Mental Illness and Exhaustion: Give Yourself a Break

Mental illness and exhaustion: Friends that seem like conjoined twins.

My friend texted to say she’d had a rough trip with her family. “Lots of stressors and I forgot my Xanax,” she said. By the time she texted, she was hiding in the bathroom, running the shower so people would think she was just taking a long shower, and sobbing.

Which got me thinking about mental illness and exhaustion, something virtually every mentally ill person I know deals with.

Any psychologist will warn you about stressors in your environment. My psychiatrist even tells me that she could make literally anyone psychotic if she were allowed to put them under certain kinds of stress. As she is a 5’2”, kind-as-can-be female, I don’t get too concerned when she celebrates this fact.

Everyone has stressors, and everyone can be pushed over the edge; it’s just that those of us with a mental illness are a good bit less capable of dealing with mental/emotional/psychological ones. And at least for me, here’s why: I already have about 80% of my capacity for stress happening inside of my brain at all times.

Whether it’s depression or anxiety or OCD or bi-polar disorder, if our illness(es) are up and running, we already feel like a normal person probably would after their most stressful week at work: Boss in a terrible mood, layoffs on the horizon, huge projects coming due, 70 hours, and missed three of your kids’ events to boot.

After all that, even a normal person would probably be pretty unhappy to find out that s/he had Friday night dinner guests coming over. But they could probably take a deep breath, muster up the last vestiges of energy they had, and smile when the guests arrived.

Now, maybe, we’re on a level playing field: you with your long week and me with my brain that never stops questioningaskingwonderingwhatifing, are both running on fumes, but if we hit the lights green and put the car in neutral as we’re going downhill, we can make it to the gas station. Maybe. If we’re lucky. If things go well, we might even enjoy the evening.

But we’re on exhausted and not at our best. If someone says the wrong thing; if your kid spills a drink; if your spouse uses that tone with you; or a million other “ifs,” we’re going to have to use the last of our energy to keep from performing professional wrestling moves on our dining room table. Actually, we’ll probably become angrily quiet and use the bathroom seven times until these intruders finally leave and we can go to bed or yell at our innocent families or pets.

I offer this not as an excuse but as an explanation from someone who has been both people in the above scenario. In my younger days, before my depression became overwhelming enough that it might well end my life if I ignore it, I could work a 70 hour week and still hang out with friends on a Friday night. Without even planning to slash their tires on my way out. I could even stomach a couple of busy weeks in a row with a not-very-restful weekend in between. Looking back, it seems like I had a puppy’s energy level in those days. I dealt with OCD back then, but it was well-medicated and fairly calm. I was pretty “normal.”

Not anymore, though. Between my OCD and my often-crippling depression, I feel like I’ve had a long week when I wake up after ten hours of sleep. If the kids are loud, or in bad moods, I’m pretending I need to use the bathroom for half an hour at a time just to attempt a reset. Which almost never works. Depression makes me feel completely sapped of energy, much like you would on the worst day of a bad cold. Technically, I probably could do the tasks that need doing, but just standing up from a chair feels like tasks 1-34. Then the guilt sets in that I can’t just suck it up and do what everyone else is able to do. And now I’m at war with two demons: the energy-drain of mental illness AND the guilt of being a human being who wants and wishes to do more.

I wish I could tell you that I’ve found a medical solution for this problem regarding our constant exhaustion. Maybe someday. But for now I offer two small things: First, you are not alone. If I can tell you anything from doing this work for awhile it’s that exhaustion is one of the most common symptoms of mental illness. I promise that you are not alone in this feeling. Second, give yourself grace. Any healing that might happen has to start there. There’s absolutely nothing wrong with providing for yourself the kind of care you need. Imagine if your body was lifting weights all day, every day, and even when you slept. You’d expect it to be exhausted. And that’s what your brain is actually doing.

To sum up: You’re very tired, and so am I. Others may not see why, but we can see why in ourselves and in others. So give yourself grace, and when you’re up for it, let someone else know they are not alone in their pain.


BEFORE YOU GO: Friends, in my consistently inconsistent fashion, I have finally gotten started with the page I began working on about six months ago. I’m as excited about it as anything I’ve ever done because it takes my story out of the center of this blog and puts yours there instead. Please head over to and listen to one or two of the stories there. THEN email me and let me know you would like to add yours. I’ll send you instructions. It can be anonymous if you want. I can even mask your voice a bit through the magic of technology. So don’t be shy! ALSO, NO MATTER WHAT YOU HAVE TO SAY, YOUR STORY WOULD HELP SOMEONE. It doesn’t have to be jaw-dropping. The more ordinary the better. I just want people to know they have company in this world. I want there to be hundreds of 15-30 minute stories there eventually. All you need is a smart phone and a quiet place to record. I can edit out all of your mess-ups so you can just talk and not worry. Please, please consider joining in the effort and email me at:


Articles for further reading:

From The Mighty

From the Mental Illness Alphabet


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Humor and Mental Illness

It’s no secret that comedians often come from very dark places. People often tell me that I’m funny, which I take to mean, “Tim, you should get help!” But they are completely right: I am funny. But seriously, I do think that, for me, humor and mental illness go hand-in-hand. I’m incessantly aware of life’s inconsistencies and ironies, and those provide perfect fodder for a few laughs throughout the day.

Last week, I watched a Netflix special that was so powerful and profound, and it got me thinking about this marriage between humor and mental illness once again. The show is called “3 Mics” and the stand-up comic is named Neal Brennan. It’s not spoiling anything to tell you that the whole 3 microphone concept goes like this: At each of the mics, he talks about different sorts of things. One is for silly one-liners; one is for normal stand-up comedy; and the last one is for, as he puts it, “emotional stuff.”

