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(Mental Health) How to Help Others

Myth 150When I look back on the person I was in college — during the worst period of my depression — I am honestly amazed that I still have so many friends who knew me back then. I spent most of my time in the computer lab talking to folks online, and barely had enough energy to eat, sleep or bathe. Everything I talked about centered around how awful life was, how insurmountable my problems were, how much of a failure I had been. When folks were kind enough to apologize when they offended my hypersensitive emotions, they were treated to small passive-aggressive jabs instead of gratitude. It was awful. I was awful. And it makes me so grateful that there were people who stuck with me through all of it.

I try to take that knowledge with me whenever I’m dealing with someone in the throes of depression or anxiety, because I know how much it helped to have people who never gave up on me even when I wasn’t capable of showing my appreciation at the time. They made one of the worst times of my life a little more bearable, and I know now that it was at considerable expense on their part. The energy and patience required to deal with me when I was in my worst depressions are more than I could ever expect from anyone, even close friends. But those people who spent it on me are people I would do anything for now.

There is no shortage of people in geek spaces suffering from depression, anxiety, or another mental illness; supporting us can be very difficult, especially if you can only do so online. It can feel so inadequate to put encouraging words on a screen when someone tells you that they just want to die, and it’s really hard to be sure you understand what they’re going through when they bring up a problem. And, quite honestly, it’s a rough deal to spend so much time and energy consoling someone when you’re online to gain some measure of relief from the world yourself — especially if it feels like all of that time and energy is being sucked into an emotional void with no measurable improvement. Still, most of us are good people who don’t want to see our friends and fellow fans suffer, so we do what we can to ease the misery where we can.

With that in mind, what can we do to make sure we’re helping friends who are having a hard time coping with mental illness? There are a few things I can recommend from my personal experience on either side of that conversation, combined with suggestions from professionals and mental health advocates. I can’t guarantee that your friend will be cured if you follow this advice, of course, or that it will even result in a marked improvement. I do think that they will help you understand what your friend might be going through and offer the best assistance you can.

Listen actively. It takes work to be a good listener. Most of us only practice what I call “surface listening”, where we pick up the generalities of what’s being said while planning the next thing we’re going to say. Deep listening, the kind where you not only hear what’s being said but work to understand the intent behind what’s being said, is both more rare and more difficult. However, for those of us stuck in a bad headspace, it can mean a lot for someone to understand what we don’t have the vocabulary or insight to say.

When I’m in a bad depression, it’s hard to open up about what I really feel. Sometimes I don’t even know what that is, so I end up talking around the problem or trying to get to the precise feeling from different angles. It can be frustrating to have this strong emotion roiling inside of you without the means to express it, only to have a conversation that leads you further away from it with someone else.

I know this sounds like depressed people might expect you to be a mind-reader, which isn’t fair. But you don’t have to be — sometimes, all it takes is really listening to what someone is saying to understand what they mean. Active listening is difficult, and like any skill it takes practice to get good at it, but it reaps dividends not just for helping a depressed friend but for pretty much any other conversation you could have.

Offer support, not solutions. This is a bad habit of mine that I’m constantly trying to curb, but when someone comes to me with a problem my brain immediately kicks over into “solution mode” where I try to attack the problem with the person who brought it to my attention. This often just causes that person to be frustrated and frequently dismiss my suggestions for one reason or another. This frustrates me because I’m too deep into “solution mode” to get what’s happening there. If this person didn’t want my help solving their problem, why did they even come to me in the first place?

The kicker here is that I’ve been on the other side of this conversation, and I know how frustrating it is to bring a problem to someone only to have them immediately go into a list of solution suggestions. It’s so strange to me that it’s so easy to be disappointed in someone for doing the same thing I do all the time when the roles are reversed; if nothing else, it’s proof that we’re just not the rational creatures we think we are.

This might not be true all the time, but for a significant portion of the cases I bring a problem to someone I’m just looking for a safe space to vent — especially in the grips of a depression. It’s comforting to have someone else offer support and understanding, to acknowledge a problem you’re having as difficult to deal with. Sometimes, it helps to know that someone cares about you and that they’re on your side.

Know your boundaries. Having a friend with a mental illness lean on you heavily for emotional support can be exhausting. It’s all right to acknowledge that. Sometimes, we just don’t have it within us to be the outlet for someone going through a tough time — while that can be a difficult realization if you feel partially responsible for someone’s well-being, it’s also important to recognize when you’re getting burned out and unable to cope with the workload.

Having a firm handle on what you can and can’t handle is important for your own emotional well-being, and when you’re getting close to your limit you have to step back to preserve your own peace of mind. It’s noble to want to be right there in the thick of things with your friend, but compromising your own emotional health for the sake of someone else doesn’t solve their problem; it only creates more to be dealt with. If you need to take some time to recharge, tell your friend as kindly and compassionately as possible, and let them know that you’ll be available some time later.

If possible, it might help to find a support group online or in person to join. This can help you learn how to cope with caring for someone better, and that you’re not alone. There might be other resources you can share with your friend or a common support network, as well.

Encourage treatment. Most of us with friends who are dealing with a mental illness aren’t equipped to handle helping them on our own. Part of knowing our own boundaries is knowing when we’re in over our heads and professional help is needed; we wouldn’t offer a diagnosis or treatment for someone with a mysterious pain in their chest, so we shouldn’t do that for mental illness either.

Recommending a visit to the psychiatrist can be a tricky subject. Even if someone has health insurance, there’s no guarantee that mental health services are easily available. Besides the resistance to seeking treatment to begin with, there might be legitimate social, logistical or financial barriers to getting the care they need. Those of us in a bad spiral might see going to a therapist as a defeat, or be reluctant about sharing intimate and painful details of our lives with a stranger. Sometimes, though, it’s the best option we have for getting help.

If you feel your friend needs to see a mental health specialist, see if there’s a low-cost or no-cost resource available and what (if anything) would need to be done in order to take advantage of it. If they’re in a position where they can see a specialist with relative ease, talk with them about their reluctance to do so and see if that can be worked through. While treatment for a mental illness can be a long process that requires patience and trust, it’s worth sticking with. Helping a friend seek the help they need might be the best thing we can do to support them.

