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Billie Lourd Shares Carrie Fisher's Cause of Death

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The coroner’s report for Carrie Fisher’s cause of death was released on Friday, six months following the actress’s death at the age of 60. According to the Associated Press, Fisher died as the result of sleep apnea and “a combination of other factors,” including drugs.

Fisher was best known for her role as Princess Leia in “Star Wars” and was an outspoken mental health activist who lived openly with bipolar disorder and addiction. The drugs found in Fisher’s system included cocaine, heroin, MDMA and other opiates. While it’s impossible to know what she took and when, the Associated Press reported that according to experts, she may have used cocaine about a week prior to her death.

Releasing a statement to People about her mother’s death, Billie Lourd, Fisher’s daughter, said Fisher would have wanted her to be open about her cause of death, adding:

My mom battled drug addiction and mental illness her entire life. She ultimately died of it. She was purposefully open in all of her work about the social stigmas surrounding these diseases.

She talked about the shame that torments people and their families confronted by these diseases. I know my Mom, she’d want her death to encourage people to be open about their struggles. Seek help, fight for government funding for mental health programs. Shame and those social stigmas are the enemies of progress to solutions and ultimately a cure. Love you Momby.

Speaking to the Associated Press, Fisher’s brother Todd Fisher said he wasn’t surprised Fisher’s health was affected by her drug use. “If you want to know what killed her, it’s all of it,” he said of his sister’s heart condition, smoking and both prescription and illicit drug use.

If you or a loved one is affected by addiction and need help, you can call SAMHSA’s hotline at 1-800-662-4357.

Image via Riccardo Ghilardi.

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14 Steps to Help Me When I Am Hearing Voices

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I sometimes hear voices when I am manic. I have also heard voices when under extreme stress, or during dissociative episodes.

I usually don’t share what is going on in my head… except with my husband sometimes and at support groups. When I have told people about the voices, they never seem to know how to respond, and don’t say things that are helpful. I thought it might help if I wrote out how people could help me during this time. Psychotic episodes can be very different for different people. For me, the battle is mostly inside my head and I know the voices are part of my illness. These are things that would help me, and hopefully, it could help someone else as well.

1. Establish my trust.

I am always really scared to share that I am hearing voices. If I tell you, please reassure me that you are a safe person I can confide in. You could do this by making eye contact and showing empathy in your voice. Tell me you care about me and want the best for me. Give me some time before I share more details. It takes a while for me to build up the courage to talk more.  Remain calm, and be sensitive to whether I want to sit apart from you or closer to you. Tell me you don’t think I’m “crazy,” and that other people have this problem too.

2. Listen.

After you have given me a little time and established I can trust you, I might start talking a little more about what’s going on. Listen with empathy and without judgment.

3. Respond to the feelings I share.

I know it’s hard to understand what it’s like to hear voices, but you can relate to my feelings. So you could say things like, “That seems so scary. I understand how you would be upset.”

4. Summarize what I am saying.

It helps me to feel heard if you respond to what I am saying by putting it in your own words and asking me if you understood it right.

5. Ask me what the voices are saying.

I may not be ready to share what the voices are saying, especially if they are saying bad things to me. But sometimes it helps to get the words out in the open and not in my chest. If I am too nervous to share, you can skip to the next step.

6. Ask me whether I am going to listen to the voices.

The voices might be telling me all sorts of bad things, but if I ignore them, it’s not so bad. If I start believing what the voices say or act on what they say, it can be a real problem. So ask me if I’m going to listen to them, or how I am going to deal with them. Maybe we can talk it over, or you will notice I need professional help to find ways to manage these voices.

7. Decide whether I am in crisis.

If the voices are telling me dangerous things and I’m listening to the voices — if I seem to be a threat to myself or others — call 911 or refer me to get professional help. If I don’t seem to be in crisis, you can go to the next step.

8. Bring the focus back to me.

When I think or talk about the voices too much, I start focusing on them too much, and they get louder and stronger. So we can talk about the voices some, but then bring it back to me. Explain you are concerned about my health and care about me.

