Finding Hope When My Best Efforts as a Therapist Fail

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Like many helping professionals, I started out in a master’s program with the goal of helping other people. I dreamed about holistically changing lives. I thought with the right training, I could truly help others. I thought it was my purpose in life.

Now I am a young therapist, two years in if you count my internships. I don’t even have a state license yet. I work in an emergency room, assessing patients with psychiatric needs. I help them get the treatment they need, provide resources, refer to outpatient providers. Sounds like a helpful thing, right? It is, some days. Until I feel like I have miserably failed my patients.

If I’ve learned anything in these two years, it’s that America’s mental health system is broken. When it comes to a disposition, i.e. where the patient is going to go next, we have few options in the ER. If a patient is cooperative and wants treatment and fits in these little boxes, everything works out. Except I work with people, and very few fit into a little box that a government agency or a CEO of a for-profit hospital system came up with. A lot more people fall through the cracks.

I have urged families to call the police on their own children because there’s no other way to get them to treatment. I have witnessed mentally ill patients be taken to jail, and there was nothing I could do. I have cared for patients who have been in the ER for days at a time, with minimal medical care, because they cannot function outside a facility. But no facility we try to get them to wants to care for them, so they just lie there until we can figure out some sort of plan or we can no longer legally hold them.

I have admitted people to a psychiatric facility knowing it probably wouldn’t help them but having to prioritize my hospital’s liability. I have hospitalized patients who truly needed it but who may lose their job due to “unexcused” absences. And they do lose their jobs every day, whether that’s “legal” or not. I have encouraged people that they will get better, when really I have no idea.

I have admitted transgender and gender nonconforming patients to facilities, unsure if their hormone regimen or even gender identity will be honored once they’re in the hospital. I’ve had to explain to them and their partners that their identity likely won’t be honored, in fact. I’ve attempted to give them autonomy in the decision but worry they’ll be traumatized no matter what.

I have advocated for patients, only to be shut down. I’ve watched as patients I knew went to the ICU after suicide attempts. I admit the same patients over and over again because nothing the system has to offer is really helping.

I’ve had good days too.

I have advocated for patients and actually succeeded. I let a patient smoke after I had to tell him he’d be admitted involuntarily. I volunteered to watch him myself. It significantly helped his anxiety in that really scary moment.

I made a patient smile after my usual joke of “hope I don’t see you again… in a good way” as he left the ER. I’ve had parents hug me, patients too. I’ve been told I’m the first person to actually help them. A patient I know really well told me how much her outpatient group was truly helping her gain insight. Some patients recover and live their lives and never see me again. That’s a good thing.

I know I help some days. But I can’t help but wonder what happens to my patients after they leave my ER. I worry for my patient when I send her to a hospital I know has a bad reputation. I do it anyway because I have to. My job is to get her out of the ER and get her to whatever facility accepts her first. Choice isn’t really part of the deal. I’ve called CPS on parents who simply didn’t want to pick up their child from the ER. I don’t know what happens to them.

I see a lot of people who shouldn’t have any diagnoses but do because we have to label them to bill their insurance and get them help. And that label could stick for decades until someone is brave enough to challenge it. I see others who have never been diagnosed, and just giving them an idea of what could be going on is life-changing because now they have a direction in which to go. They needed answers more than anything else.

I hear about horrific trauma and abuse. And I assess entitled people who want a magic pill to fix all their problems. I wish I could offer that. People ask me for more pain pills, even though I know they’ve gotten early refills for months. When I say no, they scream at me.

Sometimes, my best efforts fail. The reason I say this is because there are a lot of people out there who need to know that a bad experience with the mental health system doesn’t mean they’re all bad. Many of us really do care about each and every patient we see. We know what we’re up against with the resources we have, and we wish it were different. But right now, all we can do is fight for the best care we can give in the moment.

Working in mental health has taught me how little control I have. I only have control over what I say and how I treat people. So I hope to use that to empower people to take back their mental health and their lives, and to stand as their ally.

If you or someone you know needs help, visit our suicide prevention resources page.

If you need support right now, call the National Suicide Prevention Lifeline at 1-800-273-8255, the Trevor Project at 1-866-488-7386 or text “START” to 741-741.

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10 Songs to Help on 'Bad' Mental Health Days

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Editor’s note: If you experience suicidal thoughts, the following post could be potentially triggering. You can contact the Crisis Text Line by texting “START” to 741-741.

We all have those “bad days” — days where the protection of sheets and blankets seems like the safest place to be, like nothing bad can happen if I remain ensconced among the soft cotton and feather quilt.