Discourage abuse. One big hazard of being emotional support for someone is the very real possibility of being subjected to abusive or manipulative behavior. I’ve known a number of people who feel that their mental illness is a valid excuse for treating the people around them poorly, and far too often the people in their support network enable that behavior by letting it slide. It breaks my heart to see this. No one deserves to be verbally or emotionally abused, and mental illness is no excuse for being an asshole. Letting this go unaddressed hurts everyone involved.

If a friend is engaging in inappropriate or manipulative behavior, it’s our duty as their support to let them know they’re crossing a line — especially if it’s with us. It can be very difficult to do so in a compassionate way, and it may take some delicate handling to do so, but it’s worth it every time. It helps to make sure the behavior is addressed as separate from the individual (“you did a bad thing,” not “you’re being a bad person” for example) so the person doesn’t internalize the action to the point that it’s a part of their identity. And it might help to remember that the behavior needs to be addressed in order to truly help your friend; keeping the goal of the conversation in mind might work to keep it from derailing.

Most importantly, it makes sure that you maintain your equanimity as that friend’s support. Some of us have a tendency to make other people see the world in the same skewed ways we do when we’re depressed. Sometimes we’re driven to these actions by the irrational fear that controlling someone else’s behavior or lowering their self-esteem is the only way we can keep them associating with us. Making sure it’s known that behavior won’t be tolerated AND that the relationship is one built on positive shared values (and not fear or control) provides a clear counter-narrative to that internal monologue, and might help that friend come around a bit sooner than they would otherwise.

Even then, if the abusive behavior continues or a line is crossed that makes the relationship untenable, it’s important to establish your boundary and make it clear there are consequences for those actions. If that means ending the relationship, as difficult as that is, then the relationship must end. Supporting someone else should not come at the cost of your own emotional health. Only give what you’re willing to part with, and make sure your loving relationship with yourself remains intact.

I hope these suggestions help, and offer some small insight into the difficulties of emotional support. I’d also like to take this time to thank all the people who’ve helped me through the worst times of my life, from the bottom of my heart. I wouldn’t be where I am without your continued faith and support, even when I really didn’t deserve it. Thank you Ryan, Kyle, Odis, Brian, Matt, Mat, Cy, Sherri, Crystal, Virginia, Joe, Kaycee, and so, so many others. I think about all of you all the time, and I appreciate all you’ve done.

 
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Posted by on May 23, 2018 in Buddhism, mental-health, Self-Reflection

 

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(Mental Health) How to Help Yourself

Myth 150If I could have readers leave the Desk at the end of the month with only one new piece of information, it’s that mental illnesses are actual, physical ailments in the brain. While the way we think and perceive has something to do with how the illnesses are expressed, the fact remains that most conditions come down to processes in the brain working in ways that cause significant suffering. For folks like me, these ailments are going to stick around for a while; that means one of the best things we can do for ourselves is develop coping mechanisms and routines that help us have as few bad days as possible. Now that I’ve talked at length about the conditions I have, I’d like to talk about a few of the things I’ve learned to do that help me most.

Before that, though, I do want to make a few disclaimers. First of all I’m not a licensed professional and none of the advice you find here should be taken as gospel; feel free to discard any or all of this if your psychiatrist or psychologist tells you different. Second, this shouldn’t be viewed as the equivalent of professional help. If you have (or think you have) a mental illness, the best course of action is seeking professional treatment if at all possible. Finally, taking these steps won’t guarantee that you’ll never have issues with your mental illness. I still have bad days and I still fall into depressive episodes myself. Hopefully, though, these can help shallow out the emotional valleys and make it easier to recover from them.

THE BORING STUFF

Sleep. Sleep has been the most important thing for me to get under control for my mental health. Back in college during my worst periods I had functionally no schedule for sleep; I would instead spend as much time as possible in my dorm’s computer labs seeking out some kind of human connection to make myself feel better. But the lack of consistent sleep made it so hard to regulate my emotions, pay attention in class, or absorb the day-to-day stresses that come with a full courseload.

While the exact function of sleep is not entirely understood, we do know that a number of important “brain maintenance” processes happen during rest. For those of us who have problems with brain function, a consistent sleep schedule is one of the easiest ways we can help our brain manage what it can. Our internal clocks are different, and for those of us working jobs with variable schedules or have some other function that doesn’t let us adopt a stable routine, it might not be possible to set a consistent bedtime for, say 10 PM – 6 AM. Do what you can, but do something; seven or eight hours of sleep a night are a must before just about anything else.

Diet. Again, I know that this is some loaded advice. There are so many folks who are simply unable to eat well because they can’t afford or find fresh produce, don’t have the time or will to cook for themselves, or have other legitimate reasons preventing them from making big changes to their diet. I get it; I’m not going to ask you to go vegan or only buy organic. But small changes to your diet that recenter focus on nutrients that help your body function better can be made. A good rule of thumb is the classic quote from food writer Michael Pollan: “Eat real food, not too much, mostly plants.”

At minimum, I’d recommend eating less salt, sugar and processed foods; drinking fewer sodas and juices (even diet and sugar-free versions); eating more lean meats and whole grains; drinking more water and tea. Most carb-heavy processed foods tend to convert into sugars within our bodies (at least, to my understandings) and the simpler or more processed the carb, the faster that process tends to be. In the United States we’re all about our processed carbs, and breaking away from them can feel like swimming upstream. It’s hard, I know. But if you can have fruits, vegetables and lean meats — have as much of them as possible.

Exercise. Exerting ourselves can often trigger the body into releasing dopamine, endocannibanoids and other chemicals that lift our mood, and the best part about exercise is that there’s a near-limitless variety of things we can do to work ourselves out. There’s weight training, sure; but there’s also running, sports like basketball or soccer, yoga or tai chi, cleaning the house, or walking along a favorite trail. In addition to the benefits of regular exercise, getting outdoors also helps our bodies to make Vitamin D (which helps build our bones and protects against cancer) as well as serotonin (one of those neurotransmitters I’ve been talking about).

Personally, I love running, but the spirit might move you to try something different. I understand how hard it can be to make time for regular exercise — I still struggle with it myself. But taking even ten minutes a day to walk around the block during the day can help lift your mood and give yourself more energy.