9. Ask me what you can do to help.

Sometimes I can think of something helpful, or I might share something unhelpful.

10. Ask me what has helped in the past.

I personally have dealt with voices many times in the past. I’ve developed coping skills, but in the moment I sometimes forget them. Ask me what I have done in the past, and I might remember things I have done before that have helped.

11. Ask me if I’m feeling better.

Hopefully talking to you has helped me feel better. I might say how you have helped me. It helps me focus on the positive and see things are getting better.

12. Ask me what I’m going to do next.

Ask me what my plan is to deal with these voices. Encourage me to get professional help to talk about hearing voices, if I’m not already.

13. Say you care about me.

Reassure me that you care about me and want to be here for me.

14. Follow up.

Check in on me later on, whether it’s hours or days later, to see how I’m doing. Convey to me that you care about me and want to help me if possible.

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Thinkstock photo via AntonioGuillem

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How I Learned to Accept and Acknowledge 'Negative' Emotions

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Who Will Speak Up for “Negative” Emotions?

When I was growing up, I wasn’t allowed to be sad. It was “cheer up, don’t cry, look up on the bright side.” Anger? Forget about it – there was no room at all for anger. “We don’t get angry in this family.”

The only feelings that were approved were the bright happy cheerful ones.

Of course I did have “negative” feelings — I got scared and sad and upset — but my mom was determined to redirect everything I felt into something she could handle. “What if you look at it this way?” she would say. “Maybe it was all for the best.”

I was bullied at school for years. Once – just once – I tried to tell my parents about it. It was obvious they didn’t want to hear and had no idea what to do about it. “Maybe they are just trying to be friends,” said my mom, helplessly.

Trust me, the kids who mocked me and shamed me and called me stupid and ugly… no, Mom, they were not just trying to be friends.

But I didn’t have the words to say that to my parents.

So I kept quiet about it from then on, and I started to feel more and more anxious around people, and withdraw into isolation whenever I could. Obviously, I did get sad. And angry. But because there was no welcome, no room for such feelings, they went underground in me. Sadness was shameful. Anger was unthinkable. I had no vocabulary for such feelings, because they had never been talked about around me.

Alone in my room, I turned to poetry. Poetry was the first thing that saved me. The feelings I could never talk about came out on the page. Sadness, rage and despair came pouring out. And longing.

The person reflected back to me from my poetry was so different from the quiet, polite girl who did everything she was supposed to do. I ended up feeling even more isolated, unable to show that “dark” side of me to anyone… but at least I felt alive.

The second thing that saved me was a teacher I met in grad school. He had developed a method and a philosophy for listening with absolute acceptance to all the feelings inside us. A community grew up around his teaching — young people like me who were trying out his method as a way of life.

For the first time, it was not only OK to have feelings, but there was a way to explore them, to allow and trust that every feeling has a story to tell and can change and evolve if you pay attention.

No feelings were considered “negative.” All were welcome. Just as all people were welcome in the community we created. No negative people, no negative feelings.

The inner exploration of feelings became my life’s work. Given how I started out, I can see why.

And here’s the thing: I’ve learned it wasn’t only my family and my small town that suppressed negative feelings. It’s our whole culture, our whole country. And though my childhood was a long time ago, the shunning of “negative” feelings is still going on.

If you show sadness, you’re considered a “basket case.” If you show anger, you’re labeled an “angry person” — the kiss of death. If you show anxiety, people try to fix you or talk you out of it or explain you just have to change your thoughts… good luck with that.

The latest version of ostracizing negative feelings is a kind of pseudo-neuroscience where we are told that dwelling on negatives rewires/strengthens the negative neural connections in the brain. (I haven’t found any actual science to support this.) Methods have emerged for “thought-stopping,” which teach people to suppress any “negative” thoughts.

Really? After all these years of progress and learning about being human, is that the best we can do?

