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I Missed Suicide Prevention Week

I missed the national suicide prevention week, which ended on September 15, but this whole month is suicide prevention month I think. I feel like I needed to say something on this topic given that I have lost a few friends to suicide, and given my own history of suicide attempts. I am grateful for all of the efforts of support for suicide prevention and awareness from the National Suicide Prevention Lifeline to the American Foundation for Suicide Prevention walks and events and all other local efforts in between. To be honest, though, I don’t have any kind of big statement to make on the subject. I don’t think I will ever be finished dealing with being in a place where being dead felt like a better option than being alive. I still don’t feel like I’m ever going to feel safe from finding myself back in that place again.

I believe it is important to raise awareness of how sadly frequent suicide and near-suicide is among people who can outwardly appear normal and functional. People often cannot let on that they are struggling so deeply because they’ve been trained not to. We get rewarded for pushing through, denying our feelings, pushing our own self care to the back burner. So it’s important to spread an understanding that people can appear happy but also be struggling.

Then some of us don’t appear happy when we’re struggling. We cry a lot, sleep a lot, eat a lot, withdraw from things that make us happy, stop talking to the people who love us, and find ourselves trapped in a prison where the black depression is all we can see and feel. We believe it’s the only thing we will feel if we stay alive, so our only productive option is…

I’m about a third of the way into TMS treatment and I am in the “gets worse” part of the “it gets worse before it gets better” warning. I am in a severe depression downswing, and I’m afraid to believe that these treatments will make me feel better in case they don’t. So far it feels like I’ve gotten worse, and even though I was fully warned that this may happen, it doesn’t help me feel any better. It feels like I’ve found myself here close to the bottom again after I’ve tried meds, exercise, vitamins, more meds, therapy, diet changes, self care including the ubiquitous mani pedis and bubble baths that everyone seems so quick to prescribe, and now TMS treatment. So why am I still trying things?

I am not suicidal, I am just in a bad place mentally and emotionally. Still, this is why we need more awareness of how serious mental illness can be so that one day people can feel safe getting help before we reach rock bottom. I’m not at rock bottom, but I think if I wasn’t getting the psychiatric professional help that I have now I’d be a lot closer.

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Religion is Not Medical Advice

Christianity is everywhere. (That’s right, I’m writing a post about religion, but probably not the kind of post you’re thinking of.) Maybe because I live in southern USA, Christianity seems to be more prevalent than Starbucks or any other religion. If I lived in China I’d probably be making the same overly obvious observation about Buddhism. There are very few places that I can go here in Texas and not see a Bible verse on the wall or overhear someone talking about their Bible study. There is absolutely nothing wrong with this, and the purpose of this post is not to bash a religion. I am tolerant of all beliefs, maybe with the exception of believing that Five Fingered Death Punch is music, or that Justin Bieber is an artist. But there are definitely some situations where there needs to be a clear boundary between religion and professionalism.

The mental health care field has largely failed to recognize this boundary, though they are trying. One thing that bothers me about Christians in a very broad and general term, in contrast to other religious people is that Christians out in the wild tend to assume that everyone else believes the same things they do. Now this is important, I don’t mind when someone tells me they are praying for me. That is something personal that they are giving me because they care about me, and I appreciate it very much. What I don’t appreciate is yesterday being told by a therapist, whom I’m seeing to help me cope with a difficult situation in my life, that all I can do is pray for things to get better.

This is not professional advice. This is not teaching me coping strategies. Why would they assume that I’m even a person who prays? What if I don’t believe in prayer? Then you’ve basically just told me I’m fucked. Now, I understand this is probably not the therapist for me and I should just find someone else that will talk to me on a more professional and scientific level, which is what I need. But this is not an isolated incident. I’ve been quoted Bible verses, I’ve been told to pray, I’ve been told that with God all things are possible and that he won’t give me more than I can handle, and I’ve been told that my bipolar disorder can be healed if I work on my relationship with Jesus. All this with total disregard for the possibility that not only do I have different beliefs, but religion might just be a trigger for me. How is this supposed to help my mental illness caused by chemical imbalances in my brain?

