Sad Sick and Stuck Rethinking Mental Health

when

i was in my mid-20s life appeared to be

going pretty well

i was working at my dream job as a tv

host at a local station and i had just

bought my first home

so i was really settling in and you know

just

feeling like life was on track i was

getting to put down some roots

near family and friends so you can

imagine my surprise

when one morning i woke up and i went to

the sink

to brush my teeth and the first thing i

noticed

was a huge bald patch on the side of my

head

and when i say bald patch i mean there

was not a single strand of hair on this

patch of skin that was about the size of

a golf ball

so next thing i’m on the phone with my

mom

asking her what is going on what do i do

is this normal

and she told me i should probably go get

it checked out so i did i went to the

doctor

and i was diagnosed with a condition

called alopecia areata

and two other autoimmune illnesses and

with autoimmune disease essentially what

happens

is your immune system attacks your

body’s own healthy cells

and in my case my hair follicles my skin

cells and my mucous membranes would all

be affected

and i remember my doctors really trying

to reassure me you know that this wasn’t

that bad

the symptoms were very manageable but

there was no cure

and once you have one autoimmune illness

you’re likely to get some of the others

and there are between

70 to 80 of them everything from lupus

to rheumatoid arthritis

uh and i basically was just supposed to

accept that this was

my life now and i remember thinking

absolutely not this is not what my 20s

were supposed to look like

i was supposed to be out having fun and

dating

not going to the doctor’s office and

having steroid injections into my scalp

hoping that my hair would grow back and

i was really afraid

you know i worried what if i did get

sicker what if i lost my job

lost my house lost my hair

maybe my sanity um so i really had to

get past this initial shock

and and when i did i kind of realized

you know what i had been

ignoring a lot of symptoms for a long

time so years prior to this i had had

chronic fatigue sleep issues digestive

issues

panic episodes and these periods of

anxiety and depression

but i really thought these were just

kind of normal stress responses

to a very demanding career so i tried

everything to fix

my situation i took all the medications

my doctors prescribed i went to a number

of medical specialists and holistic

practitioners

tried every diet and lifestyle change in

the book

and honestly nothing really got better

maybe a minor improvement you know here

and there but nothing

sustainable and what was becoming clear

though was that my mental health was

suffering

profoundly so i

several years into this and several

thousands of dollars

i just decided you know what maybe i

need to stop seeing medical

specialists and start seeing a therapist

and this wasn’t something i had really

considered before because i was still

functioning you know i was still going

to work

every day and i just i think there was a

bit of a stigma attached to it

but i did finally go and see a therapist

and i didn’t realize this at the time

but this would be the catalyst for me to

completely

switch gears um go back to grad school

at age 30 to pursue a career in mental

health

and that’s what i do now so i get to

work with my own therapy clients and

support them through some of their

challenges

so you see an interesting thing happened

when i went to a therapist and really

started to focus on my mental health

both my psychological symptoms and some

of my physical symptoms began to improve

and i’ll just say here no i did not cure

my autoimmune illness i still have them