When I was mocked and teased at school, I couldn’t allow myself to feel how scared I was — because that would have made the mocking worse. Besides, I knew that if I dissolved into tears, swallowed up by my misery, nothing would have changed. But the feelings, unfelt and unprocessed, stayed in me as tension in every social situation from then on… until I met that teacher in grad school.

When feelings and thoughts are suppressed and not allowed, they remain the same — unchanged. Letting our feelings take us over and run riot is also not good… because they don’t change that way either.

What I learned from my teacher was a third way: How to welcome and turn toward any feeling and give it a space to be explored. I don’t have to be anxious; I can be with an anxious part of me, and listen to what is getting it so anxious.

When I look around the world today, I see so much division and fear. Whole races and religions are called “bad” and pushed away. We’re afraid of people who aren’t just like us. The same thing is true inside us. Whole sets of thoughts and feelings are labeled “negative” and sent into internal exile. This can’t be good.

Every feeling you have is trying to understand your situation and carry you forward. Depression is a real sign that something isn’t right. Anger says, “I need this to stop.” When you learn to listen to your feelings without being taken over by them, you live more fully. You become more “you.” You contribute more to the world, your family, yourself.

Who will speak up for “negative” emotions? I do.

Ann Weiser Cornell is the co-developer and teacher/author of an empowering skill for emotional healing called Inner Relationship Focusing. She herself has struggled with anxiety, obsessions and addiction. Her latest offering is a free online course called Transforming Your Relationship to Your Inner Critic. You can also find her at focusingresources.com.

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woman wearing striped top in greenhouse laughing

What You Don't Expect to Hear in the Psych Ward

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There are sounds you expect to hear in a psych ward. You expect to hear nurses talking to patients, medical carts rolling, thermometers beeping, doors opening and closing for 15-minute checks, and occasionally, alarms sounding. But one thing you don’t expect to hear in a psych ward is laughter. And I don’t just mean the awkward, fake laughter, like when you first meet someone or are uncomfortable. I mean full-out, belly laughter that makes your eyes water and your stomach hurt.

When I spent a week in a psych ward, I laughed far harder than I had in the months leading up to it. This might be surprising because over those months my depression had gradually worsened. You would think laughing would gradually decrease as my mood went south, and there would be no laughter by the time I was in the psych ward. And you’re right in that laughing had decreased over the months leading up to being hospitalized. But after a few days in the psych ward, once the patients had met and started getting more comfortable with one another, the laughter exploded.

I can’t remember a lot of what we were laughing about. And of what I do remember, I won’t share most of it because it isn’t funny unless you have also been in a psych ward. It’s a very dry, dark humor, and some of it could probably be offensive to someone who hasn’t had those experiences. We laughed about the millions of rules on the psych ward. For example, I wasn’t allowed scrunchies for my hair. If someone complained about a rule or talked about what they wanted to do once they got out I would often jokingly exclaim in exasperation, “I just want a scrunchie!” We would laugh at things nurses said, or the odd looks they gave us. Once I had asked a nurse for a pair of hospital socks from the supply closet. She said something funny about how she was already late to a meeting so might as well get it now, and then went into the closet. I stood outside waiting and was still chuckling a bit at her comment. Another nurse passed, gave me a deeply concerned look, and questioned, “Are you OK?” Granted, to her it looked like I was standing in the hallway just laughing to myself. A worrying but perhaps not surprising image of someone in a psych ward. I quickly reassured her that yes, I was fine. I was just waiting for socks. When I rushed to tell the other patients what had happened, this story was a hit. I often wondered if hearing us laugh this much scared the nurses and doctors, but thinking about this just made us laugh more.

In the psych ward, you get to a point where everything is funny because you are desperate for a distraction from your own thoughts and emotions. I think the laughter also stems from the community that forms. When you are in hospital for a mental illness, it’s no secret to anyone else on the ward why you are there. You’re either suicidal, detoxing from drugs, psychotic, or some combination of the three. Everyone there is scared and uncomfortable, and because of this also extremely vulnerable. Yet around you are 20 or so other people going through incredibly similar struggles. The empathy and support for one another is natural, even though you’ve just met and have little else in common.

