Max Harvey, PhD

@max_harvey | contributor
Dr. Harvey has a PhD in psychology. They enjoy researching and writing about mental health issues and chronic illness, focusing primarily on their own experiences as a member of the LGBTQ community with several chronic illnesses.
Community Voices

Navigating the Gray Space to Prevent Suicidal Thinking

Whenever somebody asks me if I ever attempted suicide, I’m not quite sure what the answer should be. Technically, no, in that I didn’t attempt suicide and fail. But also in a way yes, in that I tried to attempt suicide, but was prevented. I attempted to attempt suicide. This question seems so black-and-white to me, but in reality the truth is much more “gray.”

My journey with suicidal thinking started with chronic pain. I spent a long time suffering from chronic migraines. They had gotten to the point where they were nonstop and non-responsive to any type of medication or treatment. I was self-medicating with marijuana to ease the pain, only eventually my migraines persisted regardless of how much I used. I became addicted to cannabis and tried so hard to find a strong enough dosage and perfect strain to ease my pain. I also started abusing my prescription pain medication – thinking that more medication would help me, though this failed to work.

I was no longer able to work – the medications my doctors were giving me were affecting my ability to think clearly and remember things. I also was having other medical problems, including a condition that doctors couldn’t explain. I went to several doctors searching for answers, but was told something different from all of them. I was scared there was something permanently, severely, wrong with me – some sort of irreversible damage. Today I know the strange symptoms I had were due to fibromyalgia. But at the time, I was so scared and also so unbearably uncomfortable that I gave myself panic attacks.

On top of all that, I was struggling with a toxic relationship and unstable mental health. I was struggling with suicidal ideation for a long time, but eventually I reached a breaking point. Lacking a support system and with no hope of getting better, I decided I had enough. I decided it was time to end it all. I wanted relief from my pain and from life itself. I saw no other way of improving my life or getting help – I was exhausted from going to so many doctors and seemingly only getting worse. So, I decided to carry out my suicide plan that I had for quite some time: overdose.

The “problem”, however, was that I already hid my medications from myself when I was in a more logical state. I asked my partner to hide my medications from me, suggesting to hide them in her safe, so I couldn’t access them if I ever got desperate. She was reluctant to do this at first because she didn’t want to have an unequal dynamic in our relationship. However, I think when someone is suicidal, the partner needs to help the one who is sick stay safe. People who are suicidal are, in my experience, not thinking clearly and could possibly hurt themselves if their partners don’t step up for them in that moment. That said, I convinced her that it was necessary and she finally agreed. Fast-forward to my frenzied panic of wanting to die, I now regretted this decision. I searched everywhere for my pills, with the intent of taking them if I found them, but to no avail.

Luckily, I had an appointment with my psychiatrist the next morning. When I got there, she could tell something was wrong. I told her everything – I told her that I wanted to be 5150’d because I didn’t feel safe at home and had nowhere else to go. She agreed. Firefighters picked me up and I was admitted to the mental hospital. I stayed for 1 week. While that’s a whole other story, I can say that it was a productive visit. It started me on the life I wanted to live.

I moved away, left my partner, and stayed with my parents temporarily because I was unable to care for myself. I joined a partial-hospitalization program focused on dialectical behavioral therapy (DBT). This program changed my life. I was reluctant at first that it would make a difference, but was eventually convinced when I started seeing results. I started crying less, I started having fewer meltdowns, I stopped thinking in black and white and began thinking dialectically – I saw multiple sides to an issue, whereas before my thoughts were in extremes. During this program, I pledged to stay sober in order to remain in the program. I noticed differences from this as well – my thinking cleared, I had more energy, and my mood seemed stable. My new psychiatrist also monitored my medications and prescribed me with lithium. He convinced me of its effectiveness by saying it’s the only medication proved to reduce suicidal ideation. I have been on it now for 2 years and while I’ve experienced some mild side effects, it’s greatly improved my mental stability.

From my DBT program, I learned to regulate my emotions, practice mindfulness, and work on my communication skills. This program taught me how to be present in the moment to the extent that I experienced less dissociation. It taught me how to handle conflicts and difficult emotions. Ultimately, it altered my way of thinking and I couldn’t be more thankful. I now see what a black-and-white approach it is to think of suicide as the only option. I even see that the question of whether I had a suicide attempt is a black-and-white issue. What matters is the gray: the in-between space where there are infinite possibilities of how to handle problems, how to think about things, and how to experience the world. I try to stay in that “gray space” as much as possible now that I’ve seen how it can benefit me. It makes me feel better knowing I have so many options for how to live my life, whereas before I only saw one solution.

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Community Voices

The last months I have been thinking about euthanasia. I’ve done a suicidal attempt last year. Unfortunately my husband found me with the knife in my hands to stop me. Last week, I told my husband and two daughters that they can come and take me frim this world. I have been through all medication that could relief the pain, with an wrong effect (read MORE pain). The last thing I’ve tried it Fentanyl 25. My blood pressure went down to 75 over 40. I have constipation and low blood pressure since my childhood. With these adhesive plaster it makes it even worse, also with this heatwave (up to 39* celsius.
I am never in the mood for intimate moments with my husband. I can’t enjoy nothing more in life.
My children (both adults) tell me to never give up, because I taught them so.
I can no longer fight. Psychiatric inhouse therapy for over two months didn’t work either.
If if sleep three hours a night, it is a lot!
I used to be a very active, independent, hard working woman, whose life stopped 4 years ago. I don’t have a life, I no longer survise, I just exist.
Doctors tell me to learn to deal and live with it ...
When I ask them, how CAN I live, they send me to a psychiatrist
I can go on for a few hours, but I have been complaining already too much.
I send my hugs to everyone in these groups ❤️ 🇧🇪

