The Return of the Anxiety Monster


Recently it has come to my attention that being truly open, honest, & sincere is far more appreciated by the world as a whole than being some kind of continually positive peppy cheerleader type.  The latter becomes more of an annoyance than anything because inevitably there are times when life sucks, & at those times I think all of us desperately long for someone to validate our fears, our anxieties, & general woes about the difficulties we’re facing, whatever they may be.

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In an effort to be completely honest, I must preface this post by saying I am currently a bit of an emotional train wreck.  My hormones are all over the map (I recently came off birth control since my husband & I are trying to have a baby), work has been increasingly demanding, & there have just been a number of other stressful situations in my life lately, all of which have contributed to me struggling with my anxiety far more than I have for a long time.  And because I’m trying to get pregnant, I’m now taking a 50% lower dose of Prozac (which means I’m now on the lowest dose available), so as you can imagine that has been an additional stressor.

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In any case, this past week I was placed in a situation that brought up a lot of negative memories.  I was criticized in a way that I felt was at least 90% completely unjustified, & as usual my response was to cry.  I only shed a few tears during the actual conversation, & I did manage to stand up for myself FAR more than I would have years ago, but it took everything in me not to just break down & sob right then & there.  Trust me, when I was in the safety of my car I cried harder than I have in a long time. tears

The end result of this situation is that suddenly I felt just as small as I did so many years ago when I was in elementary & middle school & many of the other kids teased me & used my “weaknesses” to make themselves feel stronger.  Memories of being teased about everything from not knowing what an erection was to wearing the wrong style of clothes to forgetting to shave my legs to being “too smart” to being out of touch with popular music & TV shows to sucking at sports all came flooding back in a deluge of torment.  Many of these memories had not crossed my mind in well over a decade.  But suddenly the pain of those moments was just as real as if they had happened yesterday.  Suddenly I was the last kid picked in gym class all over again.  It was as if all the self-confidence I’ve built up over the past decade since leaving high school had evaporated like the morning dew on a sunny day.  teasing

And here I am two days later still struggling . . . Am I over-reacting?  Of course.  But I’m an intelligent, sensitive person who cannot help but take criticism to heart.  I do this because I truly care.  I want to be the best I can be at everything I do.  I’m not saying I need to win some kind of award for everything I attempt in life.  Hell no!  I’m just saying I have very high standards for myself, probably too high sometimes, & it’s difficult to take criticism, especially that which feels unfair & poorly presented, as anything other than evidence of a glaring failure.anxiety

I know I should just “shake it off,” forget it, & move on with my life. But that’s not in my nature.  Trust me, at times like these I would give almost anything to be so light-hearted as to be able to do that.  I’m trying very hard to remember that one person’s perception of me is simply that: one person’s perception of me & nothing more.  I hate to sound like a whiny first-world bitch, but sometimes being smart is not all it’s cracked up to be.  I’ve spent my whole life being largely identified & singled out for my intelligence.  All things considered, I realize this isn’t a bad lot in life.  There are definitely a lot worse characteristics for which one can be known. But the down side to it is that any “evidence” of failure makes you feel like you’re losing your whole identity, not to mention the inevitable phenomenon that everyone just expects you to deal with anything that comes your way because “she’s smart, she can handle it.”  Then there are also the people who think that just because you’re smart means everything you excel at must come easily to you, that you haven’t really worked for your successes, which of course could not be further from the truth.  And then there are the inevitable people who are jealous of your success & are probably just waiting for you to screw up so they can feel better about their own failures . . .intelligence

Anyway, it has also come to my attention lately that it is possible that I may be intimidating to some people.  Because I have a tendency to still think of myself as the nerdy weird girl, a bit of an ugly duckling for lack of a better term, it’s really quite incredible to me that this could possibly be true.  However, when I think about it objectively, I suppose a twenty-something woman who’s in good shape, reasonably attractive, successful in her career, happily married, & generally seen to be “on top of it all” could be a bit intimidating.  And I am all of those things.  I’ll never forget a situation in college where a friend of a friend told me that when he first met me he was really intimidated by my intelligence, but he then went on to say that he quickly discovered that I was also incredibly kind & any feelings of inadequacy on his part melted away.  When he told me that (probably 8 years ago now!!), I remember being totally flabbergasted because the idea that I could be intimidating to anyone, much less a guy, just seemed utterly unthinkable.  But I doubt he’d have admitted to such a thing if it weren’t true.  As much as I cannot help but admit that being known as intelligent & “successful” is indeed flattering, I sincerely want to be known at least as much for being kind & generous & helpful.  I guess the reason the criticism I faced earlier this week got under my skin so much is because I felt like it implied that I’m none of those things.You-are-nice-quotes-kindness-quotes-politeness-quotes

