INSIDE OUT: A LOOK THROUGH THE EYES OF THE MENTALLY ILL
The wide world of emotions... sadness, anger, happiness, guilt, sorrow... the list goes on and on. All of these various emotions, how we react to these emotions, and just every single thing about these emotions... make up what we call: MENTAL HEALTH.
Now, what is mental health? Or what is a lack of mental health (mental illness)? What does it look like? What does it feel like? To be honest, if we haven’t experienced something first hand or studied it intensely, we most likely have no idea. But we should have an idea! Because more likely than not (it’s almost guaranteed), someday, you will struggle with mental illness or someone close to you will (if you or they haven’t already).
As a psychiatric nurse and professor, a survivor of domestic violence, a wife to a husband who suffers from Bipolar, and a person who lives daily with OCD and PTSD... I am such a passionate advocate for mental health and eradicating the negative stigma surrounding mental illness. I truly believe (or I’d like to think) that more people wouldn’t give mental illness such a bad rap if they were more educated about it. Education can provide the means for acceptance in many areas of life.
So, that’s what I’m going to try and do in this post!! I’m going to use my knowledge/personal experience in mental health, my love for Disney, and my creative mind to show you what mental illness is really about... or at least give you a better idea. And what better way to do that than with the characters from Inside Out?!
MEET SADNESS
Sadness… she is the face of depression, hopelessness, and thoughts of not worth living. Depression is an illness like none other. It’s that feeling of not wanting to get out of bed. Or even sometimes, physically not being able to get out of bed. The detrimental effects of depression don’t just stick to the brain… they travel throughout the body… causing chronic pain, lethargy, and an overall inability to function. I have had small bouts of depression throughout my life, but nothing like the chronic feelings of emptiness, pain, and hopelessness that people with long-term depression suffer with each and every day.
My husband, Dan, suffers with Bipolar I Disorder, and mainly suffers from the depressive side of this debilitating illness. He has been suffering with this illness for over 10 years, and as his spouse, I have seen how catastrophic it can be. There are many times where Dan has believed that everyone in his life would be better off if he wasn’t around. Has he had thoughts of suicide? Absolutely. When he was in college, he had to take some time off because his depression, suicidal thoughts, and hopelessness became too much to handle. Just put yourself in the shoes of someone feeling like this for a minute. Reach long and hard to find those empathetic feelings. Imagine being so sad that you don’t want to be on this earth anymore. Just really, really imagine that. You have to feel so low about yourself and so hopeless about your future, that you believe the only option you have is to take yourself from the life you live. That sincerely just breaks my heart. Many people describe suicidal thoughts as tunnel vision. Things have become so dismal, that the only light at the end of the tunnel they see is suicide. They truly see that as the only way to make this unbearable pain stop.
Okay… so, what about everyone that tells people with depression to, “snap out of it”… “just get over it”… and all the other insensitive phrases? Well, let me ask you this… would you ask someone with cancer to, “snap out of it”? Would you ask someone with a broken leg who can’t walk to, “just get over it”? I don’t think so. So, what is it with depression that makes it so difficult for people to understand that this is a REAL medical problem? Because it is a real medical problem… people who have been diagnosed with depression have a chemical imbalance of neurotransmitters in their brain. Their brain isn’t getting enough of the neurotransmitter called, Serotonin. As a psychiatric nurse, I truly think the main issue is that there are no “tests” to prove mental illness. For example, with cancer, you can see the cancer in the body with different types of imaging and scans. You can literally see the cancer. Or even with something like Diabetes, you can see various lab values that lead to a diagnosis of Diabetes. But with depression, and other mental illness, there’s nothing. There’s no imaging… there’s no lab values… there’s no x-rays. Depression and mental illness are diagnosed by a patient’s actions, their thoughts, and words. That’s it. So, this is where I feel a huge disconnect comes into play, and why many people still think depression and mental illness aren’t real.
So, how do we help people with depression? What kind of treatment is out there? I think first and foremost, we all need to put on our empathy shoes and truly try and feel how these people feel. We need to feel WITH THEM. We don’t need to feel sorry FOR THEM. That’s sympathy, and sometimes, these feelings of sympathy can really put a barrier between you and a person struggling with depression. You need to be empathetic with them. People suffering with depression also need to feel that their feelings are truly validated… they want their feelings and thoughts to be heard. Many times, we are conditioned to try and fix everything. Someone tells you they’re depressed… okay!! Well, let’s get to exercising, talking to a therapist, and this and that. NO. Sometimes (a lot of the time) people with depression just want you to listen. Just listen… that’s it.