but i don’t have flare-ups the way that

i used to my hair doesn’t fall out in

chunks

anymore thankfully now it just sheds

because i’m getting older but i i don’t

have such severe

flare-ups and you know more importantly

the way that i relate to myself and

relate to these diagnoses

that has completely shifted and that’s

really improved my quality of life

so i’d like to share what i’ve learned

with you and

you know health and mental health these

are such complex topics but

this is one perspective that has been

really helpful for me so when i first

started researching all of this i

consistently found there was a huge link

between mental health conditions and

chronic illness especially stress and

trauma related disorders and autoimmune

illness

and you know i always thought well i

don’t have trauma because again i was

still functioning

and i was kind of in denial honestly so

the word trauma didn’t really resonate

with me until i came across the work

of dr francine shapiro and she describes

trauma as existing

in a couple of categories so there are

the capital t traumas which are

the things we might think of like war

natural disaster

assault and then there are the little t

traumas which are

no less significant but they might be

less visible and these can be things

like

early life experiences or life

transitions that were overwhelming for

us

and we can think of the big t traumas as

a huge wound on our bodies

and the little tea traumas are like lots

of little cuts you can bleed out from

both

so once again once i got past my initial

denial

i realized you know what yeah i had

experienced both big t and little t

traumas but they were kind of scary to

look at so for years

i just told myself i was fine and i

ignored

all of my symptoms and feelings but when

i started to learn about the physiology

behind my responses

i felt a lot less crazy because i

realized you know what it’s not about

crazy

it’s about survival and dr bessel van

der kook’s work

really helped me to understand this so

he defines trauma as anything that

overwhelms our nervous system

so it’s less about the event and more

about the way our nervous system

responds to an event

and our nervous system’s functioning is

of course influenced by things like our

biology

our environments and any trauma and

stress

but whether you identify as having

trauma

you definitely have a nervous system so

i think understanding the way that it

works can really help us with our mental

health

and most of us already know the basics

here right that we have a fight or

flight response

to stress and threats but there’s a

third response that we don’t always

talk about and that’s the freeze

response and the freeze response happens

when our nervous system decides fight or

flight are not the best option here

and immobility is so we see this in the

animal kingdom

where some animals will play dead to

deter a predator

i see this a lot now in my work with

sexual assault survivors who

you know they blame themselves for not

running away from their attacker when

what’s actually happening

is the nervous system has decided within

milliseconds that the best way

to survive this threat is to completely

freeze up and your muscles

actually do lock up it’s called tonic

immobility and you might also completely

dissociate

from that painful experience and dr

steven porgis

is a neuroscientist and he says that

getting stuck in the freeze response

can look a lot like dissociation

depression

and a general sense of hopelessness and

another piece to all of this

is that whenever we’re experiencing

chronic stress or trauma

our limbic system is activating that

fight flight freeze response

and our logic system goes offline so

