How To Help A Friend with Anxiety

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Talk to your friend about what activities are soothing, as well as what the things they really need to hear from you are. Encourage them to write these things down, with the goal of giving you the piece of paper to keep, so that you can say or do helpful things when they are having a hard time. Note: it is also very important that they make a similar list for them to refer to.

Some of the things you can say that might make a difference are:

Breathe slowly. You’re going to be okay. You’ve always gotten through this is the past, all you have to do is wait it out. I know you are strong. This will be over soon.

You are so loved, I care about you deeply, and I will help you any way you need if you tell me how.

We can get you out of this situation if we need to. (Make sure you can follow through on this.)

You are not in danger. This is your anxiety trying to take you over. I am here to help you feel safe. (If they will not respond positively to you saying that their reaction is coming from their anxiety, just promise them you will keep them safe.)

Some actions you can take to help are:

Try to remove your friend from the situation that is causing the anxiety response, like a social or family situation, the store, the mall, or a party/formal event. Go outside with them and encourage them to breathe in slowly through the nose while counting, and breathe out for half as long out of the mouth. This physically slows their heart rate. You can count out loud for them to help them concentrate, and feel cared-for. You can also offer them the option of leaving the situation entirely, if possible. It’s okay to cancel plans with friends and family in order to help your friend function. It’s something that they will need sometimes. If their friends and family can’t be understanding or supportive, they are going to lose those people eventually anyway.

Remind them to eat. Low blood sugar can trigger an episode. When you go somewhere with them, keep a piece of fruit with you.

Encourage your friend to get in to see a therapist if they don’t already. If they can’t afford it, there are some therapists who offer sliding-scale pricing, which means your friend would pay according to what they make. When they see the therapist, they should go in with goals in mind. These goals could be “I want to be calmer in public places.”, “I want to feel less anxiety.”, or “I want to struggle less with my daily life.” The therapist will then help them build tools and skills to use every day that are aimed at lessening their pain. If your friend is reticent to go to therapy, offer to help them find a therapist and to drive them to their first appointment.

Remind them often that they are loved and supported, in and out of anxiety episodes.

Remind them to do any of the activities they wrote down as “soothing”. It’s easy to forget your tools when you’re in crisis.

Please remember that your friend can get better and experience less anxiety, but they will probably never fully recover. The goal is not to be cured, the goal is to learn to live successfully, in as little pain as possible. Most of the responsibility to get better rests on your friend’s shoulders, not on yours. Make sure you take care of your own mental health before reaching out to help your friend. It’s okay to sacrifice a little for them, but if you find yourself slipping into a depression because of their situation, take some time to yourself to get better, and then return to your friendship refreshed. Since your friend has a mental illness, they should be understanding if you express the need to take care of your own mental health for a while.

It is very loving and honorable that you want to help your friend. If you have a very close relationship and you are willing to take on more responsibility, this has more ways you can help: How Outsiders Can Help – The Goldfish Painter

Fact-checking. What’s Real?

I’ve had doctors who were surprised that I can distinguish most of my hallucinations from reality, so I’m led to believe it’s not common, but I am not a professional.

I know when I’m in a psychotic episode and I can use logic to detect most hallucinations. I call it “fact checking”.

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Photo by JESHOOTS.com on Pexels.com

If I’m in the car and I hear the driver (I don’t drive. I have a license, but it scares my family. It’s disheartening at times.) singing along with the radio, I look at the driver’s mouth to see if it’s moving. Sometimes it is, and I’m hearing them singing. Sometimes it isn’t, and then I realize I’m just hallucinating them singing.

sunglasses girl swimming pool swimming

Photo by Juan Salamanca on Pexels.com

Once, I saw a young, blonde-haired boy in a blue and orange swimsuit floating motionlessly near me at the bottom of the pool. I panicked, yelled “Help!” and dove down to grab him and bring him to the surface. When I reached out to grab him, he disappeared. I returned to the surface with a pounding heart and told the lifeguard that I was mistaken, nothing was wrong and thanked him for coming to help. My whole body was shaking for the next hour. Finding out you’ve had a hallucination is comforting in that the problem it presented is not really there, but your adrenal system will continue to flood you with panic chemicals long after you’ve found out.