But what about more professional means of help? There’s counseling… and a bunch of different types of counseling, at that (CBT, DBT, talk therapy… the list goes on). There’s obviously different types of anti-depressant medications to try. Along with that, there are certain magnetic procedures to try, like TMS. And there’s also more holistic methods of treatment… light therapy, essentials oils, yoga, and so much more! The main take away from this paragraph… THERE IS HELP. And there’s always new treatments and medications becoming available!
One more very important note that needs to be said about depression… I never think suicide is the answer. Are there moments when suicide seems like the only answer? Of course. But I genuinely believe that with the right treatment team, support system, and resources… people with depression don’t need to view suicide as an option either. I never want to come off as insensitive by saying, “suicide is never the answer”, but that’s what I truly believe. I’ve been in dark places, I’ve seen Dan in dark places, I’ve seen patients in dark places, and I’ve seen people I know take their own lives by suicide… it is not the way. So, if you’re reading this and you’re struggling with suicidal thoughts, I beg of you, get help NOW. Help is always there for people who ask for it.
MEET FEAR
Fear… he is the face of anxiety and panic. Anxiety and panic come in many forms… OCD, PTSD, phobias, generalized anxiety, social anxiety, and so many more cumbersome disorders. What is it like? It’s an overwhelming feeling that your entire world is crashing down on you. You can’t breathe… you can’t see straight… you can’t function. Anxiety disorders are crippling, and sometimes, feel completely uncontrollable. But what do I know, right? Well… I know a little bit. I was diagnosed with OCD and PTSD about 5 years ago, and still struggle with the effects of these nasty disorders to this day.
But wait? What is OCD and PTSD again? OCD stands for Obsessive Compulsive Disorder, and PTSD stands for Post-Traumatic Stress Disorder. There’s a lot of stigma and misconceptions with both of these illnesses. Many people believe that OCD is just washing your hands a lot, and many people believe that PTSD can only be diagnosed in veterans. Both of these couldn’t be any farther away from the truth. What’s my journey like with these illnesses? Not fun, I can tell you that.
To give a little history… I was in an abusive relationship for about 3 years, and that is what really put me over the edge to develop my OCD and PTSD. After I escaped that relationship, things just were never the same. I started noticing some really odd thoughts I was having, and actions I was taking. What were some of these thoughts and actions? I had this constant fear that I was going to die. So, then I would do things like check my pulse and listen to my heart beat. But not just once… I would do it over and over again throughout the day. I would have thoughts that I accidentally hit someone while I was driving. So, then I would turn my car around and drive back to where I just was and check to make sure I didn’t hit anyone. But you know what was the stinger of it all? I KNEW in my head that I didn’t hit anyone. Rationally, I knew I didn’t hurt anyone with my car… but my brain kept working overload to convince me that I did. That’s the demon inside of OCD… the person suffering from OCD understands how irrational their thoughts are, but they still can’t break the cycle of obsessing over such thoughts, and performing compulsions to try and get rid of such thoughts. My list of obsessions and compulsions goes on and on… and I do still struggle with some of them to this day.
But what about the PTSD? My PTSD showed itself in a different light, but was as equally not fun. The nightmares were the worst. I would have the most vivid nightmares… that I was back in my abusive relationship… that I was stuck once again. And the most terrifying nightmares I endured? I would start dreaming of being in a happy and healthy relationship with Dan, and then slowing over time, Dan would morph into my ex. I would wake up in a panic from these nightmares. They would be so real to me that I would have to look over at Dan in bed to make sure that it was, in fact, him. That’s how real these nightmares were. So, what did I do about all of this?
I went to the psychiatrist. He knew right away that I was suffering from OCD and PTSD. Before the psychiatrist, I had gone through a handful of counselors and therapies, and nothing was helping me. That’s when the psychiatrist recommended some medication therapy. I was extremely hesitant, at first, but I eventually complied, and I am SO happy I did. I started on Lexapro, and am now on a higher dose of 30 mg once per day. Patients with OCD tend to respond more effectively to higher doses of anti-depressants. In fact, I reacted so well, that my psychiatrist said he has actually never seen anyone react so positively to a medication. While I still have the obsessive thoughts come into my head, they are much less in severity and I do not act on the compulsions as frequently. And with the PTSD, I started on a medication called, Minipress, that helps with the nightmares. Another miracle drug! Minipress is actually a blood pressure medication, but for some strange reason, it helps with PTSD related nightmares. I now have no more nightmares related to my abusive relationship!! How amazing is that?!