I really don’t know why I’m writing all of this other than to try to maintain my own sanity.  I suppose the message I’m trying to convey is that even those of us who may seem to “have it all together” are extremely vulnerable & just as hard on ourselves, if not more so, than anyone else.  The truth is none of us has it all together.  We’re all facing our own unique battles.  Perhaps it’s to my own detriment that I am so adept at seeming like I’ve got it all together because it masks the battles I’m facing with my own anxiety.  I’ve said it before & I’m sure I’ll say it again, but I truly believe the world would be a far better place if more of us were honest about the battles we’re fighting on a daily basis.  Anxiety is my battle, the anxiety monster is very real, & right now I’m fighting it harder than I have in a very long time.  So in an effort to live up to my own beliefs, this post is me being truly candid & letting you know that at this point in time I’m really struggling . . . But struggling though I may be, I won’t be defeated . . .  times are hard

Before I end, I feel like I must include this quick side-note: to the people who say those of us with anxiety, depression, or other mental illnesses should just pray more or read the Bible more, I may as well tell you to pray away your diabetes or your cancer or your heart disease.  Now do you realize how ridiculous you sound?  If you’re going to take the view that disease is a product of sin & can be cured by pure faith, then at least be consistent about it.  If you’re going to criticize me or anyone else for taking medication for a mental illness, then I better not catch you taking an antibiotic, a pain medication, a blood pressure pill, or anything of the kind.  Just saying . . .

I’ll conclude this post with one of my favorite “pick me up” songs by the talented guys from Redlight King.

My favorite lyrics from the song are below:

Risk it all, I’m gonna risk it all
I’m gonna break my back and risk it all
I’m gonna pick my spot, take my shot,
Swallow my pride and risk it all
I’m gonna risk it all
And I won’t look back
I’m gonna pick my spot,
Take my shot, swallow my pride
And risk it all

The light’s on, the last round
The dark horse keeps on fightin’

I’m gonna make a comeback
I’m gonna dig six feet up tonight
I’m gonna get it all back
I’m gonna make a comeback this time

Anxiety, you will not win.  I know I’ll never bury you completely, but you will not take away all the progress I’ve made.  You may have won a few battles here lately, but trust me, you are not going to win the war.

Anxiety, Plane Tickets, & Flying Solo


I did something tonight that might not seem like a big deal to most people but was a big deal for me: for the first time in my 20-some years of life, I bought a plane ticket.  By myself.  With no help from my husband or anyone else.  AND I did it WITHOUT HAVING AN ANXIETY ATTACK.

When my husband & I went to Montana last Fall, he bought the plane tickets (actually I paid for them I think, but he did all the work of finding & selecting the flights).  Ditto for when we went to Boston the next month for a wedding.  Furthermore, every other flight I’ve taken in my life was planned by someone else; thus, I was never involved in the tedious process of finding & obtaining tickets.  All I had to do was show up & follow someone else who knew what they were doing.airplane

Not only did I find, select, & buy the plane ticket for this trip by myself, but this will also be my first time flying by myself.  I know for most people my age this whole scenario probably seems like no big deal.  But when you have anxiety like I do, even something as “simple” as buying a plane ticket, particularly for a solo trip, can induce extreme anxiety, the kind that most people associate with taking a major exam or giving a speech.  (Oddly enough, neither of those activities has ever been all that nerve-wracking for me, with the exception of the NCLEX, although I only had major anxiety about that the day I actually took the test).

