. With my boyfriend away at another university, My friends tried to help me manage my night terrors as best they could. I slept on friends’ floors, my room-mates came and slept in my bed enduring my need to have ‘Gilmore Girls’ playing on a loop all night long.  One of my friends spent a whole night with me completely last minute, unable to leave me alone with my panic. He slept on top of my duvet fully dressed and holding my hand all night. One friend in particular took me in, made a bed on her floor, leant me pyjamas and gently woke me from my night-time panic attacks with her comfort and kind words. Although this poem is for all of them really, I think the most of her.

When all I had was You

Somewhere in the blue night,

between waking and sleeping,

I am awakened by my own red thoughts

with a gasp –

a child rearing out of the muddy, tangled waters

of my dreams –

their weeds burning my limbs and crushing

my chest.

 

I cannot breathe.

 

Outside the stars are dark and gone,

the night sky an empty hole in the universe

which I am falling through.

The street-lights puddling their orange light

hellishly, brokenly,

casting shadows on my heart.

 

But you are there.

 

A cold hand between my shoulder blades,

caressing my fretful wings.

Soft words sliding over me, washing away

my sweat and fear, and calling my back

from my need to fight,

or flight.

You lie beside me, a friend,

a sister, a godsend.

In these endless small hours you are my

penitence, my altar, I cower at your knees

begging for comfort.

 

Benevolent always, you provide.

 

Your presence pours it’s way into my

broken mind, a blend of honey and lavender,

the balm of peace, and I am astounded

by your goodness, your power.

In my minds eye I am infinitely smaller, and

cradled inside your golden arms.

 

In the morning I roll over to face

the cold dawn and

There you are, my best friend,

with hair mussed and chipped toenail varnish,

lolling across the side of the bed.

The only evidence of the dark night

is the grey rings around your eyes

and that interminable groan when the

alarm sounds.

 

Your tremendous normality startles me,

but I know who you really are.

It’s just Uni

I am sitting in the common room at University, eating my way through a whole packet of biscuits. I have just received a terrible grade, and this is the first food I have managed to eat all day. Later I would punish myself mentally for this slip up – I would take away from my evening meal and go to bed hungry, stressing about what I should and shouldn’t consume. Eating at University is turning out to be one of the hardest things – with no one who knows me to notice when I slip back into my old habits, with family far away that are too easy to lie to and a boyfriend I still try to hide things from, it’s all too easy to pretend it’s not really happening. It’s not back to where it was.

I am standing by the railings in the dark, watching the waves catch the light from the golf club, and I cannot stop crying. I cannot go home, to my room mate and my studies and the bright lights of a public university home, but there is nowhere else to go, no friends I trust well enough yet to call. I am paralysed by my own fear of how afraid I am, how lonely I am, as if I were to say it out loud, it would ruin me completely. So I stand, in the dark, the freezing breeze off the north sea searing my tears into my cheeks. I can’t stop thinking about walking into the sea and closing my eyes.

I am waiting in the doctors office, clasping my mental health questionnaire in my hand. Two weeks ago I broke down on a plastic chair in my doctor’s office, and he sent me home with this questionnaire – a selection of cartoon happy and sad faces, a poorly executed scoring system rating my emotions from 1-10 – and gave me two weeks to see if I was simply sad. Even now, holding the piece of paper that tells me my melancholy has taken me deeper than homesickness or the blues, I torture myself with wondering if maybe, actually, there is nothing wrong.

Maybe the shaking in the middle of the night, the inability to sleep, the terror of being alone, the panic that comes when faced with food and the absolutely crippling lethargy is simply evidence that I am just bad at University. Bad at life. Maybe it’s me. Maybe it’s all me.

‘It’s just Uni,’ some people said. ‘It’s just what it’s like.’

It’s not just Uni. If it was just Uni, it would get better when Uni stopped. If it was just Uni, then it wouldn’t follow me around when I was back at my parents house, it wouldn’t loiter in my Christmas and Easter breaks like a bad tune in the back of my mind.  But even if it is ‘just Uni,’ does that mean I have to live like this? Fearful, sleepless, stressed, anxious, exhausted? Even if it is ‘just Uni’ don’t I deserve to feel better? Don’t you?

Yes, you do. There is no such thing as ‘Just Uni.’

Triggers for anxiety and depression come in all shapes and forms. A burglary. A mugging. An incredibly stressful job. A significant death in the family. A terrible medical diagnosis. And yet we rush to qualify our feelings. It’s ‘just’ stress, it’s ‘just’ exhaustion, as if our mental health were a mouth ulcer that would clear up in a day or two. It’s remarkable. If you were really struggling after being told you sick with an incurable disease, would anybody say, ‘Oh don’t worry, it’s just the cancer?’

We pretend we don’t have a rating system inside our head that tells us when its appropriate to be sad, or to be sick, but we do. And as a society, we generally don’t believe that mental health is sickness. And if it is, you can only get it if things have been really, really bad. And we have a very clear idea of what Really, Really bad means.