So, if you are living in a constant state of fear and panic… there is hope!! You don’t have to endure these feelings without any help from professionals. While medication therapy can be very effective for some people, it’s not for everyone. There are a plethora of non-pharmacological treatments available too, such as EMDR, exposure therapy, CBT, and so much more!
MEET DISGUST
Disgust… she is the face of negative stigma, and the face of embarrassment… embarrassment to receive mental health treatment. How long did it take to start receiving mental health treatment for me? I would say about 2 years… 2 years too long. Does Dan still feel uncomfortable talking to others about his Bipolar? Abso-flippin-lutely. Why? Because he still gets the looks. The looks that when he says he has Bipolar, people automatically think he’s going to instantly start taking off all his clothes, running around the streets, and start screaming. Do people with Bipolar do this? When they’re manic… yes. But that is far and few between. And guess what? People who stay on their medications, rarely have manic episodes. IN FACT, they live a fairly high functioning lifestyle. Yay!
But I can guarantee 110%… everyone who has struggled with some form of mental illness has felt guilt, shame, embarrassment, and the blunt effects of negative stigma. But here’s a question… where does all the negative stigma come from. Oh boy… we really have history fighting us on this one. Let’s take a look…
To start, there is SO MUCH history on the treatment of mental illness and how it has evolved. There are books, college classes, websites, and so much more dedicated to this topic. But for the sake of everyone’s time, I’m just going to give a brief overview on things.
In the “olden days”, people who suffered from psychosis (mania from Bipolar, Schizophrenia, etc.) could have been viewed as demons, witches, and any other type of derogatory figure. Guess what they did with them? They either killed them, excommunicated them, or locked them away for life.
Remember those ghastly “psych wards”? Yeah… those probably weren’t much fun. People got locked away… sometimes for life, and treated like garbage. They were chained up, beaten, stripped of all their clothing… and the horrible list goes on. And these establishments were supposed to be “therapeutic”. Where is the eye rolling emoji when you need it?
Even in little things like the words we use in today’s society. For example, we often say that someone “committed” suicide. Well, when most people think of the word “committed” they think of a crime or something illegal. So, utilizing this word alongside suicide automatically gives it such a bad connotation. Suicide is a terrible effect of mental illness. Just like someone can die of pneumonia from AIDS… someone can die by suicide from depression.
And don’t even get me started on the media and movie industry in how they portray mental illness. If you actually want to watch a legitimate movie about mental illness, please check out “A Beautiful Mind”. To this day, it’s still one of my favorite movies.
So, what can you do to help decrease the negative stigma surrounding mental illness? Talk about it. Educate yourself. Be compassionate. I’m not saying that everyone who reads this needs to become a loyal advocate for mental illness. To be honest, it’s not everyone’s passion in life. But what I am saying is that people should be aware of it. But really, all in all, everyone just needs to be kind. You never know what someone is struggling with behind closed doors. Simply treat everyone with empathy and gentleness… and the world of mental health and illness will be a much better place.
MEET ANGER
Anger… he is the face of everything frustrating and difficult related to mental illness. Is having a mental illness frustrating? OH YEAH. It’s bad enough you have this condition that is seriously weighing down on your life… but some of the most frustrating aspects of mental illness is the treatment that comes along with it all. What does that look like exactly?
Finding the right psychiatrist. I can’t even begin to tell you how frustrating it was to find an actual good psychiatrist for Dan. And when I say “good”… I mean someone who actually cares about his well-being, is educated about his medications, and checks in on him. One psychiatrist he had let him go off his Bipolar medications. What?!
Finding the right counselor. To go along with finding the right psychiatrist… finding the right counselor, and one that you feel comfortable with can be even harder! Why? Because every time you visit a new counselor, you have to tell your story over again. And again… and again… and again. It can be so tiring and draining. And quite frankly, it leaves many people giving up on the hope of counseling.
Finding the right medication regiment. This is probably one of the most frustrating aspects of mental health treatment. Let me give you a little glimpse here… a patient is starting on an anti-depressant. After a few weeks, the patient starts having horrible side effects. So, the psychiatrist tapers the patient off that medication (which can take multiple days, and sometimes even weeks). The patient starts on another medication… only to find out they are allergic to this medication. The patient then tries a third medication, but it doesn’t really seem to be helping. Oh yeah… you really have to give about 6 months to let the medication reach the therapeutic level. Are you serious…? Can you now understand why a patient may get a pinch angry at this entire process?