In any case, as “silly” as it may seem, one of the most beneficial things I’ve learned from a dear, dear friend of mine who is bipolar is that, particularly when you have a mental health issue, even something as “small” as mild anxiety, you have to learn to celebrate even the minor victories.  You have to learn to recognize when you’ve reached a milestone in your recovery, if you will.  I hate to use the word recovery because I don’t believe my anxiety is something I need to or can “recover” from.  It’s not an illness, like the flu or strep throat, mostly because it’s not something that can be cured with a week’s worth of medication with only a small chance of recurring later.  But my anxiety IS a disease that I have to learn to manage, just like many other folks have to learn to manage diabetes or heart disease or any of a myriad of other chronic conditions.hello-my-name-is-anxiety

In my case, I’ve realized that buying a plane ticket by myself for a trip I’ll be taking by myself WITHOUT HAVING AN ANXIETY ATTACK is indeed a victory.  It’s an accomplishment, just as much as is giving a successful speech, acing an exam, winning a game, or any other more commonly recognized achievement.  A year ago, before I started taking Prozac, I can tell you without any doubt that this would not have happened.  So this is progress for me for sure.anxiety meds

As I was telling a friend at work last week, the longer I’ve been in therapy, the more I’ve realized that my anxiety has very deep roots.  In other words, this is something I’ve been struggling with more or less my entire life.  It’s probably the major reason I wasn’t a very happy child.  Don’t get me wrong; I wasn’t depressed or suicidal or anything like that.  But I just never remember experiencing that carefree existence that most children seem to enjoy.  I still feel guilty for that sometimes because my parents were & are wonderful people who did so much to ensure that I had a healthy, happy home.  But I’m slowly beginning to understand that it was my own anxiety that prevented me from fully embracing life for so many years.  And that wasn’t my parents’ fault.  Or mine.  It’s just the way it is.anxiety charlie brown

The trouble is that when anxiety is something you’ve battled for so long, it’s very easy not to realize that it isn’t normalAfter all, the only brain you know is your own!  This is why it took me over 22 years to realize that maybe, just maybe, the constant swirl of anxiety in my brain wasn’t normal.  Better yet that it wasn’t how things HAD to be for me.  I look back now on my college years & I so regret not seeking help sooner.  It’s not that I didn’t have a good time & create lots of wonderful memories.  I absolutely did.  But I also know it could have been much better.  I’m also very aware that on the outside I probably seemed like I had it all together . . . & in a way I did.  I graduated with a 4.0 GPA, I maintained my relationship with my high school boyfriend (now husband), I passed the NCLEX on the first try, & I got married & started my first nursing job within 3 months of graduating from college.  Outwardly, I suppose I was the definition of “put together.”

A very simplified explanation of anxiety . . . but it made me laugh.

A very simplified explanation of anxiety . . . but it made me laugh.

But on the inside my brain was a wreck.  No wonder I struggled with high blood pressure for a while!  My mind, & subsequently my body, was on constant overdrive for so many years.  As my husband describes it, I had this endlessly “chattering squirrel” in my head that was always, always, always thinking, thinking, thinking!  Despite what many people think, having anxiety isn’t just spending too much time pondering the “what ifs?” of life.  It’s so much more than that.  It’s a brain that never stops, that plans everything, & perhaps more than anything just doesn’t know how to shut up & relax.  And a brain that can’t relax is a brain that will eventually burn out.anxiety

This is why I’m so incredibly grateful I took the advice of a friend & sought help: first through therapy & eventually by adding medication (Prozac).  Through a combination of the two, I have come to an even greater appreciation of so many things in life that I’ve always enjoyed but that I can now enjoy even more & thus utilize to further relieve my anxiety: music, books, my relationship with my husband, & so much more.

Trust me, there are still days when I struggle with my anxiety.  There are times when the idea of interacting with anyone other than my husband or closest friends seems like torture.  But those days are much fewer & further between now.  And even when they happen, I have the foresight to know they won’t last forever.  And that one bad day doesn’t doom me to a bad week, month, year, or life.bad day quote

I’ve wandered a lot in this post.  But, as I’ve done so many times before, I want to encourage anyone who is struggling with anxiety, depression, or any other mental illness to seek help.  Admitting that you need help is NOT a weakness.  Let me repeat that: needing help is NOT a weakness.  Rather it is the first & perhaps most important step in creating a better, more peaceful life for yourself.MentalHealth-HeadGraphic-250px

Looking back on my childhood, adolescence, & even into college, there were so many signs that the anxiety I faced on a daily basis was not normal.  But they were mostly things that only I knew about (for example, the hours I spent awake at night off & on for years & years thinking about the Holocaust & how horrifying that was) . . . My point is that I didn’t realize how bad things were until I got the courage to ask for help.  And now that I’ve gotten help & my anxiety is so much better managed, I honestly can’t believe I struggled alone in silence for so long.  But I suppose sometimes we have no idea how dark the night is until we see the light of day.  I’ve found that light, & there are days when it is dimmer & days when it is brighter, but I think I am now even more grateful for the light since I know what it was like to live in the dark for so long.

