Clean flesh, delicate, never maimed.

My scars tell a story that I’d prefer to delete.

And unlike the spirit that intensifies, gets wiser and more vigilant with its wounds, bodies are lazy.

Destroy it once, it will never be perfect again.

All you children with the lines, marks, nicks and perfectly aligned holes.

The skin at the scene of the attacks trying way too hard to appear innocent, way too pallid to be natural.

Believe me, I know.

You can’t even remember how you gave yourself that scar but it still itches and glares an angry red.

Your sneaky body has you twitching on the left when you know the scars are on the exact same spot on the right.

All of you whose pupils widen in disbelief and you flinch at the sight of our skin, please pretend it’s natural.

I have natural scars too.

At six, I jumped off a gate. My face hit the pavement and soaked it red. A thin white bridge still lays sprawled against my forehead, only visible when I ache with anger.

At ten, I cracked my wrist in half. I am reminded of my forever damaged bone when it rains, or when I strum my guitar for some time.

At fourteen I had shingles. White clumsy patches are still scattered on my stomach.

But the difference is that the intentional scars bring emotional torment too.

They agonize me, revolt me, prompt my emotions, memories beliefs and urges.

It’s a fight.

Don’t finger them. Scratch them. Don’t look. Trace them with marker. Drink up photos of self-harm. Cover up. Hurt some more.

They scream at me. From someplace deep inside.

They remind me of all the times I kept things in and bled them out.

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My sister-in-law is bipolar.

My son is divorced. Well, his mother-in-law is bipolar. What can you expect?

It’s all over, the judgment. The stigma won’t go away.

Yet, I believe the greatest stigma is inside my own heart.

I hate myself. I hate myself for being so hopelessly bipolar.

I want to be free. Free to follow my heart and accomplish goals. Goals that others have mastered in their twenties. I am in my thirties and I don’t see an end. I don’t believe I will ever be able to get that degree and take that job I really want.

I’m a playgroup Morah. No, not the Morah. The assistant. I help out wherever it’s needed. I love the children. I enjoy my job. But it’s not ideal. With this job, my bipolar states don’t get in the way. I can be happy and actively involved with the kids, or I can choose to sit quietly near them, cutting and pasting.

I dream of being the Morah. I dream of teaching first grade. I dream of doing social work. I know I have the ability for these careers. I can do it. And yet. And yet, with bipolar in the way, it will be near impossible.

I have my ups. Days when I want to sing and dance and life feels so blissful. Days? It’s more like hours. Because it quickly spirals to intense energy; intense irritability. The slightest stimulation feels like too much. Noise is amplified. Things I need to do feel burdensome. And people around me are treated to my irritable behavior. I leave that up to your imagination.

My brain is exploding and I want to bang my head in the wall, bite myself, anything to take away the tension. I want to die…I slide down into the muck. Sad, tired, unable to do anything. Feeling so depleted, so hopeless. I stay in bed, my blanket over my head.

Life is hard. So hard.

I am bad. Bipolar is just an excuse, isn’t it? Judgment pounds at me.

Maybe it’s not just bipolar. Maybe it’s Borderline Personality as well. Now I’m really messed up.

My husband is suffering. My kids are suffering.

Does it matter if you create a mental health organization if I’m judging myself as bad? If life hurts so much that death is better?

How will it help my inner world change? How will it help me do more in my life besides fighting my emotions and urges?

Maybe that’s my purpose in life. To fight myself. To apologize one hundred and one times to my husband and children for hurting them; for being.

I can take all my dreams and trample them in the dust. I will never amount to anything.

I am bipolar. I’m sorry.

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Why all his friends run
And everyone says he ain’t fun
Life is just a scam and con
He feels like he’s done

The voices in his brain
Drives him insane
With no direction or lane
He feels like in the drain

I’m done with the world
I can’t take it, who would?
Running away from everyone I should
I can’t anymore who could

With saliva and sweat
I’ll make a bet
That all I need is for the world to let
To hide in my safety net

Sinking and sinking
Just my brain spinning and thinking
Without even blinking
I’m done fighting

Months go by
No one notice my pain, or telling me hi
Locked in my pupa up high
This isn’t a joke or a lie

Sitting there with so much pain
Thinking I’ll never appreciate the sun or rain
With this amout of guilt and shame
I have no wish to continue this game

Laying in my bed
Thinking I’m good as dead
Depressed about the life I had
With a mom and dad
That were always so mad
And never wanted me so bad

I felt something moving inside
But I couldn’t even hide
I tried turning to my other side
This isn’t something I can abide

Hope is shining in
There is a small grin
Maybe life isn’t made to always be in the bin
Maybe one day I’ll fly and stop the spin

Pushing and breathing
Stopping the chatter and meeting
There is no time for talking
Or even space to be walking

Depressed says no way
Hope responds “breathe” you say?
Depressed says don’t you dare
Hope responds breathe I sense a glare

Hope says keep the fight
You might find delight
Maybe tomorrow or tonight
You will see the light

Pains and aches
My body shakes and wakes
It reformes and takes
Wings it makes

Final push through
Out of my stuckness and glue
I spread my wings into the blue
Passing the electric wire with the shoe

I laugh and fly
I can’t believe I was once Depressed and shy
I feel like I can almost touch the sky
I never thought “I wanted to die”

Metamorphosis it might be
Don’t blame he or she
The more pain your life brings
Just might mean that you’re developing stronger and more beautiful wings

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In the middle of a very chilly winter, I took a big step in my frum (religious) journey and moved into a large community where I would be able to live, go to shul – and the biggest benefit for me – attend Seminary. I was excited. I was thrilled. I had no idea what was coming for me. But, mostly, I was very naive.

I had never felt the need to have to “trust my gut”. I had never truly felt lost. I was someone who, since childhood, had always felt a certain and clear sense of direction.

A little over a month into Seminary, we went to a local Rabbis home for the Friday night meal. It was that night that started months of abuse.

I watched a few of my own friends being sexually abused and they, in turn, watched the same happen to me.

I was numb. It was like all of the happiness was drained out of me. Food didn’t taste the same, the sky never appeared quite as blue, my eyes quenched constantly with the ever-flowing tears that my soul really felt broken. I lost that certainty and direction that I had always held close to me.

Not only was I uncertain about where Hashem could possibly be taking me -but I didn’t know if I could hold on for another day. I lived in constant fear and I questioned myself throughout every day: why couldn’t I protect myself?

I knew that I needed someone – but I didn’t want to need anyone. I just wanted to pretend that it never happened. I wanted – I needed a hand to hold and someone that I knew would be there and wouldn’t see me as less of a person (at the time, my worst fear) because of all of this. My best friend was one of those abused, and after it happened, neither of us spoke about it. To me, it didn’t even exist.

But, the lovely thing about the trauma that comes along with abuse is that your body remembers it even if you force yourself to forget the details.

Dealing With The Symptoms

It was several months in when I questioned if I could keep on existing. I didn’t feel that my existence mattered. I felt dirty and used all of the time. I wasn’t good enough or deserving of anything in my mind. And the people in my life that I thought I could trust – teachers, other adults – fed into my fears and distrusts.

I felt trapped and I really believed that I had no one and that no one would believe me or even really truly cared. I felt like a burden – which kept me locked inside of my head instead of going to the people in my life who would have been there for me.

It was one day, months in, that I returned home from seminary, and decided to take a shower. I had the first real panic attack I’ve ever had. Everything that I’d been experiencing passed in front of my eyes. I was dizzy, I couldn’t stop crying, pain seared through my entire body.