After the morning psychoeducation groups, there isn’t a lot to do in a psych ward. So simply because you are bored (and because it will look good to the doctors), you end up hanging out in the common areas with the other patients. I’m quite the introvert, and even I spent a lot of time there. We had SVU marathons, played the game Fact or Crap, and ordered late night mac and cheese.

Now it would be a massive stretch to say I enjoyed my time in there. I was still sick and needed to be there for a reason. Plus, as someone with obsessive-compulsive disorder (OCD), the lack of my usual routine and sense of control was terrifying. Still, it wasn’t a completely awful experience. After all, a lot of therapies teach to not view the world in black and white, but to see the grays too.

I can look back on those evenings spent with the other patients and even have some fond memories. I’ll certainly remember the laughing fits, and with a sense of gratitude. It kept me going through tough, sad, long, boring hours on the ward. It kept me connected with others and helped prepare me to re-enter the “real” world. Perhaps most importantly, the laughter planted tiny seeds of hope for a future I might be able to have, one that I couldn’t have seen alone. Now it’s time to keep laughing and keep watering those seeds.

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. Head here for a list of crisis centers around the world.

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

Unsplash photo via Brooke Cagle

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What It's Like to Be an Extroverted Introvert and Highly Sensitive Male

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Try to explain to people that you are two things that don’t make sense to most of the population, including, at one time, myself. Tell them you are an extroverted introvert and highly sensitive male (HSP) in today’s world. The first question I usually get as people learn this about me is “are you gay” (not that anything is wrong with that. Nod to Seinfeld). But the sad truth is that it is unexpected for men to act a certain way and to have certain feelings and issues. But I am not alone and it took me a long time to find others who were like me. It took me a long time to learn about me.

It started innocently enough as a young boy. I remember having strong emotional feelings most of my young life. Things were either up or down and I felt I was relating to what others felt around me. I also remember, very early on, that music, television and movies were very important to me. All were for the same reason — that I could relate and remember how I felt and where and when it was I saw or heard each of these things. I also recall always being very touched by the lyrics in music. It’s not that the beat wasn’t important either, but songs could make me sad and cry or be happy and energetic. Music has always held a very close place in my heart. That is because musicians pour their hearts into lyrics and depending on your age and feelings, these affect you. At least they did me.

But as I grew into a school age boy, I found the weakness in my extroverted introversion and high sensitivity. Well, I didn’t find the weakness — bullies at my schools did. They found me easily affected by their bullying and as hard as I tried, I could not mask these emotions. At the same time, my extroverted introversion had me wanting to be liked and be part of the crowd, yet also made me different. As time went on my conditions became my insecurity and my own disbelief in myself. I wondered for many years what was wrong with me. Why didn’t others feel these feelings strongly like I did?

As time went on, these bullying years would haunt me and I would struggle through my high sensitivity to ever let them go. This is what us highly sensitive people don’t share — we don’t ever forget how we felt during both the highest happy times in our lives and particularly the lowest painful times. We can recall them on a dime. For years after all these things happened, I didn’t even believe it myself, trying my hardest to bury my authentic self every day and be who I thought others wanted me to be.

But this was quite painful. Yes, it was mentally painful, but fighting, trying to be an extroverted non-sensitive male was physically painful for me. I would have stomach problems all the time from age 16 until I learned about my personality issues. Of course, I would learn in a hard way also, by experiencing low self-worth, leading to stress, to anxiety and finally to depression as I fought my authentic self. I could have given up so easily at this point. It was the lowest point of my life and I thought every day that I would lose my job, my wife and my children. It physically hurt very badly.

But, the good thing about hitting rock bottom is that there is nowhere to go but up. So, the choice was to wallow in my self-pity or do the work to learn about who my authentic self was. I chose the latter and through the help of mentors, professional mental health experts, coaches and self-help books, I found out who I truly was. But, best of all, I found out that being an extroverted introvert is a real issue, as is being a highly sensitive person. I found out that my authentic self was nothing more than the makeup of who I was… who I was supposed to be. So, I embraced it and built skills to work with these personality traits — to both work with them and not allow them to run my life, but work my life around them.