Getting more sleep, eating better food, and developing a regular exercise routine are all suggestions that any of us who’ve gotten professional help for our mental illnesses have heard time and time and time again — but there’s a reason for that. Taking care of our most basic needs is incredibly important. Not only does it help our body develop the tools it needs to manage the imbalances in our brain, but it also encourages us to change our relationship with ourselves. I’ve found that making sure I eat, sleep and move well helps me to think of myself as someone worth caring for and also helps to make me more sensitive to those needs. I have a better gauge for when I’m hungry, or really need sleep.

LESS BORING STUFF

Meditation. There are a lot of misconceptions about what meditation is, and that might be because everyone who practices it has a slightly different concept of what it is. In popular culture, meditation is the emptying of mind and communion with everything around you in the present moment; it’s an act of peaceful enlightenment that you have to do perfectly the first time you do it or you just can’t.

I’m here to tell you that meditation is messy and disorganized. I’ve meditated (almost) every day for seven years or so now, and most days are still a struggle against “monkey mind”. Meditation is not the mechanism we use to force ourselves into mindfulness and peace; it’s the mechanism we use to watch and accept our own thoughts as they arise.

When I sit on the meditation bench, I replay past arguments I’ve had with people; I think about the many mistakes I’ve made; depressed and obsessive thoughts pop up all the time. That’s completely fine — that’s what I’m on the bench for. However, so many of us believe that the thoughts or feelings we have are inherently bad and meditation is the way we rid ourselves of these thoughts. That’s not the case: these thoughts and feelings are natural, and it’s OK to accept that we have them. Acceptance of these difficult emotions and the thoughts they’re associated with is the first step we need to take in order to make peace with them.

Meditation as a daily practice allows us to gain better insights into the deeper layers within our thought process. We might notice, for example, that the same kinds of situations trigger a specific memory or regret; or we might notice that there’s a common thread in the things that make us angry or sad. If we accept this, we can then explore these insights with a gentle and compassionate curiosity. Perhaps, in time, we can even resolve the things that cause us suffering.

That definitely takes work, persistence, and faith in the process. But it’s been worth it to me. Due to my meditation practice, I have a much better understanding of when I’m in a depression or particularly rough bit of anxiety; that allows me to handle myself better when I’m in those spaces so I’m not as likely to do something that I’d later regret. That alone makes the depressions easier to deal with.

Making a care packet. One of the things that I like to do for myself when I’m feeling fairly well is making a “care package” for a future version of myself struggling through a bad depression or anxiety day. This can include one package of my favorite candy, a story or novel that I love, a playlist that lets me “lean in” to that feeling of sadness and turn it into a cathartic experience, or a Snuggie, or a really sweet letter or gift from a friend. Your mileage may vary with this, of course, but now that I can somewhat anticipate when I’m hitting a downward spiral I can look into the small things I’ve left myself to feel better and use them.

Of course, the things in your care packet don’t have to be physical objects: it could be permission to cancel a social engagement without feeling guilty, or a day to binge-watch a show in your pajamas. The main idea is to accept that there will be moments where despite your best efforts you hit a rough patch, and to do little things in advance that will help your future self ride out those times. In addition to giving yourself presents, it also helps retrain your brain to treat yourself a bit more kindly and to recognize that these “flare-ups” aren’t your fault. Sometimes they happen, and it’s important to be kind to yourself when they do.

Engage and learn. For most of us with mental illnesses, it can feel like we’re the only people who have this messed up thing where our brains lie to us about how the world works every once in a while. The terrible thoughts, the embarrassing emotions, the situations that are surprisingly common for those of us with deep depressive episodes — all of these can make us feel alienated and broken beyond the possibility of repair. The stigma that surrounds these illnesses can make it hard to open up about them, to share experiences even with other people we know going through the same thing.

That’s why learning as much as we can about our conditions and engaging with others who are also coping with them can be so important. The messed up things we do or think at our worst might be a fairly common experience; or we might, through the course of consoling a fellow sufferer, learn how to be gentler with ourselves dealing with a similar problem. There are a large number of online resources for depression, anxiety, and ADHD — even grouped by location, background, or lifestyle. The Internet is a wonderful gift here, in that it’s given us the capability to share our struggles in ways we’ve never been able to before. It might help knowing more about what you’re going through, and that you’re not the only one going through it.

These are some of the things that have helped me build better coping strategies and resilience against my mental illness. I sincerely hope they help a few of you out there, as well.

 

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(Mental Health) My Executive Function

Myth 150Attention Deficit Hyperactivity Disorder is a bit of a misnomer; I think the name is a big reason why ADHD is so poorly understood and controversial as a mental illness. Those of us with the disorder aren’t necessarily hyperactive, and it isn’t always characterized by a deficit in attention. We aren’t bouncing off the walls from one thing to another, never able to finish a project because we have so much energy to burn off and no way to actually direct it. I mean, it’s partially true — but never in the way that people unfamiliar with the disease or its critics imagine it to be. ADHD is, like almost all other mental illnesses, a fairly complex disorder that can have a variety of expressions.

Also like so many other mental illnesses, the exact cause and nature of ADHD is poorly understood. However, there’s been a lot of research for it possibly because it’s such a controversial subject, with a number of scientists spearheading research to better classify it. We do know that ADHD expresses itself differently in children than it does in adults, primarily because undiagnosed children develop internalization mechanisms in order to “hide” symptoms, cope with them in increasingly complex social or professional environments, and attempt to deal with the lack of support or understanding for their difficulties.

We do know that ADHD is primarily a dysfunction of the parts of the brain that govern executive function, which leads to problems sustaining attention, being organized, and procrastinating. It affects planning, prioritization, time management, impulse control, decision making and mood regulation. In children, this can look like they’re incredibly hyperactive and impulsive, with a tendency to lash out and ignore instruction. In adults, this often looks like someone who is a ‘space cadet’ — lazy and unfocused with no capability of remembering the things they need to.

In any case, it’s generally accepted that the frontal lobes in the brain handle executive functioning. While there may be differences in the structure or volume of brain matter in this region, there might also be really hyperactive dopamine and norepinephrine reuptake mechanisms there. Since those neurotransmitters are very important for brain function in these regions, this can result in the neurons in that part of the brain working “sluggishly” because there simply aren’t enough chemicals within the synapses needed to promote enough electrical activity. This is why, paradoxically, stimulants like Adderall and Ritalin work so well. They increase the level of dopamine and adrenaline (epinephrine) in the brain. It’s also why folks with ADHD tend to seek out constant stimulation; it’s the brain trying hard to get its fix.