I’ve never had any other health professional say anything like that to me.
“Oh, you have a urinary tract infection? I have some antibiotics, but instead let’s sing hymns until it goes away, and by the way this isn’t optional.”
“X-rays confirmed that your finger is broken. Let us pray.”
I think it’s because there is still so much unknown about mental illness, and we don’t like saying “I don’t know what to do.” God is another unknown, so we explain the unknown with the unknown. We don’t know why medications work or don’t work. We don’t know enough about the roots of mental illnesses to be able to treat them specifically. We’ve come a hell of a long way in the last century, and we’re continuing to learn more and more every day. But I’m just going to come out and say it: religion is not a mental illness treatment.

It helps a lot of people, and that’s great. I believe that people need to practice and believe what makes them feel whole as a person, and do what gets them through the day in their private lives. But religion is not medical advice. Mental illness is a medical condition. I don’t want my mental health professionals telling me, or even implying that my treatment would be more effective if I practiced a specific belief. This is an option, sure, and it helps some people. But like any treatment, (religion is not a treatment goddammit) what works for one person might not work for another.

So please, please stop making the practice of Christianity seem like it’s not optional. Please stop assuming we share the same beliefs when you know nothing about me. Please stop assuming that I’m going to share my beliefs with you at all. Please just treat me for my medical condition. It’s okay to say “I don’t know.” I accept that. I just want to feel better.

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Mental Health FAQ

When you go to a psychiatrist appointment, a general practitioner appointment, or a therapist appointment to address your mental health issues it can be scary, especially if it’s your first time. I was terrified the first time I decided to see a therapist when I was 20 years old. I was alone, I had no support, I didn’t know anyone who had seen a therapist, and I had stress diarrhea for weeks. The first time I brought up my depression with my general practitioner was scary also because I was terrified that he wouldn’t take me seriously. The first psychiatrist appointment ever was daunting because I didn’t want to believe that I needed a psychiatrist.

I imagine I’m not alone in my fears because living with mental illness is scary. We are up against a stigma that spreads through almost all parts of our lives. Even when we ask for help, things can go wrong. But when things go like they’re supposed to, there is progress. I have been to many therapists, may psychiatrists, many GP’s for mental health, and I’ve seen good ones and bad ones, and ones that have just not worked for me. Here are a few things that I wish I could have known when I started treatment. If you are considering getting help for your mental health, I applaud you and hope this helps.

Q: What will a therapist do on my first visit?
A: They will introduce themselves, and they will ask you why you came in. This is not a judgement, they want you there, and they want to know how to help you. Even if you aren’t able to be articulate why you’re there, do the best you can. They will ask you questions and lead the conversation when you’re not able to.

Q: What if I’m embarrassed by something I need to talk about with my therapist.
A: Your therapist will never judge you. The truth is that they’ve probably seen it all. I tend to seek out older therapists who have been practicing for a long time because there is literally nothing you can say that will surprise them. Being honest is the only way to make true changes in your life. You’ll get out what you put into therapy.

Q: What if I don’t like my therapist?
A: The best thing you can do is be honest with your therapist and yourself. It’s okay to discuss this with the therapist. If you can’t work it out, find another therapist you can work with. It takes some trial and error sometimes, and there is absolutely nothing wrong with leaving a therapist you’re not comfortable with. This applies to all doctors and psychiatrists as well. Trust is a big part of mental health treatment.

Q: What could a general practitioner possibly know about mental health?
A: Enough to help point you in the right direction when you need help. Sometimes a GP is all we have available to us, and there’s nothing wrong with that either. They can prescribe medications and refer you to a psychiatrist or therapist if they think you need it. Go to who you trust as your first step.

Q: Is it as interesting to sit in a psychiatrist’s waiting room as you’d imagine?
A: Waiting rooms are always professionally discreet. No one is even paying attention to you much less trying to guess why you’re there. I’ve never felt unsafe in a psychiatrist waiting room.

Q: What is the difference between seeing a psychiatrist and a general practitioner?
A: A psychiatrist specializes in only mental illnesses and mental illness medications. They will be more up to date on specific medications and specific diagnoses and can provide a more in depth mental illness treatment. Generally, the philosophy is that if it works, keep doing it. I mean that if your GP prescribes you some medications that make you feel better, then keep taking them. If your GP has tried everything they know to try (like in my case) they may say go to a psychiatrist to try something different.