When he first went to the “emotional” mic, I figured he might be doing just a different sort of comedy – making fun of himself and what a crybaby he is or something like that. So when he started talking about his depression, I was intrigued. Here was a guy who clearly understood depression. I can always tell when someone truly speaks depression and when they just want to pretend like they understand to be nice. Neal speaks depression fluently. But he threw me for a loop because he never rescued the “bit” with humor. He was just plain and simply talking about his deep battle with depression. He was mixing humor and mental illness, but not by making mental illness funny as many try to do. Instead, he was giving it its full, brutal, weighty due.

Then he did more standp-up comedy (probably 70% of the show is stand-up comedy), but then he came back to the mic. This time he talked about his father. His father was terrible, but I’ll let you watch and hear for yourself. It’s horrific. But also powerful in a way that only tragic things can be.

Overall, this hour-long Netflix special felt like taking the perfect, soothing bath. I felt like someone had told it like it is in a way that made me feel like I had a new friend. I loved the comedy, too, because what else are you going to do when life can look so grim and tragic other than try to laugh a little. Brennan found the perfect marriage between humor and mental illness, giving each their proper place and weight. And while I’m pretty sure Brennan isn’t an avid follower of this blog, I felt the kinship that I hope to share with you: We may not know each other, or ever meet for that matter, but I hope you are encouraged to know you are not alone. Mental illness is a lot of things, but one of them is certainly LONELY.

So go watch Neal Brennan’s special or call a friend who gets it or email me or post a comment or whatever…find a friend because we are out here, and you are not alone.
I write this blog because I want people to feel encouraged that they are not alone. Please share it with someone who might need to read it. Thanks!
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Mental Illness and Relationship Problems

There’s a sign at the Zaxby’s near my house with a quote from John Wayne that reads, “Life is hard; it’s harder if you’re stupid.” I’d like to make a similar sign that reads, “relationships are hard; they’re harder if you have a mental illness.”

I’ve come across countless people since I started this blog who have basically the same story: I’ve lost friends’ and family members’ support because of my illness; I have no one left.

My friend who battles profound depression had a group of friends tell her they couldn’t go through one more bout with her and they walked out of her life.

My friend with severe OCD had a decades-long friend ditch her because she couldn’t get over her germ obsessions to take the dog to the vet when it was sick.

Some don’t get dumped so precipitously. It happens slowly, too: This week I came across a great article by a college student about how anxiety is an unacceptable excuse for not being able to go out with friends. Most people will put up with an anxious friend who often backs out of plans at the last minute, but few will do so indefinitely. They give up and move on to people who aren’t worried about ridiculous things.

My own friendships have been harmed or lost due to my hypersensitivity. Over the years, more times than I can count, I’ve gotten upset by things that wouldn’t upset other people. I am incapable of just “moving on” and so I tend to tell the other people how I feel. Often I do this nicely; sometimes I don’t. But surprise, surprise…a lot of people don’t enjoy this quality of mine which is a mixture of OCD (I can’t just let it go) and anxiety (a fear of abandonment that leads me to wonder why other people have treated me a certain way).

Sometimes just telling another person they’ve upset me, even nicely, makes them distance themselves from me. Thankfully, many of my friends have been able to handle that version of me. What’s harder to handle is the anger that sometimes rears its ugly head in my confrontations. On an aware-of-the-world-around-me scale, I’m living at level 9 out of 10 all the time. So when something causes you to go from your normal 3 to an angry 6 (call it a normal argument level), I would then be at a 12. I say things I shouldn’t say; I get more angry than I should probably ever get; and our argument goes from something normal and irritating to something that might end our friendship.

I’ve had more of these arguments than I care to list. I’m incredibly ashamed of them, and I’m not even willing to go into much detail here because the shame is still so palpable. But over the past few years, as I’ve really struggled to maintain my grip on sanity, these blow ups have been painfully prevalent.

Those on the receiving end of all this perceive it as simply bad behavior. They can’t fathom why you’ve taken a “small” conflict and turned it into something enormous. The reality is, you can’t either. But you keep doing it because your brain doesn’t have a normal baseline, and sadly, your illness doesn’t show up on an X-ray; it shows up as “behavior that you should be in control of.”

If you are mentally ill in some way, I suspect you have stories of your own. Often the trouble comes from people who think you should just “get over it.” Sometimes it comes from your own quirky (I refuse to call it “bad”) behavior. Regardless, mental illness makes relationship more difficult than they already are. My hope is that this blog can in some small way be a touchstone to let you know that you are not alone and that you deserve better: You deserve understanding, patience, grace, and kindness. You are some of the most caring and tender souls in the universe and it’s a cruel joke that you often can’t find the understanding you need. Keep fighting; I hope you will find someone(s) who let you be you, quirks, relationship difficulties and all.

To those of you who are the supporters, this is where you have the chance to help erase the stigma. When someone you love has a mental illness, accept the very real truth of this…just as you would if they were in a wheelchair or had a chronic disease or even something like cancer. You’d change your expectations to accommodate for the illness. You don’t have to quit holding them accountable: you can still tell them when they’ve stepped over a boundary line, but you might start from a different place than consuming frustration or raging anger. Start from the same place you would if your friend in a wheelchair got frustrated navigating the park and just gave up and decided to lag behind for the rest of the trip. Maybe they were whiny; maybe they took their frustration out on you or blamed you for wanting to come to this hilly park; maybe they acted like an ass. You can tell them that, but give them a little grace, too. You’ve never been to a hilly park in a wheel chair.

Finally, please remember this if you take nothing else away: the quote at the top about those who cease to be friends is true. If you give up on a friendship when the other person is still willing to work on it, your part of the friendship wasn’t as genuine as you may have thought. I don’t say this to shame anyone; I use strong words here to drive home my point. Truly caring for a mentally ill person means there are going to be some tough waters to wade through. Please stay the course. We need people in our lives who will do that.


To Know We Are Not Alone is now an official 501c3 entity. Our mission is to educate, encourage, and connect people who suffer from mental illnesses. Please help with a small (or large) donation if you can. You can do so here.

More importantly, if you know someone who needs to know that they are not alone in their struggle with relationships or mental illness, please share this post/blog with them. Thank you!