People with ADHD tend to have other mental illnesses, either as the direct result of the physical/chemical issues within the brain or due to the struggle to understand and cope with the illness. Depression and other mood disorders, anxiety disorder, low self-esteem and other issues all tend to pop up; I know for the longest time, before my diagnosis, I thought I was simply broken. I couldn’t make my brain do the things I know it needed to, and my focus would just slide off a task that I knew would require sustained, intense effort. This has been the case ever since I entered high school, to be honest — it was then that I realized I couldn’t simply coast through lessons, but I had never learned how to actually work for the consistently high grades I had gotten before. It was a pretty hard crash, and I never managed to recover from it.

For me, ADHD expresses itself in the form of intense procrastination on projects that I know will be difficult and require sustained focus, detailed effort and a lot of moving pieces. The kinds of stories I like to write are the worst for this, and I genuinely wish I could adopt a style closer to, say, Vonnegut or Douglas Adams or Charlie Jane Adams. But stories with tightly-written plots and thoughtful, nuanced takes on difficult themes often require great care, and I so badly want to make sure that I’m treating these subjects with the mindfulness they require. It’s been a great struggle to fight through a brain that simply doesn’t have the equipment to be as organized and detail-oriented as it needs to be.

It took me a long while to come to grips with the possibility that I had ADHD, mostly because of the stigma and controversy that exists in the media. There’s a steady diet of hot takes out there suggesting it’s a made-up disease, or that it’s especially overdiagnosed in children who are just being regular kids, or that drugs like Adderall and Ritalin are abused by people who are looking to stay up all night and crush that exam or work project.

There’s also a heavy stigma around the use of Adderall. Do you remember that (likely doctored) Calvin and Hobbes comic where Calvin is prescribed medication and it forces him to ignore Hobbes? I’m not going to lie, that scared the shit out of me — the thought that my ability to daydream, to be creative, would have to be sacrificed in order to be productive haunted me for a long time.

calvinhobbes

Seriously, this is nightmare fuel.

But now, of course, I know that’s a false dichotomy. ADHD actually hinders your ability to be creative; if you’re like me, you get hyperfocused on one aspect of the story and (because of my anxiety disorder) fall into a loop where you feel you need to rewrite again and again and again before you’re allowed to move on to the next aspect. Then, you get burned out or distracted and end up with three paragraphs that have been polished to within an inch of their lives.

Medication is absolutely a viable option for treating ADHD, especially in adults, but it’s only one avenue of treatment. Cognitive behavioral therapy (CBT) and other techniques are needed in order to unlearn all the bad habits that our own stumbling about to deal with our brains might have introduced. It can also give us a greater understanding of our individual challenges with ADHD and offer ways to cope with them.

Now that I know that my executive function is impaired and that makes it really difficult for me to stay on task, resist distractions, stay organized and deal with my impulses in a healthy manner, I’ve taken steps to address those. Developing routines that teach you how to consciously do what many others can do in their own heads has been a lifesaver; it’s how I make sure I take my medication, meditate, feed and water my rabbit; it’s how I make sure I’ve broken down projects into bite-sized chunks that I can actually handle one at a time; it’s how I make sure I write down just about everything I need to remember and keep on top of my to-do list. It’s still a struggle to get things done, but I’m no longer wondering why things are so hard or what’s wrong with me. There’s nothing “wrong” with me; my brain works differently from most and while that offers certain challenges it also opens up a lot of benefits too.

Hyper-focus, for example, is a tremendous tool. I know that if I’m emotionally invested in something or fascinated on a certain level it’s a lot easier for me to enter a state of flow where that’s all there is in the world. If I can find a way to access that feeling for a certain project, it’s much easier for me to devote a significant chunk of time to it. Learning how to be organized and mindful is also a strange fringe benefit, but it’s served me well. My Bullet Journal and I are super-best-friends, and the organization, mindfulness and productivity it has brought me feels so much sweeter because it’s been so hard won.

It’s also enabled me to recognize problems with executive function in other people. If someone can never seem to be on time, or forget things if they don’t write them down, or constantly misplace things, it doesn’t bother me nearly as much as it used to. Understanding myself and how I work allows me to be more compassionate towards the difficulties that other people face. It’s so very hard to be an adult, where it feels like you’re juggling balls and spinning plates all the time, and people only notice the kind of job you’re doing when something goes crashing to the ground. All of us are trying to keep too many things in our heads at once; it’s kind of a blessing to know how impossible this is and stop trying.

Symptoms and issues of ADHD can happen to anyone, but that doesn’t mean that ADHD isn’t a “real” illness. Multiple symptoms have to be present for a long time in order to be diagnosed, and medication can also have a weird ‘calming’ effect. For example, meditation and Adderall enables me to focus much more easily than I would be able to otherwise and I’m much more resilient against distractions.

If you think you might have ADHD — or even just an issue with your executive function — it’s best to learn more about how executive function works, what it looks like when that region of the brain isn’t working as expected, and schedule an appointment with your doctor to discuss the possibility. Even if it turns out you don’t have that diagnosis, there might be other issues or more information that might help you improve your focus, organization, and memory. Regardless of whether you’re neuro-typical or coping with a mental illness, proper nutrition, regular exercise and enough sleep are foundations for better mental health.

This post is a part of Mental Health Awareness Month; all month long I’m writing posts about my personal experience with mental illness, the stigma that prevents conversation and treatment, and bits of fiction that highlight these issues. If there’s a subject or aspect that I haven’t covered, please leave a comment!

 
 

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(Personal) Cracking Myself Open

Myth 150One of the earliest memories I have about my mental illness is breaking down in the middle of lunch in sixth or seventh grade. Things were not going well for me. I was a shy and awkward kid who loved reading fantasy books. I was really sensitive, so I didn’t hold up to bullying very well. And I had gotten into trouble enough that in addition to homework and everything else, I had to write a sentence “I will not…something something something.” 1000 times.

I was sitting alone, trying to think of what impossible task I should do over lunch and how I could justify putting off the others, when I just needed to put my head down. It didn’t help. Tears welled up and I let them fall. My entire body locked up. All I wanted to do was curl up tighter. Someone found me, stood me up, and asked me if I had eaten anything. Then they marched me up to the lunch line.

