Worth. No quirky titles, this one has drained me.

This post has been the bane of my mental world for the last few weeks. I have written and rewritten it, but I have been totally at a loss for how to make it say what I want it to say. A large part of the reason is that I don’t actually know what I am trying to say. My personal sense of worth and where I generate it from is bringing my self-awareness of who I am into question. I am tired and I am confused and I can’t turn back. To be dramatic about it, I am trapped in a personal worth vacuum. My external supply has been almost cut off and I have little to no skill to create it independently.

This needs more explanation, but I am trying to ‘radically accept’ (DBT lingo) that this post is likely to make little sense to anyone but me. I still think that it needs to be published though, otherwise things down the road are going to look like they came out of nowhere. I’ve been aware for many years that my sense of self is not well defined. There are many reasons for this and many examples I could give, but I am not going to go into that detail here. What is relevant right now is that the work I have been doing in DBT, in therapy and in my personal experiences, has made me see that most of my anxiety in relationships, professional settings and surrounding my lack of autonomy, comes down to the need I have for who I am, what I do and where I fit, to be defined by others. I just don’t have the skills to bolster myself up, praise myself and consider myself capable of achieving things. 

I cannot see my self-worth unless it is reflected back at me by how I interpret other people’s actions towards me. Yes, it is not even so simple as judging myself on how people treat me, it is based on how I interpret how they treat me. So, unless it is clear, direct and positive, there is more than enough room for me to interpret my existence to them as a hindrance, and therefore consider myself to be worthless, unlikeable and unloved. Even more so because I am not coming at these situations from a positive or confident place. If I believe 'they' do not see me as worthwhile, likeable and loved, I have no means of knowing myself to be anything else but worthless. One of the biggest consequences of this is an intense guilt when I try to do any thing that means I put myself first, like self care, having time alone or requesting something I need from someone else. There are so many nuances that I could write for pages and pages and would still never be able to fully convey where I am. If I wrote it all, the contradictions would end up making it more confusing than it already is.

To bring it to the point, the problem this awareness has brought is that I can now see how unhelpful and unsustainable it is to keep getting my self-worth fix from the interpretations I make of other’s thoughts about me. To take it a step further, I am beginning to think that it is unhelpful to expect any of my self-worth to come from anyone but me. People around me can probably offer space for reflection and insight, but they shouldn’t be the source of my opinion of myself. That is ridiculous. I won’t explain all the reasons why it is ridiculous, but trust me, it is.

So I need to find my self worth from within me. I should like myself, shouldn’t I? But how? I have no concept of how to like myself let alone see myself as valuable. This is a whole new skill set, one that I am starting from scratch. And in the mean time, I have gone cold turkey from my usual source. I have little lapses, but they are rough because I notice them just a fraction too late and, because I don’t like myself yet, I beat myself up over it.

And here we are. You have read all of that and made it to the final paragraph where all the paths I have drawn should come together in a heartfelt life anecdote, but not today. What I will do is share the project I have started in hopes that I will soon be able to write a better version of this post. My therapist has suggested an art project where I draw where I am now, where I want to be, and then draw a series of images that show how to get from one to the other. I’m not sure yet how this will translate into a sense of worth, but the process of creativity that I started this year has already helped me give awareness and order to my thoughts and emotions. I am hoping that having a directive art project will speed this process up a little.

‘Where I am at now’ is on the left, and ‘where I want to be’ is on the right. I’m not sure how the sharing process will work, but I will be sharing.

Nothing stands still but me: Three months into DBT

I completed my first module of DBT, distress tolerance, two weeks ago. In true blogger form I had an idea in my mind that I would be writing a quirky, slightly angsty, uplifting post with just the right amount of buzzfeed quip to share my journey thus far. That is how all my posts sound in my head before I write them. But no matter how much I thought of it, I couldn’t bring myself to sit and write it. It would have been a lie and the predictability of it bored me. Instead, I am writing about where I am now, after three months in DBT.