those thinking parts of the brain like

the prefrontal cortex

aren’t even fully available so this is

why it’s really hard when

you’re in like a really heated argument

with your spouse

to come up with a rational solution to a

problem

and when we’re constantly in fight

flight freeze our body gets worn out

and our thinking processes are affected

so there’s a very

real physiological component to

psychological health

ultimately we’re wired for survival and

our symptoms and behaviors often make

sense

in the context of trying to meet those

survival needs

even our most stubborn behavioral

patterns things like addiction

perfectionism codependency these can be

survival strategies

that we’re using to either get our basic

needs met

or to cope with our needs not being met

but we don’t usually think of it

like this right we think well something

must be wrong with me i’m weak i’m lazy

and it kind of makes sense because we

live in a society that

reinforces this message that we need to

hustle

hard to be worthy and never ask for help

and so we really normalize our actual

human needs

not being met and then we tell ourselves

we just need to toughen up

and try harder what do we do

instead here we have to start listening

to the wisdom

in our bodies and get curious about our

needs starting with one of our most

basic needs which is safety and not just

physical safety but a nervous system

that feels safe

and dr poor just says that safety is a

prerequisite to meeting a lot of our

other survival needs like connection

because without safety we’re not going

to get closer to other people and we’re

definitely not going to meet

our higher functioning needs like joy

and creativity

but what’s amazing here is when we

create safety we can support the ideal

environment that’s going to encourage

recovery and change to occur

naturally and change really can occur on

a neurological level

so neuroplasticity means that our brain

can create

new neural pathways and learn to

function

and respond in different ways so

let’s say one of our basic physical

safety needs are met

but we still feel unsafe in our own

bodies and this was a really tough one

for me it took me years to go from

my body is betraying me to my body is

protecting me

i really had to learn about my nervous

system and kind of befriend my own body

before it started to feel safer for me

and so i like to think of a dysregulated

nervous system

as a kind of chaotic house and if you

ever watch

the netflix show tidying up with marie

kondo you kind of already know what i’m

talking about here

but if you’ve never heard of her marie

kondo is a decluttering guru

and she helps these really stressed out

families reorganize their homes and

reclaim a sense of peace and this is a

pretty big task because you’ll see

in these homes you know families who are

not getting along

there’s stuff everywhere one person

might have a hoarding problem

and they’re just not functioning well

because the stuff in their homes has

become

overwhelming and when marie comes into

the home

the first thing she does is kind of

unexpected so she’ll gather up the whole

family

with all their disgruntled feelings

and she’ll ask him to sit in the living

room and she’ll usually kneel on the

floor and

put her hands on the floor and she’ll

ask everyone to close their eyes and

she’ll say

i want you to thank your home for

keeping your family safe

and this moment this recognition of the

home

as a supportive structure often brings

people to tears

because they’ve simply never seen their

homes as a haven

they’ve seen it as a source of stress

and shame

and i think this is how many of us feel

about our own bodies

but with marie you know instead of