It felt like my entire body had fallen asleep. I didn’t have full control over the way I moved, so I just lurched around like Frankenstein’s monster. I couldn’t stop crying. There was no way I could eat, or speak, or open my mouth. When the lunch lady asked if I needed anything, all I could do was sob and shake my head and lurch back to my seat.

To this day I have no idea what to call that episode. A panic attack? A nervous breakdown? Who knows. But it happened again when my sister ran away from home, and again shortly after I dropped out of college and moved to Arkansas.

I’ve been dealing with depression and anxiety for my entire life. Most of the memories I have of my childhood are unhappy ones, where something in my brain just snapped and a response rose from within me that I still don’t understand. What’s more, I can remember similar things happening to the people around me; my father’s mind going after his divorce, retreating further into himself; my mother disappearing for hours to sleep off depression; my sister’s mood swings; the strange rumors that dogged certain neighbors. When I was growing up, our understanding of mental illness was little more than being able to identify “crazy” behavior; if someone did something “crazy” once too often, then they were branded. And there wasn’t anything they could do to shake that off.

Even now, knowing what I know about my family history and the struggles that my siblings and I face, I see that for the most part that understanding hasn’t deepened much. My sister is on medication that makes her incoherent or sleepy. My brothers still do things they don’t understand. And, now that she’s reaching the end of her life, my mother is beginning to forget things and become confused.

It’s taken me a long time to come to grips with my mental illness, to accept it and learn how to incorporate it into my self-image. But there are so many black Americans and others in the diaspora who either can’t or won’t for a constellation of reasons. Most of us simply can’t afford treatment for mental health issues, and wouldn’t know where to begin even if we could. There is a stigma, even now, around therapy and medication that makes it difficult to encourage folks to seek out. There is still this narrative that those of us with mental illnesses are just “weak” or “whining” and only need to “get your mind right” to overcome them. We know so little, but we have such strong opinions.

Talking about my personal struggle with these things is still frightening to me, even though I do it so much. But it’s important that I do. Within black circles, and geek circles, and even Buddhist circles, there is so much misinformation about mental illness and what people who deal with them are like. If being open about them can help to dispel that, then that’s what I have to do. For my family, for my friends, and for my community.

If you are dealing with a mental health issue, please know that you’re not alone. There are more of us than you know, willing and able to lend a hand. If at all possible, do what you can to lessen the stigma around these issues — especially in minority groups. There is no shame at all in having a chronic mental illness, or in seeking treatment for it. There is no shame in doing what you need to do in order to be the best person you can.

 

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(Mental Health) What The Chemicals Feel Like

Myth 150I have dealt with depression for my entire life. I suffered from it before I even knew what it was; some of my earliest memories are staring at the ground, feeling empty and sad for no reason. My first suicidal ideation happened when I was in 6th or 7th grade and before that I imagined running away from home or beating people up with such vicious and satisfying fervor that thinking back on it makes me cringe. If I wasn’t sad, I was angry, and if I wasn’t either of those I was wishing that I could be someone I wasn’t or some place that didn’t exist. Up until I was 13 or so, schoolwork was my one refuge.

The reason I say this is to give a sense of how long I’ve been living with this. Knowing what I know now, I can look back at moments that have always stuck with me and determine exactly what was going on. When bad things happened, the emotional response I had to them was borne out of a persistent and deep depression. I would either feel a knowing, exhausted acceptance (Of course this bad thing happened to me, what else would?) or a sudden and intense anger at the world. There were times where I felt too depressed to move or think, so I would simply sit and stare at the back of a couch for a few hours. Anything to pass the time without having to exist.

Over time, through high school, college and afterward, I learned to develop a vocabulary for my experience. Learning more about other people’s experiences helped me to shape my own in a more solid way. Even still, depression is as difficult to talk about as any other emotional state, perhaps more so. Everyone experiences joy in a slightly different way, but everyone has experienced joy. Trying to explain depression to someone who has never been depressed is trying to communicate something with no common frame of reference.

But here, I’ll try anyway.

For me, depressive states are marked by three things — a lack of energy; a sad and hollow feeling; and an irrational anxiety about consequences, especially social ones. I become hyper-aware of small facial expressions and vocal inflections that might indicate someone feeling negative towards me, and discard anything that might offer a counter-narrative. If someone has anything good to say about me, they’re either lying because they’re nice people who want to spare my feelings or they don’t truly know me yet.

Depression shrinks my world until I’m the only thing in it. Everything that happens contributes to the story I tell myself about how I’m a terrible and broken person, or how the world is cruel and unfair, or how the burden of being alive is simply too great to bear. I recognize that when I’m really depressed I get really narcissistic. I can’t stop thinking about myself or my lot in life. Even when I realize it’s an irrational line of thinking, I can’t help it — everything is about me.

The lack of energy is maybe the worst part. It’s like you have this bank of willpower or ability, and for most people the basic stuff doesn’t cost much of anything. Getting out of bed? That’s like, one energy point. Taking a shower? Three, maybe five, depending on how sleepy I am. Getting dressed and going outside? Well, anywhere from two to ten energy points. If you have a bank of 100 every day that you need to use until you sleep, your day is generally filled with activities that maybe use 75 of them.

But when I’m depressed, everything is so much more expensive. Waking up and having a thought costs energy, so going down the list of things I have to do is enough to drain me. Getting out of bed can cost 75 energy points; it’s all I can do at that point to shuffle to a couch, turn on the television, and lie back down. That’s it. That’s all I’ve got.

The neurotransmitters in your brain are the chemicals that help regulate your internal cycles, and when they’re unbalanced it can throw your whole energy system out of whack. Depression severely limits your energy budget, so you just don’t have a lot to spend. It can seem like a mystifying thing to most people if someone spends a week in bed, or can’t actually make a can of soup for themselves. But in those instances, just interacting with someone — telling them I’m hungry — is a Herculean effort that exhausts me enough to bring me to tears.

For a while, I went through this cycle where I would dip into a mild depression for a few days to a couple of weeks, then come out of it. When I came out of it, I felt like I could do anything. I’d make plans and set goals because I didn’t want to waste any more time, but that level of energy is not permanent. It’s like winning $500 in the lottery. You’re flush for a while, but you’re back where you started a lot sooner than you would think.