I frequently have visual disturbances, the most common of which is smoke or bent light in the air. Imagine billowing smoke, and then take the same curves and lines you would see and turn that into light. It’s a lot like the reflection of light at the bottom of a swimming pool. It doesn’t obscure my vision, it just passes over it. This is usually the first sign I’m having psychosis.

Following the billowing light, I usually become very frightened, with the cause being some vague danger, a threat to my loved ones’ or my safety. I frequently ask if we’re safe (anyone in my life knows to expect this, and fortunately the answer is always “yes”) and sometimes need my fiance to search the house for strangers on my behalf. This fear is paranoia. I actually consider myself lucky for not having more specific fears. The more specific the fear I’ve had in the past, the more intimidating it was. Sometimes, if I’m in public during a psychotic episode, I will believe that I can hear everyone’s thoughts and that they can hear mine. I’m afraid I’ll think the wrong thing and everyone will hear me and get upset. That’s a great example of a paranoid delusion. In this state, I know I’m in an episode, which allows me to continue to move through the world looking a little bit normal (with the guidance of a loved one) even though I’m inside of an absolutely insane situation. I can experience it as real, the way I’m being forced to experience it, but pretend that nothing is happening and just do the things I’m told to do, like walk next to someone, get in the car, or stand in a line. This level of coping with psychosis is ninja-level. I cannot express how hard I have worked to get to the point where I can actively fear for my life and stand in line at the grocery store at the same time.

Being 12 years into my treatment for bipolar, nothing now is nearly as scary as it used to be. I used to be completely entranced by horrific hallucinations and believed completely that they were real. I once sat next to Satan on an American Airlines flight (I really was on an airplane). He had a little boy in his lap, and I was trying to figure out how to signal to the stewardess that the boy needed help, but I was nearly paralyzed by fear. I looked down between my feet so he couldn’t see me crying, and the floor of the aircraft had disappeared. I was sitting 40,000 feet above the earth with nothing between me and the tiny lights below but air. That was real to me.

By 3 years ago, I’d come around to being aware of almost all my hallucinations. I once saw a flock of black angels/bird people flying over the car I was riding in. I knew it was a hallucination, but it still mattered to me. I wasn’t at all afraid. It was beautiful. I watched them swoop and dive around each other. They were fast and graceful. I watched until they disappeared. That memory is still special to me. That experience was only mine. No one else in the world can possibly have that memory, not even the people that were there.

Knowing I’m having hallucinations is much easier than knowing I’m having paranoia or delusions. Paranoia and delusions are less tangible. Seeing something is easy to disprove, especially if it disappears while I’m watching it, which is frequent with my visual hallucinations. If the person is singing in the car, I can watch their mouth. But if I believe I’m not “safe”, for whatever vague, paranoid reason, it is very hard, and sometimes impossible, not to trust my gut. Instead, I have to trust someone else’s gut. My fiance is my partner in life, and we have been through enough episodes together to have each other trained in what to do. If he’s the person I’m with, which is usually the case, I have to ask him questions, sometimes repeatedly, about the nature of actual reality as he is experiencing it. I use him to check what is real. I ask him about the validity of things I see, hear, and think. I will ask him if we’re safe, and he’ll say yes. If I don’t calm down, he will describe why we are safe. If I’m far enough gone that I can’t calm down, it’s probably all terror-crying from that point on anyway, so he just takes me home, stays with me and reiterates that we are safe. I much prefer hallucinations, as you can imagine. They, at least, can sometimes be fun. Paranoia, so far, has never been fun for me.

I am self-aware enough now that I know when I’m in an episode most of the time. Sometimes someone else will point it out before I’ve figured out what’s happening, but as soon as I realize it, I am able to stay grounded in that knowledge. Knowing that I’m in an episode and that I can’t stop it sometimes feels like falling, only I never land. It just goes and goes, without my permission, and I can’t change it. The intensity of it can be ridiculous. Humans shouldn’t be able to manufacture that level of intensity, especially with no external source. It can be quite incredible, in the original meaning of the word. In fact, that incredibility is part of why fewer people understand or validate mental illness. It sounds made-up.

Knowing I’m experiencing psychosis keeps me grounded and safe during episodes. I know to alert my fiance or family, and I follow their lead, at least until I get out of public. At home, I am better able to cope with whatever counter-reality comes my way.