Whatever you're facing, you are not alone.

Whatever you’re facing, you are not alone.

If you’re living in the dark of anxiety, depression, or any other mental illness, please don’t suffer alone.  Get help.  Life CAN be better.  I am living proof.

America’s Mental Health Crisis


I’ve had several different topics up for consideration on the blog this week, but in the wake of the tragic suicide of Robin Williams I’ve decided to continue my focus on mental illness.  As our country, indeed our world, tries to come to terms with the paradox that a comedian as brilliantly talented as Robin Williams could suffer from depression so severe that he would end his own life, I hope that we will each open our minds to understanding the true gravity of mental illness.

Every few years when a celebrity commits suicide or dies of a drug overdose, our society gives a cursory nod to mental illness & the same old platitudes are rolled out over & over: “Anyone can suffer from depression.”  “Get help.”  “Don’t suffer alone.”  While all of these things are true, the sad reality is that true change never happens.  The same old stigmas against mental illness persist which only contribute to the negative cycle of these diseases, making it difficult for people to even seek treatment.  For those who overcome the stigma & do seek treatment, the lack of adequate resources continues to make finding & continuing treatment a true challenge.

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To understand the gravity of mental illness, one must first understand the prevalence of the problem.  According to the National Institute of Mental Health, a branch of the National Institutes of Health, some 18.6% of adults in the US suffer from some form of mental illness.  Read that figure again: 18.6%.  That is almost 20% of the population!  (Please note this does not even include substance or alcohol abuse.)  Anxiety & depression make up the largest percentage of this figure with schizophrenia representing about 1% of the US adult population & bipolar disorder about 2.6% of the US adult population.  While these figures may seem low, consider that out of every 100 people you know, at least one or two of them are probably suffering from one of these serious disorders.  Regarding anxiety & depression, the NIMH reports that almost 7% of the adult population in the US has suffered at least one major depressive episode in the past year & that about 18% of the adult population has suffered a major anxiety episode in the past year with a life-time prevalence as high as almost 29%.  Furthermore, it is estimated that as much as 25% of homeless people are suffering from a severe mental illness.  Shockingly, suicide is the tenth most common cause of death for adults in the US, according to the CDC.

I do not mean to overwhelm you with numbers & statistics, but my point here is that mental illness is extremely common.  It does not discriminate against age, race, gender, religion, wealth, intelligence, or talent.  ANYONE can suffer from mental illness & many do.  For some people mental illness is transient & with proper treatment they may never suffer from it again (this is more common with SOME cases of anxiety or depression).  But for others it is a chronic condition that will persist throughout their lifetime (for example, bipolar & schizophrenia are rarely, if ever, transient conditions).

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Sadly very little is understood about the causes of mental illness.  Certainly most doctors & scientists would agree that mental illnesses are affected by both nature (genetics) & nurture (environmental factors).  But for the most part we are just treating the symptoms with mental illness because we really don’t know the exact cause.  There is little research in this field so sadly there are not as many advances in treatment as one would hope.

As I mentioned earlier, the accessibility to treatment for mental illness is sorely lacking in this country.  Not only are there far too few psychiatric facilities for the seriously ill, but access to outpatient therapy is far from adequate.  For example, without insurance my therapist would cost almost $200 a session, a price I could not afford to pay more than a few times a year & a price that would be absolutely prohibitive for many Americans.  Prior to the 2008 passing of the Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act, more commonly known as the mental health parity act, insurance companies were not required to provide equal access to mental health treatments.  Even after this, many insurance companies provided minimal access to mental health treatment.  With the passing of the ACA, we can only hope that mental health services will finally begin to expand & that greater accessibility will finally take shape.  The sad reality is that those suffering from mental illness, particularly severe mental illness, are more likely to have difficulty holding down a steady job which translates into being uninsured & unable to afford the treatment they so desperately need.  It’s a vicious cycle that often never ends.