I quickly composed myself and ran to the kitchen, where I phoned a friend.
I shook as I dialed her number, uncontrollably crying. She came in a few minutes and as I kept getting sicker and dizzier – my emotions more intense than in the minutes prior – she called Hatzalah.

I remember so vividly, one of the Hatzalah members who had me sit in the ambulance looking at me for a long time before asking me if something was wrong. If something had happened. He kept pressuring me to tell him what was “really” going on. At the time, I was so upset and angry. I didn’t know what was wrong with me; it felt like he was accusing me of something. Only now do I look back and wish I could thank him. He was able to point out something that some of the people who saw me every day weren’t able to see. Someone who was really hurting and longed for help.

Getting Help

Shortly after my hospital visit, I was convinced to try therapy. At first, I couldn’t imagine entrusting someone that I didn’t know with all of this. But, after my first session, I felt a weight lifted off of me that I hadn’t felt in so long. It has taken time to work through all of these intense feelings and unashamedly – I’m still in therapy growing and taking back my life.

It feels unreal to sit here in my living room – very much alive – realizing that I almost gave up. ​ As I sit here, fully conscious, my life has pulled itself back together beyond what I could have imagined. It’s incredibly imperfect, but I can see and feel the healing in my life. Because I reached out, I was able to save myself from the unthinkable.

Since all of this, I experienced living in Israel, finding community, building relationships and connections, and most of all – healing and becoming more of a whole version of myself that I wish could go back in time and hold my shattered self. 

When I allowed myself to reach out (no matter how hard it really is!), when I allowed myself to be cared for and to accept the support of others and to be okay with not handling everything all on my own – that’s when the core of my own personal healing began. From someone so dear to me teaching me the importance of trusting ourselves, being someone who truly listened and allowed me to feel my pain but encouraged me to grow and heal – to my Rabbi who constantly encourages me to never give up on my own future and to keep paving the way.

Never Give Up

I want to encourage you to never give up, because there are so many people who deeply care about you. And as someone who couldn’t allow herself to ever believe that: I’m telling you – it’s not just a shallow statement – it’s true. I never believed that I would make it to a path of healing. I could barely breathe through an hour – much less an entire day!

Please allow yourself to reach out for help, please don’t be silent when you’re being hurt, please trust your gut on what’s right for you and learn to be in-tune with your own needs. Keep fighting for the beautiful future that you deserve. Hashem has a bright and beautiful plan, even when you feel abandoned and alone. Trust me on that.

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The Importance of The First Sentence 

The first sentence of a patient’s note is called the chief complaint. It is meant to be a brief concise title to the rest of the note. Medical personnel make a list of possible diagnoses based on it to help them figure out what the patient has. The first part introduces the patient and gives a medical history that is relevant to the complaint. For example, “Eight-year-old boy with a history of asthma…” The second half of the note is a list of the most salient symptoms. For example, “…presents with four days of fever and cough.” However, it would be inappropriate to put down, “Eight-year-old boy with ADHD presents with four days of fever and cough.” What business does ADHD have in steering a diagnosis? Therefore, putting a mental health diagnosis in the chief complaint when it has nothing to do with the symptoms is not only inappropriate but could bias a provider’s thinking in determining the proper diagnosis and possibly compromise the patient’s care. I would like to share my experience and examples where I felt bias was a part of it due to my bipolar being put in the chief complaint. 

Examples of Bias

One day, I noticed my eyes looked puffy. I was encouraged to go to the emergency room by my nephrologist, but before I went, I didn’t want to be perceived as a hypochondriac, so I asked every nurse in my building if my eyes were puffy. Even my boss (a physician) said she saw it the day before. But the ER staff simply declared they did not notice any puffiness and sent me home. 

A few days later, not only my eyes but my whole face became grotesquely swollen, so I returned to the ER. This time they did a CT scan and came back with a diagnosis of multiple lymph nodes. 

I kept asking for an infectious disease consult to evaluate the large lymph nodes, but they kept refusing. In the end, I went straight to one of the best infectious disease specialists on my day off. He took me seriously and ordered a bunch of tests, and no good doctor will order unnecessary tests. As a pediatrician, I see enlarged lymph nodes all the time, and I have a good idea of what to do for them, so I don’t know why the doctor in the ER didn’t take me seriously unless my bipolar biased them. (Of course, there’s a saying that “doctors make the worse patients.”)

Because of the large lymph nodes, the medical staff on my case had an initial working diagnosis of lymphoma (a type of cancer). They actually did not tell me this; they did not tell me about some malignant findings on my CT scan, nor that they were consulting oncology. The funny thing is when I saw the oncologist in my room the next morning, I didn’t think anything of it because he is my regular hematologist. (These are cancer doctors. They are called “Heme/Onc” for short because they also do blood disorders.) By the way, my final diagnosis was blood clots and I feel well now.

My other example that I feel might have had an element of bias or at least a discomfort for any mental health patient was the off-timing of my meds. While hospitals may be notorious for this, as patients, we tend to be more sensitive. One night it was 8:00 already and I usually take my meds early. I asked the nurse when was I going to get my meds and he said I was set for 10:00, so I foolishly said, “If I don’t get them soon, I might get all bipolar on you.” He just left the room without saying a word.

Then my worse fear came true. They took a lithium level and they probably didn’t time it right. So it was in the toxic range, and they called psych and lowered the dose. Luckily, I have a super nice psychiatrist who I was able to get on speakerphone and explain the proper dosage to them. We redid the levels and returned to the original dose when I got home. 

Takeaway Message

The reality is we can’t control what medical professionals put on our charts (unless maybe we lobby against mental health bias). If possible, having an advocate with you is always helpful. I was told once in residency that you can’t control what others think or do, only how you react toward it. I know that bipolar doesn’t define me. So, yes, be on the lookout for bias, but at the same time, don’t let it affect you. 

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My mind plays on me relentlessly. I wonder if it’s all true. It must be so because it feels so. I try to tell it to be quiet, but then it gets even louder, terrifying me. Thunder rolls, and a thought so terrible goes rumbling by. Like a bolt of lightning, I see the truth. I stop breathing. No one loves me for real. No one can ever love me. I feel the lightning thought penetrating through grey mass and the pain, like a sharp knife, wedges itself somewhere deep inside. Thoughts of escaping this prison desperately pound their way through the storm. I need to get out. My mind is exploding. I scream.

And then, as the rain continues pounding through me, and the thunder and lightning continue their show, I feel a gentle hand. It extracts a bit of that grey mass, gently rubbing it between warm palms. Slowly, the little grey bit gets softer. The hand continues rubbing, gently, gently on all the bits of grey mass. Each bit gets a bit of compassionate rubbing, and slowly, I can feel my mind coming back to me. Slowly, ever so slowly, I can start to breathe again.

The prison gates are still there. Painful memories, invalidation, paranoid thoughts, and the all-powerful critique all vie to keep the gates firmly shut. They will not relinquish control too easily. But sometimes, I can reach in, and with hands so warm and steady, I can love that grey mass that’s working so hard. I can gently tell it to relax a bit, while I take over the reins. The grey mass responds surprisingly well, and then I need only remember that I do have the upper hand in this prison. I can set the rules. Even in prison.

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I was born with generalized anxiety disorder: a genetic, textbook case. Because of it, nearly my entire childhood was hell. I was afraid of everything, all the time. And if there was nothing to be afraid of, I was just plain afraid, the venomous feeling spurting through my veins as baseline existence. The crux of the torture lay in the social arena. Despite such anguish, I didn’t know I had a problem. I was born that way; as far as I knew, everyone’s brains functioned like that. I assumed my problems were my own fault. However, thank God, after many a wave of unnecessary cortisol, midnight meltdowns, self-imposed starvation, and excruciating Shabbatons, I was diagnosed. I began to understand. And the diagnosis came with meds, magic pills that freed me from the shackles of pathophysiology and elevated me to a paradisal future. Outside of high school, I was able to reinvent my identity, and surprisingly emerged an outgoing, confident, and amazing young woman.