Read More About Psychosis

Read More Personal Experiences

(Quick! Take a 4-question quiz to let me know how you feel!)

“How Can People On The Internet Help Me With Severe Depression?”

All people on the internet can do for you is to listen and respond. We can offer our support through words and remind you that you are not alone. We will be here in the middle of the night. We will hear you, and we will try to help.

 

Move forward with the hope of treatment and remission. You need to be seeing a psychiatrist and a therapist. Depression is hard, and you may not have much energy or functionality today. That’s okay. Make your one task for the day “Make an appointment with a psychiatrist”, and even if there is a long waiting list, set the appointment and put it on your calendar so that you will have help in the future. Do the same thing tomorrow, only with a therapist.

 

If you already have a psychiatrist and therapist, stay vigilant in keeping your appointments and taking your medicine. Start to build your toolbox of coping strategies,(that link is to a list of all of my coping tools) and use it when you’re in pain, even if that Sunflower CCmeans you are using it all day, every day. You cannot be cured, but your pain can be managed. For your next appointment, take any notes you can on your symptoms, triggers, medicine effects/side-effects, sleep problems, eating problems, and daily moods. There is no wrong way to take these notes, just write down information every couple of days about things you experience in your illness. The important thing is that you have everything written down for the doctor. The doctor will only be as good as the information you give them, and you are your best and only advocate as the patient. Don’t rely on only your memory to communicate with your doctor, because memory is fickle and fallible, and doubly so with Continue reading

The Ultimate Guide To Taking Psychiatric Medication

(Quick! Take a 4-question quiz to let me know how you feel!)

When you first start psychiatric medication, you honestly don’t know what you’re doing. I wish that there was a class on how to be a good and helpful patient that anyone could take for free when they get their first script, but instead, I will write out the things I believe are crucial in order to make significant progress aided by meds.

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Patient Skills For a Lifetime

Although I am not a doctor or any sort of health professional, I do consider myself a “professional patient,” due to the past 13 years of dealing with bipolar disorder, major depressive disorder, and generalized anxiety disorder. All that time, I have been in treatment with psychiatrists, psychologists, therapists, general practitioners, and specialists in various fields. The following is what I’ve learned.

The Rules

  1. One psychiatric medication does not work the same on everyone. And if you’re already telling other people about your meds (what works for you and what doesn’t), then please read the disclaimer that needs to come before any advice you hand out.
  1. Sometimes a psych med has the effect of causing health problems, making things worse, or affecting you in a way opposite of its intended purpose. An example is that for some people, some antidepressants can cause suicidal ideation, and some antipsychotics can cause hallucinations. These effects happen to a small minority of people, so this doesn’t mean you shouldn’t try them. Because…
  1. Psychiatric medication can save your life. A med can bring you back from the brink. A med can improve you enough to be able to use coping skills, which is difficult in a nonfunctional place…
  1. Doctors are stabbing in the dark when you begin treatment. This means that you will probably have to try more than one medication before you find one that works. Once you find one that works, then you will need to…
  1. Adjust your dosage and time of the dose with the guidance of your doctor. Often, a medication that works for you a little bit can work for you a lot after you figure out what time(s) of the day make you feel best. This is often called “tweaking the dose.”
  1. To learn how the dose needs to be tweaked, you will need to KEEP NOTES. Print out a mood chart from the internet (search “mood chart”-it’s easy). Go to Kinko’s or the library if you don’t have access to a printer. I know some apps do the same thing, so look for those instead if you’re inclined. Or just keep a notebook. It doesn’t matter how you do it as long as you have the following information in an easy to read way:
    • Your daily mood status
    • What you are taking, what time and how much (you don’t need to write down the things that don’t change every day)
    • Your mental illness symptoms, especially anything severe or unusual for you
    • Other health problems
    • Any problem behaviors or events (like self-harm or episodes)
    • Any insight you notice about how you are being affected
  1. Bring your notes with you to the doctor. Some doctors’ appointments are as short as 10 minutes, so every sentence counts. Having all the information on hand eliminates the need for telling long, rambling stories full of irrelevant details. This is probably the most important thing to do in your relationship with your psychiatrist.

Continue reading

What is EMDR?