Q: What is the difference between a psychologist and a psychiatrist?
A: A psychologist will be your therapist and cannot prescribe medications. A psychiatrist will prescribe your medications. Most psychiatrists don’t do therapy, but there are some who do. I’ve never been to one who does, but it sounds like it could be a nice simple “one stop shop.”

Q: What’s the deal with medications? Are they pills that make you happy? Are they just a crutch?
A: Mental illness is much more complex than happy/sad. The hardest part of getting mental health treatment is that there is still so much that even the experts don’t know about it. They don’t know exactly why some medications work and some don’t, or why it’s different from person to person. While mental illness is a real, diagnosable medical condition, just like diabetes, or a broken arm, the treatment is different for each person. A doctor will pretty much treat a broken arm the same way for each person, because if they do, it will heal. Unfortunately depression and other mental illnesses are not so linear. We use medications as a way to stimulate our brain chemistry to do what it should be doing anyway. Just like a diabetic gives insulin because it’s what their pancreas is supposed to be doing anyway. Medications are not happy pills. They are not a crutch. They help clean up your thought processes and clear pathways so that you can function as yourself, just like when you clean out the hallways of a house so you can get around the house with less stress. I was prescribed medications for the first time at age 20, and I carried the bottle around, unopened, until I was 22. I was afraid of the stigma. I was afraid that they would give me a false perception of the world. I wish I had been more open minded sooner though, because it was the depression that was giving me the false perception. The meds helped me see more truth.

Q: Is it possible that medications won’t work?
A: Unfortunately there’s always that possibility. Sometimes it takes trying a few medications that don’t work before finding ones that do. It can be a frustrating system because often you have to take the medications for several weeks before you know if they’re helping. It can be so time consuming. It’s an imperfect system, but it’s the best one we have right now. There’s so much research being done about treating mental illness, learning why it happens, and learning what the symptoms mean that there are new options available all the time.

Q: Can insurance be a pain in the ass when it comes to mental health?
A: Sometimes. Mental healthcare is still a completely separate section of insurance from healthcare (guess what, it’s all healthcare!) and it can have its own rules. The issues I’ve run into over the years are that insurance can sometimes dictate how many therapy sessions you get per year, and they can limit the options for doctors you can see. The staff at therapist and doctors’ offices are pros at dealing with insurance, and will work the system if they need to to get you what you need.

Q: Is it okay to be scared?
A: Absolutely. Getting help is supposed to be the greatest thing you can ever do, and there are supposed to be circles of cheerleaders following you around wherever you go, and everything is supposed to be perfect and amazing and rainbows and smiles. Well, getting help is a great thing, but more than that it’s a brave thing. We’re still in a world where it’s often an uphill battle to get help for mental illness. I wish to god it wasn’t. I wish that mental health was treated like the rest of healthcare, and that people didn’t have to be afraid and anxious to seek help or even avoid seeking help because they’re afraid they won’t get it. I’m going to be real with you – getting help can be hard work. I will cheer for you and assure you that you’re not alone, I will share everything I’ve been through in hopes that it helps, but I can’t tell you that it will be smooth sailing. I do think you’re worth the fight. I also believe that you can be strong and brave and terrified all at the same time. And I think it’s worth asking for help, even if it looks like just showing up in a doctor’s office, not making eye contact, and saying the word “Help.”

These questions and answers are based on my own experiences, and my own fears before I got into treatment. I have not had a smooth ride with mental illness or its treatments, but I have met some really good people along the way who have helped me a lot. I’ve met some good people who haven’t helped me too. And I’ve met some idiots. But so far I haven’t given up on myself, and I don’t think you should either. I hope that at least some of this is helpful.

If you have any other questions, or if you have any other insights from your own experience that you think might be helpful to someone else, leave them in the comments or you can e-mail me. I don’t claim to be an expert, but between all of us I bet there’s a lot of really good information out there.

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The Greys and Army Greens

Why does reading about someone who has bipolar give me a start? Why does hearing about someone who committed suicide make me feel just a little bit jealous? It doesn’t mean I’m a bad person and it doesn’t mean I’m crazy, that’s just the nature of triggers I guess. I’m reading a book that mentions someone’s family member who had bipolar (by the way I’m careful to say “has” bipolar as opposed to the more commonly used “is” bipolar because our conditions do not define us) and refused to take medications because they didn’t want to be “dulled.”