The Virtues of Retelling

This retelling has several virtues. First, it’s incredibly optimistic. The focus of the narrative is the solution and my current upward trajectory. The story doesn’t attest to current struggles or personal weakness; it doesn’t beg for pity or gush insecurity.

Beyond the optimism, this narrative is a retroactive, hyper-intellectual account of thousands of concrete experiences spanning over a decade and a half. Instead of an artistic venture to create empathy and emotion — instead of depicting memories to transmit the raw human pain of mental illness — I make use of disease labels and hormones. Everything is told from the perspective I have now. People don’t need to know every embarrassing moment and toxic relationship I’ve had. While “opening up“, I hide my old insecurities and bad decisions.

But the quintessential advantage of the narrative is that it completely eliminates blame. According to this story, I didn’t do anything wrong. It was a disease. The same way diabetes is a disease, the same way cancer is a disease. Anxiety, I claim, isn’t an intrinsic attribute but a removable obstacle. I can’t be held responsible for any of my thoughts and words and actions from ages 0 to 17, thank you very much.

I have mountains of shame about the person I was for the vast majority of my life. And I don’t deal with it. I deny it.

Is this a narrative I create for my own comfort? Obviously. Like any story, it says more about the writer than it recounts the past. But it’s also true…I mean, I genuinely believe its implications. My own experiences confirm that mental illness is extrinsic, and psychiatry and mental illness advocacy also address mental illnesses as diseases. Extreme fear is debilitating, so why would anything be my fault?

Bringing Family Into The Narrative

For a while, I contentedly adopted this story with its simplicity, optimism, and spirit of mental illness awareness activism. (Pretty much the three main things you look for in a good story, am I right?)

However, as I overcame my own problems and projected more energy externally, the happy ending of my gift-wrapped narrative became more layered. Maybe I was in a psychologically good place, but, you might remember that I mentioned that my anxiety is genetic; my family remains a crash and burn mental illness wreck site.

My mother has anxiety. Since she suffers from clinically diagnosable fear, she’s too afraid to endow control of her brain to another person, and uses her MD to self-medicate inaccurately, saving the remaining anxiety to fuel the unhealthy stress-reliant life she’s built for herself.

My sister (who we shall call Sarah) suffers from anxiety and insomnia.

My brother (Shlomo) suffers from anxiety, and in the past has experienced major depression, panic attacks, suicide attempts, and hospitalization.

My uncle has schizophrenia.

My cousin suffers from anxiety.

Both my grandmothers are on antidepressants.

My other brother (Moshe) suffers from the dual conditions of being a third child and having three mentally ill siblings.

So Shlomo has always been on the misbehaving and immature side, and, growing up, we all took issue with his disposition and criticized the way my parents raised him. However, about two years ago, things significantly deteriorated. Simple instructions, like stop watching TV or go brush your teeth, would result in cataclysmic meltdowns and shrieking. He would curse at and hit my parents. Soon, he stopped going to school. One night, he tried choking himself with a pillow and was hospitalized soon after.

He was sick. He was crumbling into fear, insomnia, anger, and self-hate–causing tremors that erupted onto the family. Living with him was torture. Moshe and I were trying to live normal, high school lives, but our house shook with shrieking, cursing, and fighting. The family dynamic was stifled with tension and frustration. Moshe and I hated Shlomo for behaving the way he did and were frustrated with our parents for allowing him to deteriorate. When he went to the hospital, our parents left us completely to spend every daylight hour sitting in the waiting room to be let in for two thirty-minute intervals each day. Moshe was only a freshman at the time, and our parents’ attention was stripped from him. We resented Shlomo – both as a person and the source of damage.

At one point, Sarah came home from college for a family vacation. At the airport, Shlomo characteristically refused to cooperate. We all schlepped extra bags so he could carry nothing, but he nonetheless unleashed an enormous meltdown, filled with stomping, yelling, and cursing out my parents.  and I commiserated, insulting Shlomo and the negativity he endowed our lives. But Sarah, despite not living at home, told us not to blame him. It’s not this fault, she said. He’s really the one suffering.

At the time, her sanctimonious preaching irritated us, but in hindsight, I’m hard-pressed to counter her statement. If I believe I’m not at fault for my feelings and actions while intensely anxious, how could I have harbored animosity for Shlomo? Maybe I should’ve overcome my frustration and supported him through his difficulties. After all, he is my brother, and I know firsthand the horrors of mental illness.

I experienced a similar dilemma with a classmate I shall call Shimon. Since freshman year, Shimon and I shared many friends and nearly all our classes. To the best of my anxiety-hindered abilities, I reached out to him, tried to become friends. Again and again, he brushed me off and reached out to mutual classmates in my presence. I was irate — and the pain of rejection was magnified by my anxiety disorder. What made it worse, everyone thought of Shimon as practically Hashem. He was smart, nice, athletic, fun, and a devout Jew. Hurt by his rejection, I tried to find something wrong with him to legitimize my resentment. He was a hypocrite, I decided. How could he bear the title of good Jew but be so selfish? How could he go to Yachad Shabbatons but not give someone “uncool” the time of day?

This was, of course, before I was diagnosed. Once I understood the illness and my ability to overcome it, I rethought my frustration with Shimon. After all, my anxiety seriously impaired me socially. Was he really responsible to befriend someone he wouldn’t enjoy being around? Would I have wanted a fake friend anyway? He was never actually mean to me, always polite, at worst a combination of passive aggressiveness and standard teenage boy idiocy. He hurt me, but technically, he didn’t do anything wrong.

Forming My Takeaway Message

So how do we deal with problems like these? How do we balance the injustice of subjecting people to consequences of decisions they could not make and the injustice of having our mental health destroyed? How do we reconcile our woke understanding of mental illness as a legitimate disease with the need to keep ourselves shielded from proliferating shrapnel? In these stories, who’s right and who’s wrong?

First, I find it crucial to unequivocally state:  denial is not a solution. For years, lacking a diagnosis, I believed admitting to my issues meant surrendering to weakness. I thought strength meant pushing through. And it was horrible. I learned the importance of being honest about needs and problems, irrespective of whether you’re sick or collateral damage. We’re often told things like “look at the brightside” and “make the best of it”, which are really great advice in lots of situations. A festering psychiatric disease poisoning its vicinity like toxic gas is not one of those situations.

But while venting about these problems, it’s important to remember that mental illness is not a choice. While it’s okay — maybe even necessary — to be angry or frustrated, the anger and frustration must be directed at the situation or the disease, not the person. We live in a society in which the law is trusted to find justice. To right wrongs by punishing the guilty. Such a system instills the fundamental contention that problems have causes; in other words, that there’s always someone to blame. But the truth is that not all crimes have criminals. In the world of mental illness, there are deaths without murderers and jails without wardens and fear without danger. Sometimes the action and its consequences are ridiculously disproportionate, as if blown up under a microscope. Sometimes there’s no action at all to pinpoint as the source of blame; pain and suffering manifest from thin air. So the message of this story isn’t incredibly optimistic and there’s no real solution: sometimes we have to accept negativity unprovoked.

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I tried once. There was no answer.

I sent a text a little later. There was no answer.

I tried to call the next day. There was no answer.

I send a text later that day. There was no answer.