The lack of energy is often accompanied by a worsening sadness that bottoms out into this numbness where feeling anything happens at a distance. Anything that tries to shake me out of that is met with anger. I think a lot of depressed people have this reaction, too; when you try to work with me on solving the things that are wrong I am really not interested in hearing it. Anything I could do would be way too much work (because I have no energy) and probably not yield results anyway (because my brain will chemically not let me be optimistic). I’ve been in a room full of people trying to cheer me up or offer a way out of what’s going on, and I’ve batted down every platitude or piece of advice. And I’ve been part of that concerned group of friends, getting increasingly desperate, confused or angry about why my friend just won’t TRY to make things better. It’s easy to forget in that situation that just having this conversation might be taking all the energy this friend has. It’s difficult for everyone involved.

As I grew up, I knew that the way I feel sometimes is not “normal”, and that the people who stuck out their necks for me would eventually run out of patience and understanding. That made me feel worse. No one wants to be the person who drains the emotional energy out of everyone they meet, and there are a lot of times where it feels like social interactions are this out-of-body experience. The sane part of me is watching the rest simply stand there like an immovable wall while friends, family, colleagues and acquaintances try to chip away at the fog that surrounds me. Knowing that I make other people sad and worried is an awful feeling, and it burdens me further during those times when I’m least capable of carrying that weight.

I don’t mean to make this sound like being concerned or trying to help a depressed friend is something that never helps and shouldn’t be done. I am trying to explain why I’ve responded (and will respond) to those attempts in a particular way. In the depths of depression, everything gets twisted through a filter into its worst possible shape. Worse, we can see it happening in real time, but can be powerless to stop the process.

So in really bad depressions, I would vacillate between reaching out to people and pushing them away. I would have to express the way I felt to someone, anyone who would listen, but I resented any attempts to make me feel better. In those terrible days and nights, what I wanted more than anything is someone to just let me be understood, but would let me know that they loved and cared for me. At the same time, I fully understand how hard it is to sit with someone who is suffering deeply and intensely. The people who are often best equipped to help someone out of their depression are often the same people who are devastated by being in its proximity.

Symptoms of depression vary widely. Some people have physical aches or pains; others get irritable or agitated. Some withdraw into silence or isolation, and others cry, scream and throw things. We each suffer in our own ways, and each of us have learned to deal with these senseless feelings in various helpful and not-so-helpful ways. To those of us on the outside, the actions make little sense. We know, and chances are they’ll make little sense to us when we’re through that rough patch. But in the moment, it’s an inarticulate, clumsy reach for something to get us through the next hour, or minute, or several seconds. Those moments when our brain chemistry goes wrong can feel like an eternity, and the crushing weight of that can make it impossible to regain any sense of perspective.

I know this was a little rambling, but I hope it was at least a little helpful. If you would like to share your personal experience of depression, or have questions about the behaviors or feelings of others, please do so in the comments. And if you’d like to know more about what it’s like to live with depression, here are a few links:

Depression Quest — This is an interactive story game by Zoe Quinn (yes, that Zoe Quinn), and it struck me as one of the absolute truest expressions of depression ever. I…can’t play that game for long.

Depression Comix — This is a series of comics that illustrate the weird rabbit-trails of thought depressed people stumble down all the time. It can come across as a little pithy, but I can relate so much to so many of these.

Adventures in Depression — Allie Brosh of Hyperbole and a Half fame penned this two-part comic essay about her bout of severe depression, and it’s really illuminating, funny and heartbreaking.

I’ll try to have fiction posted on Friday; next week, I’ll talk about a few things that have helped me cope with my own depression and a few more things that might help friends and loved ones who want to care for a depressed person in their lives.

 
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Posted by on June 1, 2016 in mental-health, Self-Reflection

 

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(Mental Health) What Is Depression, Anyway?

Self Improvement 150On the weekend before last, I walked all night to raise money and promote visibility for suicide prevention and related issues. There were more than a thousand people with me, all dedicated to this cause because they had been touched by mental illness and the havoc it can wreak over the lives of people who cope with it and the people who form their support network. It was a sobering thing, knowing just how many people were directly affected.

Walkers wore honor beads to show their connection to suicide. Green meant you had a personal struggle or attempt. Gold meant you lost a parent; white meant you lost a child; orange meant you lost a brother or sister. Red is for losing a spouse, purple is for losing a friend or other loved one. There was a rainbow of colors over a sea of blue shirts that day, and the sheer variety of people wearing green beads really blew me back. There were old hippies, young video game nerds, intellectuals and business-people, homemakers, people of color, couples and whole packs of others. I could look at someone, see their green beads, and know that I’m not alone in what I survived. So many people from so many different walks of life also deal with depression and the suicidal ideation that can be a part of it. It was inspiring, but also surprising.

We don’t talk much about suicide or the conditions that lead to it — namely, deep depression and anxiety. I can understand why. Mental illness is something that can be very hard to wrap your brain around; one can understand it logically, or have an idea of what it’s like through metaphor. But when you’re dealing with a loved one who feels like they’re only burrowing deeper into a hole you’re trying to pull them out of, it can be exasperating, confusing and make you feel hopeless.

Why do we do that when we’re depressed? What’s actually going on when people like me are in the worst of those troughs? I wanted mainly to try and explain things on a few different levels — what physically or chemically happens to the brain; what it feels like to me personally when it does; how it looks to our support networks; and what the depressed and their loved ones can do to help manage their condition before, during and after episodes. This might take me a little while to do, and it’ll most certainly take multiple posts. I want to make sure that my information is correct and any recommendations made are helpful, but also please keep in mind that I’m not a mental health professional. I have intimate knowledge about this, but I’m not trained to deal with it any way.

Depression (or major depressive disorder, or chronic depression) is a mood disorder often characterized by deep feelings of sadness, hopelessness, numbness, loss of interest and lethargy. People within a depressive episode can appear sad or empty to the point of near-catatonia; angry or irritable; entertain irrational thoughts or worries that leads to catastrophic imaginings; be unable to sleep, or sleep too much; appear tired or “slowed down”, so that thinking and speaking are noticeably delayed; appear distant, aloof and/or unable to explain what’s going on. There are a lot of other symptoms, of course — depression isn’t a “monolith” illness, and everyone’s relationship with it will differ depending on physiological and environmental factors.