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Max Harvey, PhD

What to Do If PTSD, Trauma or Abuse Is Affecting Sex

The first time I remember my post-traumatic stress disorder (PTSD) affecting me during sex, my partner threw me onto the bed and then I started sobbing. This is when I had to come to terms with the fact that the sexual abuse I experienced as a child still affected me as an adult. After learning more about PTSD, I realized it had been affecting me in many more ways during sex. All of the major symptoms of PTSD were also interfering with my sex life: detachment, dissociation, flashbacks, intrusive memories and mood instability, among others, each became present during sex. I have many examples of what it’s like to have PTSD during sex, but I didn’t realize my PTSD was bothering me at the time. Looking back, it seems obvious. For example, I struggled with dissociation/depersonalization/derealization a lot. I often stared up at the ceiling or off into space with a blank mind, felt separate from my body while I waited for it to stop, or saw myself have sex while being behind or floating above my body like a fly on the wall. These are just a few examples of dissociation during sex. The other symptoms of PTSD can affect sex as well. For example, flashbacks and intrusive thoughts can cause major problems. I can be having a grand ol’ time until, suddenly, the way my partner touches me zaps me back to remembering one of the most horrific traumas of my life. Then, I have to try to push that out of my head and try to resort back to what I was doing as if nothing happened. In the case of sobbing when I was thrown on the bed, clearly that wasn’t possible. My partner was frightened to see me crying and not know why. I had to lie there for a while to recover from what happened because the flashback was so powerful. It helped to then share my story and talk about what I was experiencing; it gave the memory less power. 1. Flashbacks. Flashbacks and intrusive memories are a major part of PTSD. It’s what most people think of when they think of PTSD, even though there are many more symptoms. Flashbacks are some of the most powerful symptoms, which means they can be devastating when it comes to sex. If I’m having sex and even for one second have a flashback where it feels as if I’m back to being sexually assaulted by my abuser, then it’s near impossible to be able to continue having sex after that. It’s incredibly disturbing, confusing, distressing and frustrating. 2. Detachment. Sometimes during sex, I can start to feel emotionally numb, detached from myself or have trouble feeling pleasure. This is most likely another form of dissociation where I don’t quite feel like myself and I don’t know why or how to fix it. In my case, I try to just keep going and focus, but that’s easier said than done. Having trouble feeling pleasure is one of the most emotionally destroying aspects of having sex when you have PTSD because, for me, I’m not sure how much of it is caused by my body shutting down from previous abuse. These forms of detachment can make even wanting to have sex challenging because I will think I won’t enjoy it or that I’m broken and other self-defeating thoughts. Of course, all of those types of thoughts only make it worse. 3. Negative thoughts and beliefs. Another issue with having sex when you have PTSD is that you can view sex in similar ways as the abuse. It’s common to think things such as that you are only there for the other person’s pleasure, that you’re a vessel or that you don’t have your own agency to say no to sex or certain acts you may be uncomfortable with. These thoughts can be extremely damaging psychologically. Personally, I have been buried in them. I will have sex when I don’t really feel like it, then end up being detached or dissociating, so then the sex isn’t great and it doesn’t work out for anyone. I don’t recommend it. It takes a lot for me to be able to turn down sex or say no to doing certain things. When I found the power to say no, it was incredibly scary, but also completely worth it. 4. Mood instability. Another common symptom of PTSD is mood instability. Sometimes life can feel like an emotional roller coaster and I don’t always know why. When it comes to sex, I might want sex one minute but then something will happen and I’ll change my mind. This can be incredibly frustrating for my partner. I will want to have sex, but then something subtle might trigger me or I might have an emotional flashback or feel some negative thoughts about myself, and then it’s as if I become a completely different person. My mood changes and even if I say that I still want to have sex, it’s clear that I shouldn’t or that I don’t really want to. This can also happen during sex. My partner might say something or do something, maybe I’ll see myself in the mirror, or something will trigger me to have some negative thoughts and all of a sudden my mood will go into a downward spiral that I’m frantically trying to get out of. How to Have Better Sex When You Have PTSD: 1. Mindfulness. For a long time, I struggled with thinking I was broken and could never have a good sex life because of my PTSD and childhood sexual abuse . It wasn’t until I discovered how mindfulness can improve anyone’s sex life that I realized I could apply that to me. It’s even more powerful for people with PTSD or who have trouble focusing. I read a book, “Good Sex: Getting Off Without Checking Out” by Jessica Graham, that showed me how to be mindful during sex. It provided mindfulness/meditation exercises to try during sex. This was mind-blowing for me. For example, one exercise focused on paying attention to different sensations. This was great for when I was dissociating because if I felt myself drifting off, I could have something to focus on that would pull me back in. This also made my sex life way better because I was way more present than ever before. It also made me closer to my partner; we were closer and more connected to each other. 2. Relaxation. Another important aspect that improved my sex life is relaxation. This may seem obvious, but to me, it wasn’t. During sex, I had the tendency to tense up my entire body. This makes it difficult to receive pleasure when your body is preparing to receive pain. I did more meditations to learn how to relax in general because I realized I was always tense, and it was just worse during sex. I also read another book, “ The Survivor’s Guide to Sex: How to Have an Empowered Sex Life After Child Sexual Abuse ” by Staci Haines, and it included a section on how to relax your body to enjoy sex and even make it easier to have an orgasm. It works! It involves pushing your muscles out instead of holding them in, if that makes sense. That’s what worked for me, at least. 3. Communication. The last major thing that helps my sex life is communication with my partner. It’s common knowledge to have open communication in relationships , but this means different things to different people and not everyone really follows through with it. My partner and I are completely open with each other. Being the partner of someone with PTSD is not easy. It can be emotionally draining, challenging, frustrating and even scary to see your loved one go through something and not really be able to make it better. The partner of someone with PTSD wants to have a healthy sex life too, and this can be difficult to deal with PTSD when they don’t have it but are only seeing the effects of it. I often think about how my partner sees how PTSD is affecting me but only from the outside, not knowing what goes on inside of me. I try really hard to communicate it, but it’s never the same. My struggles with PTSD during sex affect both of us, so I communicate why I’m behaving the way I am or what’s going on with me so she understands. I think this has brought us closer and also helped her understand PTSD better. It has improved our relationship which, in turn, has led to more intimacy and better sex. Having PTSD during sex can be challenging, to say the least. Flashbacks, dissociation, detachment, mood swings — all of these symptoms (and more) are not something I want to bring into the bedroom with me. I don’t want my partner or myself to be thinking about my past abuse when we want to have sex. So, I’ve tried a lot of different things to find a way to make our sex life better. What has worked for me boils down to mindfulness, relaxation and communication. Each of these things helps someone with PTSD in general, but when brought into the context of sex, they can make your sex life incredible. Mindfulness taught me how to stop “checking out” during sex. Relaxation taught me how to make my body physically ready to receive pleasure. Communication taught me the importance of bringing my partner on my journey with me because my sex life includes both of us. I am still learning new strategies to improve my life with PTSD, but for now this has been the most effective approach at healing my sex life and healing me as well.