Finally, you returned my call. The explanation was simple; you were busy, packing to go away for the weekend, and so we didn’t manage to connect. 

Me vs. You

To you, that is simple. But to me, it’s another incident. Another situation that caused me much pain and anguish. When I reach out to you, it takes tremendous effort and work. The depression in my heart says ‘Don’t Bother. Not Worth the Risk’. But then my brain tries to be rational. How can loneliness get helped, if I don’t reach out? And this time my brain won. But only to some extent. I reached out but didn’t get answered. I opened my heart which is so vulnerable, and it got a blow.

I know. The issue isn’t with you. People tend to get busy and return calls or texts a day or two later. The issue is me. The issue is my heart, my depression, and my pain. Because all this reaching out to others is too much for me. I am way too sensitive, lonely, and needy, to just handle not getting a response.

Can I Build Any Connecton?

I don’t let people realize the amount of maintenance it would take, to have a connection that doesn’t hurt me all the time. But I realize the amount. I know the searing pain of depression and loneliness. And then I wonder.  Maybe I was created different than most people. Maybe I am just not like most human beings. And I know the answer; that I am not like others.  My insides are different. My emotions are different. My heart is constructed of damaged muscle that just can’t get past its pain.

And so I question myself. Is there a place for someone like me in this cruel, dark world? Is it even possible for someone like me to have a life without too much pain? Is there an option for me to have one happy day? To just feel connected to other human beings? I don’t think so. The people of this world don’t talk and communicate my language. There is no friend to reach out to. Only a trained professional that has learned her trade and therefore knows the facts. Not another human being. Not a sister or a brother. Not a friend or a relative. My language cannot be understood by others. Is there someone out there that speaks my language? That understands my words? My pain and frustration?

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I wish you knew how frustrated I feel when I have a setback.

I wish you knew how hard my mental illness can be on my friends and family. 

I wish you knew how annoying it is to be scared of things that most people aren’t. 

I wish you knew how difficult it is to not be able to do the things that I used to be able to. 

I wish you knew how often I appear perfectly fine when really I’m panicking inside. 

I wish you knew how scared I am of having a panic attack at any moment. 

I wish you knew how jealous I feel of people without mental illness. 

I wish you knew how many times I’ve gotten frustrated during therapy. 

But there are a lot of other things I wish you knew, too. 

I wish you knew how strong my mental illness has made me. 

I wish you knew how lucky I am to have supportive friends and family. 

I wish you knew how happy my dad gets when I tell him I’m doing better. 

And I wish you knew how caring he is when I tell him I’m doing worse. 

I wish you knew how many times I’ve faced my fears head on. 

I wish you knew how many times I sacrificed the short-term for the long-term.

I wish you knew how many times I didn’t keep my mental illness from controlling my life. 

I wish you knew how blessed I feel to be able to afford therapy. 

I wish you knew how happy I feel when I can help others who are struggling. 

I wish you knew how awesome it feels to see myself making progress. 

But lastly, above all, I wish you knew how proud of myself I am, for going out there and trying my best every single day. 

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The loss – 

The loss happened over many years and many hours. 

It was stability mixed with instability; and emotionally crippled parents who mixed difficulty with support, peace and closeness.

The loss…

was in inappropriate accusations… 

was not being allowed to stand up for my own feelings… 

was in losing a childhood to fear that a child shouldn’t carry…

was in taking responsibility because that meant some stability…

was in parents who didn’t respect the boundaries that keep children safe…

The impact…

is that I will never have a happy childhood with wonderful parents…

is that I lost security, trust, stability, support…

is that I can hardly connect with my own feelings…

is that it’s really hard to trust others… 

is that I hardly can trust in myself and my ability to weather challenges…

is the lack of the normal blueprint of human relationships that allows a healthy give and take…

is the lack of my inherent value as a human being… 

is a mixture of sadness, anger, and guilt because my parents weren’t always bad…

In the sadness and grief…I only wish for…

the ability to feel fully once again…

to let go of the control that keeps me from feeling…

to experience a sense of stable worthiness in my life… 

to find internal peace strong enough to quiet the internal unrest…

to trust that others will hold me when I experience pain… 

to let go of the control that keeps me from feeling…

to see how strong I am, I can face my feelings… 

The results

I am so sad, I can only feel angry…

I seek to destroy myself and others…

I feel hopeless for a positive future…

I feel my emotions in a mumble jumble…

I have so absorbed the negative messages that I feel worthy of being destroyed… 

I feel like my real value is evil and I am the worst person around…

I struggle to let go of the fear that keeps me from feeling sad…

What can I do with this? 

Although I am angry, I seek not to destroy truly, because I know what it’s like to be destroyed…

I seek to be kinder, more compassionate, and caring to myself and to others…

I deserve to start with myself and to forgive myself…

I can stand up to the internal voices that say the worst about me… 

I can believe in my own goodness, strength, inherent value, beauty, and courage…

What is the unique purpose and meaning in my experiences?

Why…

did Hashem give me such a painful internal journey?

did Hashem give me a life where I feel like I lost my hope and my future salvation?

does my heart pulsate with such deep pain?

Possibly…

1. Hashem did it so I should be depressed forever. 

Probably not. I think Hashem wants me to serve Him with joy.

2. Hashem wanted to ruin my life and future.

Probably not either. He wants me to have a happy successful future. That’s why He gave me amazing support and ability to make great choices.

3. Hashem hates me.

Probably not either. Hashem loves me and means my best.

So what’s the point? 

Is the point…

that I should serve Hashem with joy despite my challenges? Could be…

that I can come out stronger and happier even with what I’ve been given Could be…

to give up a little and let Hashem run my world… likely

to get sechar (reward) for every amazing choice I make, for every positive thing I tell myself, for every positive connection I seek to nurture? Forsure 🙂 

On this Tisha B’Av, I want to unify as one team with all Jews… when I am so angry and sad about my own destruction, I start to feel the pain of others too… 

So what is the point? To let go and to let grow.
Thank you Hashem.

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Age Group: Youth

Message from The Artist: YOU ARE NOT ALONE. The importance of mental health is, unfortunately, not often given enough attention. Neither is the severity of its impact upon people struggling with their mental health. This drawing depicts a young woman’s head and heart, both filled with words which express conflicting positive and negative feelings, showing a person struggling with her emotions and mental health. Despite these struggles, the person says the words “I’m fine.” People tend to mask their feelings instead of expressing them. This drawing demonstrates the internal struggle EVERY SINGLE PERSON faces, no matter if they admit it or not. The reality is that people are often too scared to talk about their emotions or mental status for fear of negative judgment. We need to create a society where people feel safe to talk about and address their mental health in a positive and supportive environment.

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Age Group: Youth

Message from The Author: A teenage girl, struggling to be happy with herself and her life. (Trigger warning: Contains swearing, suicidal thoughts and depictions of self-harm.)

My fingers drummed on the side of the bathtub. The sun was setting outside, and it was getting dark. The yellow bathroom light cast a weak glow around the room.

I was perched on the side of the bath, my fingers gently sliding up and down the blade of one of my razors. The sleeves of my hoodie fell past my wrists, and I held the blade carefully, almost reverently, so as not to cut myself.

How ironic.

My phone, on the other side of the bathroom, buzzed softly. Probably another text or comment on Instagram, telling me and everyone else how ugly or fat or awful I was.

I could have deleted the post. But I couldn’t delete the comments from my brain; harsh and cruel and with absolutely no idea of the effect they had on me.

I pressed the tip of my finger into the point of the razor blade. A bead of blood appeared, scarlet red against my pale skin. It didn’t hurt that much. I breathed in, and out.