So what’s going on in the brain that depression manifests with such different symptoms? Why do some of us get really sad and still while others get agitated, angry or paranoid? Why is it so difficult to treat depression with medicine or lifestyle changes, like so many other illnesses?

That’s a difficult question to answer, simply because so little is known about the physiology of the brain and how it relates to mood. The brain is a frighteningly complex organ that is really a bundle of inter-related systems working together to do amazing things — if any one of them runs into a problem, it can cause changes that are hidden through some dependencies and rise in others. The simple fact of the matter is we can’t pinpoint to one part of the brain and say with certainty that this is the part that causes mood disorders.

What we do know is that there does seem to be a genetic component, and parents can pass depression and other mental illnesses to their children. For example, my biological mother was schizophrenic and the children of schizophrenic people are at a higher risk for chronic depression. There is also a physiological component that might take a bit to explain.

So, our moods are actually electrical and chemical messages that travel through our brain. What happens is an electrical message is sent from a neuron, travelling down the long trails called dendrites to the end of the branch. Think of it like a rural family walking down a long dirt road to put a message in a mailbox. That message can be anything from “This thing you’re touching is very hot.” to “You are getting sleepy.” That message changes from an electrical stimulus to a chemical when it reaches the mailbox, and that chemical is called a neurotransmitter.

Receptors at the end of dendrites for other neurons are specially formatted for any of the 30 (identified) neurotransmitters; when those receptors pick up the neurotransmitter, it converts the chemical message back into an electrical impulse which races along the dendrite (that dirt path), into the cell body, and then to the axon — which changes the electric impulse back into a chemical — and the whole process starts all over again. We have anywhere from 10-100 billion neurons in our brains, and they can communicate with each other in less than 1/5000 of a second. It’s amazing stuff; our brains are processing incredible amounts of information at astonishing speeds, converting electricity to chemicals and back again.

So what happens to the message once it’s been received by a neuron? Well, it’s released from the neuron that started it and floats in the synapse — the space between neurons in our brain. It’s then either taken back by the neuron that started it (that’s called reuptake) or broken down into another chemical called monoamine oxidase (MAO).

There are three neurotransmitters that have typically been focused on when it comes to depression — serotonin, dopamine and norepinephrine. Any one (or more) of the three have been shown to have unbalanced levels in people who are depressed. Basically, the chemicals that tell our brains to regulate our mood, sleep, appetite, stress and sexuality are in short supply or the brain has trouble actually knowing what to do with them.

While at first we believed that it was the level of these chemicals that were the main cause of the problem, there has been research that indicates it might be the connection between neurons in certain parts of the brain — like the amygdala, thalamus and hippocampus, all of which have been shown to be physically different in people who deal with depression. Anti-depressants target certain processes in our brains to elevate the level of these neurotransmitters and to improve the number and quality of connections in the areas of the brain associated with them. SSRIs, or selective serotonin reuptake inhibitors, basically prevent one of these neurotransmitters from being called back to its parent neuron. So there are more of them floating in the synapse, waiting to be picked up by other ones and pass along the appropriate messages. MAOIs, or monoamine oxidase inhibitors, are drugs that prevent these neurotransmitters from being broken down if they’re not doing the reuptake thing.

So, to sum up, depression can be caused by an imbalance of three neurotransmitters — serotonin, dopamine or norepinephrine. This imbalance could be caused by an overly efficient reuptake process that calls back these chemicals before the job is done; it could be caused by bad connections between synapses in certain parts of the brain; it could be caused by the brain’s inability to form these chemicals properly to begin with. Each possible medication treatment targets one aspect of this problem, and possibly only one neurotransmitter. That is why it can take some time for medication to work in the first place (because physical and chemical changes to the brain don’t happen overnight) and some time for your psychiatrist to find the right medication (because the problem might not be that your serotonin is too low, it’s that your dopamine can’t attach properly to synapse receptors).

Even though our brains have a “post office” that passes along literally billions and billions of messages between neurons every single minute, sometimes something goes wrong with the system and we lose the ability to send and receive postcards that say “Having a great time, I hope you’re doing well!” Sometimes, it’s not even something in the brain — it could be hormones that are causing different physiological responses in the body that ultimately end up affecting the brain. There are no quick or inexpensive tests to pinpoint exactly what’s going on with the chemicals in the brains and bodies of us depressive people, so medication is often our most educated guess.

There are, of course, different kinds of depression. Major Depressive Disorder is what most of us think of when we talk about depression, but there is also Persistent Depressive Disorder (where depression lasts more than two years), Bipolar Disorder, Seasonal Affective Disorder, Postpartum Depression, Psychotic Depression (which is accompanied by hallucinations, delusions and paranoia) and others. A proper diagnosis can lead a psychiatrist towards one or more medications, but most often treatment will happen on multiple fronts; while looking for a chemical solution, cognitive behavioral therapy can help us identify and manage thoughts and emotions that come from depression.

What’s important to realize is that depression is a distinct physical illness — as real as diabetes, AIDS or Parkinson’s Disease. There is a real chemical and/or physiological disorder in our brains that affect how and what we think, our levels of energy, our ability to manage conflict and stress in our lives.

During depressive episodes, our brains are going through changes that make it much more difficult to manage our moods, sleeping patterns, appetites and other things. When we’re depressed, we may literally be physically incapable of being happy, maintaining a balanced perspective, sleeping or eating as we should, or even getting out of bed. The chemicals that allow us to do that are simply not present or active within our brain.

That is what those of us who manage depression have to face. While many of us are lucky enough to have access to mental health care and responsive treatment, many more of us are unable to visit a therapist or psychologist; have no means to seek help; or are in an environment where mental illness is poorly understood, stigmatized or completely ignored. Those of us trapped within those situations often have no recourse but to suffer alone and helpless.

So many of us who have this illness recognize that there’s something wrong with us; that we can’t feel happy or motivated or interested the way most people can, or that we feel empty and hopeless even though we have no reason to. We know that our inability to do everything that might be expected of us can be a real burden on those around us, and that it can be difficult or impossible to explain just what’s happening to us. When we’re in a place where getting out of bed and just taking a shower is all that we can do today, it can be extraordinarily alienating for even the most well-meaning advice to miss the mark of our experience, to offer ideas or solutions that the depressed person is simply incapable of imagining.