Finding support from your family and friends. Would you guess that a majority of my patients don’t have a healthy support system? TRUTH. Many of my patients have gotten divorced, lost custody of their kids, broken bridges with family members, or simply don’t have loved ones who accept them for their mental illness. Wow. That last one is kind of sad, isn’t it? Trust me when I say this… the treatment of mental illness is a team effort. You need all the teammates, coaches, and cheerleaders you can get! And many people who don’t have a support system wind up homeless, in multiple psychiatric hospitals, or worst of all… taking their own life.
Finding meaning in life. The biggest struggle with mental illness… finding meaning in life. So many times, I have heard… “What am I doing here?”… “No one would really miss me if I were gone.”… “Everything is just blah.”… “I just feel like I have no purpose in life.”. How does one find meaning in life? The answer is… I have no clue. Why? Because to find one’s meaning in life is completely subjective. Some people find it in their faith, where other people find it in their job. You can’t tell someone how to find meaning in their life… they have to figure out that one for themselves. And let me tell you… that is so extremely difficult for some people.
Just like any other medical condition, mental illness has an ongoing list of challenges, difficulties, and obstacles. And most of the time, it’s a lifelong illness. Running into all these barricades can lead to frustration, anger, and in the end… ultimate surrender. So, when you think that mental illness is an easy fix, or that someone can just “pop a pill”… think again.
MEET JOY
Joy… she is the face of pure happiness and the feeling of being content with life. Joy is the epitome of a healthy mental state. Oh, if we could all feel like Joy, right? While it’s not very realistic to be joyful every second of every day, there are small steps we can take each day to become a happier version of ourselves…
PHYSICAL ACTIVITY
You’ll hear this one every single time. Being physically active will lead to a healthier mental state. Getting out and moving releases Serotonin, which is that “happy feel” neurotransmitter. And when we release more Serotonin, we feel happier!! And let me set the record straight… this does not mean you need to go out and do an hour of intense hit workouts. Absolutely not. Even just walking around for 15 minutes is so good for your mind!! And also, don’t forget… participate in a physical activity that you actually enjoy!! Don’t like running? Try biking or rollerblading instead!! Engage in an activity that you love, or get out there and try something new!
One of the most important aspects to remember about mental health and mental healing… it’s all about baby steps. Maybe you can’t get out and walk for an hour… but you can get out and walk for 15 minutes. Maybe you can’t run that 5k you used to be able to run… but you can run a half mile. And you know what? Hopefully with further healing, you’ll be back to being able to run that 5k. Mental health healing is not a sprint… it’s most definitely a marathon of healing.
HEALTHY DIET
While eating healthy is typically associated with positive physical health, it’s also associated with positive mental health! There is so much research being done on how certain foods are better than others when it comes to mental health… new information is being discovered almost every day! But here are some little tips on how to bring up your mental health in relation to foods you consume…
DO NOT eat foods or drinks that contain a lot of sugar. Too much sugar can contribute to higher levels of depression and anxiety.
DO NOT drink alcohol. Alcohol is a depressant, and leads to higher levels of depression. So, if you already struggle with a lower mood, and you drink alcohol, your mood will fall even lower.
DO eat dark leafy greens. These types of food help protect the brain, and serve as an extra defense mechanism against depression.
DO eat complex carbohydrates. These foods (quinoa, brown rice, whole grains) provide the body with good energy, and help fight off feelings of sluggishness.
DO NOT eat processed foods. Processed foods tend to fluctuate your energy levels too quickly. So, you’ll be feeling tired one minute, and then okay the next minute… then back to feeling tired again.
I could go on and on about different foods to eat to help strengthen your mental illness… but there’s probably a word count limit on each blog post. Hehehe! But if you’re looking for more foods to add to your diet, make sure you’re finding your information from a reliable source (like a medical journal or research article)!
MEDITATION
Meditation (or yoga) is an absolutely amazing activity to partake in when trying to better your mental health. Meditation has been known to help lower stress levels, improve sleep hygiene, and help regulate emotions. When you slow your body and mind down to practice the art of meditation, you will be contributing to a more overall positive life outlook. If you’re a little hesitant on where to start for meditating, I would search on YouTube for beginner meditation practices.