My phone buzzed again, with a cheerful beeping noise. Mom, on her way home from work. I would have to leave soon, paste on a smile and pretend my life wasn’t the shitty mess it was.

But not yet.

Slowly, I pressed the blade to my thigh- high enough that even if I wore shorts, no one would be able to see it. My hands suddenly felt much heavier than they actually were. My shoulders slumped, as if just now remembering the weight that was on them.

I hesitated.

I had only done this twice before. Two faint scars, barely visible in the dim light. In the moment, it always felt intoxicating, almost addicting. I would never say it out loud to anyone, ever, but it almost felt triumphant.

Like I was in control of my life, at last.

But then, hours later, lying in bed, I would sob into my pillow and wonder why I was so broken, when everyone else had it all together.

Or maybe they didn’t.

Maybe they were just better at mending all the cracks.

I held the blade against my skin. It was cold. So, so cold.

I couldn’t do it.

I hurled the blade across the room.

“Fuck,” I muttered. I slammed my hand into the side of the bath. “Fuck!”

Tears pricked against my eyes, blurring my vision. I wiped them away. I wouldn’t cry. I couldn’t.

I curled my hands into fists. My nails dug into my palms, creating tiny crescent moons. Little scars that no one else would ever notice, but I always would.

I clenched my fists harder.

“Fuck,” I gasped, tears finally falling freely. “Fucking coward.”

Because that’s what I was, wasn’t I? Unable to make the cut. Unable to make the leap. Unable to let go. Because I hated my life, but I was unwilling to end it.

Coward.
Loser.
Disgusting.

Not good enough.

Not good enough.

Not good enough.

I wasn’t good enough. I would never be good enough. I was useless.

“Useless,” I whispered. The blade, lying on the other side of the bathroom, glinted in the yellow light. Taunting me.

My phone buzzed again.

I considered throwing it out the window, but I refrained. Mom would have to pay to repair it, and I wasn’t that bad of a daughter.

Maybe that’s why I couldn’t end it. I didn’t want to hurt her. I didn’t want to hurt anyone.

And yet I kept on hurting myself.

My phone buzzed again. It seemed to be almost shouting at me.

I heaved myself off the side of the bathtub. Even crossing the bathroom floor felt like it took a huge amount of effort.

I picked up my phone, grimacing when blood smeared against the phone case. I wiped it off and scrubbed at my eyes again, before clicking it on. A dozen texts appeared.

Hey

What’s up?

I was wondering if u wanted to meet up tomorrow

We could go shopping?

Omg there’s this amazing ice cream place I have to take u to

Respondddd

The tiniest of smiles crept across my face. Summer- who lived up to her name- was a bubbly, bright girl who seemed full of sunshine. At least, until she’d confided in me last year that she’d had a terrible eating disorder and had been in rehab for three months.

Even the idea that she wanted to get ice cream was a big step. I smiled softly at my phone screen. It had taken so much strength for Summer to overcome her anorexia, and I was so proud of her.

Sometimes, I wondered if I could talk to her. She knew what it was like, in this so-called world that was actually a fucking living hell for a teenager just trying to grow up.

No one made it out unscathed.

I had entertained the idea, of course. Telling someone. Actually confiding in someone.

I’m not okay.

Help me.

I can’t do this.

A million things I could say, just to communicate how fucked up I really was.

My phone buzzed again.

I know ur there! R u ok???

I got ready to type out the usual, constant, I’m fine.

Instead, I typed an N, and then an O.

Fingers trembling, I pressed send.

The reply came through moments later.

Do u wanna talk about it?

Not really, I typed.

That’s ok 🙂

I’m here for u, ok? We can talk over ice cream 😀

I laughed, watery and shaky. A sound that I hadn’t heard in months.

“I’m home!” A voice yelled from downstairs. “I’ve got pizza! Your favourite!”

I shoved my phone in my pocket. “Coming!”

I picked up the blade and hesitated, only for a moment. Then I dropped it into the bin.

I wasn’t okay.

But maybe I could be.

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As her father, how could I disagree with her plaintive cry for freedom from the pain? I just wanted her to feel better too. I had witnessed all her treatments, all her efforts, and her ongoing agony, the only response I could come up with was, “No, I forbid it. I love you. You may not kill yourself. I would miss you too much.”

She rallied by saying that for years she had held herself back because of the pain and trauma she knew this would cause her parents and family. However, enough was enough. She had not asked to be born. She had not asked to suffer. And she had the right to end her pain, no matter how we felt about it. 

I stood my ground. I also gently proclaimed my hope in a future I knew she could not see.

She called me selfish. Selfish to have given birth to her in the first place, and selfish to demand she stay alive now. Selfish to offer a light at the end of the tunnel that she did not believe was there. I responded that I could not have known life would be so hard for her—for most of us it really is not, and I hoped and believed things would change for her. And then I added that I could live with being called selfish, but not with permitting her to kill herself.

Five years later, through a combination of cutting-edge therapy, medication, and an iron will, she is starting university in the Fall. She is eager to finish high school and really start living! She yearns to make new friends on campus and fill her mind up with all the goodies Western culture has to offer. Does she still have anxiety? Yes. Does she still have bad days? Yes. But she has found a balance where her life is really worth living, a life in which she can use her unique talents, skills, and sensitivity to help others and contribute to society.

If There Was Physician-Assisted Suicide…

I shudder to think what would have happened if we had lived in a society where medical assistance in dying (MAID, or, physician-assisted suicide) was legally available to all. Where the notion of living through one’s pain or with a disability is so unacceptable that everyone has the right to choose an easy death instead. Where a person with a chronic mental illness can request legalized euthanasia.

As UN experts have asserted “there is a grave concern that if assisted dying is made available to all persons with a health condition or impairment, regardless of whether they are close to death, a social assumption might follow (or be subtly reinforced) that it is better to be dead than to live with a disability.” And, if this assumption, is coupled with a foolproof and comfortable way of dying, three of the major inhibitions to committing suicide will have been removed: societal approbation, fear of failure and fear of pain. In fact, those who choose not to burden society and their families with the psychological and financial burden of their illnesses may become heroes, thus further tempting both family members and those in pain to subscribe to the suicide option before death is imminent. I might add that as long as death is an option, many patients will find it difficult to do the hard work necessary to get better. And the easier an option death is, the more difficult it is to focus on the hard work needed to live. After all, if death is always perceived to be a possible, simple, and beneficent solution, why search overly hard for another.

When Pain is Made The Problem

Pain is the body’s way of telling us that something is wrong and we need to fix it. Extrapolating outwards, pain and adversity are the world’s way of teaching us to innovate and overcome, so it is painfully ironic that the West is ever more rapidly entertaining and legalizing death-on-demand as the solution to pain. When pain (even intense, unbearable, and chronic pain) itself seems to become the problem and assisted suicide is the solution then something has gone terribly wrong with the human drive to overcome, to repair and better the world. I have learned that while there is life, there really is hope. To suggest otherwise is to give into the overwhelming pain and despair of the sufferer, a pain that the world must certainly acknowledge but need not give in to.

Imagine, if I had lived in such a society, all those therapeutic modalities and technologies designed to help my daughter would never have been invented (what would have been the point, death is cheaper, more likely to succeed, and foolproof). My daughter would have died years ago and instead of entering university this Fall, instead of making her own contribution to the world, she would have been interred in the ground. Another life cut short before it had a chance to blossom, and as a society that encourages those in pain to choose death over life, we would have had her rose-red blood on our hands.

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Look at your children and imagine them being overwhelmed by an illness that has no cure. Imagine being powerless to stop it. 