Max Harvey, PhD

How Changing My Name Changed My Mental Health for the Better

Last year I went on medical leave from work. While I was gone, I worked on both my physical and mental health. I also wrestled with my gender identity — specifically worrying about how “out” I wanted to be, which labels fit and how much I wanted to transition. I already knew I was genderfluid, but always presented as relatively feminine or neutral. Now, a more masculine side was coming out and I was having a hard time dealing with it. I ended up settling on the labels genderqueer and non-binary to describe me to the outside world. I started dressing more masculine, got a crewcut, dyed my hair blue, and started using the pronouns “they/them.” All of this helped shed the “old me” and quell the gender dysphoria that was the main problem which started all of this. My body now felt like it belonged to me. My head attached to my body when I looked in the mirror for once. The rest of my body looked like me. It no longer felt like the “meat suit” I previously described. It felt solid, it felt like me. However, I was still struggling emotionally. I was in a relationship that wasn’t going well to put it lightly. My health was draining all of the life out of it. I knew I had to do more to feel like this “transition” was “enough” (because I did not want to take any hormones or undergo any medical transitioning). So, I changed my name. My birth name is incredibly feminine and made it hard to feel masculine whenever I heard it used or had to say it. I wasn’t transitioning to be a man, so I chose what I thought of as a gender neutral name, Hayden. Sadly, I don’t have a great story about why I chose it. I sent a list of names to my friends and they said they liked it so I tried it out and it stuck. I tried out names by calling in take out orders, seeing how each name felt as I said it, and then again saw how it felt when I heard it said. This was actually incredibly effective. I had strong reactions to what definitely was not my name and then neutral and then Hayden, which actually felt “right” (sounds made up, but it’s true). Plus, I looked up “Hayden” on Wikipedia and it said it originally meant “heathen,” which definitely describes me. So, I was sold. At first it was just a social name change. I only told my closest friends and people I saw when I was out in public. I also was participating in an intensive outpatient program at the time and used the name there. It was challenging having my issues there because I felt like no one understood what I was going through so I spent a lot of time educating everyone. I even wore a t-shirt that said “THEY THEM THEIR,” because I got so annoyed at being misgendered. Eventually people got on board and it felt good to hear strangers or acquaintances use this name, especially if that was the only name they knew me as. All of this served as “practice” until eventually it came time to tell my family. I wish I could skip this part, but I suppose it’s part of the story. Because of my health and being out of work, I had to move in with my family. I told them my name, educated them on my pronouns and gender identity, and told them that even though they will always know me as my birth name, that name doesn’t suit me so I want the rest of the world to see me as Hayden because it suits me better. I asked for them not to use my birth name. I would like to say that they used my name and pronouns and that was the end of the story. The reality is much messier. There were many fights, many corrections, many self-corrections, and even a family meeting held by a therapist from a new partial hospitalization program I was attending. I spent many hours working with three different therapists and one psychiatrist talking about this issue because it was making my mental illnesses and suicidal ideation worse. Through all of this, they all affirmed that my name was Hayden. Everyone in the program called me Hayden. I spent all day being called Hayden, then went home to hearing variations of my birth name — Hayden. It’s been over a year since I moved out, but this still happens. I gave up trying to get them to use my pronouns and just focused on my name, thinking that would make a difference, but it didn’t. I know some people feel stronger about this issue (hearing their birth name), and don’t get me wrong, I do hate it, but not at the expense of having a relationship with my family. So, once it became time to go back to work, I moved out from my family’s home and back on my own again. After a few weeks at work I realized I couldn’t continue this partially-out lifestyle. I had to come out at work. I am fortunate to work in higher education, known for its liberal attitudes and safe spaces, so I felt relatively comfortable with this nerve-wracking idea. First, I saw our LGBT resource center director for guidance and was encouraged to come-out, explaining that California just passed the California Gender Recognition Act which allows non-binary individuals to have gender identity documentation that includes a non-binary category (on their driver’s licenses for example), giving them full recognition in the State of California. Excited and motivated from this discussion, I marched into my boss’s office and told her that I had been living under a different name for the past year and that I’m non-binary and use they/them pronouns. She did not blink. She was just purely logistical and asked what my new name was so she could notify IT. I was glad to put the focus back on work so we listed all the steps that I needed to take to make my name change official at work. After meeting with my boss, it was time to notify my coworkers and colleagues. I wrote a very short email explaining my name change and pronouns, excluding the part about being non-binary because I thought it was irrelevant (looking back, I would leave it in for clarity). Then, it was official. IT changed my name on my email, phone, and internal systems. Even though my name wasn’t legally changed yet, it was starting to feel official. It left me wanting more. I wanted to finish this name change process so I could move on with my life. I felt incomplete not having my name legally changed…it was as if my name wasn’t fully “mine” yet. So, I filed the (very expensive) paperwork to change my name. I got a court date where I had to go defend myself for why I wanted to change my name. On the paperwork, I simply put that I was non-binary and wanted a name that better suited my gender identity. When the court date rolled around, I didn’t have to say much. My name change was granted. It was official. Right? It was confusing because here I had a court order saying my name was changed, but nothing else to prove that was my name. So, time to go to the DMV. I quickly went over there to change my name on my driver’s license and decided to mark the “X” for non-binary on my driver’s license while I was at it. Now it felt real. I had proof that my name is Hayden. I had proof that I’m non-binary. Even though I shouldn’t need external validation to feel good, it does help. My driver’s license is more to me than external validation — it’s legal documentation so it’s just plain inaccurate to not update it after receiving the court order of my name change. Having the court order, driver’s license, and my information updated at work all solidified my identity. They proved, to me, that my identity is valid and that the State of California and my work view me as valid as well. Suddenly, my dysphoria lifted. My symptoms of borderline personality disorder all lessened. My dissociation, mood swings, emotional outbursts, suicidal thinking, and gender/body image issues all basically disappeared. For the first time in my life, I finally felt comfortable in my body. I looked how I wanted to look for the most part. Being non-binary can be confusing in general because for many of us it means falling in the middle of the gender spectrum, so that can make  figuring out what to wear really frustrating. I err on the side of men’s clothing most of the time, but the important thing is that clothed or not, my body looks like it belongs to me (which is an achievement when you have body dysphoria). I also have grown more confident. When people misgender me or call me by my birth name, it doesn’t bother me as much as it used to because I have proof in my wallet what my name is. I know who I am. Maybe that was the problem — everyone calling me different things made it even more confusing for me to figure out who I was, when I was trying to figure that out for myself. Now, I have a new sense of confidence in all areas of my life. At work, I notice I’m more outspoken than I used to be. I’m guessing it’s because I had to fight to be who I am. In my new relationship, I stand up for myself and make sure I am treated fairly. With my healthcare, I stand up to my doctors to make sure I’m getting proper medical care. I advocate for myself. With my family and friends, I’ve come out to all my extended family and friends. There’s no more hiding or alternate versions of me. I’m finally being honest with myself about who I am, and that makes me feel stronger, braver, more confident, and happier than I could have ever imagined possible. I would never have believed that something so basic as a piece of paper changing my name could make such a profound impact on every area of my life and on my general well-being, but I’m proof of why transitioning into your authentic self can save your mental health.