They are days where my neck and shoulders ache from tension and I feel like my jaw is going to explode right off the sides of my face. Days when every face seems like judgment day and every whisper sounds like an accusation, a guilty verdict. Days when every noise sounds like impending doom and destruction. Days when nothing seems to go right and I have to concentrate on breathing and taking it slow. One step at a time. One foot in front of the next.

On days like these, I find comfort and release in music … sometimes. When nothing else is there for me, these songs help pull me through.

1. “Break On Me” by Keith Urban

This song is an actual emotional release, perfectly describing “those days.” It feels like a hug.

2. “How Not To” by Dan + Shay


This song is about recovery and endurance through strength and love. It helps me to know all is not lost and better days are ahead.

3. “Keep Your Head Up” by Andy Grammer

This is a happy beat — just a small reminder to “keep your head up” through the tough days.

4. “Humble and Kind” by Tim McGraw


Just a reminder there a good people in the world.

5. “Why” by Rascal Flatts


This is a very emotional one and very close to my heart. Rascal Flatts sing about the tragedy of suicide and the terrible aftermath.

6. “Let It Hurt” by Rascal Flatts


Here is another emotional release. Take all that pain and “let it hurt, let it bleed.” I’ve cried through this song countless times and felt better afterward. Essentially about bullying but can really take on any meaning.

7. “Stand By You” by Rachel Platten


This one is a reminder you have your “people” and they won’t leave you. The music is uplifting and the words are inspiring.

8. “Fight Song” by Rachel Platten


This song is empowering. Keep fighting!

9. “Gravity” by Sarah Bareille


I like this song because it can be interpreted in countless ways. It’s about whatever is pulling you into a negative gravity. The music is enchanting and I find it to be eye-opening and uplifting.

10. “Here Comes Goodbye” by Rascal Flatts


This last one is one of my favorites. It does have a bit of a morbid twist, but at the same time, it shows love and afterlife. There are sadness and comfort in the lyrics. The music is poignant and flows over you.

Music like this has saved me many times. I am not alone. Neither are you.

If you or someone you know needs help, visit our suicide prevention resources page.

If you need support right now, call the National Suicide Prevention Lifeline at 1-800-273-8255, the Trevor Project at 1-866-488-7386 or text “START” to 741-741.

We want to hear your story. Become a Mighty contributor here.

Unsplash photo via Sai Kiran Anagani

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Just So You Know, Someday You’re Going to Be OK

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I want to be the girl everyone thinks I am.

The one who’s taken on the world without any sort of issue. The one who stands up for everything she believes in. The girl who’s managed to change sceneries time and time again without even batting an eyelash. I want to be the girl in my photos who’s smiling or laughing with different people in different places.

I don’t want to be the girl who’s currently cowered under her duvet wondering when everything got to a point of no return. I don’t want to be the girl who’s been under such stress from her own depression and anxiety that she’s had to move back home. The girl who’s had trouble admitting to herself that things aren’t going well. That everything that’s been going on lately has been way too much for her to shoulder on her own.

I want to be the girl who used to have everything come so naturally and easy that it looked so effortless. Life doesn’t work that way, though. If there’s one thing I’ve learned over the last 26 years of being on this Earth is that at one point or another we’re all going to struggle. Some of us will struggle privately and manage to pull ourselves out of our darkest moments.

Some of us will realize there comes a time and point when we need to lean on all the people who love us wholeheartedly for extra love during times of despair.

The older I get the more I realize we’re so scared to talk about when we’re going through the really bad lows. That is largely due to the new normal of being flawless on social media. We look at everyone else’s lives that are going perfectly and compare them to our own. Comparison is natural, but we shouldn’t compare ourselves to such extreme points that it makes us question our own worth.

I find my default is comparing my older self to my younger self. I look back at 21 and think about how back then I was drinking way too much, dating really shitty guys and ignoring all of the mental health warning flags that kept appearing. I didn’t give a shit about being unhealthy because I didn’t have time to care about myself. I was too busy trying to find my worth at the bottom of a bottle or on the other side of some loser’s bed. To me though, in those moments of comparison, everything is idealized and romanticized. I only see the good.

I can logically look at those situations now and see the imperfections within them. I can see the damaging behavior I had allowed into my life daily.

I can see the fact that those decisions I made back then have made me who I am today.

While I wouldn’t change any experience I’ve had, I just wish I had been honest with myself back then. Maybe then I wouldn’t be the girl who’s holed up in her bedroom trying to figure out how to feel happiness again.

It’s scary to stand here with my chest open and all my feelings spilling out of me like I don’t have any time to catch them. It’s scary to admit my depression has hit such a low that my life has now been altered in major ways. It’s scary to think that from here on out I’m probably not going to be the same person anymore.