I am a male with these traits. I like sports OK, but like a good conversation around feelings much more. I like to feel my emotions, both laughing and crying. I like to listen to others and have an empathic sense about what they tell me and what they need. I learned to change aspects of my life so that I lived healthier and could work through my personality. I embraced who I was and now realize I am lucky to feel so much and to be able to be an extroverted introvert, because I know that even this writing is because of these personality traits. No, I’m not easy to live with. I have never been, even with myself. But truly, is anyone? No, most people don’t understand when I share this with them. They just don’t have the same empathetic ability to understand what I tell them I’m feeling. I accept all that, and those who love me and want to be with me make that choice as well.

I look at it this way in the end. I would rather feel too much than not feel at all. I would rather deal with the dichotomy of being an extroverted introvert than to only be one or the other. But most of all, I embrace the uniqueness of me, but that also I am not alone. There are many of us out there and once we stop hiding behind what we think others expect us to be, we become who we were meant to be. And that is the true blessing of being our authentic self.

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9 Secrets of Dads Who Live With Mental Illness

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We often look to our dads for protection, wisdom and guidance. Maybe they’re the man who slays the dragons under our beds. Or maybe they teach us how to throw our first baseball on a crisp fall day. They’re almost always the one person who refuses to read the instruction manuals of, well, anything. And they’re often the man who furiously searches for solutions to problems that have left us in a puddle of tears on the bathroom floor.

Dads can be a child’s biggest role model — their superhero, if you will. But sometimes, we forget that dads must confront their own battles. That is why we asked the dads of The Mighty’s mental health community to tell us the “secrets” they wished others knew about being a father who lives with mental illness. Because even though dads may be our superheroes, doesn’t mean they don’t deal with the symptoms, stigma and effects of mental illness.

Here’s what they said:

1. “I’m doing everything I can so my daughters can grow up in a world where they aren’t afraid to ask for help if they need it.” — Sean H.

2. “I wish people understood what it’s like be a parent, want nothing bad to ever happen to your kids and still want to end your own life.” — Shawn H.

3. “I didn’t ask for this illness. [I wish others would] understand it more.” — Kev C.

4. “I guess it would be a story I tell my kids: A young person walking down the street sees a big, strapping man grunting and sweating carrying a large backpack across his back. The young person laughed because while the pack was big, the man hauling it was obviously powerful. The man stopped, unslung the pack, and set it down. ‘Pick it up,’ he told the young person. They tried and the pack didn’t budge. They got friends to help lift it and the friends left when they realized how difficult it was. After watching for a bit, the man opened the pack to show it was filled with lead bricks and then re-slung the pack across his shoulders. The young person asked why he carried the burden, to which the man replied, ‘It’s my burden.’ The young person’s heart went out to the man, and he traveled with the man, pushing up on the pack to ease the weight.

My eldest girl has taken this story to heart and helps folks whenever she can, my boy is too young to do much more than hug his daddy’s neck, but even that helps ease my own pack.” — Kevin G.

5. “Not so much to understand, but to step back and listen to what I’m opening up with.” — Andrew T.

6. “To understand how tough it is — trying to be the dad you so want to be, but the OCD is questioning every single move you make. Also understanding you may seem to be distant but it’s only because you love your family so much and you are genuinely scared.” — Robert K.

7. “I wish people would not view me as some sort of monster. Many years have gone by without being able to be a father to my son due to the thoughts of some people thinking that mental illness makes a person dangerous.” — Gordon M.

8. “My kids (who are adults now) are very understanding and supportive. I just told them I’m still the same person and don’t treat me any different.” — Glen C.

9. “I wish mental illness was not viewed as a character flaw/weakness!” — Mark C.

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. Head here for a list of crisis centers around the world.

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