It doesn’t mean University, moving house, losing a pet, or struggling to be employed, even though these things are perfectly capable of sending a person into a spiral of depression or self-doubt that can damage their mental health significantly. Instead we view these things, these triggers, as mundane facts of life. Things we should be able to ‘get over.’ It’s ingrained in us.

‘Man up.’

‘Push through.’

‘Deal with it.’

‘Get over it.’

But what happens when we can’t ‘get over’ it?

Suicide remains the leading cause of death for men between the ages of 20 and 34. A lot of those men might well have been at University. During my time at University there were several suicides – all of them men, all of them with reputations for being happy, kind, interesting individuals. But it’s just sadness, it’s just being low, it’s just getting stressed. It’s ‘just’ Uni.

It’s not ‘just’ Uni. It’s not ‘just’ anything. It’s many things, could be several things, it might be a combination of a chain of events in your environment, or it might be a imbalance in your brain chemistry that you have been fighting all of your life. One thing’s for sure – it’s definitely something. If the symptoms are real, then the problem is real.

I have graduated University now. I made it through in a way I never thought I would, but there was so much darkness. So much hard work to be done, not just in the classroom but inside myself as I fought to keep myself alive.

This week I am writing about mental health with an openness that has frightened me in the past, but I am doing it because, like me, there are people who need to be heard and need to speak out. Who need to say the words to someone for the first time – ‘I feel depressed.’

or, ‘I think I might have anxiety.’

or, ‘I am really struggling with my eating.’

Maybe you are at University, maybe you aren’t. The article that prompted this post was about university anxiety, and can be found here (http://www.buzzfeed.com/maggyvaneijk/no-one-likes-me-anyway?bffbuk&utm_term=4ldqphz#4ldqphz) Maybe you still struggle with something and you need to be heard, for the first time or maybe for the hundredth. I am sure there are people who wish to hear you and be there with you, but even if there aren’t, I am.

This week I am being as open about what I go through and as available to people who might be going through it too as I possibly can be. To hopefully give someone that extra ear, that figure in the darkness listening to me, that I struggled so much to find at the beginning. But even though it seemed to be at the time, I can swear to you that it is not impossible.

 

Being mentally healthy

It’s mental health week on one of my favourite websites, and after years of posting thinly veiled references to my mental health on my facebook account (articles about mental health, stories about eating disorders, government plans to cut spending to mental illnesses etc) I decided to post a link to this blog – the evidence of me being mentally unhealthy. Mentally devastated. Mentally broken down.

I realised, looking at this very major website as it posted stories of celebrities eating disorders and anonymous tales of struggles with OCD, just how hard it is to be open and honest with the people around me, the people I interact with every day, about my position as a person who struggles with mental health. I realised how easy it was for me to write a post to my friends detailing problems at work, problems in family, and anything to do with my political views, but the idea of simply writing down – ‘I am very depressed today,’ and clicking ‘post,’ was unthinkable.

When I do identify my problems –  I, like most people, like to identify in the past. ‘I was depressed.’

‘I had an eating disorder.’

‘I really struggled with anxiety.’

These things aren’t untrue, there have been specific periods of my life when I have been very unwell,  but they certainly don’t give the whole picture. They don’t say that every day I wake up and take a little green pill, because when I don’t, I might not get out of the bed. They don’t say that everything I eat, every morsel I put in my mouth, is a tiny, tiny victory. They don’t say that I am a castle of a human being, built with lines and lines of necessary battlements to keep the monsters of anger under control and away from my soul.

So I decided to say it. Say that, yes, whilst it is my past, it is also my present, and might very well be my future. There have been times when my depression has been crippling, when my problems with eating have nearly ripped up my family, when my anxiety has ruined my friendships, and there are times when these things are like a minor headache you fight with some ibuprofen or some paracetamol. Still there, but fading slowly. Today, tomorrow, things are not as bad as they have been, but every time I put my problems in the past tense, I know that I am lying a little bit. I am being a traitor to the truth that I know: that mental illness is not a phase. That depression can be as persistent and brutal as a degenerative disease. That suicide is a symptom and not a failure.

In this place, to the people who have read this blog and followed this journey, none of this will be a surprise. You have watched my broken poems emerge from the darkness, watched my stilted prose try to give shape and name to something I barely understood. But to those who might be looking for the first time, for whom this might be the first moment you have equated the woman on your newsfeed with a mental illness, I just want you to know that since I am done mincing my words about my mental illness, I invite you to be honest too. If you have questions, if you have thoughts, if you want to talk, or even if you have anger and sadness you need to express then I am here for you. By admitting that I am still here, that I am still in this place and working through all of these things at my own slow run, I am hoping I am creating a space for you to talk too, if you need it.

I have depression. I have anxiety. I have problems with my eating. Sometimes I have them all at once, sometimes not much at all, I’ve had them in the past and I might not have them in the future, but mental illness is my present tense.

If it’s yours too, then we are here together, at least.