Despite the prevalence of mental illness, Americans have been slow to understand the gravity of these disorders.  The stigma against mental illness is real.  Far too often those suffering from anxiety or depression are accused of “just not being thankful enough for God’s blessings in their lives,” showing a clear misunderstanding of these disorders.  Or how often have you heard someone casually scoff that a person who is a bit moody or difficult to handle “must be bipolar”?  Indeed the lack of knowledge of mental illness has led a great deal of the population to confuse schizophrenia with multiple personality disorder, the latter of which is actually an extremely rare condition.  I for one grew up thinking schizophrenia was the same as “split personality” when in reality schizophrenia is a completely different, though just as serious, disorder.  Again a lack of understanding of mental illness leads to a great deal of fear surrounding these conditions.  How many times have you read a novel or seen a movie in which a serial killer or some other heinous villain is depicted as being schizophrenic, psychotic, or otherwise mentally ill?  Indeed, after almost every mass shooting or bombing, the accusations of bipolar, schizophrenia, & general mental illness are thrown out by every media outlet.  Once again this feeds into the fear of mental illness.

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The reality is that research has consistently shown that those suffering from mental illness, particularly severe mental illness such as bipolar & schizophrenia, are actually far more likely to be the VICTIMS of violence, be it abuse, rape, or murder, than to be the perpetrators of such violence.  But this is NOT the picture depicted by the media, whether in response to real-life tragedies or in books & films.  Tragically, even within the healthcare field, there is a great deal of prejudice against mental illness.  Far too often the moment a nurse or doctor sees a mental health diagnosis, an eye-roll ensues & the patient is viewed though a considerably different lens than someone without such a diagnosis.  What I’ve found in my own practice as a nurse is that patients who are actually mentally ill, if treated properly, are in fact no more difficult to care for than anyone else.  While I’ll be the first to admit that I feel ill-prepared to handle patients in acute psychosis, in general I’ve found that mentally ill patients do not deserve the negative stereotypes so unfortunately assigned to them.

My point in writing all of this today is to help people understand that mental illness is extremely common, but it’s not something of which we should be afraid or ashamed.  Though the treatments available are far from perfect, they can & do make a tremendous difference.  If you’re looking for a personal perspective, I am happy to report that I am already feeling significantly better since starting my own anti-anxiety medication just a week ago.  With a combination of cognitive behavioral therapy with my therapist, regular saturation in music & other such relaxing activities, & now Prozac, I can honestly say my anxiety is becoming more & more controlled.  While I have no idea what it’s like to suffer from a severe mental illness, I do know that having my anxiety better-controlled is greatly contributing to my quality of life.  But I couldn’t say that if I hadn’t sought treatment last year (first through therapy & now additionally with medication).

Furthermore my hope is that after reading this you will become more aware of your own prejudices against mental illness.  We’re all guilty of them at times.  Having a dear friend who is bipolar has radically changed how I view mental illness, as have my own struggles with anxiety.  What I’ve learned is that mental illness is just one aspect of a person; it doesn’t define them.  No one chooses to be mentally ill just as no one would choose to have diabetes or heart disease or cancer.  I’ve also learned that sometimes just being a friend & lending a supportive hand & a listening ear is one of the greatest things you can do for someone suffering from mental illness.

I am not my mental illness

 

As former NJ governor Richard Codey stated, “For too long we have swept the problems of mental illness under the carpet…and hoped that they would go away.”  But the reality is that these problems are not going away & probably never will.  But if our society can decrease the stigma against mental illness & increase our understanding of these conditions, we can offer more hope to those suffering.  Remember, if you’re not part of the solution, you’re part of the problem.  Be an advocate for proper understanding & treatment of mental illness.  Stand up to those around you who propagate negative, harmful stereotypes against the mentally ill.  The grim situation of the mentally ill in this country will never change until our attitudes about mental illness change.