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Anger and Mental Illness

I’ve been told many times that I might have a teeny tiny tendency to fly off the handle in the midst of conflict. To which I say: “Guilty as charged!” I have anger issues.

Therapists say that anger is a “secondary emotion,” meaning that there’s an underlying cause, which is the actual problem. So when someone gets angry, it’s really hurt or fear or sadness manifesting itself as anger. Unfortunately, anger, at least for a man, is more socially appropriate that sadness or fear or hurt feelings – not that those are the only three things that become anger, but those are the top three for me.

I hate to brag, but part of my problem is that I’m often way ahead of people, but not in a I-already-looked-up-the-directions-to-the-restaurant sort of way (I never look up directions until I’ve actually started moving in the car). My way-ahead-of-you-ness is more like this: When you pissed me off yesterday by saying something that you thought was no big deal but I was upset by because I’m hyper-sensitive, I started having a conversation in my head that involved all the possible things you might say to me, and if you say x, y, or z, I’m going to lose it because there’s a backstory to why those sorts of comments infuriate me going all the way back to fourth grade, but there you went and said that very thing, and now I’m as pissed as if you punched my wife in the face, so please forgive me while I slash your tires because you said THAT.

I’ve never actually slashed anyone’s tires, and for the record, I’ve never punched anyone, slapped anyone, or even grabbed anyone by the hair and swung them around just to scare them. Never. Basically, when I’m mad, I become the world’s best arguer, you see, because I’ve already had this conversation 64 times before we got started. I did not want to have this conversation 64 times, but my feelings were hurt, and I have these overwhelming abandonment issues, you see, so the second things go awry, I’m basically a little child who is scared.

And like a scared little child, I lie awake and think of all the awful things that might happen mixed with all the awful things that have already happened, and I’m inconsolable. I just happen to be a grown man with a pretty good handle on the English language so that makes me a little child who is good at making you feel pretty bad about yourself. And because I’m a grown man, I’m not allowed to do what kids do: ask incessant questions to try to feel safe…or cry to the person who upset them because they haven’t learned the stupid social code that tells them not to admit weakness…or even just sulk until someone drags it out of them. Nope, I just start putting up the defenses, which involve an angry tone of voice, body language, and words.

Certainly not all folks with a mental illness respond to the world around them in anger. However, all mentally ill people I know struggle mightily with feeling misunderstood. Because our brains won’t cooperate, we respond to situations in extreme ways. Here’s a metaphor: We’ve all had that road rage encounter where something very minor goes awry, and another driver absolutely loses it – honking, shooting the bird, maybe even pointing a finger gun at you and pretending to kill you, as I once had happen. The natural reaction, of course, is to think, “What has humankind come to? What kind of crazy people are out here wandering the streets? I hope that guy accidentally cuts all of his fingernails way too short and lives in pain for a week.”

But we also, hopefully, know that whatever happened in that moment is certainly not the whole story…that the healthier reaction, if we could sit down with Road Rage Man would be to ask, “What’s going on that something so minor upset you so much?” For our own sanity and the sanity of the world at large, the better reaction would be to feel sorry for someone who overreacted so badly. No one overreacts without cause, and who knows what justifiable reasons that driver actually has to pretend to kill you just because you moved over a lane when he wanted that empty space to himself?

I assume the analogy is clear, but I like overstating the case, so I’ll spell it out for you: Mentally ill people (and plenty of others, too!) are the angry driver. Are they overreacting? Of course. Are they far too angry about the situation at hand? Definitely. But might they have a very good reason? Yes.

That doesn’t mean you allow people to walk all over you or yell at you unnecessarily. But it means you will improve your relationship with your mentally ill loved one if you can learn to see past the surface behavior and try to understand what’s at the root of said behavior. For my part, I know I’m angry. That’s not news to me any more than my awareness that I’m male. But it’s also true that, when someone will stick around long enough to get past my fit of rage, they will realize that I’m actually just sad and fearful and broken. And those emotions are far easier for most people to interact with than anger.

So for those on the “giving” end of the anger, you’re not alone, and mercifully, I’ve discovered that there are some people out there in the world who can see past your anger. Try not to shut them out the first time they infuriate you. Many of them really do want what’s best for you. And for those on the “receiving” end of the anger, take deep breaths; try to be patient; and try to see that your loved one might not mean to fire finger guns at you; they’ve just been sitting in traffic for a long, long time.


Well, the time has come to ask what I hate asking because I am pathologically afraid of annoying people. But the reality is that this endeavor has grown beyond a simple blog. I’m already spending a couple of thousand dollars a year now that I’m podcasting and doing some advertising (promoting) on Facebook. In the near future, I also plan to start at least one and hopefully multiple small groups dedicated specifically to helping mentally ill people know they have company. That, too, will require time and money. Long story short, I need some additional resources. Now that I have 501(c)(3) status, I can ask you for help while at the very least offering you a tax deduction. There are 3 ways to donate:

  1. You can transfer money directly from your bank via PayPal donations (seriously, why don’t you have a PayPal account by now, people?!).
  2. You can use PayPal to make a credit card donation.

  4. You can write an old-school checks (ask your grandmother to show you how to write one, and then email me at for the mailing address).

All covering-up-my-discomfort-with-humor aside, I want to grow this endeavor into something that helps more people and helps them in more of a variety of ways. Anything you can contribute would be profoundly appreciated.


More importantly, if you know someone who needs to know that they are not alone in their struggle with anger or mental illness, please share this post/blog with them. Thank you!


Want to know when there’s something new here? Sign up for the blog below. Tim also has a Facebook community called To Know We Are Not Alone and frankly, so if you’re on Facebook, join us there, too. [jetpack_subscription_form title=”” subscribe_text=”” subscribe_button=”Sign Me Up”]



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Podcast: Talking about Mental Illness at Work

In this episode, Tim discusses the pros and cons of telling people at work about your mental illness. He also welcomes two guest contributors whose experiences differ somewhat from his.