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EMDR, or Eye Movement Desensitization and Reprocessing, is a partially physical treatment in psychotherapy used to reduce psychological pain associated with trauma. It involves watching a light move back and forth, tapping your hands on your legs, or holding two small vibrating paddles, one in each hand, while letting your brain relive a traumatic event. The physical component (be it the moving light, the tapping hands, or the vibrating paddles), causes bilateral stimulation. When combined with the brain’s amazing ability to make sense of complicated feelings and situations, effective healing can occur.

We have two hemispheres in our brains; the right hemisphere and the left hemisphere. They are connected in the middle by a part of the brain called the corpus callosum. The corpus callosum does the job of communicating thoughts, memories, emotions, and other information between the two hemispheres. When you experience a traumatic event, your brain makes a fixed memory, including all of the physical and emotional feelings you had at that moment. This is sometimes referred to as a “flashbulb memory” (flashbulbs were used with old cameras as the necessary light source for a photo), because the image is frozen in your mind in great detail, and details will remain there, largely unchanged, for years. It is important to note that most memories are extremely flimsy and subject to change, even from hour to hour. Flashbulb memories are different. They are “stuck” in a neural memory network in a specific part of your brain and are cut off from the rest of your brain. Anything that comes in contact with this “stuck” part of your brain will be negatively affected by your trauma. The stuck trauma can cause negative thoughts, feelings, and behaviors. This is where EMDR comes in.

Bilateral stimulation means that both hemispheres are stimulated alternatingly (right brain, then left brain, then right brain, then left brain, and so on). Bilateral stimulation is the crucial element in EMDR because it aides the corpus callosum in communicating between Continue reading

On Gaining Weight. And Losing weight. And Gaining Weight…

conv meditation.jpegTrigger Warning: This article discusses weight loss, severe weight gain, and disordered eating.

Psychiatric drugs make weight gain so, so easy. My first antipsychotic made me feel like I was never full for the first year and a half that I took it. I would eat seconds, thirds, fourths, dessert and second dessert. I would get the feeling that my stomach hurt from being so overly filled, and I would stop at that point. I would have a stomach ache for the next hour, and I was still hungry. This was when I was at Oberlin and had access to a cafeteria. Yikes.

The weight gain was slow at first, but over the years I grew to a size that was unacceptable to me. A big problem I have is using food as a pleasure button that I push to entertain myself. Eating makes me feel good, so I want to do it more often than is healthy. Sometimes I go on binges and don’t purge afterward. I’ve also gone through years in my life with symptoms of anorexia. Eating disorders are real mental illnesses, and while I’ve only been informally diagnosed by my therapist as having some sort of disordered eating, I know how complicated my relationship with food is, and that it’s not a healthy relationship at all.

I have had a period of my life during which my relationship with food was very healthy, Continue reading

A Manic Introduction to a Realistic View

What will I be without my illness?

This question terrified me. And it terrified me to admit that I was terrified because that meant something was wrong with me. And there is. There is a pretty massive thing wrong with me: I have a broken brain.

Along with that broken brain came a personality developed from the results of mental illness. There is a lot I have not been that I want to be. I have rough spots and ugly edges. Now I know that I can make those edges any way I’d like them to be. I have the power to do all of the things I want to do. They are all completely possible. I can step out of the cage and grow into whatever I want to be.

I had a seizure, and it changed me. I woke up in a slightly different world. It’s beautiful. I have the power to make all of the things I want into reality. That is an incredible gift. My life is going to be meaningful.

Now that I have all this power, I have to start looking at what it is I want. If I could pick anything… and I can pick anything… then I need to think hard about what I want my life to be.

Of course, any joy this high comes under scrutiny. Mania is always possible, and it can give one delusions of grandeur. That is what this looks like from the outside, and I know my family will be worried. But having a seizure made me wake up different, and now I’ve got everything figured out. Or, rather, I know how to figure anything out. I will have to work hard, but I know that I can. I just have to keep putting small thing on top of small thing until I make something big.

The paragraphs above were written during mania. I rarely have “happy” mania, but I definitely did when I wrote this. I remembered today that I started writing an article a few nights ago and I wanted to sit down and finish it. I remembered that the article had a positive perspective, and I was excited to see what I had written. Then I read it and immediately went “Oh. Delusions of grandeur.” It made me smile.