Max Harvey, PhD

How I Use Extreme Sensations to Practice Mindfulness for Mental Health

Warning: Don’t try this at home or without a trained professional. When I saw the flame float in front of my eyes on the fire wand my girlfriend was holding, I was mesmerized, calm and completely focused. How could I think about anything else when there was fire right in front of my face? Not just that, but fire that will soon be touching my body? To say I was alert is an understatement. Before I tried fire play with my girlfriend, I was in a dialectical behavioral therapy (DBT) program. Part of the program focused on mindfulness and how to “downregulate” (bring your emotions down to baseline if you’re starting to feel upset). The program showed how focusing on sensations can help emotion regulation. We enjoy sensations with the warmth of a hot shower, splash of cool water on a warm day, massages, touch, essential oils, feeling textures, spicy foods and more in everyday life. Imagine what we could do if we really put effort into experiencing sensations. In the program, we did something called “ice dives” where we filled a large bowl with ice cold water and then dunked our faces in it for as long as we could. The therapists timed us while this happened. The goal was to get to 30 to 60 seconds at least. After that, our heart rates would drop as if we had taken a benzodiazepine and we’d have to go lie down on a mat on the floor because it would calm us down so much that some of us would fall asleep. We did ice dives for a lot of reasons. Sometimes it was just for fun or for practice. But we all knew it was really used as a way to regulate our emotions if we needed to. I used ice dives to handle my emotions (I struggled with bipolar disorder and it also helped my migraines) for the duration of the program and a little while after that. I loved the intense sensation of burning coldness and holding my breath. I did this practice several times a week. It left me feeling clearheaded, calm and tired. It made me focus on the present sensation instead of what was going on in my mind or elsewhere in my body. I loved the way I felt afterward and how clear my mind was. I wondered if I could get the same feeling from doing the opposite sensation — extreme heat. That’s when fire came to mind. I had done fire play before, but not in a very meditative setting. My first time, I basically helped demonstrate how it was done for an audience. Nervous, anxious and oh yeah, naked in front of a bunch of strangers, this was not a relaxing first time experience. But I did have a lot of fun. The person performing the fire play on me was very theatrical and comedic, which eased my nerves. I only wanted the fire done on my back so I couldn’t really see what was happening (for better or worse) and this also meant I couldn’t pay attention to the flames — I only felt what was happening. What was happening was very light tapping of warmth and then his hand covering the fire out. It felt sensual, but given the context, it wasn’t as relaxing or transcendental as I wanted. Instead, I was at a BDSM dungeon with a bunch of strangers being entertained by my experience. It was more like sitting too close to a warm fireplace. At the time, I didn’t know what else to expect, so this was enthralling fun for me. However, after learning DBT, and mindfulness specifically, it left me wanting to explore BDSM more (probably not what my therapists intended). Unlike popular belief, BDSM is nothing like “50 Shades of Grey.” It’s actually a very rich, complex community with a strong philosophy of any adult activity being safe, sane and consensual. With those ground rules, there’s basically limitless activities to engage in. In BDSM, there’s sensation play, but I stayed away from it for the most part because when I go to a dungeon, I go to feel pain. Because isn’t that what dungeons are for? No. It turns out you can do a variety of activities and I was just now exploring this. After my DBT program, I became really interested in mindfulness and how it could relate to sensation play. Ice cubes, feathers and fire are all about focusing on the sensation, and letting go of any other thoughts or emotions. I wondered the extent of this effect (whether it could be as intense as an ice dive for example). So when my girlfriend (who recently had gotten trained in fire play) gave me the opportunity to be lit on fire for my birthday, how could I resist? This time, it was just the two of us. It was way more intense. I focused all of my attention and energy on what she was doing. Every movement was quick, searing pain followed by the coolness of her hand. It was sensual and intense. Most importantly, I realized in addition to my emotions feeling calm, my chronic pain was gone too. I have pins and needles paresthesia over my whole body that is not treatable by anything, and this was the first time I wasn’t distracted by it. This was the first time my shoulder didn’t hurt either, and my head didn’t ache — my body felt good, alive even. Psychologically, I felt better too. I felt excited, as well as grounded. My emotional pain was gone, too. Previously, I was having problems from post-traumatic stress disorder (PTSD) with dissociating too much, but I couldn’t dissociate while that was going on. I couldn’t even be anxious, because for me, it had a calming effect. It didn’t last of course. I came back down to feeling my pain again, but with a warmth cast over me and a calmness from this extreme meditation we just engaged in. My fire play and ice dive experiences taught me the power sensations can have on the mind. Feeling extreme enough sensations can have extreme effects on the body. Fire play is an extreme way to practice mindfulness. Focusing your attention on the fire can give temporary pain relief as well. This probably has to do with an endorphin rush, but the effect is strong and real. Although temporary, I’m glad I was able to experience this because it taught me if I focus my attention on one place strong enough, that may ease my pain elsewhere. I told the therapists at my DBT program about my fire activities. It took awhile for them to get on board, but once they understood it was about sensation seeking, they came around to accept it. I don’t engage in fire play often, but I like knowing it’s an option if I need an extreme meditative practice to ground me. Focusing on sensations can help quiet the mind and also cause us to enjoy an experience we might otherwise take for granted. Fire is just one extreme form of this, and luckily, I was able to try it by someone who was trained and had the proper equipment, so I could experience the intense mental and physical relief that is possible. I now appreciate sensations in a much deeper level than ever before, knowing that they can be used as aids in mindfulness practices. I will always love feeling the warmth of a flame, but when that’s not possible, it’s good to know I can always take an ice dive.