shaming these families for having so

much stuff

she simply invites them to look at all

of it

to acknowledge all of it the painful

memories

the items that need repairing that have

been neglected

the messy parts that aren’t helping

and every item in the house gets

addressed so she’ll tell them to pick an

item up

hold it and feel whether it sparks joy

or not and if it doesn’t she’ll tell

them to thank the item

then repurpose it or let it go

and as the house becomes reorganized and

repaired

the whole family starts functioning

differently

there’s better communication there’s

more compassion

and there’s really more safety in the

home both emotionally and structurally

and this is so cool to watch you know

and of course if you’re watching it on

netflix you get to see it all happen

in 45 minutes but in real life this is

not such a

quick process because it really requires

us to slow down

and look at our stuff and when we look

inward we might find trauma that needs

processing

we might find that we’re living with

stressors that are really activating

that survival response

but when we can start to honor our pain

and start seeing

our bad habits as survival strategies

we can start to listen to what our body

is telling us

and it will often speak to us in

emotions

every emotion has an intention to

communicate a need

or to protest a need not being met and

when we ignore the emotion we also

ignore the possibility

of meeting our own needs sometimes our

bodies will speak to us

in symptoms in discomfort and pain that

force us to pay attention but we’re so

quick to think of symptoms

automatically as being a sign of

pathology

when sometimes they’re just a sign of

our humanity

and we think there’s something horribly

wrong with us when the fact that we are

currently alive is a sign that there’s

something very right with us

our nervous system is doing its job so

instead of making our mental health

about our perceived deficits

and character flaws sometimes we should

really be

asking ourselves what do i need to feel

safer

right now and there are so many ways to

create internal safety

whether that’s practicing healthy

boundaries and protecting your

environment

or mindfulness and deep breathing

exercises

that really counteract the shallow

breathing of the fight flight freeze

response

it’s different for everyone but we first

have to learn to stop

bypassing ourselves and instead ask

ourselves what needs are not getting met

and how can we choose to organize and

protect

our homes if there’s one thing you can

take away from this i hope it’s this

two ask yourself over and over again

what does your body

need and then to listen until you start

to feel

more at home in your own body with

practice and support

you can learn to reorganize your home

appreciate the safety it has provided

for you

and find the joy you didn’t think you

could have

thank you

you

我 20 多岁的时候,生活似乎

过得很好

生活步入正轨,我开始

在家人和朋友身边扎下根,所以你可以想象

当一天早上我醒来时我的惊讶,我去

水槽刷牙,我注意到的第一件事

是一个巨大的秃斑 我头的一侧

,当我说秃头的时候,我的意思

是这块皮肤上没有一根头发

,大约

有高尔夫球

那么大,所以接下来我要和妈妈通电话,

问她什么 我该怎么

办这是正常的

,她告诉我我可能应该

去检查一下,所以我去了

医生

,我被诊断出患有

斑秃

和其他两种自身

免疫性疾病,本质上是自身免疫性疾病

会发生什么

是你的免疫系统攻击 是你

身体自身的健康细胞

,在我的情况下,我的毛囊我的皮肤

细胞和我的粘膜都会

受到影响

,我记得我的医生真的

试图让我放心,你知道这不是

那么

糟糕,症状非常容易控制,

但是 无法治愈

,一旦您患有一种自身免疫性疾病,

您可能会患上其他一些疾病

,其中有

70 到 80 种,从狼疮

到类风湿性关节炎,

呃,我基本上应该

接受这就是

我现在的生活 我记得

我当时完全没有想过这不是我 20 多岁

应该看起来的样子

真的很害怕

你知道我担心如果我真的

病了怎么办如果我失去了工作

失去了我的房子失去了我的头发

也许是我的理智嗯所以我真的必须

克服最初的

震惊当我这样做时我很善良 意识到

你知道我长期以来一直

忽视很多症状,

所以在此之前几年我有

慢性疲劳睡眠问题消化

问题

恐慌发作以及这些时期的

焦虑和抑郁

但我真的认为这些只是

一种正常

对一个非常苛刻的职业的压力反应,所以我尝试了

一切来解决

我的情况

你知道这里

和那里的一个小改进,但没有什么

可持续的,但越来越清楚的

是我的心理健康正在

遭受

严重的痛苦,所以我花

了几年时间和

几千美元

我只是决定你知道我可能

需要什么才能停止看医学