It’s an awful thing to be in that place. We can often be unable to think of times when we didn’t feel this way, or imagine a future in which we won’t feel this way. This is going to sound lame, but U2’s song “Stuck in a Moment That You Can’t Get Out Of” was a revelation for me; it really captured the major problem of depression for me, that idea that this is something ugly and permanent that I will have to bear for the rest of my life.

For those of us with this illness, there are a number of things that make our manifest symptoms and internal experience unique. Specific brain chemistry, personality traits, environmental and social factors, hormonal imbalances, life experience and so many other factors contribute to how we express, cope and view depression. And I know how difficult that is to help with, but trust me — it’s not any easier for those of us trapped inside of our own heads.

On Wednesday, I’ll talk more about my personal experience with depression. But for now, here are a few links that offer further information.

All About Depression — A website that offers information and resources about what depression is, how it works and manifests, and treatment options.

What Causes Depression? — A page from the Harvard Medical School that talks about what we know (and still need to learn) about the physical and chemical roots of depression.

Antidepressants (Wikipedia) — Wikipedia, of course, has an extensive article on antidepressants and how they work chemically. What’s interesting is we still don’t know exactly WHY they work; but the data gathered over the decades prove that they do.

National Alliance on Mental Illness — NAMI is the leading organization in the United States dedicated to mental illness and improving the conversation about it within our country. They also have tremendous resources, information, and outreach.

See you folks on Wednesday. If there are any questions about depression or comments about information I’ve presented here, please let me know!

 
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Posted by on May 30, 2016 in mental-health, Self-Reflection

 

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A Look Into the Future

Fandom 150I’ve been a little more quiet on the writing front than I feel comfortable with, but there’s a reason for that. When I get deep into various projects, I tend to talk about them less because I guess I don’t want to reveal how the sausage is made before it’s presented. When I push a story out into the world, I want the story to stand on its own — I don’t think the audience should have any thoughts on the author and the trouble or decisions he made to have the story turn out the way it did.

Right now, I’m working on “A Stable Love” and having a lot of fun with it. The characters are surprising me, and that presents new challenges for me to think about, and the writing has been relatively smooth as I march towards its conclusion. I was having a lot of trouble with the first part, which I thought I needed for set-up, to establish the characters and the central issue, but when I got rid of it and moved the beginning of the story ahead, the world just opened up and things became a lot easier. I’ve shown the customer what I have so far and received an enthusiastic response, so that’s incredibly encouraging.

I’m working on another story for MegaMorphics, an old-style APA, and its fall issue. I want my work appearing there to be a bit more polished and considered, which means working on it before the deadline! I have an idea for a Halloween story that I’m pretty excited about; I hammered down the idea with another contributor in hopes of a collaboration contribution — I work the story, he works the art. I’ve never written a story like this before (it’s horror), and I’m trying to do a few things that I’m not sure about. It’s exciting but difficult work, and I’m looking forward to how it will turn out.

After that, working on a story for People of Color Destroy Science Fiction that I’m really excited to tuck into, and the prize story for a very generous fellow who donated the most towards my Clarion Write-A-Thon during week 6. I’ve given both of those some thought, and I think when I actually sit down to write them, the work will come relatively easy.

This is a completely new experience for me. As much as I love writing, it’s always been extraordinarily difficult. I have perfectionist tendencies that have caused storms of anxiety, and that makes it hard to see anything but the mistakes. I’ve never been able to write shitty first drafts; I know writers who create such polished work right off the top of their head, and it’s impossible not to compare yourself against that. My character work is never where I want it to be, and when the characters actually begin to live and breathe and deviate from the plot it legitimately freaks me out. I have no idea how to handle that.

But that’s the state that I’ve always given lip service to wanting to go. Writing, for me, feels like being a conduit for something. When the ego drops away and I’m connected directly to the story, it feels like I’m possessed by something, transcribing an event as being dictated by someone “not me”. When a story is really flowing, it’s an out of body experience. And I know how crazy that sounds, but it’s true.

For the longest time, I’ve never trusted myself to tap into that. Knowing the history of mental illness within my family, and dealing with my personal experience there, I’ve been very afraid of indulging any tendencies that could exacerbate those issues. Does writing make me crazier? Is it likely that one day, when working on a particularly intense story, I could have some kind of schizophrenic break? My life unfolded the way it did because my mother did not have any semblance of reality, was paranoid, unable to take care of me. I couldn’t live with myself if I forced my husband and my friends to go through that.

I didn’t even realize I was having that thought before doing the work I’ve been doing in my Anxiety group class. And realizing that writing, mental illness and anxiety had coalesced into this huge mental knot is ultimately freeing. I’m more willing to take risks with it, just because the feeling I have when writing is worth it. And that means I’m more willing to make mistakes and learn from them. I no longer catastrophize the consequences; if I fail, I can come back from that. With my mental illness, I trust my medication, I trust my self-care process, I trust my behavioral therapy, and I trust my support network.

For the first time, being a writer isn’t some distant dream for me. It’s who I am, and it’s what I do. And I’m so very excited that I have an opportunity to do the things I’ve always wanted to do, that I get to be the person I’ve always wanted to be.

I have an idea for a serial story originally released on-line. It’ll be furry stories, sci-fi and modern fantasy, adult. Right now, I would love to write about 1500 words a week, release that part in certain places, then collect three or four parts into a chapter that’s released in a more polished form elsewhere. Once the story is finished (I’m thinking anywhere from 8 – 13 chapters per serial), hopefully I can polish it further, and release it as an ebook or self-published novel.

In order to work on this project, I’m launching a Patreon. Folks familiar with my furry work should know what to expect from the Jackalope Serial Company: stories about growth, personal and otherwise. When I’m ready to go live and work on the serials directly, I’ll post a link with more information. But for now, I just wanted it out there. I’m expecting to be ready to go with it by the beginning of November.

I’ve also reached out to a few friends about the Furry Mental Health podcast; the person I know with the best equipment and knowledge for it suggested that I present a proof of concept to him for six shows, with subject matter, segments outlined, all of that. It’s a solid recommendation, and I’m working on that. I would like to start recording THAT at the beginning of the new year, with episodes coming out in February or March.

So that’s my plan for the rest of the year. Full steam ahead on short stories, getting the Jackalope Serial Company off the ground, putting together a first season of the Furry Mental Health podcast. I’m incredibly excited about all of this, and I can’t wait to actually share finished stuff with you very soon.

 

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