The person ultimately killed themselves, and it sounds like they had a lot of struggles in life. I can relate very much to not wanting to be dulled. Taking the relatively large number of medications, in addition to making me fat, turn my brain into fog. My feelings are dull and I don’t get as much enjoyment out of things I normally enjoy, but when I feel sad I feel it too strongly. The thought of getting off my medications just so I can feel something again is very appealing. But the consequence of doing that is that I will probably end up either hurting everyone I love, putting myself on the streets, or dead. At least I would feel life again, though!

I’m not going to go off my meds, but it will never stop sounding appealing. I think of the days when I wasn’t on medications or wasn’t taking my meds like I was supposed to, and though I had huge mood swings on a daily basis, I felt love like fire, I felt joy doing the things I loved, even the lows that I felt so strongly made me feel alive. I was connected to life. Sure, I wasn’t sleeping or eating much, and I would have days at a time where I would cry in bed barely getting up to pee much less function like a human. But that’s part of what made me feel alive.

Now I’m taking all the handfuls of meds like I’m supposed to, but I feel a muted sense of being alive. There are many things that make me happy: my boyfriend, my dog, my friends whom I cherish. The love for those things runs deep. But everything feels muted. I still have the mood swings, but they’re not as extreme. The “even keel,” the “baseline” doctors want me to stay on feels Okay. I am Okay. Life doesn’t have the reds and blues and purples and lively yellows anymore, just greys and army greens. My memory is shot, focus is a challenge, I often feel like my personality has gone into hiding, my hands shake, my energy is in short supply and I’m often too tired to function, but I am Okay.

Not fantastic let’s-get-up-and-go-I-don’t-care-where. Not terrible, hopeless, I’d be better off dead. Just okay. I am so lucky to have people who care about me and are always there to help me through the days, even the days when the high/low extremes come back and I’m not Okay anymore. In the meantime I’m living in the fog and reminiscing about the times when I felt like I was living in brighter colors.

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A Note on Self Harm

Trigger warning: this post talks about cutting and self harm

This is probably the most difficult subject to talk about, but that might be why it’s the most important to talk about in order to fight the stigma of living with mental illness. That’s the theory I’m working from, anyway, because that way the pain of talking about it publicly has a purpose.

I have used cutting and other forms of self harm such as bruising myself and using diabetes as a weapon – binge eating without giving insulin, or even eating normally and purposefully not giving extra insulin – since I was a teenager. As a teen I was not allowed to ask for help when I needed it, so I would cut myself – usually on my face – to show people I needed help. I stopped doing this until I was in my early thirties.

I was in a toxic marriage and needed help but wasn’t getting it, so I started cutting again. The urges surprised me since they were so strong and I haven’t felt them since I was a kid. All of my pain in my marriage was invisible, so the cuts, the blood, the scars were all proof that I was in pain. It was outside of my head, which was a relief.

My marriage ended and I started cutting again. My life was suddenly in chaos. I lost everything: my house, my family (in laws), my job, my car (totaled it), my jobs (lost two in a row), my dog (liver failure), I almost lost my dad to complications of surgery, and I was trying to survive on my own in an upside down world. My depression was spiraling downward at an alarming rate, and I started cutting again. I dug into my legs with a sterile needle (always sterile, I don’t want to do damage, I just want the pain) as a way to gain a sense of control.

If I cut I bleed. If I bleed there’s pain. Cause, effect. Very straightforward. Absolutely nothing in my life was straightforward, I was in control of nothing, none of the causes had effects that made any sense. Surgery is supposed to heal, not try to kill. Working hard is supposed to give you job security, not take it away. Dogs are supposed to live forever. But I know exactly what happens when I put a needle on my skin. This year when my marriage ended and I lost everything was what led me to my second ever psych-hospital experience, but I will go into that story more another time.

I had a counselor recently whose response to me talking about my cutting was, “Most people grow out of these urges eventually. Almost no one continues to cut after age 30.” Yeah, well first of all, you’re talking to one of us over 30, so check your facts. Second of all, that’s not true at all, there are many adults who self harm. But people over 30, this arbitrary age when life is supposed to magically get better, don’t feel like they’re allowed to talk about it. I told this counselor, “I don’t know what you’re trying to tell me. Do you think I’m doing something wrong?” She said no, I was doing nothing wrong, I was just using an old coping mechanism. She said the urges should be getting fewer and further between. I said they’re not, they’re more frequent and getting stronger. And I know I’m not the only one. I’m not an anomaly of her inaccurate statistic.