Helpful websites (the links are giving me trouble so you’ll have to copy and paste these):
Music credit: Lady Antebellum, “Compass”

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After Orlando

My friend Matt, from California, texted me this week to say how much things like the Orlando shooting affect his moods. I understood what he meant. When I’m not doing well, I literally can’t read the news – any news – because the bad news (most of it) will inevitably send me spiraling downward.

Rather than heed the internal voice that told me to stay away from the news about Orlando, in an attempt to make my own life miserable, I did the equivalent of a diabetic eating nothing but donuts: I started sharing my political views on Facebook. There’s a reason people suggest not doing this, and now I know what it is: people are fucking crazy. And illogical. And mean. And, well, stupid. (Not you, of course!)

Not to mention the “me” part of the equation: I’m hypersensitive, opinionated, liberal (with lots of conservative friends), and mentally ill. I don’t know how long it’s going to take before I realize that I am not emotionally equipped to have “spirited” debates about things like whether or not a 9-year-old should be allowed to take her AK-47 to the playground for recess, but 40 years haven’t done the trick. I STILL think, “this time, I’ll be fine. My brain is in a good place (which it’s not, actually)…I can deal with a little backlash.” So I post something nice and benign, something Gandhi would probably post, like this: “I think semi-automatic rifles are helpful…for identifying the people with the smallest penises and the greatest need for a therapist who specializes in daddy issues.” Oddly, people react negatively, and then guess what? I get my feelings hurt because I’ve been misunderstood. Again. (For the record, I do like the idea of the post above, but what I actually posted was a good deal more nuanced and generous.)

But completely seriously, I’ve discovered yet again how bad it is for my brain to get into debates without some really safe boundary lines. I only have a few people in my life with whom there is enough trust and safety that I know we can discuss anything openly without me losing my shit at some point. It’s true that perhaps the quickest way to send me over the edge is to make me feel misunderstood about something I am passionate about. I still can’t entirely identify why it makes me so angry to feel like someone isn’t hearing me out or catching my drift, but aside from threatening my wife or children, it’s the quickest way to see my very worst side. Please don’t try it!

In talking with my mentally ill pals, what I’ve discovered is that this sensitivity is a common theme. Our brains are already hardwired for chaos, fear, depression, anxiety, obsessive thoughts, etc. We don’t need any help going down rabbit trails that are unhealthy. So when a “friend” calls us “willfully ignorant” or “just another liberal who espouses tolerance while being intolerant,” we are not able to, as some seem capable of doing, think to ourselves, “Oh well, that’s just X’s opinion. We’ll agree to disagree.” Instead, we lay awake at night going back and forth between mentally drafting angry responses to wanting to cry for how misunderstood we feel. And this, my friends, has been my week: attempts at dialogue leading to arguments leading to hurt feelings leading to lost sleep, anxiety, incessant what if questions about how to proceed, withdrawal from family, extra doses of Xanax, and so on.

So the first point I’d like to make is this: If we are going to take care of ourselves as mentally ill people, we have to be willing to set different boundaries than our “normal” friends set. So often I am guilty of berating myself for not being able to do things like so-and-so does them, and my friends tell me this is true of them, too. But we have do some inner child work here. We would never tell a five-year-old that he should be able to do what a fifteen-year-old does. Likewise, we must parent our own inner, mentally ill child and reassure him that it’s okay to not be like the other boys and girls. It’s okay that he can’t handle the madness of Facebook the week after another massacre. If Sally can handle it just fine, let her. I’m not Sally. I will do what’s best for me. It’s not so different from alcoholism. The alcoholic has to forgive herself that she can’t hang out at bars with friends. Sure, the rest of her friends can do so, and sure, she wishes desperately that she could. But the bad too far outweighs the good, and she has to gently, lovingly care for the inner child that simply isn’t capable of handling the temptations of a bar.

There’s another angle on the Orlando shootings in regard to mental illness, though. It has to do with the “all of these mass murderers are mentally ill…that’s the problem we should be focusing on” utterances of this week. On a practical note, and for the record, anyone who says, “THIS is the issue we must focus on” is oversimplifying the problem. It’s never just one thing. But the reality is that virtually every shooting is perpetrated by someone who is mentally ill. I once talked to a very experienced therapist who made the point that he didn’t think anyone who WASN’T mentally ill even had the capacity to commit murder. It may just be that, in order to kill someone, by definition, one must be mentally ill.

This week, yet again on Facebook, during one of these, uh, er, discussions I was having on Facebook, someone pointed toward mental illness as the thing we really need to be talking about. I whole-heartedly agreed. But I don’t think I meant what she thought I meant. I wouldn’t put mass murder at the top of the list of reasons why we need to address mental illness in this country.

First on my list would be simply the quality of life for mentally ill people…then maybe preventing mentally ill people’s suicides…and so on. As horrific as these mass murders are, what might be even more horrific is the daily trauma faced by millions of people who suffer inside their own minds and can’t find anything to make the problem better.

It’s amazing to me that we can send a rover to Mars that communicates with earth and we can send an email to Japan that takes less than one second to get there, yet despite the collective thousands and thousands of years those of us who participate in this blog have spent seeking mental health treatment, many of us are more hopeless than ever. We’ve tried the drugs, the talk therapy, the shock treatment, the magnetic field treatments, the deep brain stimulation, the support groups, the illegal drugs, the alcohol, and yet, we are still DESPERATE for something that provides even just a little bit of relief. People who like to point to the mental illness crisis as the reason for these mass shootings may mean well, but if they really knew what they were talking about, they would sound this drum day in and day out on behalf of those of us who grimly hope that we will one day be the victim of a mass shooting. Many more lives are being lost at the hands of mental illness than the victims of shootings. Millions of people right here in America have lost their lives in an entirely different sense. Let’s talk more about how to help those people.