Imagine watching them transform before your eyes from a carefree and confident child to one overcome with sickness and despair. 

Imagine having your dreams of watching them learn and grow and succeed replaced with constant worry for what the future holds. 

If you want to understand my fear

Look at your children and imagine them not wanting to live another day because the hopelessness is too great. 

Imagine a constant cycle of hospital visits to stitch up yet another self-injury, to attempt to stabilize yet another bout of suicidality. 

Imagine the sound of your ring tone day or night inducing heart-stopping panic because too often, when the phone rings, it’s somehow related to another unstable episode. 

If you want to understand my exhaustion

Look at your children and imagine never being able to relax because you spend every moment worried about them. Not worried like all parents worry. Worried because you understand, in a very realistic and practical way, that you know your child will never be fully safe. NEVER. Because the illness is chronic, comes and goes without warning, and is always lying under the surface no matter how well it is being managed. 

Imagine that you spend every moment of your entire life worrying about them because of this. Every moment of your entire life.

Imagine a new normal where you and your spouse take turns being awake for hours at a time throughout the night because sleep is elusive despite debilitating exhaustion.  

If you want to understand my stress

Look at your children and imagine using all of your financial means to try and provide for them so that they receive the best possible care, all the while knowing that nothing will fully help. 

Imagine every hard earned cent, every savings account, every loan, being accessed and drained just to try and keep your children alive. To try and find a reason to believe that it will be worth it. That something will change. That, this time, someone will find a way to fix it.  

Imagine feeling that your other children deserve better, deserve more, but cannot have it because the finances are all tied up in mental health treatment. 

Imagine wondering how you will manage to afford everyone’s needs in the years to come… Hoping that happier times will arrive…. college, weddings, grandchildren… But not knowing how you will be able to provide for them. 

If you want to understand my faithlessness

Look at your children and remember how grateful you were when they were born healthy and whole. Imagine devoting your life to them, being good parents and good people, wanting only the simplest of good things for them. 

Imagine praying for their recovery with unmitigated fervor, day after day, year after year, only to watch them sink further into darkness. 

Imagine trying to maintain faith, watching people around you go about their lives unencumbered, wondering what it is you could possibly be expected to do differently to save your child from suffering.  

Imagine trying to understand how innocent children deserve such an abundance of pain. Not just the existential principle that all people wonder about. Look at your actual child and try to find any logic in a world where they deserve to have their life destroyed. 

Imagine your child asking you these questions and not knowing how to answer.

If you want to understand my family

Look at your children and recognize that their health and happiness mean more to you than any other thing. 

Imagine that it doesn’t matter whether they fit a mold, whether people understand, whether they follow the path you hoped they would, back before you understood how complicated life can be. Because all that matters is that they are healthy and happy. 

Imagine wishing with every fiber of your being that your children will internalize this belief. Will figure out who they want to be and live life fully and contentedly. Happily and healthily. Because, really, little else matters when you consider the alternative. 

If you want to understand my frustration

Look at your child and imagine that hardly anybody supports them. Imagine that society around you does not accept that they have a real illness, no matter how many times you have tried to explain it. 

Imagine sitting by helplessly as your children are shunned by their friends who are made uncomfortable by their illness. Who choose to abandon them rather than trying to understand them, who don’t know how to accept that they can’t control their illness and therefore need the friendship more than anything. 

Imagine seeing other families, whose children have other types of illness or have experienced other types of trauma, being supported endlessly by the community. Prayer rallies, financial packages, meals, free gifts and getaways to help relieve the stress and the burden that illness brings to a family.  

Imagine desperately needing that kind of support but knowing that it barely exists because mental illness isn’t considered as real or as unpreventable as other types of illness. 

Imagine knowing all too well how real and unpreventable it is, but not being able to convey it to others despite your best efforts. 

If you want to understand mental illness

Look at my child. Imagine the smart, beautiful, capable, talented, loving, remarkable person beneath the illness. She is there and she is fighting to be seen. But if you want to understand, you have to be willing to look.

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Four Possible Dangers

Here are four reasons why your year in Israel may present the danger of developing mental health challenges, or of previous mental health challenges worsening. (For the purpose of simplicity, when I write “Yeshiva”, I am referring to both Yeshivas and Seminaries.)

1. Without fully appreciating it, you are leaving the comfort and support of your family. Parents know their kids very well; they can often spot when something is not sitting well with their child and help them through it. As caring and invested as the Rebbeim and staff are in each program, they do not have the type of history with you which your family does. Even if they do spot something, it is unlikely that the Rabbi or staff member would be able to offer support as effectively as your family back home. Additionally, there is a level of wanting to present a certain image to the staff in your Yeshiva, leading you to be less likely to say that you are having a tough time and talking it out. The result is that worries or depressive thoughts could be allowed to fester in your head, rather than being addressed as early as possible.

2. In the intense yeshiva environment, you may end up using negative motivation to keep yourself going instead of using a desire for success. In other words, you might tell yourself to learn so I don’t end up in hell rather than learn so I make it to heaven. Developing tendencies to use negative motivation can lead to beating yourself up emotionally if you don’t hit the standards which can be explicitly or implicitly set in your program. Every sugya you don’t understand, wrong answer to a question in Shiur, or late start to a day becomes another “proof” to yourself that you’re failing. Depression or anxiety disorders thrive off of such mindsets. These disorders don’t just affect your life in Yeshiva: Depression sucks out your energy and motivation for all activities, leading to more “failure” and thus worse depression in a vicious cycle. Anxiety can almost begin to become your default mindset. Instead of just being nervous in front of peers in Shiur, you are training yourself to be nervous about saying the wrong thing in any group setting, which has far-reaching consequences.

3. A Yeshiva is a totally new type of environment; all of the old markers of success and established hierarchies are gone. You can very easily fall into the trap of defining your success not based on your own achievements and progress, but based on comparing yourself to how you perceive your peers are advancing. When these inaccurate and unfair measures are not met, you run the risk (if not inevitability) of slipping into negative self-talk and potentially developing depression.

4. Many students begin their year with a pre-existing mental health challenge that they are totally unaware of due to the stigma and lack of discussion about mental health issues. This lack of discussion also means that you haven’t been taught the warning signs that should alert you to seek help before a problem gets out of hand. A pre-existing condition plus the above challenges is a very dangerous combination.

Solutions and Strategies

Here are some ways to help combat these potential problems:

1. Ask your Yeshiva if they include a session discussing mental health during orientation. In this session, they can explain what mental illness is and identify warning signs to watch out for (in both yourself and peers). The session should identify a qualified staff member for students to turn to with questions. If the program doesn’t have someone on staff, they should explain what resources are available for students and where they can turn to. Having a top-tier Rabbi or staff member as one of the leaders of the discussion is key to normalizing discussing mental health, making it more likely a student will feel comfortable stepping forward if they are struggling. The reality is that discussing mental health concerns with a qualified staff member is not a sign of weakness; it is no different than checking in with your primary care doctor about a concerning physical symptom. Just holding this session during orientation will make that fact loud and clear.

2. While a session described above is ideal, the reality is it may not happen. For this reason, it is important to take the initiative and do your own research about mental health and how to identify warning signs. Here are some examples of signs to look out for in both yourself and peers:

• Putting yourself down while learning. (I’m so dumb; everyone is moving faster than I am; I never understand Shiur; I’ve never had an original idea in my life.) These are signs of falling self-esteem and should not be considered healthy motivators.