Max Harvey, PhD

When Using Medical Marijuana for Migraine Became an Addiction

I began using medical marijuana as a treatment for my chronic migraine, anxiety and bipolar disorder . I experienced episodic migraine attacks for 15 years, but they recently turned nonstop and no treatment so far had helped. My insurance had denied Botox — a proven treatment for migraine — and my doctors were afraid of me getting medication overuse headaches or addicted to opioids, so I self-medicated while I figured out what to do. I used cannabis for migraine for 2 years. I started using only when I had a migraine attack (i.e., when my constant migraine got unbearable), but eventually turned into a daily habit. I couldn’t use it during the day because of my work so I had a stabbing migraine attack all day and waited until I got home to vape. I used a dry herb vape pen and got very into all the different strains I could buy. I tried buying high CBD strains, as everyone su ggested, but those weren’t effective for me. I also used edibles and tinctures because I’m against smoking . I became a bit of a cannabis snob. It became a hobby for me … a very expensive hobby. At my worst, I was vaping multiple times a day (all day long) until all I could do is lie in bed or on the couch and watch my relationship disintegrate before my eyes. My migraine attacks weren’t getting better — they seemed to be worse — and I was fighting with doctors and insurance companies to be treated. I was also in the middle of a psychiatric meltdown due to my borderline personality disorder (BPD) , bipolar disorder or post-traumatic stress disorder (PTSD). The diagnosis isn’t as relevant as the symptoms — I was depressed, suicidal, paranoid, dissociating and empty. It was unclear how many of my issues were due to my mental illnesses, he alth issues or an unhealthy relationship . Adding heavy doses of marijuana on top of all that was not a wise decision. Time passed and it wasn’t until I started treatment for my eating disorder that I recognized I was using the same patterns with food as I was with cannabis. This is most likely a BPD trait : I was us ing because I felt empty inside and I was looking for something to fill the void. I also noticed it wa s interfering with my new relationship — by this time, the old one had ended — and I wanted to save it. I wanted to be present for our relationship . I didn’t want it to fall apart like my last one. Every weekend, I lay on the couch and watched life pass me by, and now I wanted to be present for it — finally. I weaned myself off of it until I slowly didn’t need it anymore. I was afraid to do this because I was certain my migraine attacks would get worse, but they were already terrible so I gave it a shot. Turns out, they got better. My mood improved and stabilized, too. I’m now six months sober. It happened so effortlessly. Sure, there were urges, but then I would focus on my reasons for abstaining and remember it’s not worth the cost. I also used a lot of mindfulness techniques I learned from dialectical behavioral therapy (DBT) and a recovery program. For example, the “cope ahead” technique involves imagining an upcoming difficult situation and what healthy coping skills you would use to handle it. Imagining the consequences of using marijuana for my migraine versus ice and other self-care aids has proven really helpful. Also, just being honest with myself about why I want to use cannabis (is it really a m edicinal reason?) has helped me stay grounded. Sobriety has given me a clarity of mind I couldn’t have anticipated. If I would have known this is what my mind and my life could be like, I would have done it a lot sooner. Answers to life problems just seem so obvious to me now, where before it would be an emotional struggle and I would have to ask several of my friends for advice before doing anything. I feel grounded and sure of myself for the first time ever. This feeling is something I do not take for granted and I think that makes it all the more powerful. Marijuana was no t the answer to curing my migraine, but abstinence isn’t the only thing helping me either. Being sober, I became more creative at problem-solving. I put my ego away and started over again: diet. I noticed that dairy gave me a migraine attack and caused horrible fatigue. When I ate a vegan diet, I felt better by keeping my migraine at bay. My doctor also prescribed a transcranial nerve stimulation device for when I do have a migraine attack and it is incredibly effective. I also changed some medications around too. A big factor was ending a toxic relationship and moving out of a stressful environment. I tried to treat my migraine from all angles that I could. Now, migraine attacks are something I need to watch out for but they no longer rule my life. Marijuana is something that started as medicinal b ut eventually was recreational. It wasn’t long after that it became an addiction . People may say marijuana isn’t addictive, and that might be true physiologically, but because of my brain chemistry — my existing mental illnesses — and life situation, it became a behavioral or proc ess addiction . Breaking that addiction fre ed me from my migraines and freed me to live a better, sober life.