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How To Help Someone with Mental Illness

supportIt can be awfully hard to know how to help someone with mental illness! Take me for example: Saturday morning, I was comatose with depression on my couch for four hours, hoping for a stray meteor to find its way to me. Today, I’m overflowing with so many exciting ideas for how to solve the world’s problems that I would challenge Steve Jobs to a Battle of Creativity. This, my friends, we call Bi-Polar (type 2 to be exact). You can imagine what fun my wife and kids have playing the “what mood will daddy be in ten minutes from now” game (for now, Ann has a small lead over Josiah, and for some reason Ellie Ruth isn’t very good at the game…she’s way behind, but I’m starting to develop some special signals for her so she can catch up).

So perhaps I’m the wrong person to write this post, since I haven’t had to be the supporter in any substantial way. Thus, what follows is simply the advice of someone WITH mental illness(es) to those who, thanklessly, painfully, fearfully…are supporting someone with mental illness.

A friend of mine recently called looking for advice on how to support his deeply depressed wife. Like many people who are NOT mentally ill, he was frustrated and baffled by his wife’s behavior and her unwillingness to listen to reason. He continued attempting to have conversations with her about how he could help, but he was thwarted by her erratic answers – sometimes she simply told him, amidst sobs, that she didn’t know how he could help; other times, the “saner” moments, she was reluctant, even embarrassed to discuss her previous behavior and couldn’t/wouldn’t offer much in the way of advice to her husband about what she needed when she was in “that place.” My friend was stumped, scared, and frustrated.

Perhaps you’ve been there if you’re reading this…You want to help, but you don’t know how, and the person you are trying to help behaves so inconsistently that you never know if you should leave them alone, hug them, take them to the hospital, or tell them to snap out of it. I’m quite sure my amazing wife, Ann, would understand your frustration as she has felt it with me (but not for at least an hour or two!).

I certainly can’t speak for everyone with mental illnesses, but I’d like to offer a few pointers that might be of help:

    1. Take charge lovingly. Recognize that you are the one who is seeing the world more clearly than your mentally ill loved one, and take charge of the situation lovingly with that in mind. For example, my young children wear me out mentally. I’m just not cut out to be with small people for prolonged periods of time without becoming extremely overwhelmed and ultimately depressed/angry. But I want to be a good dad/husband, so I often am with them for long periods of time, thus becoming overwhelmed, depressed, and/or angry. My wife knows when I’ve had enough based on how I speak to the kids, and she is usually kind enough to ask me, “Do you need a break?” But here’s the problem: My broken brain can’t see straight in those moments, so guilt usually wins out over my mental health and I say, “No.” The truth is, and I’m not saying that this is fair, that I want Ann to say to me: “Tim, you need a break. Go take 15 minutes of alone time and then we can reassess.” I would take her up on it 100% of the time, but when I’m left to make the choice for myself, I’m not able to think reasonably, “You know, I do need a break, and yes, my wonderful wife, I’ll accept your offer!” Again, that’s not necessarily fair, but if you, the healthy one, will take charge of the situation, I for one would appreciate it, and I suspect others with a mental illness want the same thing.
    2. Don’t expect them to be reasonable. Once again, I’ll use my children as an example. When one of my children throws a temper tantrum, I, of course, get frustrated by their behavior. Despite having plenty of evidence that you can’t reason with a small child who is throwing a tantrum, I continue to try to reason them out of this behavior by saying things like, “You’re not helping the situation” or “You’re making your own life worse by acting this way.” Any reasonable person would understand what I mean, right? Of course! But a tantrum-throwing child isn’t in a reasonable state of mind, and “fighting” a tantrum with reason will only lead to frustration for both parties. The best solution when a child throws a tantrum is to literally put them in a safe place so they can “process” their anger without hurting themselves, your dog, their sibling, or your eardrums. It’s the same thing with a mental illness: Help the person get to a place, literal or figurative, where they can feel what they’re feeling safely and productively. Having dealt with OCD my whole life, I am well aware that my obsessive thoughts are unreasonable…that’s why they’re so disturbing! But that hasn’t enabled me to stop them from running through my mind. This is where this piece of advice ties back to #1: You, the sane one, need to lovingly take charge. If someone is in the throes of depression, don’t tell them to look at the bright side. Instead, gently insist that they go do the thing(s) that tend to help them improve. For me, it’s time to myself to think and write…it almost always helps. If not that, then working with my hands on a tangible project will sometimes do the trick. Sometimes, there’s nothing that helps, but when I’m in the midst of depression, it’s virtually impossible for me to stand up for myself and to take what I need. I can’t be reasonable, but if someone around me can push me in the right direction, it might help me get back to a good place more quickly.
    3. Set boundaries about how you will respond to their struggles. As you probably know if you’re reading this, it’s exhausting to support someone with any illness, especially one that is unpredictable and turns your normally-rational loved one into an irrational mess. The friend I mention above confided in me that his wife is not above a little melodrama, so he’s never sure how much of her behavior is attention-seeking and how much is authentic. My advice to him was to tell his wife that he had no choice but to take her at her word…the stakes are too high. Thus, if she says she’s suicidal, he should tell her that he will take her to the hospital because he can’t take the chance that she’s just being dramatic. Another important boundary involves the mentally ill person taking his/her pain out on the care-taker. I’ll use myself as an example here: When my OCD regarding my wife (see my book for more on this) is raging, one of the natural compulsions is to think that talking to her about it might help me get to the bottom of my concern. It won’t! Ever. And it’s entirely unfair for me to talk to her about my negative thoughts about her. All that will do is to hurt her deeply. In this case, we have a boundary that when I’m obsessing about her, if I need someone to talk to, I need to pick one of the other close friends (or a therapist) to discuss this stuff with. The scenarios are endless for what boundaries you might need to set, but start paying attention to yourself, and know that the best way to love someone is to be the healthiest version of yourself so you can be there for them when they need you most. It might take time to figure out the appropriate boundaries, but don’t feel guilty for needing to set them. It’s ONLY by setting them that you can help your mentally ill loved one thoroughly.
    4. When they’re feeling good, ask them how they want/need to be dealt with in the bad moments. Most people with a mental illness have their good days and their bad days. As someone who offers support to a mentally ill person, your best resource might well be that very person, but only when they’re in a good place. This will have to be an ongoing conversation about what is and is not helpful to your loved one, but every day, week, and month you gather more data that can be used to help both you and the other person move forward to a more healthy place. As I’ve mentioned before, one thing I need when I’m in a bad place is for my wife, who is quick to recognize it these days, to take the lead and tell me what to do. In my case, she needs to tell me to take some time away to hit the reset button. When I’m in that bad place, I’m nearly incapable of taking care of myself, but by staying physically present with my wife and kids when I’m not doing well can cause a lot of unnecessary damage – a lot more damage than would be caused by my taking a “time out” to get my head clear. Your loved one might not know how you can best help them right away, but tell them to ponder and pay attention to what they need when they’re not doing well. Maybe it’s a hug; maybe it’s a time out; maybe it’s a trip around the world on a Disney Cruise ship…who knows? But let your mentally ill loved one be your most helpful resource when they are in a healthy enough state to think clearly about what they would want/need in their bad moments.
    5. Take care of yourself. This goes back to #3, but I can’t say enough about it. If you’re not healthy, you can’t be of very much help. Think of it this way: If you were taking care of someone with the flu, you’re not much good to them if you run yourself so ragged that you get sick, too. Not only do you endanger their health further, your own ability to respond to the sick person promptly and thoroughly is diminished if you aren’t healthy. The same goes for mental health. Figure out how to fill up your own gas tank so you can help the person you care about. If your tank is empty, you’re of no real use to them.
    6. Give grace…to yourself and your loved one. Start with yourself. This shit is hard! It ends friendships, marriages, and even lives. Don’t fall into the trap of blaming yourself for not always knowing the right thing to say or how to be of the most help. Instead, literally say this to yourself, “I’m doing the best I can, and that’s all I can do.” It sounds corny, but having been forced by a therapist to do this myself, I can say it actually works: Look in the mirror and affirm yourself for trying, for loving someone who isn’t always easy to love, and for demonstrating the truest version of love – the unconditional kind. And don’t forget to give grace to your mentally ill loved one, too. Hopefully, they’re trying as well, and some day down the road, we’ll be better and figuring out exactly what part of a person’s brain is malfunctioning. Those x-rays or images will make it easier to understand that the person isn’t necessarily choosing to be an erratic ass. Most likely, they’re similar to a person with a broken leg trying to walk without a cast or crutches. If the bone was sticking out of their leg, it wouldn’t be hard to give them grace for going a bit slower than normal or yelping in pain every few steps. But mental illnesses aren’t visible…yet. So whatever metaphor helps you recognize that they’re dealing with something that really is physical and that really can’t be just wished away, try to remind yourself that you can’t expect someone with a broken brain to process life the same way you do. And once again, when you fail, give yourself grace. Then try again. That’s the best you can do.