There are many many many adults who hurt themselves in secret, suffering in a very painful silence. There’s an Instagram account I follow that is called Faces of Fortitude: “This project lays a foundation of healing thru portraits of those affected by Suicide & Mental illness.” A photographer takes pictures of people who have survived depression, suicide attempts, trauma, and self harm, and tells their story in the caption. There are amazing stories and powerful photos, and it is inspiring to read. In one of the stories the person advised against tattooing over or hiding your self harm scars, but advised wearing them proudly because they are reminders of what you survived and of how far you’ve come.

I respect this sentiment, and if it were anything but self-inflicted scars I would agree. But I still have times when my own scars can be triggers for me to want to hurt myself. I have gotten several tattoos that cover my scars, and I did it because I wanted to turn something painful into something beautiful. That is what I would rather look at than scars, reminders, of painful moments. When I have the urges to hurt myself, they are difficult to shake. The pain is actually what brings me relief. Totally intuitive, right?? So when I see the scars, the memory of the pain makes me want to cut again. It’s all complicated.

Cutting and self harm are complicated. We don’t do it for attention. We do it because the pain, the blood, the bruises, the scars give us something that we need so desperately that we have to hurt ourselves in order to get it. Maybe it’s validation we need, or a way to ease our depressive thoughts without trying to kill ourselves, or maybe we need to get the pain out of our heads and into the outside world. Whatever our reasons are, we don’t have to be teens. We are mature, fully functioning adults with hidden pain that we don’t know how to express otherwise.

When you see us in the wild, don’t judge us. Just know we are in pain, or at one time we were in pain. You can understand and relate to that. That’s all it is, so I wish it didn’t have to be a secret. Thank you for letting me share a little bit about my experience.

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Speak Louder Than the Stigma

The stigma surrounding mental illness is no joke. People struggling with mental illness feel isolated, ashamed, invalidated, and hopeless in a world where their condition isn’t taken seriously. There have been huge strides over the past few decades toward treating mental illness with the care it deserves, but there is still a long way to go. We who suffer from various mental illnesses often feel different from everyone, and we learn to feel shame for having an invisible illness, and the results of this can be deadly.

As long as we let ourselves give in to shame and stay silent about our experiences, the stigma isn’t going anywhere. I understand  that there are social and professional boundaries in place, and even though they are based in stigma we can’t always call our boss and say, “I can’t come in today because my depression is making me feel like I need to cut myself so I’m going to see the psychiatrist.” Things just aren’t that open yet. But someone could go up to their boss and say, “The migraine medication I’m on is making me throw up so I can’t come in today,” and no one would bat an eye. What is the difference between these two statements? They are both medical conditions.

Why is there so much shame enveloping the mental health statement especially when there are so many of us suffering from similar symptoms. How many people are not seeking help at all because they are afraid they won’t be taken seriously? I was one of those people. I’ve been invalidated and not taken seriously. I’ve had to make up the stomach viruses, fevers, and severe illnesses that would explain my missed days at work because of severe depression. I might as well have had those viruses with as bad as I felt, but I didn’t feel like I could tell the truth. And I felt every ounce of the shame that came with it.

I propose that we start speaking up. Not in a way that will make us lose our jobs – sometimes you just have to play the game to survive in this world. But when we feel shame, I propose we push through and talk about depression, anxiety, borderline personality disorder, whatever issues we are dealing with. Talk about the feelings we feel because we have to live with an invisible illness, about how we often feel alone. Talk about the positives (yes, there can be some) and the negatives. Basically, talk louder than the shame. Louder than the stigma. That’s the only way to fight it and break it down.

We are enough in and of ourselves, and that means that no matter who makes us feel less than or who tries to invalidate our experiences no longer has the power to change who we are. We are strong. We are not alone.

And one day, if we work hard, we can be completely shameless.