Max Harvey, PhD

How to Support Your Non-Binary Family During the Holidays

I didn’t celebrate Thanksgiving with my family this year and I’m not sure if I’ll celebrate Christmas with them either — not necessarily because I don’t want to, but because I am putting self-care first. As a non-binary person, it has been challenging to get my immediate family to understand my existence. I have educated them on the idea of gender identity — of my gender identity, pronouns and name changes. It’s a lot to take in for someone completely new to the queer community or LGBTQIA+ issues. The idea of “coming out” and doing this same level of education with my extended family is mortifying. These are people I’m not as close with, people who I feel will be critical of me, and people who will make it uncomfortable to enjoy the holidays. I don’t want the focus of the holidays to be on me coming out, but I am also sad to miss out on seeing my family members. However, it is too hurtful to hear my birth name (being “dead-named”) and pronouns instead of the name and pronouns I chose to represent my non-binary identity. Granted, most of my family members don’t realize they’re hurting me because I have not come out yet, but I also don’t feel comfortable to do so. I choose to stay home for the holidays and then see individual family members on my own time so I can spend more quality time with them and have a better opportunity to come out if I feel safe doing so. Gender non-conforming, non-binary and transgender folks all can have an especially hard time during the holidays because of a lack of acceptance, increased depression and anxiety, and simply all of the terrible ways we are mistreated or face microaggressions this time of year. If you have a friend or loved one who is non-binary or gender non-conforming, here are a few things you can do to ease their anxiety during the holidays: 1. Call them by their name. I realize this one sounds obvious, but for some reason, it is really challenging for people — especially parents, siblings and grandparents. If your non-binary family member told you to use a different name when referring to them than the name they were assigned at birth, then only use that name. I realize there’s a learning curve for people to adjust to the new name, but it’s not up for discussion and your opinion about whether you like the name is irrelevant. It’s not about you. It’s about them. And they chose this name, felt comfortable enough to share it with you in hopes of your understanding, and so it’s a matter of respect to continue using it. Every slip up I hear (or worse, deliberately calling me by my birth name) puts me in a state of anxiety and self-doubt. It’s really an unnecessary feeling because it’s just a name and an issue that could’ve been avoided entirely. When I changed my last name for marriage, I didn’t experience any of the resistance I’ve faced when changing my first name. People used my married name as a sign of respect and the same should hold true for people changing their first names. It’s a small change on your part but makes a huge difference on their part. This shows them you respect them, you see them for who they are and you still love them. So please, use their chosen name. 2. Use their pronouns. Going along with #1, if your non-binary family member asks you to use different pronouns when referring to them (or him/her), please honor this request. If your response is that “them” is for multiple people, read this article over again. I am only using the singular “they” pronoun to refer to a single non-binary person. If their pronouns sound strange to you, again remember that your family member thought long and hard about what pronouns feel right to them — something not every person does — and these pronouns are the ones that help them feel seen as their authentic self. When you use the wrong pronouns, this is considered misgendering them. Imagine if they called you “she” or “he” instead of whatever your pronouns actually are. Wouldn’t it feel wrong and insulting to you? Even though your family member is asking you to adjust your language with new pronouns, they still might feel insulted if you slip up constantly or flat-out refuse to use the new pronouns. There should be a learning curve when it comes to changing pronouns and names, but only a curve and not a permanent line. When I don’t hear my pronouns by my family (which is constantly), I feel like they don’t respect my gender identity and they don’t understand how hurtful they are being. It is crucial for transgender and non-binary folks to feel validated to improve their mental health, especially during the holidays. If you want to validate your non-binary family member, please use the pronouns they request 100 percent of the time (whether they are present in the room or not). 3. Educate yourself on trans and non-binary issues. Gender identity is complicated and it can be helpful to educate yourself on transgender and non-binary issues. Do your own research, without the request of your family member, so that the burden of education is not placed on them. Learn how to be respectful and supportive. When I have to explain my gender identity and explain non-binary issues in general to my family, it is completely nerve-wracking and emotional. If my family members had ever done their own research on these topics then our conversations would be easier because they would be more informed and have other sources of information than just me. It also would have avoided me from hearing invalidating and untrue comments like “it’s just a phase,” “it’s not real” or “you’re just mentally ill” — whatever you do, don’t say these things. The holidays can be a hard time of year for LGBTQIA+ folks. Transgender and non-binary youth have especially high rates of suicide attempts. In one study, over 50 percent of transgender males, almost 30 percent of transgender females and 42 percent of non-binary youth attempted suicide at some point in their lives. This is why education, validation and support are so crucial for your non-binary family member. 4. Respect Their Privacy. If your non-binary family member came out to you, that does not mean they are ready to come out to everyone else. They put their trust in you and hoped you would respect their journey. It may take more time for them to be comfortable enough to tell other family members or they may never want to come out to everyone. The holidays can be especially triggering if you’re not out. Transgender and non-binary folks want to hear their chosen name and pronouns and be treated based on their gender identity. If their family members don’t know about their gender identity, then, of course, the person is going to have to deal with hearing their old name and pronouns and be treated based on the gender roles of their sex assigned at birth. This can be incredibly traumatic. For me, it can lead to feelings of anxiety, anger, self-doubt, depression and sometimes even suicidal ideation. So, if your non-binary family member does not want you to share information about their gender identity, please respect that and let them come out in their own time. Ask your family member if they are comfortable going to large family events where they might be misgendered. If they aren’t comfortable with that, then please respect their wish not to go this year. Maybe they would be willing to see Grandma on another day with less of a crowd, for example. Not only will this save your non-binary family member from being misgendered and upset during the holidays, but they will also feel loved and validated by you for asking and respecting their wishes. 5. Love them just like you would before they came out. Your non-binary family member probably hopes you will still love them after they come out. One way to show you still love them is to treat them similarly as before they came out. The caveat to this is any gendered treatment should change. For example, if men and women get different types of presents or play different games during the holidays, you could ask your family member which “side” they would like to be on or if they had an alternative idea that would make them more comfortable. As a non-binary person, the whole idea of grouping people by gender is absurd and unnecessarily stressful for me. I don’t want to be on either side, but I also don’t want to seem unfriendly. I would participate in games or activities that had nothing to do with gender. Picking a side would make me anxious — I would feel like a fraud on one side and would have gender dysphoria on the other side. Maybe just do what teachers do in school — count off randomly between one and two, and then group everyone by number. This will also get family members to talk to each other who might not otherwise socialize much. You can give suggestions like this without “outing” your family member. You could come up with it as wanting to do something different this year and never even needing to mention your family member. The holidays are about coming together and enjoying each other’s company. If you truly love your non-binary family member, show them you care by being sensitive to their needs and communicating with them in a validating and non-judgmental way about their holiday wishes.