**People often ask if it’s okay to share what I write with others, as if I am trying to keep it private. Uh, yes, it’s okay since I do publish this on the interweb. But really, I’d be most appreciative if you share this blog (or post) with others. Who knows where it will lead? Thanks for your help!

Other articles you might enjoy:

Amy Glynn reflects on Robin Williams’s suicide in a compassionate and helpful way, acknowledging that we should wish our friends who commit suicide had been equipped to stay around longer, but we should never simplify their behavior as “selfish” or “a permanent solution to a temporary problem.” A refreshing piece!

“7 of the Most Helpful Things You Can Say to Someone with Depression” An excellent piece that “gets it right” about how to help someone who is depressed.

(This post is also a page on the blog. It can always be accessed from the top menu.)

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You’re not “so OCD”!

"Sounds like an obsessive-compulsive disorder. Normal people don't spend that much time washing their hands."Last week, within 24 hours, I heard two blithe references to people “being OCD” on TV – one on The Mindy Project when someone said they organize their closet by color and Mindy said they were OCD, and one on Rachael Ray’s afternoon show when a chef said he’s “very OCD” in the kitchen. (Quit judging my TV habits, please.)

This is more than a touch annoying to someone who battles the demon of OCD daily, and my friends with OCD agree that this is one of the more obvious demonstrations of how poorly mental health problems are understood, especially OCD. I’ve recently learned that the World Health Organization lists OCD as one of the 10 most debilitating diseases known to man. Ponder that for a second.

Just to clarify, OCD means Obsessive-Compulsive Disorder. It causes one’s brain to fixate on horrific and terrifying things (these vary but they usually involve death, harming others, sexual aberrations, etc.). The person doesn’t want to have these thoughts and feels overwhelmed with anxiety because of them, leading to compulsions which are an attempt to get rid of said thought(s) – the (warped) reasoning being that, since the compulsion leads to a momentary lessening of anxiety, continuing the behavior will remove the anxiety completely. It doesn’t, but someone with OCD keeps trying their compulsions anyway. Many movies and TV shows have attempted to portray OCD, but they always do so in a very generic way, as with the show Monk or the movie As Good as it Gets, wherein Jack Nicholson plays a reclusive writer who does things like separate his M&M’s by color and turn the lock on his door a certain number of “magic” times.

The problem with these depictions is that it’s impossible to show the inside of a person’s brain, so all people see is the weird behaviors, and thus these sorts of Hollywood characters become lovably quirky rather than the inwardly tormented, often suicidal people that they really are. It’s virtually impossible to explain what it’s like unless someone actually has it. The best TV depiction of OCD is all of the shows about hoarders, as hoarding is a variety of OCD. The person thinks that if they get rid of something, a disaster will happen that could’ve been prevented if only they’d kept that empty yogurt container. Strange, yes, but that’s why those people fill their homes with “junk.” It shouldn’t be any more entertaining to watch than the show Intervention. The hoarding shows should be educational and sad, not entertaining, as they tend to be…”Let’s watch someone be crazy and chuckle at their silliness!”