• Consistent oversleeping or lack of focus. If you find yourself doing either of these, it may not be fair to simply call it laziness; it could be a sign of depression. Even without realizing what’s triggering it, these behaviors can signify a desire to dissociate from challenging or upsetting situations. If you notice this happening with a friend, approach them from a place of concern rather than disappointment and ask how they’ve been feeling (see 3, below). If you notice this with yourself, don’t assume that this is happening because you are failing and not good enough to succeed in the program. Instead, confide in someone you believe will be non-judgmental, allowing you to get your feelings and thoughts off your chest as a first step.

• Frequently lashing out at others or consistently insulting other people. This often belies a deep self-esteem issue. Since the person doesn’t see themselves as good enough or successful, they try to bring others down with them. Don’t let their comments bother you. Rather, mention their behavior to a Rabbi or staff member who can try to help them work past what is triggering it or can arrange further support.

3. Learn how to talk to a friend you are concerned about. My method is to approach the person and say: “I am here to ask if everything is OK, because you have been doing such and such behaviors, which seems out of character for you. I am only speaking to you because I care about you and want you to be at your best.” This will hopefully take your friend off the defensive. Being specific with the behaviors you have noticed shows that you have been paying attention to them from a place of caring. If they do open up, just listen. If you’re concerned that they might be developing a mental health challenge or could just benefit from further support, urge them to speak to a qualified staff member and offer to accompany them on their way there. This will help take some of the nerve off of seeking help, as well as make it more likely that they will actually go. Additionally, be sure to follow up with your friend so they know you are there for them and want to help however you can.

4. Before leaving for Israel, familiarize yourself with where the best mental health help is, whether it be a qualified staff member at your program or outside help. This will make it much more likely that you actually seek out help should you begin to struggle. You have already done part of the work needed to seek help and maybe more importantly have instilled in yourself the understanding that it is OK to ask for help.

Have An Incredible, Healthy Year!

It is my hope that the guidance above will help ensure that mental health challenges don’t crop up during your year in Israel. In fact, you may even take the opportunity of this unique year to address a pre-existing mental health challenge. Please note that none of these lists should be considered exhaustive by any extent. These are simply observations from my years working in mental health advocacy as well as spending two years at a yeshiva in Israel while battling through mental health challenges.

*A similar version of this piece was originally published on Before Your Year

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Age Group: Youth

Message from The Author: This is a poem describing what living with OCD feels like.

Every day, thoughts haunt me

Fierce compulsions taunt me

I’m trapped within a war zone

And there’s no way to escape

Fears and worries grip me

False obsessions trip me

I’m trapped by monstrous OCD

There’s no step it won’t take

The crashing thoughts, the crashing fears

The endless struggle, endless tears

My life is not as all appears

Inside, I’m falling fast

The constant struggle, constant fight

My mind is dark, a raging night

And yet there’s still a bit of light

Someday this time will pass

Someday, I’ll be okay again

I know this monster isn’t me

It’s not my fault, this OCD

It’s not my fault this challenge was hand-picked for me, I know

I have my hopes and dreams, I do

I’m still a person, just like you

Just right now, I am struggling to control where my thoughts go

Please don’t judge me

Don’t judge me for symptoms that I can’t control

Don’t judge me because of this part of a whole

I have a disorder

But I am not a disorder

And someday, the raging darkness will disappear

I can do this

I can fight this

And win over OCD

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Age Group: Adult

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Age Group: Youth

Message from The Artist: There is a quote in Harry Potter, “happiness [hope] can be found, even in the darkest of times, if only one remembers to turn on the light.” Just as thousands of candles can be lit from a single candle’s flame, hope will never be decreased by being shared. This lonely candle represents an individual during a difficult time. But it is the strong, unwavering flame of a person who has hope despite challenges. Rather than depicting a single candle, its shadow is a candelabra, demonstrating that one person’s positive outlook can be magnified and influential. Sharing a positive outlook can spread hope to help others.

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They say it is a holiday of freedom 

Celebrate 

Remember

Rejoice in redemption

But I do not need to taste salt water to be reminded of tears. 

And I do not need to eat a poor man’s bread to be reminded of affliction. 

We awaken each morning to another day of slavery, bound to a master that will not set us free.

Chronic illness shows no sympathy. 

The prayers and cries have left us empty. 

The brick and mortar paste has left a lump in our throats that never leaves. 

Freedom, they say.

But this darkness is not one that will be lifted through sacrifice. 

It is a plague we have been told we must accept and learn to live with. 

How can we rejoice in a freedom that we have been denied? 

Despite the endless years of toil and pain, no reward awaits.  

Just an ongoing cycle that waxes and wanes, like the moon. 

That sliver of light, which shines through the blackness and taunts us with hope, but always remains out of reach. 

In desperation, we yearn to be clean and fresh and new.

To laugh with a lightness we haven’t felt in years. 

To rediscover the youthful innocence that we once knew. 

We struggle to remove the buildup of bitterness in our hearts. 

We desperately wish to be set free. 

To dance with a free spirit on solid ground as the waters burst open and clear a path for a renewed life, washing our burdens away. 

They say it is a holiday of freedom. 

But they also say we will never be free.

Not from this illness.   

So how can we celebrate, endlessly awaiting a miracle that never comes?   

We are not supposed to rely on miracles.   

But only a miracle can set us free. 

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On a recent email thread of a small group of very close friends, in response to some funny comments in the midst of a particularly silly conversation, one asked the other if “her psychiatrist had upped her meds.” Most others in the group found that hysterical. I started to tear up and chose not to reply. 

Selectively Sensitive

In a world where political correctness and social awareness have taken top billing, it baffles me that people still make comments like these without recognizing the insensitivity. Memes and jokes about “insane asylums” and psych meds and shock therapy are still pretty common.  And it’s not ok.

No longer is it socially acceptable to use denigrating terms towards others that were once commonly accepted just a few decades ago. “Retard” is just one example (and I cringe just to write it here even for the purpose of illustration). Nobody with any type of moral compass would let that word pass their lips in this day and age. And yet, when it comes to offensive mental health terms, it seems we are still light years behind. While we are careful not to insult someone with a noticeable disability or difficulty, it does not occur to us that someone struggling with mental health deserves the same courtesy. Using words like “mental” or “psycho” to describe someone is standard banter. People will often declare dramatically “I’m going to kill myself!” because they’ve got too much homework or had a stressful day taking care of their kids. These types of accepted words or statements make light of situations that are all too serious for those of us dealing with real, diagnosed mood disorders or suicidality on a regular basis. 

Think about if you were a parent who has had to watch your seemingly healthy, normal child struggle with medication doses to help stabilize her psychosis, spend months upon years in and out of psych hospitals, undergo shock therapy, and battle mental illness with every fiber of her being to get through each and every minute of every day. You have visited a child psych ward and listened to the schizophrenic mutterings, witnessed the mindless pacing, and heard the painful cries. And then, you had to walk away from your own suffering, innocent child, leaving them to be surrounded by those sights and sounds indefinitely while fighting their own demons. Well, let’s just say you wouldn’t be so quick to post on social media that your home is an “insane asylum” or make offhand comments about psych meds or shock therapy. 

Putting Things in Perspective

I am perfectly aware that my good friends who made the comments mentioned above meant no harm. They know about my children’s struggles and have supported us wonderfully throughout them. Yet, they didn’t have a second thought about making this type of commentary, even in my presence. This fact only serves to illustrate my point that we are nowhere near as sensitive as we need to be about mental health terminology

I hate to be “one of those people” who insist on nitpicking about something that might not seem like such a big deal. I am not the type of person to be oversensitive. However, there is a difference between being oversensitive and hyper-aware. I am the latter. While I hate that I have become that way through my own personal experience and exposure, that is my reality. The best I can do with it is hope to be able to utilize my experiences for the betterment of the world. 