 We get caught up in the fact that there will be people who turn their backs on you when you start getting real about your mental illness. We start to worry that the judgments are going to be worse that silently struggling through the day. We don’t want to start being handled like we’re breakable. While I know the only thing that should matter is getting better, I also am well aware of how it feels to be belittled for having anxiety and depression.

So while you’re sitting at home, trying to figure out if you should keep on pretending that you’re OK, or if you should reach out to someone close to you to tell them that right now you’re not sure how to keep it together, my advice is this; it’s always better to deal with it head on than to let it fester. Fuck anyone who thinks you’re weak because of your mental illness.

You are brave. You are strong. You will find your happiness again. All you need to do is put yourself first and other’s opinions last.

If you or someone you know needs help, visit our suicide prevention resources page.

If you struggle with self-harm and you need support right now, call the crisis hotline at 1-800-273-8255 or text “START” to 741-741. For a list of ways to cope with self-harm urges, click here.

We want to hear your story. Become a Mighty contributor here.

 Thinkstock photo via JulJuli

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When You’re Anything but OK

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Let’s get real with each other. You’re struggling. I can see it. Your family can see it. Hell, even you can see it. The problem is you’re not sure how to fix it anymore. You started out so hopeful and bright eyed, but now here you are, just trying to get yourself out of bed. You’re trying to remind yourself the reasons why life is worth living.

It started out like a regular day. You were just a ‘normal’ person, casually walking through the streets when it happened. “Is this it?” your brain asked you. You tried to shake that thought from your head. Is this really all there is? Is this how life is supposed to feel? Is 20 percent of the time being happy enough? Do you really give a shit about yourself anymore? Why are you even here?

The harder you fight to have those thoughts disappear, the more they continue to pop up until you can’t breathe. Until you can no longer handle it and you collapse. Struggling for air. Tears streaming down your face. It’s pain. It’s pure, extreme pain.

So while you try to beat your demons on your own, your family and friends are watching. Confused on how to help. They don’t know whether to bring it up or let it go. They don’t know if this is just a bad day or week or month or year. They don’t know if this is a passing phase or if you’re going to continue to pretend that you’re fine.

Honey, you’re not fine.

You’re not fine if you walk around in a haze. A haze that clouds everything great in your life. We all go through tough times. We all have times in our lives when we need to fight harder to see the good instead of the bad. We all have times where life really just isn’t giving us any breaks. We feel as though we’re the only people going through this. We feel like this storm is never going to pass.

You feel things start to slip, too. At work you can barely concentrate on the tasks in front of you. You miss things. You never miss things. You go one day without a shower and that’s OK, but by day three of not giving a shit how you look you realize that’s not the person you used to be. You even start pretending you’re busy in order to not be around people. Going out in public, surrounded by different bodies, is your current nightmare.

Your depression has gotten the worst of you. You wonder again if this is it. Is this what life is going to be from now on? Is this your new normal? If it is, then you’re not sure you even want to keep doing this. You feel so worn down, so tired of continuously trying only to be pushed right back down to the bottom again. Again and again you fight and again and again you lose. You’re losing the battle internally because you’re just so exhausted.

Resilience. This word has come up. You’re wondering if you would be considered resilient because of the amount of times you’ve come back from the darkest places in your mind. Your bounce back isn’t as quick as it used to be. Now you’re just struggling. You’re floundering. You’re down right losing your battle to your internal demons. You’d like to go one goddamn day without crying. Is that too much to ask?

So while everyone can see you’re stressed and you can feel it, what can you do to help lift some of the weight on your back?

You need to talk about it. You need to allow someone else to help you with what you feel like would only be a burden. You need to be able to admit when it’s too hard and you need to be able to talk to someone, anyone, when you need help.

I know that’s not easy. It’s definitely easier said than done. But if you don’t do it, if you don’t start talking or start allowing someone to see you in those vulnerable moments, the harder it will be to find yourself again.

So don’t keep everything to yourself. Someone who loves you wants to be able to help you. All you have to do is let them.

If you or someone you know needs help, visit our suicide prevention resources page.
If you need support right now, call the National Suicide Prevention Lifeline at 1-800-273-8255, the Trevor Project at 1-866-488-7386 or text “START” to 741-741.

We want to hear your story. Become a Mighty contributor here.

Thinkstock photo via evgenyatamanenko

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Why I'm Going to Keep Attending My Counseling Sessions

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I started attending the counseling service at my sixth from college last week, and I already feel like this was a bad idea. But I am determined to stick with it. I know these are just nerves, and I know this will get better. And this is how I know that, although I currently want to sink back into my protective hole and continue on alone, counseling is the best next step for me.

1) This is someone who is a specialist.