Most importantly, if you’re reading this & you feel like you might be suffering from a mental illness of any sort, I hope you’ll have the courage to get help.  The world can be a cruel place for the mentally ill, but nothing is worse than suffering in silence when help really is available.  To those who are lucky enough to not suffer from mental illness, open your eyes & your mind to those hurting around you.  Don’t diminish their disease by telling them it’s not real or they’re just looking for pity.  Encourage them to seek proper treatment & be that listening ear when they need it.  You never know when you might save a life by doing something so simple.

mental illness not contagious

 

Statistics & other information found at:

http://www.cdc.gov/nchs/fastats/suicide.htm

http://www.nimh.nih.gov/Statistics/index.shtml

http://www.nationalhomeless.org/factsheets/Mental_Illness.pdf

The Negative Emotion-Guilt Complex


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Last week I had my monthly session with my therapist & I told her how that week I’d had my first real anxiety attack in at least a month or more.  It happened on Monday afternoon of last week when I was just feeling overwhelmed with my busy schedule, working overtime, lack of sleep, etc.  Thankfully with some encouragement from a dear friend of mine, diffusing & applying several essential oils, & some deep-breathing exercises I was able to quickly move past the anxiety attack & get on with my busy day.  It felt like such a big step for me to be able to tell my therapist that not only was that my first real anxiety attack in a long time but, perhaps more importantly, I didn’t allow the attack to ruin my entire day or week.  Instead of feeling defeated & discouraged & beating myself up over having a “bad day” I just rejoiced in the fact that I was able to recover so quickly & move on with my life.  You have to understand that ordinarily when I have high anxiety days or anxiety attacks for whatever reason (often there really is no reason) I not only have to cope with the anxiety itself but also with guilt over suffering from anxiety problems.  This guilt of course only serves to compound the problem.

I grew up with the idea that certain emotions in & of themselves are sinful.  I’m not sure exactly where I got this idea but it was just there.  Add that to the perfectionistic, high-anxiety personality I was somehow born with & you’ve got a pretty difficult situation.  For the first 18 or so years of my life, whether I wanted to or not, I believed that “negative” emotions such as anger, fear, hate, frustration, sadness, etc were sins.  Naturally this created a horrible cycle in which I felt guilty for experiencing these types of emotions & then the guilt just triggered more sadness, anger, whatever & the cycle continued.  What a mess!

The older I’ve gotten the more clear it’s become to me that no emotions are ever sins in & of themselves.  Feelings are feelings, nothing more, nothing less.  They are what make us ALIVE.  They are what make us human beings.  For example, it is only human nature to be angry at times, even to the point of wanting to hurt someone or something.  It is what we DO with our emotions that matters.  For example, when we strike out in anger at someone, whether verbally or physically, that is when we cross into sinful territory.  Allowing so-called negative emotions to overcome us to the point of being permanently bitter is also perhaps sinful.  But again it is not the feelings themselves that are the problem; it is the actions that spring out of them.  And I for one believe that, though fallible, we as humans have the power to control our emotions.  We might not be able to stop ourselves from feeling angry or frustrated over certain things.  Nor should that even be the goal.  But we DO have the power to stop those emotions from ruling us & causing us to act out in ways that hurt ourselves or other people.  To me that is the definition of sin (I hate that word but can’t think of anything better at the moment): something that hurts yourself or someone else.  I know that is kind of vague but the world is vague.  We only try to paint life in black & white because of how confusing it can be, to try to make sense of a world that is often unfair & cold.  But we do ourselves a disservice by trying to understand a very grey world in only two very extreme colors.  There is so much more to life than that.

I still struggle with anxiety.  But it’s not something that defines me anymore.  And I still struggle with not feeling guilty over having anxiety or experiencing other “negative” emotions.  But the greatest freedom I’ve found in life is when I let go of the guilt & just allow myself to feel whatever it is I’m feeling at that moment.  I have found that these so-called negative emotions leave a lot faster when I just admit what I’m feeling instead of trying to force myself to feel some other way out of guilt.  I don’t know if anyone else struggles with this or if it’s just me.  But I don’t think I’m that unique so I’m sure there are others out there fighting this battle too.  And I hope that if you’re one of those people & you’re reading this that you will be encouraged to move past the guilt & to learn to just enjoy being alive.  We all have our inner battles & we all have bad days because of them.  But as long as we don’t allow those days to define us we are winning. 

P.S. Whether you struggle with any particular mental illness or not, I strongly encourage everyone to consider seeing a counselor or therapist at least once in your life.  As a friend of mine once told me, we can all benefit from having someone to vent to who isn’t emotionally attached to us because no matter how “perfect” our lives may be, we all have issues we could benefit from discussing with an impartial mind.