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TW – Depression Can’t Be Fixed

*TW means Trigger Warning, meaning what I’m about to say has the potential to trigger someone’s past trauma, past painful experience, or something they are struggling with. If someone is “triggered,” they can feel that pain all over again and put them in a challenging emotional or mental position. I will not censor my experiences because I can’t account for all possible triggers. However, I respect the things that people have had to go through, and I can indicate that I am about to talk about suicide; you can choose whether to keep reading or not. Please take care of yourself first.

If you need help now, call or online chat with the National Suicide Prevention Lifeline now.

We need to talk about suicide because it has taken too many people from us. I have lost friends to it, and it’s hard to miss the celebrities who died from suicide: Robin Williams, Chester Bennington, Amy Buell, Kate Spade, Anthony Bourdain. Ugh, just making this list gives me a heavy heart. But as difficult as it is to think about, I think the prevalence of mental illness in our lives is all the reason I need to talk about it. It seems like we don’t talk about suicide until it happens to someone we know. This is more than enough for us to take it seriously!

It is important to remember that depression can’t be fixed. Mental illness can’t be fixed. I love my friends deeply, and when one of them is hurting it makes me sad. It makes me want to do something, anything, to fix it. To take my friend’s pain away. Unfortunately depression doesn’t work like that. We have to consciously love the person over the disease.

My friend called me last night and said they wanted to end it all. I’ve been in that place before myself, but it didn’t make it any easier to know how much pain my friend was feeling. They told me how much I had meant to them over the years, and that they love me. This is a friend I “met” in an online support group more than 15 years ago, so we’ve never met in person. My friend told me, “I always wish we had met in person,” and the wording stabbed at my heart. Through many many tears I said,”We still can. I love you. Please don’t kill yourself tonight.”

…And that’s all I could do.

I wanted to drive to their house, knock the bottle of booze from their hand, and just hug them until they felt better, and I might have if they didn’t live a two day drive from me. (I love dramatically knocking things out of people’s hands, too.) Personally, I have attempted suicide three times in my life, which I will get into more later, but having been there myself does not make it easier to see others go through it. However, it does give me some perspective on what can help in these moments, and what my role is as a friend. The biggest two things that help me are honesty and humor. Don’t try to protect my feelings, and don’t let me take myself too seriously.

I resisted the urge to list all the things my friend had to live for because that would be assuming I know what they find meaningful. It’s easy to project our own experiences onto people in these situations, and I wanted very much not to do that. Instead, I was honest about my feelings and my selfishness.

I said, “I know this is selfish, but I don’t want to lose you. Not today. I mean one day, yeah when you’re being a real pain in the ass we’ll talk again, but not today.” They laughed, which made me feel relieved at that moment of time I bought for them. Humor can save a life. That’s what I tell myself when I’m unable to stop making “that’s what she said” jokes, when that fad ended like four years ago, but it’s true. Depression lies to us and tricks us into taking ourselves too seriously. It robs us of perspective and keeps us locked in a dark metaphorical room, isolated from people who love us. Eventually it can make us believe that we don’t matter.

I got to talk to my friend from their dark room last night. I am scared. I’m scared that they won’t answer my text this morning. I’m disappointed that I didn’t fix them – even when I know that’s not how it works. I’m heartbroken that I even have to entertain the thought that I might lose my friend. But I told them and showed them that I love them, and that is what I could do. I hope it helped, but I don’t know if it did. I may never know, but I did try.

I perhaps have a unique perspective, and am not suggesting this as a template for anyone else’s situation. If someone is talking about wanting to kill themselves and you are uncomfortable, which, let’s be honest, you should be, you do not have to deal with it alone. Call the National Suicide Prevention Lifeline (I put this number in my phone and have used it) and they will help you help the person you love. Then make sure to take care of yourself, getting help dealing with the feelings that come with being in this difficult situation. Depression lies and we tend to believe the lies before we can fight it. We can’t fix it, but we can fight it.

I don’t know if my friend will answer my call today or not. I sure hope they do. My stomach is knotted with the thought that they might not. But I’m glad they reached out to me last night, I’m glad I got to say I love you, and I had the personal boundaries and wisdom to know that I didn’t have to fix them. We can’t fix something that isn’t fixable, all we can do is love it, call it a pain in the ass, and laugh at it, making the time we have on this earth a little more bearable.

Continue reading TW – Depression Can’t Be Fixed