JOURNALING
Journaling is something I would ALWAYS talk with my patients about doing when they were in the hospital. What is it about journaling that can be so helpful? Journaling is another way for people to express their thoughts and emotions. Many times, it’s really difficult for people to talk about their emotions, feelings, and experiences. So, instead of keeping that all bottled up inside, they can slowly start to express themselves through journaling. This way, their feelings are getting released, but they’re not having to talk to anyone about it. And I’d also like to mention… journaling is a form of art. And maybe, writing in a notebook isn’t your form of art. You can still tell your story and release your feelings in another form of art… like drawing, singing, dancing, or any form of emotional expression!
ESSENTIAL OILS
I love essential oils so much!! I recently started using essential oils, and now recommend them to everyone! Essential oils are an amazingly holistic way to improve your mental health. Here are a few of the more common essential oils, and how they help…
Lavender… this is a calming essential oil, and can help with sleep and anxiety.
Lemon… this oil can give you a refreshed sense of being, and can also help with concentration and anxiety.
Rosemary… this scent can help with feeling run down, and overall mental fatigue.
Peppermint… this is an invigorating smell, and can help with remaining alert and increasing energy.
One really awesome aspect of essential oils, is that you can use them in a variety of ways!! My favorite way is through a diffuser, but you can also dab some on your skin (most commonly on the inside of your wrists), mix them in with your bath water, or by dry evaporation. If you are uncertain you can use essential oils because of a certain medical condition, please consult your primary care physician.
SLEEP HYGIENE
Sleep, sleep, sleep!!! One of my favorite things! Hahaha. But in all seriousness, sleep is so important, and I always focus on my sleep so much because I know how important it is! When working with patients in the hospital, I have seen people become admitted in a complete psychotic state, due to lack of sleep. And in all honesty, once they rested and got an adequate amount of sleep in the hospital, their mindset returned back to reality. It is scientifically proven that once you hit the 72-hour mark for no sleep or seriously diminished sleep, you are at-risk for symptoms of psychosis. Most all adults should be getting between 7 to 9 hours of sleep per night to function at their highest mental capacity.
COPING SKILLS
Now, ending with one of my favorite things… coping skills! Every single person on this planet should have at least 3 to 5 healthy coping skills they can use when they start to feel “mentally strained”. And the great thing about coping skills? The sky is the limit!! There are so, so many coping skills that you can use and develop on your own!! What are some of mine? When my OCD or PTSD starts to kick in a little more than normal, I like to… take a hot shower, cuddle or pet my dogs, and edit photos… just to name a few. But coping skills are totally subjective to YOU. And what works for you may not work for someone else, and vice versa. But I challenge you, if you don’t have a list of coping skills already, take a few minutes today to develop some!
A quick side note here… please make sure you are utilizing POSITIVE coping skills. Some people say cutting is their coping skill. Absolutely not. This is a maladaptive coping skill, and will only lead to harm. And this can be quite a struggle for some people… finding positive coping skills to replace their negative coping skills. But again, just to reiterate, please only use positive coping skills!!
And one last thing I want to say… foster appropriate discernment. I love this word because it holds so much meaning to it. When it comes to your own mental health, you know yourself best. So, utilize discernment in what you should and should not be doing. For example, there have been numerous academic studies that have shown how watching the news can lead to higher levels of depression and anxiety. Why? Because the news can clearly show a lot of destruction and negativity in the world. So… if this is something that bothers you, then don’t watch the news. But instead, maybe listen to some motivational podcasts. The main point I’m trying to make here… is that if you know something is negatively contributing to your life… take it out of your life!! And this can go for people too. If someone in life is bringing you down, then it’s time to re-evaluate that relationship. The moral of the story? Utilize sound discernment when making choices in your life that will affect your mental health.
Have you met all the faces of mental illness? Of course not… but you’ve met a lot of them. And I truly hope that after reading my words, you can feel a little more on what it’s like living with mental illness. But… so what? What is this really all about? To me, it’s a chance to decrease the negative stigma that surrounds mental illness. And if we work to decrease the negative stigma, we can hopefully shed some positive light in the world of mental illness. Because the bottom line is this… people with mental illness deserve to be treated with dignity, respect, and kindness. So, let’s all start doing that! And if you are already doing this, that’s so great to hear.
When I talk about mental illness, I always have to state this disclaimer… if you are struggling with thoughts to harm yourself, kill yourself, or hurt someone else… please seek professional help immediately. That could look like calling 911, calling a trusted family member or friend, or taking yourself to the emergency department at your nearest hospital. Please know you are never alone in this struggle. Peace and love to you all!
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