But here’s the thing that actually makes it a true brain disorder: The person with OCD is every bit as aware as you are that his/her obsession(s) are absurd. My friend Riley who just died of OCD (sure, it will be chalked up to an overdose, but I’m telling you, Riley’s overdose was only an attempt to make his brain shut the hell up for a few hours. Countless people have died of OCD, but not one of them has that listed on the certificate of death…another indication of how little people understand). The person with OCD can offer far more “reasons” than you possibly could of why s/he should quit thinking about these things. And that’s the fucking madness of it, my friends…we want to stop, but our brains won’t let us. Literally.

As I’ve thought about how to write about this issue, here’s the analogy that came to my mind: If you know about ALS (Lou Gehrig’s Disease), it seems like just about as cruel a fate as life could offer. Like Stephen Hawking, those with ALS have brains that remain perfectly functioning while their bodies make it impossible for them to do anything, including communicate. Those who are forced to watch it happen must feel almost as tormented as the person to whom it is happening.

A severe mental illness is essentially the other side of the same coin: One’s brain is the torture chamber while the body remains perfectly normal. By no means am I trying to belittle something as awful as ALS or to say that any one life-sucking affliction is worse than another. Rather, I’m trying to get your attention just a bit by describing the inner torment of a mentally ill person. I once said to a counselor that I’d agree to have my legs removed in order to get rid of OCD…in a heartbeat. She sort of looked at me doubtfully, and I reiterated it: “I wouldn’t even hesitate for a second.” Others with OCD have echoed my sentiments throughout the years.

Let me tell you about the treatment for OCD so you might understand why so few people are willing to follow through with it. If medication is ineffective, the only other hope for someone with OCD is to undergo Exposure and Response Prevention (ERP) treatment. I tried this for awhile, but my obsessions are so intangible and my compulsions virtually unnoticeable and unstoppable because they are about 95% internal, the doctor agreed that I was hard to treat. But in the same conversation he told me that the easiest version of OCD to treat is germophobia.

Now, if you’re someone who carries around hand sanitizer and uses it a lot, you are NOT a germophobe. A true germophobe might take a shower that lasts 3 hours and come out bleeding or raw from scrubbing themselves so hard. If they mess up their shower rituals, they will start all over to make sure they do it “right.” A germophobe isn’t someone you see on a plane wearing a mask. A germophobe isn’t on the plane at all because they are locked in their house vacuuming a room 18 times in a row to make sure they’ve done it “right” and gotten all the dirt up. If someone has OCD, they are in a mental prison than never goes away – ever. I have literally had the same maddening thoughts in my head (see my book) for 12 years, and I cannot think of a moment when those very thoughts are not at the forefront of my brain.

So, the ERP treatment for this true germophobe, according to the doctor I saw is one of two options: 1. Don’t bathe or wash your hands for a week. 2. Put your hands in the toilet and don’t wash them while sitting with the doctor for your entire session. Even a completely normal brain would struggle with either assignment, I suppose, but in the context of OCD, you are asking someone to do something that scares them so much that their lives are completely dedicated to preventing the disaster that might happen by being exposed to a germ. If you’re scared of heights, this would be equivalent to being forced to stand on the plexiglass platform jutting out into thin air at the Sears Tower for an hour. Or if you’re scared of snakes, this would be equivalent to letting snakes crawl all over you for the 45 minutes of an ERP session.

Why do I feel compelled (funny pun, huh!) to write all of this? It’s not so you’ll feel sorry for me or anyone else with OCD…It’s so you’ll be a bit more thoughtful about minimizing the torment of mental illness. If you like your closet a certain way, don’t say you’re “OCD.” If you having an emotionally up and down week, don’t say you’re bipolar. Shoot, you might not even want to say “I’m depressed” when you have a bad day anymore. These things aren’t jokes. They take people’s lives away in a literal sense but even those of us who haven’t harmed ourselves are living in a prison that you can’t see. Even when we act like we’re doing okay, we’re actually hiding from the embarrassment of telling you how hard things actually are (see my post about why “how are you?” is the world’s toughest question).

Over the past few years, I’ve had two casual conversations with business men who have said OCD is a great quality in employees because “those sorts of people” do the best work. My friends, this is akin to telling someone you think cancer is a great quality because you prefer bald heads to hairy ones.

Even psychiatrists and therapists will tell you that OCD is one of the least understood mental illnesses. Depression, bi-polar disorder, anxiety, and ADD are FAR better understood and more easily treated than OCD. There are some anti-depressants that happen to help with OCD, but there is no such thing as a drug specifically for OCD, as there are for the other mental illnesses I just listed. If you have OCD, doctors basically start throwing darts semi-blindly and hoping one of them gets close to the problem. Often, medications don’t work, and for obvious reasons, people resist the idea of ERP. Then comes the decision of how long one is willing to live with the inner torture.

So this post has been a tad heavy, no? At least the comic at the top is funny, right? But I don’t write this to weigh you down, but as always, with the hope of educating a few folks as to the often-hidden suffering of those with a mental illness. Eventually, I have no doubt that the masses will recognize mental illnesses for what they are – faulty wiring in the brain – no more and no less. But sadly, we still live in a world where, according to one recent survey, nearly 50% of evangelical Christians still believe that prayer is all that’s needed to heal a mental illness. Would they say that about cancer? Obviously not. In the 1980’s, many people thought AIDS was God’s judgment on gay people. Thankfully, with enough education, most people don’t see it that way anymore. I hope that mental illnesses will be next in line to get fair treatment in the minds of the mentally healthy, but the only way that will happen is for people to get educated.

So, as always, I’d like to suggest that you either reach out to someone you know who’s battling a mental illness to let them know they are not alone. Or if you know someone who might need a bit of education on these matters, share this post with them.

Thanks for putting up with some not-so-light reading! You’ve survived. I’m done.