We Can Fix This Together

Let us work together to bring mental health awareness beyond just the knowledge that people around us are struggling. That’s an important first step, but it’s just the beginning. Mental illnesses don’t discriminate on who they affect, just as physical illnesses don’t. Similarly, the realities and sensitivities towards mental health struggles need to equal those that we have towards physical health. You wouldn’t jokingly tell someone who shaved their head that they look like a cancer patient. You wouldn’t call someone who is recovering from a tragic head injury a retard. You wouldn’t joke about going on a drinking binge in front of a recovering alcoholic. Don’t tell someone who is being a bit silly that they belong in an “insane asylum”. Because trust me, I’ve been on the inside. And if your home actually felt like one… You wouldn’t be laughing. 

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He walks the streets doing his business in the city

Tall, handsome, and strong, the picture of dignity

The outside giving no hint to his departing sanity

As the image of perfection, inside he has no clarity. 

So strong, he has no strength

So weak, he can have no weakness

So many friends to call his, he has none at all

So many people who love him, he remains so alone.

So much dignity, he is left with none at all

So much inner pain, none can hear his call

So whole, he can’t show that he’s broken

So broken, how will he ever be whole.

He walks the streets doing his business in the city

Tall, handsome, and strong, the picture of dignity

The outside giving no hint to his departing sanity

With such strength and such weakness,

How will he ever live happily?

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Running Out of Gas

This mentality quickly spiraled to dangerous lows. I pushed and pushed until I couldn’t push anymore. My car “ran out of gas,” as my therapist told me. Instead of pulling all-nighters to get that perfect grade, I simply didn’t have the energy anymore. For me, it was “all or nothing,” so if I wasn’t going to put in my “all,” then the latter would suffice. I started missing tests, which led to missing school, which led to missing more days when I was supposed to make up the missed tests.

My friends have always been so incredibly supportive, but I was SO sensitive all the time. I was so scared of hurting them: I was overthinking every situation, believing I was in the wrong always, and it was exhausting for both me and them.

Then seminary came. I’ve always felt a very strong connection to HaShem–or so I thought. My connection to Him, my strive to grow closer, was fueled by my anxiety–my feelings that I wasn’t and wouldn’t ever be enough of an Eved HaShem (servant of G-d). So I would try harder–until that car’s ‘engine’ also failed.

Disappointing Therapist Experiences

Seminary started off great. I was inspired, I was eating well, and I felt good. But it was an illusion of health, and not a reality. I began feeling numb and frustrated with myself that I wasn’t spiritually achieving all that I had hoped for. I began to give up more and more. I spoke to therapists but they couldn’t help–they wouldn’t listen or understand. One told me in our first session that my life would end in divorce if I didn’t take the medication that he told me to. When I politely asked another therapist if I could leave the session, as I felt that it wasn’t going anywhere positive or productive, she told me, “Where do you think you’re going? You must pay me XXX shekalim.” I know that payment is necessary, but to her, I was just a business transaction, and not a fellow human.

Four therapists/psychiatrists later, I felt depleted. I kept pushing for help, and I got nowhere. With that, I lost hope. The next doctor prescribed me medication for depression–what? Me?! I had always been stressed and anxious, wanting to achieve more. When had I lost hope? When had I lost optimism, not being able to imagine or even WANTING a better future for myself? How on earth could I have gotten this far down?

Anxiety Turns to Depression

As a result of my emotional distress, I gained a very significant amount of weight in two months. I had previously struggled with negative thoughts about body image, so this weight gain only triggered more anxiety and distress in regards to body image.

I began to stop caring about my looks. I did this not from a place of confidence, but from a mindset of “Who cares?” I’m going nowhere in life anyway. So let me just continue to eat my sorrows.

I desperately want to care to push myself out of this, to get the help that I know I need. I’ve tried–I am trying. I am on a new medication, and I am speaking to a therapist. But I don’t feel the desire to care.

Worries for the Future

All of my friends will be getting married soon, but not I. Do I even deserve to be married at some point? Will I be able to be healthy and stable enough to be able to get married? And even then, who on earth would want to marry someone who didn’t show up to high school, came home from seminary early, and has a mental illness? If I had a son and he was dating, I would be really worried about him dating a girl like me. So why on earth would I expect anyone to want to marry someone like me–even if I do by some miraculous event become healthy enough for marriage?

That thought really scares me–it really really does. I’m supposed to be entering adulthood, but I feel that I’m more of a child than I have ever been. I’m ashamed. I hope I can get somewhere good and healthy. I hope HaShem still has it in His plans to see me married with a healthy family. I hope that He gives me the koach (strength) I need to help myself (with the help of professionals). Because if not, what is my life? Where am I going? What am I here for?

To clarify, it’s not that marriage is the goal. Health is the goal. But at some point, starting a family is also a goal of mine. And that is scary to me because I don’t even know if the first goal is attainable. And if it is, our community judges every action we make so harshly (and rightfully so sometimes), I don’t know who would be enough of an angel to marry someone like me.

Will things ever change? Will they ever get better? Is this what G-d has planned for me? Is this all there is for me? It’s possible. And that’s what scares me: the possibility that this is my future. If that is the case, then I must simply learn to handle what I feel, and just live. But shouldn’t I be happy? Shouldn’t I be able to have a future not just alone, but with others? The answer is not certain.

And again, that’s what terrifies me.

Editor’s Note:  While we often publish stories of people further down the road towards improved health, Refuat Hanefesh knows that many stories are still in progress – just as this author’s is. We wish her much success on her continued path to better health and look forward to one day soon posting her next chapter.

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I am just so elated to get the medication that can help me live my life better. 

So I google and open Zocdoc reviews, psychology today pages, and LinkedIn profiles. I see photos of men and women, of all ages and stages, who spend their day helping people like me find the peace and stability I seek. 

I don’t even want to wait. I wish somebody could offer telehealth psychiatry tonight. I’ll take it now, get a prescription, and get it to the pharmacy. I’ll just be so relieved to have these little pills that can positively impact my life. 

Getting To This Place

I’ve arrived at this decision from a place of strength. There were many years that I was struggling, not seeing the value in how medications could help me. However, therapy has done wonders in leading me to this moment. There are things that I’d like to accomplish in my life, and medication can help. I feel happier and more secure than I’ve ever felt.

My Original Psychiatric Journey

A few years ago, I used medication for a short period. While on medication, I was blessed to meet myself, a really great person who I had not met in years. I found my voice, my strength, and my personality emerged. It fascinated me that negative parts of myself that I had always chalked up to “things I need to work on” were in fact just emotional challenges that the meds were extremely helpful with.

I had some bad side effects and did not continue medication at that time. But the experience allowed me to work through some of the fear, sadness, and worry that I had about meds and how it would impact my life. I came around to really appreciating the wonderful things that can be found in those little white pills.  

Today

It is still challenging for me to move forward today because I’m the holistic, naturalistic, type. I barely take pain medication, and for mental health, I’d prefer to try to take vitamins before taking meds. But I’ll take both if that’s what the doctor recommends.

Interestingly, after all this, I’m shocked at myself that I’m not ashamed, embarrassed, or worried about the impact of this step. I’m ready!

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Depression is checking for messages, waiting for phone calls that don’t come.

Depression is tired. Too tired to care. Too tired to love. Too tired to live.

Depression is blaming myself for falling and needing superhuman strength to pick myself up.

Depression is quiet.

Depression is secretly eating away at my personality, my zest, my abilities and talents.

Depression.

Head spinning.

Eyes closing.

Escape

Sleep

A temporary reprieve

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