Max Harvey, PhD

When You Don't Feel 'Disabled Enough' to Deserve Help

“Would you like to have a seat?” Apparently this person was speaking to me. It took me a moment to register why they were asking if I wanted a seat when there were a dozen other people standing and watching the live performance with me. I looked down and saw my cane, and then it clicked. “Oh, they think I’m disabled and can’t stand. I’m not really that disabled. Other people probably need to sit more than I do. The reason I brought the cane was to help me stand anyway.” All those thoughts ran through my head. I’ve convinced myself that my cane is a prop to make my invisible illness more visible, instead of accepting that I really do need to use it. It started when I was taking public transit. I saw people sitting in the disabled seats who appeared to not have a disability, while I was left standing. I was so tempted to say something like, “Excuse me, if you do not have a disability then would you mind letting me sit there because I do have one?” but I couldn’t muster up the courage. Instead I just shifted my weight back and forth on my feet – feet that ached as if I had worked a 12-hour shift running around at an amusement park – and tried to ignore the pain in my joints and the chronic fatigue that was begging me to just lay on the floor for the remaining 45 minutes. By the time the train reached my station, I had to brace myself against the wall and sit down to catch my breath before proceeding to walk to my destination. I really did need a seat then, and this time was no exception. I have fibromyalgia, but I’ve always secretly thought I might not really have it and even if I do, it’s not that bad compared to other people. My mom has fibromyalgia and her pain is everywhere. She can barely move and when she does, she constantly moans out in pain. That’s not me. Sure, I have aches and pains, chronic migraines, and possibly some nerve damage, but I mean it’s not that bad, right? I’ve managed this long. But it irked me that I could have used the disabled seating and yet I didn’t have the courage to ask. Knowing that I would equally look like I don’t belong in those seats, I thought using a cane would help show that I do have a disability and I do have a right to sit there even though I may be young and look healthy otherwise. I tried this and it worked. It was such a huge relief. But then I noticed something else: the cane actually helped me! If I couldn’t find a seat, at least I had this cane to lean on and when I walked it could ease some of the pain in my joints. I talked to my doctor about this and she agreed I should use it, which helped validate my feelings. I still don’t think I need it, but it definitely does help. So why is it so hard to accept help? This nice person saw I might be struggling and offered to help, but I declined. The truth is I really was struggling to stand and did want to sit, but I didn’t feel worthy and I didn’t want to make a scene. I was used to feeling that type of discomfort and I could manage just like I always do. Except I didn’t have to suffer this time, but I chose to anyway. It’s as if I’ve invalidated myself so much that even though I can say “I have a disability,” I have a hard time when I realize strangers view me as being disabled and just as worthy to receive special accommodations as anyone else with a disability. As the night wore on and other seats opened up, I finally was able to sit and rest. When it was time to stand back up again, I ached so bad to stand that I swore to myself I would not decline a seat ever again. I know I’m not alone in feeling “not disabled enough.” It’s tough when there are so many disabling conditions out there and we constantly compare ourselves to each other, never thinking that our condition warrants some extra help every now and then to make our lives easier. So for all of you who struggle to feel that your disability is valid, I say to you: You are enough. You are “disabled enough.” Your disability is legitimate. Your doctor recognizes this, so you should too. Why struggle when someone reaches out a helping hand? Accept the assistance graciously and appreciate the moment of pain relief you get because of it. You deserve it just as much as anyone else. You are worthy.