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Antidepressant Side Effects: Weight Gain and Hurt Feelings
This isn't actually me, but I do like the t-shirt.

Antidepressant Side Effects: Weight Gain and Hurt Feelings

I stand an imposing 5’9″ with an average build, so I should probably weight 160 to 170-ish. But ever since starting bi-polar medication (Seroquel to be exact) I can’t lose weight. I spent all of last summer exercising diligently 4 times a week for 45 minutes at a time…and doing the “fat burn” session to boot…only to lose exactly 0.0 pounds. Nothing, zip, nada. Still feel like the guy in the picture below after all that hard work!

In reality, I only weigh 196.6, so I think it’s fair to say that I’m still pretty normal insofar as Americans go, but sometimes I feel like I should go on Biggest Loser. Other times, it feels nice to have some heft – a sort of way to mark my territory in the world around me. But unless I want to go off of Seroquel, it’s probably there to stay, joining whatever future pounds find their way to my mid-section.

This past Sunday my wife and I were packing to return from a trip to visit extended family. I pulled out the electric scale from the bathroom in order to weigh our duffel bags so as not to exceed the 50 pound airline limit. The relative in question, who shall remain anonymous, stood looking over my shoulder at the scale, apparently unaware that most people’s weight is a matter of some sensitivity.

There it was: 196.6 lbs.

Not only did said relative stand there staring at the scale as I weighed in, s/he was also kind enough to comment: “Woah, 196, geeeeeeez!” s/he said with genuine shock at the number (I guess I carry my extreme fat well, right?!).

Time for Biggest Loser, I guess.

Perhaps I’m just looking for an excuse, but anti-psychotics like Seroquel are notorious for making the battle of the bulge quite difficult. I suspect it is at least somewhat to blame for my inability to lose weight. Even if it’s not, I was annoyed the the general oblivion this person was demonstrating toward other people’s struggles. Maybe I seem like someone who can take it, but the truth is, I’m not. I’m one of those terrible sorts, unfortunately, who can dish it out but can’t take it. I suck at taking it!

Here’s another example: At a recent dinner, some other anonymous relatives noticed my bleeding fingers – thank you incessant anxiety that prohibits me from sitting still. After allowing them to examine them more closely, one of them asked if my fingers hurt. “Hell yes they hurt,” I said. The response: “So why don’t you stop?”

There it was after 38 years of picking at myself…THE SOLUTION! Just stop. I immediately took the advice, quit being anxious, quit picking my fingers, and I’ve never been anxious again.

Actually, I shot this person an internal bird and went on picking my fingers…and went on wishing that these people who genuinely love me and care about me would do their part to be sensitive to the battles that rage inside of me.

To be entirely honest, I’m probably more guilty of these sorts of insensitive comments to others than either of the offenders above. As a teacher, it’s rare that I make it through a day without regretting some jab or joke I make in class (I’m well known for my filter-less mouth). Nevertheless, both of these episodes really pissed me off, and if I could have a do-over, here’s what I’d like to say in response to my recently hurt feelings:

“Listen, I’m doing my best here! Every day is a roller coaster of my own bad brain chemistry mixed with the medication side effects that I HATE but that are better than the alternative. Cut me some slack! If you’ve known me for more than a week, you should know that I’m not playing with an ordinary deck of cards. I know my charm and brilliance mask my inordinately screwed-up brain chemistry, but news flash: I’m messed waaaaaaay up! So back off and let me pick my fingers and struggle with my weight in my own way.”

Did I say any of that? Nope. As usual, I sunk inside my head, thinking about how no one understands and how lonely I feel and started telling myself that maybe I’m just making a bunch of excuses for my problems when really I could easily fix them all. Maybe what I call antidepressant side effects are cleverly masked crutches meant to prove that I really have a problem when I actually don’t.

But seriously, people, I do.



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Acupuncture and Crazy Religious Beliefs

Accu 3

I’ve been wanting to try acupuncture for my overall lack of mental health for quite awhile, and this morning I finally had an appointment with a woman whose English was so bad that I finished most of her sentences for her after losing patience with her stumbling diction and incessant hand motions (you know, the universal sign language that means “If I just wave my hands long enough surely this person will learn to speak my language”). For some odd reason, I found her complete Chinese-ness reassuring. If someone is going to stick needles into my body, they’d better have a thick accent and at least one statuette of a kimono-clad woman in her office. Check and check!

I don’t have any clue yet whether this will help with my mental health, and quite honestly, my brain is so prone to ups and downs (thank you, bi-polar II) that I might well think something has worked when I’m just on a natural high. We’ll see.

But honestly, the more interesting part of the experience had nothing to do with the needles or the broken English or the wall full of Chinese herbs. No, the best part of this story came as I was leaving home to head to the appointment…As I was leaving, my wife’s “small group” from our former church was arriving. It consists of three women around our age and one woman who is about twenty years their senior who “mentors” them. This very sweet and well-intentioned woman asked where I was headed, and when I told her, her face sprouted a concerned look. Then she said, “You need to pray for protection because acupuncture involves spirits, and you don’t want to open yourself up to an evil spirit.”

Having grown up in and around fundamentalist Christianity, I have heard this view expressed before. It’s basically religiously-justified xenophobia, the attitude being very much an us vs. them mentality: “Surely God can’t/won’t be involved in any Eastern methods of healing or hope. No, those versions of health come from evil spirits that the Real God is fighting against. But make sure you ask the Real God to help you in prayer; otherwise, he’ll just ignore your misfortune as you allow evil spirits to invade your unsuspecting body. Muhahahahaha!”

While I find the aforementioned ideas laughable these days, I’m also well aware that dogma is not unique to Christianity. Even the acupuncturist, from what I could understand, was espousing her own version of dogma. She boldly claimed that I should be off of all five medicines that I take with enough acupuncture treatment. If she’s right, I guess those evil spirits know what they’re doing. For now, my cynical self suspects that both ladies are wrong. I’m just hoping for a small step forward here, ladies. Is that too much to ask?!

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