专家 并开始看治疗师

,这不是我之前真正

考虑过的事情,因为我还在

运作你知道我仍然每天都

在工作

,我只是觉得这

有点污名,

但我最终还是去看了治疗师

,当时我没有意识到这一点,

但这将是 促使我

完全

转换的催化剂 嗯,

在 30 岁时回到研究生院从事心理健康事业

,这就是我现在所做的,所以我可以

与自己的治疗客户一起工作,并

支持他们度过他们的一些

挑战,

所以你看

当我去看治疗师并真正

开始关注我的心理健康

时发生了一件有趣的事情 他们,

但我没有突然发作,

我以前的头发不再大块脱落

,幸好现在它只是脱落了,

因为我变老了,但我

没有那么严重的

发作,你 更重要的

是知道我的方式 对自己说,并

这些已经完全改变的诊断联系起来,这

确实提高了我的生活质量,

所以我想和你分享我学到

的东西,

你知道健康和心理健康这些

都是如此复杂的话题,

但这是一个 这

对我真的很有帮助,所以当我第一次

开始研究所有这些时,我

一直发现

心理健康状况与

慢性疾病之间存在着巨大的联系,尤其是压力和

创伤相关的疾病以及自身免疫性

疾病

,你知道我一直认为我

不知道 “没有创伤,因为我

仍然在起作用,

而且我有点诚实地否认,所以

创伤这个词并没有真正引起

我的共鸣,直到我遇到

了弗朗西娜·夏皮罗博士的作品,她将

创伤描述为存在

于几个类别中 因此,

我们可能会想到诸如战争

自然灾害

袭击之类的大写 t 创伤,然后还有一些不重要的小 t

创伤 很重要,但它们可能

不太明显,这些可能是我们难以承受的

早期生活经历或生活

转变

,我们可以将大 t 创伤视为

我们身体上的巨大创伤,

而小茶创伤就像

很多 小伤口你可以从两者中流血,

所以一旦我克服了最初的

否认,

我意识到你知道是的,

我经历过大创伤和小

创伤,但它们看起来有点可怕

,所以多年来

我只是告诉自己 我很好,我

忽略

了我所有的症状和感受,但是当

我开始了解

我的反应背后的生理学时,

我感觉不那么疯狂了,因为我

意识到你知道疯狂

不是关于生存,而是关于生存和 bessel van

der kook 博士的工作

真的帮助我理解了这一点,所以

他将创伤定义为任何使

我们的神经系统不堪重负的东西,

所以它不是关于事件,而是

关于我们的神经系统

对事件

和我们的神经系统的反应方式 系统的

功能当然会受到我们的

生物学、

环境以及任何创伤和

压力等因素的影响,

但无论你是否认定有

创伤,

你肯定有一个神经系统,所以

我认为了解它的

工作方式可以真正帮助我们的心理

健康

和大多数 我们中的一些人已经知道这里的基本知识

,我们

对压力和威胁有战斗或逃跑反应,但还有

第三种反应我们并不总是

谈论,那就是

冻结反应,

当我们的神经系统决定战斗或战斗时,就会发生冻结反应。

飞行不是这里的最佳选择,

而且不动是所以我们在动物王国中看到了这一点

,有些动物会装死以

阻止捕食者

我现在在与

性侵犯幸存者的工作中经常看到这一点,

你知道他们责备自己没有

跑步 当

实际发生的事情

是神经系统在

几毫秒内决定了

应对这种威胁的最佳方式时,远离他们的攻击者 是完全

冻结并且你的肌肉

实际上确实锁定它被称为强直

不动,你也可能完全

脱离那种痛苦的经历,

史蒂文·波吉斯博士

是一位神经科学家,他说

陷入冻结反应

可能看起来很像分离

抑郁症

一种普遍的绝望感和

所有这一切的另一部分

是,每当我们经历

慢性压力或创伤时,

我们的边缘系统就会激活,以

对抗飞行冻结反应

,我们的逻辑系统会离线,所以

大脑的那些思考部分就像

前额叶 皮质

甚至还没有完全可用,所以这就是

为什么当

和你的配偶

发生激烈争论时很难想出一个合理的解决方案来

解决问题,

而当我们不断在战斗

飞行时,我们的身体会冻结 筋疲力尽

,我们的思维过程受到影响,

所以心理健康有一个非常

真实的生理成分,

最终我们 为了生存,

我们的症状和行为通常

在试图满足这些生存需求的背景下是有意义的,

即使是我们最顽固的行为

模式,比如成瘾

完美主义相互依赖,这些可能

是我们用来

满足基本需求或满足基本需求的生存策略

应付我们的需求没有得到满足,

但我们通常不会这样想,

我们认为

我一定有问题 我很弱 我

很懒 这有点道理,因为我们

生活在一个社会

强化了这一信息,即我们需要

努力工作才能成为有价值的人,并且永远不要寻求帮助

,因此我们真正将我们的实际

人类需求正常化,然后我们告诉自己,

我们只需要坚强起来

,更加努力地尝试我们该怎么做

而不是在这里我们 必须开始倾听

我们身体中的智慧并对我们的需求感到好奇,

从我们最基本的需求之一开始

,即安全,不仅仅是

身体安全,而是感觉安全的神经系统

鲍尔博士只是说,安全是

满足我们许多

其他生存需求(例如联系)的先决条件,

因为没有安全,我们将无法

与他人更亲近,我们也

绝对无法满足

我们更高功能的需求,例如快乐

和创造力,

但令人惊奇的是,当我们

创造安全性时,我们可以支持理想的

环境,鼓励

恢复和自然发生的

变化,变化真的可以发生

在神经层面,

所以神经可塑性意味着我们的大脑

可以创造

新的神经通路并学会

以不同的方式发挥作用和反应,

假设我们的基本身体

安全需求之一得到满足,

但我们仍然对自己的身体感到不安全

,这对我来说真的很艰难

身体在

保护我

我真的必须了解我的神经

系统并在我自己的身体

开始对我感到更安全之前与它成为朋友

,所以我喜欢想到广告 将

神经系统调节

为一种混乱的房子,如果你

看过 Netflix 与 marie kondo 一起整理的节目,

你就已经知道我在

说什么了,

但如果你从未听说过她的 marie

kondo 是一个整理大师

和 她帮助这些真正压力重重的

家庭重组他们的家并

恢复平静感,这是一项

相当大的任务,因为你会看到

在这些家庭中,你知道那些

不和睦的家庭

到处都是一个人可能有囤积问题的东西,

而且 他们只是不能很好地运作,

因为他们家里的东西已经

变得

不堪重负,当

玛丽回到家时

,她做的第一件事有点

出乎意料,所以她会

带着他们所有的不满情绪召集全家人

,她会 让他坐在

客厅,她通常会跪在

地板上,

双手放在地板上,她会让

每个人都闭上眼睛,

她会说

我要你感谢你的家人 为

确保您的家人安全

而在这一刻,这种将

家庭

视为支持性结构的认识常常使

人们流泪,

因为他们根本从未将自己的

家视为避风港

,而是将其视为压力和羞耻的来源

,我认为 这就是我们中的许多人

对自己身体

的感受,但你知道,玛丽并没有

因为拥有这么多东西而羞辱这些家庭,

而是邀请他们查看

所有这些

以承认所有这些痛苦的

记忆

需要修复的物品

被忽视

了无用的凌乱部分,

房子里的每一件物品都得到了

解决,所以她会告诉他们拿起一件

物品

拿着它,感受它是否会激发快乐

,如果没有,她会告诉

他们感谢物品,

然后重新调整用途或

放手 我在情感上和结构

上都是如此,看到你知道这真是太酷了

,当然,如果你在 netflix 上观看,

你会

在 45 分钟内看到这一切,但在现实生活中,这

并不是一个

快速的过程,因为它确实需要

我们放慢脚步

,看看我们的东西,当我们向内看时,

我们可能会发现需要

处理的创伤

我们的坏习惯作为生存策略

我们可以开始倾听我们的身体

在告诉我们什么

,它经常会在情绪中对我们说话

每一种情绪都有表达

需求

或抗议没有得到满足的需求的意图,

当我们忽视这种情绪时 我们也

忽略

了满足自己需求的可能性有时我们的

身体会

在不适和疼痛的症状中与我们说话,这

迫使我们注意但我们

很快就会自动想到症状

有时它们只是

我们人性

的标志,当我们认为我们现在还活着的事实表明

我们的神经系统正在做它的事情时,我们认为我们有什么可怕的错误 工作

,所以有时我们应该

问自己,我现在需要什么才能让自己感觉

安全,而不是让我们的心理健康

变得更安全

或正念和深呼吸

练习

,真正抵消

战斗飞行冻结

反应的浅呼吸它对每个人都不同,但我们首先

必须学会停止

绕过自己,而是问

自己哪些需求没有得到满足

,我们如何选择组织和

保护

我们的家园,如果你能从中

拿走一件事我希望是

这两件事问你的 一遍又一遍地自我

你的身体

需要什么,然后倾听,直到你通过练习和支持开始

自己的身体感到更加自在

你可以学会重新组织你的家

欣赏它为你提供的安全感

并找到你的快乐 没想到你

可以

谢谢你