Michelle Pugle

5 Things That Happen When You Doubt Your Own Diagnosis

I was diagnosed with fibromyalgia at the age of 23. And I’ve doubted the diagnosis ever since. It’s not easy to say that, you know. I don’t want to suggest that other people’s diagnoses are not real. I don’t want to suggest that I don’t believe in fibromyalgia — there is enough doubt surrounding the chronic illness as it is. So for the record, fibromyalgia is real, and it’s life-changing. It’s a hard diagnosis for me to swallow, and perhaps that’s why I’ve been so skeptical. Or maybe it’s been all the other “professionals” (general practitioners, chiropractors, massage therapists) who have doubted my diagnosis… Maybe their doubt doubled with mine made fibromyalgia something impossible to accept in my story. Whatever the reason, I doubt my diagnosis and I’m not the only one. So, for anyone out there doubting their diagnosis (whatever it may be), this is to let you know you’re not alone. Here are five things that can happen when you doubt your diagnosis: 1. You make excuses for your symptoms. When you feel one of your symptoms creeping up, you might write it off as being attributed to something else entirely. For example, if you can’t sleep because of intense back pain, you tell yourself it’s just because you were at the computer all day. This seems plausible enough to believe, but part of you always wonders the truth. 2. You downplay how you bad you really feel. You may not let yourself feel the full reality of what’s going on because you don’t buy into it. When people ask you how you’re doing, you always say “good” or “great” even when you feel anything but. You won’t even admit to yourself how bad you truly feel. Instead, you tell yourself it’s just a little discomfort or a rough day. 3. You hide your diagnosis from others. When you don’t believe your diagnosis, you don’t share it with others. You don’t want questions you can’t answer. And so, you hide what the doctors have told you in hopes that the symptoms will improve with a little time or self-care. 4. You push yourself to prove a point. Your logic becomes self-destructive. If you can still do the things you used to before you got sick, you can’t actually be sick. You will force yourself to do things to confirm you are able. You will overperform to prove to yourself and everyone around you that you are well, even when you feel anything but. 5. You question your doubt. When you’re feeling so poorly that you can’t quiet the denial anymore, you start to doubt your doubt. Maybe the doctors were right. Maybe you should go back and seek treatment. Maybe you’ve been in denial and it’s time to accept the diagnosis. You experience fear and worry. And you’re not alone.

Max Harvey, PhD

Why My Mental Health Means I Am Not Celebrating LGBTQA Pride This Year

Pride started as a way for LGBTQA+ folks to step up and fight for their rights. Today, modern LGBTQA+ pride festivals and parades consist of vendors marketing to a marginalized population. It is also filled with straight allies getting drunk and taking over our space. The political nature of Pride is barely there. Now that “gay marriage” (note: it is “same-sex marriage”) is legal in the U.S., many Americans seem to believe LGBTQA+ issues are resolved. We have many other serious issues, including high rates of suicide and murder, which still need to be addressed. Those are some of the issues I have with LGBTQA+ pride in general, but this year there is a more personal reason for why I’m not going. Simply put, I’m not proud. I’m gay and I am comfortable with that. However, this year I also came out as gender-fluid and non-binary. I’m told I was “born this way” or that “all gender is fluid,” but I don’t feel that way. Instead of feeling proud to be a part of the LGBTQA+ community, I feel shame and depression for being who I am. I want to reject this identity. I don’t want to accept who I am. I want to be wrong, but I know this identity is real and I need to accept it. Some days are more difficult than others. The slightest comment can trigger overwhelming gender dysphoria and anxiety that will leave me feeling suicidal for days if not longer. The truth is, society doesn’t accept people like me. Even some people within the LGBTQA+ community don’t accept non-binary folks (people who don’t identify as either man or woman). We are told this is our family, but I hear the same invalidating messages from this new family as I hear from the outside world. I know I’m not supposed to compare myself to others or care what other people think, but it’s hard to accept myself when I’m hearing hateful remarks inside and outside of our community. Many people in the LGBTQA+ community still think in binary terms. They equate male and female with man and women, when in reality these are distinct concepts. LGBTQA+ issues are discussed as “gay and lesbian issues,” ignoring the wide spectrum of sexual and gender identities encompassed within this community. All of this stems from an antiquated, generational mindset that will hopefully evolve soon. I know all of this, yet I still can’t ignore these voices and feel proud of my gender identity. It’s hard enough to accept myself, and it’s even harder when people who are supposed to support people like me are shutting us out. I want to be like LGBQ people who are cisgender (the sex assigned at birth matches their gender identity). I wish I didn’t have to think about whether my gender identity matched the gender I was assigned at birth. I wish I didn’t feel a constant state of fear and gender dysphoria simply for existing. I wish I didn’t have to question whether I was “just confused.” I wish I didn’t have to hear from both people within and outside my community that my gender identity wasn’t real or it was “just a phase.” I heard these same sentiments when I came out with my sexual identity. It is so triggering and re-traumatizing to have to experience all these emotions again as an adult. Now I have the coping skills and support to process them better, but I honestly do fall apart at times. I feel weak for not being out and confident about who I am to everyone I know. I feel like a freak and I wish I wasn’t this way. I want to be “normal” and cisgender. I feel embarrassed, thinking what if it is just a phase or just due to my mental illness. So, this year, I’m not going to celebrate LGBTQA+ pride with a community that doesn’t fully accept me and reinforces my own negative feelings about my gender identity. I can’t pretend to be proud of something I am secretly ashamed of and wish desperately I could change about myself. Pride is so heavily focused on corporate sponsorship, alcohol and partying to the point that it becomes full of repression. We all ignore the pain we’re going through. We drink and dance it away. I can’t drink my gender dysphoria away. I wish my medications would even let me drink at all. I don’t know what I need to finally accept myself and feel proud, but I am not there yet and I am done pretending everything is OK for a weekend while there is so much suffering on a daily basis. I pretended I was OK for too long and I have had enough of hiding how I feel. I am working hard at finding ways to affirm my identity, but my pride will come from within myself and not from celebrating in superficial LGBTQA+ pride celebrations. If you or someone you know needs help, visit our suicide prevention resources page. If you’re feeling suicidal, or just need a safe place to talk, you can call the Trevor Lifeline at 866-488-7386 . We want to hear your story. Become a Mighty contributor here . Photo by Chris Johnson on Unsplash