It made me smile because I can appreciate the more ridiculous things about my disorder. For years, when I had to come face to face with a shortcoming, weakness, or disability, I would cry and feel deep hopelessness. It felt like I was worthless and broken. Now, I have gotten better at accepting that I am disabled, and I don’t need to be ashamed Continue reading

How to Survive Depression

When you’re deep in a depression, not much appeals. Nothing sounds fun. Nothing seems worth doing. When that happens to me, I know I’m not just bored. I’m depressed. Losing interest in things you usually care about is a normal and typical symptom of depression. For many very lucky people, sadness passes in a day or so. For those of us whose sadness lasts weeks and expands into full depression, we need a plan. Deep depression can lead to suicide or suicide attempts. If you’re going to stay alive, you need tools to help you do so. Suicide happens when the pain you experience exceeds your ability to cope with it, so if you’re going to stay alive, your options are to lower the level of pain or increase your coping ability. This explanation is not original to me, so don’t credit me for it. I use it because it’s a clear and simple analysis of a messy state of mind.

So. You’re depressed. Time to get to work. Self-care is where you begin. Self-care is easier than all-out self-love, which is often not possible when you’re depressed. Taking a shower, brushing your teeth, or eating something is a good place to start. If you’re severely depressed, all three of those things may be impossible. If those things remain impossible for more than two weeks, you need medical intervention (click to learn how to be a “professional patient”). If that’s where you are right now, then the job I assign you for today is to make a doctor’s appointment. That is the only task you need to do today. You can do one thing. You can spend the rest of the day watching TV and crying (or whatever you do to cope) if you need to, just get that one thing done. It’s the first step to saving your own life.

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If you are still able to do something like take a shower or feed yourself, you might be able to get through this without medicine. Granted, if you have a mental illness diagnosis, you DEFINITELY need to call your doctor immediately, but if you have a situational depression from something like losing a job, ending a relationship, or grieving a loved one, you might do just fine with some added coping skills.

Steps To Surviving A Depression or Depressive Episode

  1. Lower your standards. You are not having a normal time in life so you cannot have normal expectations of yourself. Make your daily list short. Celebrate small victories, like any act of personal hygiene. Even brushing your teeth is a win when you’re not really so hot on staying alive. Your life right now is monumentally challenging, and recognizing and respecting your current abilities go a long way toward better self-esteem.
  2. Make a List. Write down the things you can reasonably get done in a day. For example, today I’m getting sick, and I’m worn out and a little depressed. So the list I made today was “weigh self, make pill case, drink coffee, shower, dress, work on my website, eat dinner”. That’s all that I’m requiring of myself today. On better days, I know I can do more, so I write more down, like exercise or socializing. Cross things off as you go along to show yourself that you’re getting things accomplished, and if the next thing on your list seems too hard, write a time down next to it for half an hour to an hour from now, so that you can take that time to gather your strength, courage, and energy to do the next task. I frequently have to do that with showering, otherwise, it won’t get done. I sit for thirty minutes just mentally preparing. Same goes for exercise. You can refer back to your list throughout the day, and if all the tasks are crossed off at the end of the day, please be proud of yourself for that.
  3. Set realistic goals. If you are not up for company, cancel plans. If your job is killing you, take time off or apply for disability benefits (in the U.S.). If you can’t get your chores done, only ask 5 minutes of yourself a day, and don’t beat yourself up for it. If you can’t do your homework, talk to your professor (this is really important if you’re a student. When you are honest with a teacher or professor about your mental-illness-caused limitations, they will be much more likely to be lenient on deadlines and work with you to help you complete a class.) If going to school is killing you, take a semester off. Be realistic about what things are threatening your life. Do not expect to be more resilient than others. Do not hold yourself to the same standards you did when you were healthy. And don’t measure yourself against an ideal, healthy person who does not exist. Instead, measure yourself according to your values, and how well your actions line up with what is truly important to you.
  4. Be sweet to yourself. Use kind language when you speak to yourself, always, but especially when you’re depressed. I know this is very challenging. I’ve been meaner to myself than anyone has ever been to me, most often in episodes or during depressions. No matter who you are or what you’re experiencing, you’re a worthwhile person, and who you are is absolutely enough. What you’re feeling now won’t last forever; you will live again. Be as patient with yourself as you would be to someone you love who is hurting. Say kind things. Be nice. You deserve to be treated well, especially by yourself.
  5. Write down your feelings. Even if the act of writing makes you cry very, very hard. When you’re finished, you will have a deep feeling of calm that could last up to a few hours. Writing is a proven effective therapeutic activity with very clear and real results. You might not want to want to do it, but it truly will help you cope almost immediately.
  6. Get sunlight. Go outside, even if you just sit on your front porch for five minutes. Sunlight stimulates chemicals in our bodies and brains that are important to mental health, like lithium and vitamin D. Having the right balance of chemicals is more than half the battle with depression. You are also more likely to see something beautiful if you go outside. It’s amazing out there, always.
  7. Pick soothing activities. Write down one or two to do today. Pick something like watching TV, coloring, reading, or playing with a fidget toy. Mess around on the internet. Anything easy that’s not challenging and won’t steal your limited and precious energy.
  8. Get good sleep. Insomnia and depression often go hand in hand. If this is you, med up. There are lots of over-the-counter sleep aids, and I’ve had good luck with most that I’ve tried. I recommend Unisom, Alteril, and melatonin. Most people would be fine taking just one of these OTC sleep aids, but you can ask your doctor if they can be combined. You might sleep for a long time, which is not a bad thing. Sleep is foundational, and doubly so if you’re mentally ill. Set an alarm for noon and try to stay up until eight in the evening. Take your sleep aid at seven and you’ll probably be asleep in the next hour or two. This schedule allows lots of time to sleep without messing up your circadian rhythm and turning your sleep habits upside down.
  9. Use coping skills when you feel suicidal. You can borrow mine.
  10. Hug a pillow while watching TV. I don’t know why this helps me with depression, but it really does.