This is someone who deals with people just like me on a day-to-day basis. I know that no two cases are the same, but this person talks to loads of teens, my age, in my area, who also self-harm; who also struggle with food; who have parental issues. This woman will have seen it all and will have knowledge far beyond myself or my friends or my parents. She will know what best strategies to offer to cope, how it will be best to talk to my parents, and how I can get past this stage in my life. This isn’t just a random person I happened to bump into on the street: this is someone who can help.

2) It will be a constant support.

This scheduled, weekly session is something I know I can rely on, and when living with obsessive-compulsive disorder (OCD) this is a godsend. It will be punctual, routinely and organized. I won’t have to worry as to when I have to talk to someone, when I need to reach out for help. A constant support provides a steady hand, and that is just as important as the actual help — to know someone is there, without the fear they will leave, without the fear they will give up hope on you — that is the one thing everyone in need deserves, and it is the one thing the counselling will always offer.

3) It will give me an anchor in my worst times.

When I happen to find myself at a low point, the tether of hope linked to the counseling sessions could be the last string to hold me up. If I stopped the sessions, I would be giving up my lifeline. One thing everyone should have, but sadly not many people do have, is a lifeline they can hold onto. That could be the one thing which saves a person. I’m not implying counseling is a guarantee, but what harm can a little extra protection do? Especially for those who need that little bit extra.

4) It gives my friends and family hope.

Even if it may not seem all that useful to me yet, my seeing a counselor will let those close to me relax a bit. They will have support in the knowledge that I am being proactive — that I am getting help. If they see I am trying, they are sure to have a weight lifted. Counseling is something you have to do for yourself while helping those around you too. I spoke to one of my friends about counseling for a long time before I finally signed up, and I could see the light shine in her eyes when I finally went. She wanted me to get better, and that is a magical piece of hope in itself.

It may not seem like counseling is helping much when you first start, but all we can do is keep going with it. These things take time, and — although I’m not there yet myself — I know this will get better.

If you or someone you know needs help, visit our suicide prevention resources page.

If you struggle with self-harm and you need support right now, call the crisis hotline at 1-800-273-8255 or text “START” to 741-741. For a list of ways to cope with self-harm urges, click here.

If you or someone you know is struggling with an eating disorder, you can call the National Eating Disorders Association Helpline at 1-800-931-2237.

We want to hear your story. Become a Mighty contributor here.

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Having a Good Day When You Have a Mental Illness

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Today was a good day.

I woke up at 6:35 a.m. I opened my eyes to sunlight coming through my blinds, but it was different from the day before. Today, it signified a fresh start, a beautiful beginning and happiness. Most days, the sun feels like it’s mocking me. It usually feels cruel, how it makes everything so bright when my brain stays so dark. Today, I rose with the sun.

I looked beside me and there was my boyfriend, still dreaming sweetly with a slight smile on his face. At that moment, his eyes blinked open and his smile grew. He reached for my hand and drifted back to his dream while I smiled next to him. How lucky I was to be able to catch that moment. How lucky I am to have someone so caring, so loving, so gracious and so kind.

I quickly realized that this day was going to be unlike many I have had in awhile. My brain has been an awfully messy place to be. My anxiety usually doesn’t let me rest and it’s been evident with my sleep patterns. Usually, my mornings are filled with dread, panic and a million questions I ask myself before my feet touch the floor. I overanalyze things until I cry and stress to the point that my eyelashes have started to fall out and I break out in hives all over my body. I find myself wishing I would be able to outrun my thoughts and I couldn’t even begin to tell you how many times I have cried into tear-soaked pillows at night until I fall asleep. I have taken my sadness and anxiety out on my loved ones more times than I feel comfortable admitting. Anxiety and depression have had their way with my soul and mornings have gotten increasingly bad.

It was so refreshing to wake up and take in the beginning of the day without worrying about something. I thought clearly for the first time in months. I felt loved and appreciated from not only my boyfriend but from myself too. I felt like I would be able to not only get through the day but really, truly make it mine.

For those of us who fight anxiety and depression, good days can be few and far between. I believe they are designed for a reason and reach us at the exact moment we need them. We savor the good days because we know we may not get another one for a while. We enjoy the good days even more because we know how bad the bad days can actually be.

I am not foolish enough to tell you to find a day and make it good because it isn’t that easy, but I will tell you when the good day arrives, grab on to it with both hands. Squeeze every second of joy you can get out of it. Make memories to calm you when the hard days are upon you. Know there will eventually be more days like this, but never take for granted the one you have been given now. Laugh loud and laugh hard. Smile, breathe, feel the warmth of the sun on your face and remember you are worthy of days like today.

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