 

If you are currently suicidal, put this number in your phone! 1-800-273-8255

If you’re working through a depression right now and you feel suicidal, call this helpline: 1-800-273-8255. Whatever your current situation, nothing is permanent. It is possible for things to get better. Don’t believe that it can’t ever get better, because that’s not true. It can always get better.

 

By Emily Harrington, The Goldfish Painter

 

My disclaimer:

I am not a doctor or any sort of mental health professional. I am a psychiatric patient with multiple mental illnesses that I have survived for 13 years now. My secondhand knowledge comes from doctors, psychologists, therapists, books, college courses in psychology, and the internet. My firsthand knowledge comes from the feelings, experiences, thoughts, symptoms, problems, and solutions that I have lived through. I know myself well, but again, I am not a professional. The information on this site is not a replacement for getting an actual diagnosis or professional help. Coping skills are fantastic, and I hope you learn some here and that they help you, but please seek and continue real medical treatment if you are struggling with mental illness. I wish you the best. You can do hard things.

How To Support To A Mentally Ill Loved One

One of the biggest worries of a mentally ill person is that they are a terrible burden on their friends and family. As an outsider, most of what you can contribute is verbal. Regularly remind your loved one that they are not a burden, they are not going to lose you, you love them, and that it’s okay to be upset. Physical contact is also very powerful: a hand on the back, a squeeze of the hand, or a hug can make an enormous difference in the current mental state of your loved one in crisis. If it’s appropriate to your relationship, lay with them and hold them, or let them put their head in your lap so that you can pet the side of their head. This sounds very basic and very infantile, but the difference you’ll make is enormous. Just being present with your sick loved one is powerful. Try to listen without judgment, and try not to give advice, only reassurance that they’re safe and loved. If your loved one is very sick and not making good choices, keep them at home. Even a trip to the grocery store could be catastrophic for their state of being. If they’re not making sense, do not let them cook or drive, and keep a close eye on them to keep them safe.

If your loved one is suicidal, take them immediately to the emergency room, because they’re going to need to Continue reading

The Disclaimer For Your Advice

Meeting Myself CCEach person is mostly like every other person, but not exactly. And the not exactly goes to varying degrees. Some people are sick. Of the people who are sick, there are many different body parts that can be sick. Of the people with one specific sickness in one specific body part, each will have different and varying degrees of the effects of the illness and the effectiveness of their treatment.

Every illness is like this. The world is full of different people; mostly all the same, but each with a personal experience that no one else gets to experience. My mental illnesses are different from yours. Mostly the same, but different.

Don’t assume you know what someone feels because you wear the same label that they do. I, for example, do not have happy mania. Continue reading