As with the start of all endeavours, when I began DBT I imagined my future self in three months time to be vulnerable yet making steady progress in building some good quality coping skills. Now that I am here, it feels less like healthy progress and more like the walls of reality are pushing themselves in around me. You see, when I first had the BPD diagnosis, I wasn’t shocked or surprised, but I think I was nicely buffeted by my super-ego, plus it was something of a novelty to have a diagnosis that wasn’t depression. As the DBT program goes on and I gain more insight into myself and what BPD is, the layers of what forms my surface actions are making themselves known. For example, I felt OK with my diagnosis because it was novel, but not horrible, because I was not as bad off as some others, but why do I think that:

Layer 1: I have this diagnosis, but I’m not as bad off as other people.
Layer 2: Being not as bad as others means that I don’t need as much help as them.
Layer 3: That means my need comes secondary to others
Layer 4: I’m not worthy of the help, I shouldn’t take the time that other people need.
Layer 5: I am unhelpable, I should be left by the wayside so people who are helpable get the time they need.Layer 6: No one can help me but myself
Layer 7: I can’t help myself, this is too much for me.

Layer 6 is unrealistic and based on a poor sense of self brought on by early childhood experiences yada yada yada, how it happened isn’t the point. It is a core idea that goes through a process of being justified so that my surface self can use it logically. Those core beliefs can be good or bad, realistic or unrealistic, I doubt the psyche really discriminates when the correct formula is in place. I have spent my life thinking that the first layer of thought was the core, but now it turns out some of these ideas run much, much deeper and impact more than I imagined. I think most people live like this, but from what I understand of BDP, the core beliefs are maladaptive, and if mine are maladaptive at the core it is going to take more than some positive thoughts to change them.

What makes it harder is that I have grown up believing these thoughts and their respective feelings were correct. To be shown that there are other ways of thinking, feeling and acting, ways that are ‘healthy’ and which most people do- well, it is almost like being told that my parents aren’t my real parents. Nothing about the here and now changes, the world keeps on spinning and I am who I am, but everything I thought of as me is fundamentally different and I can’t understand why.

Now, I keep finding myself at standstills. Am I making a decisive action, or is this black and white thinking? Is this moment really a bad one, or am I lost in emotion? Does that person really think that about me, or am I projecting? I end up not acting because I am confused about whether it is the right thing to do or if I am being overtaken by irrational thoughts. So I just stand there, dumbfounded and feeling like like I am in purgatory.

When I look back, I have often stood in that fear of movement, but I’m still here and still a long way from where I once was. Time drags me forward regardless. It’s the idea that I have been incapable of actively choosing where it has dragged me to that hurts the most. Is that the next step, to act with agency?

As you finish reading, be sure to reassure me like I am helpless while also praising my superior wisdom. I want you to do neither and I want you to do both. Which turns out, is a BPD trait, at least I know I am normal as far as that goes.

Creating Creativity

Lately I’ve been contemplating on the fearlessness I had as a child. For some that might mean jumping off things, trying anything you were dared to, acting the clown or talking without restraint. I would call my experience of it as being fearlessly creative. I drew and painted without consequence. My ‘works’ weren’t to hang on my wall, to put up on the fridge, or to be praised for. They were creations for creativity’s own sake.  Drawing was the bliss that Joseph Campbell would tell me to follow.

My memory would have this fearlessness disappear when I was maybe 13 or 14. I dug deep and tried to recall when that fearlessness dissipated, and there are a few moments in early high school that would have contributed. They weren’t life-shattering events; they were small and subtle experiences, the kind that people involved wouldn’t even recall. Theses moments made me self-conscious about others seeing my work. For the first time I learnt that these items, which were given life by something within me, could be used to make judgments about me, both good and bad. Being graded on my creativity in the school system is an obvious one, but there were a few personal exchanges too. It just happened that perceived judgment mixed with a poor sense of self resulted in hiding my work and talent away. It was no one’s fault, just an unfortunate combination.

This disconnect from my creativity was brought to my attention when a friend asked me “Is your desire to think about art greater than your desire to create it?” I paused and tried to answer, but I couldn’t get the words out.  I wanted so much for my reply to be “Thinking about it is my greater desire”, but I knew that wasn’t the honest response. I know how happy drawing and painting makes me, why would I only want my answer to be ‘to think about it’?

The words I wanted to say and the words that were true stuck in my throat while my mind tried to decide which one had right of way. Thinking and theorizing about creativity is safe. This is a genius ploy of my super-ego to keep my creativity, and me, safe from judgment while still allowing a space for it in my life. In the few seconds it took me to answer, I saw that I had most certainly forgotten my fearlessness and my bliss. If my answer was ‘to think about it’, my life was destined to be one half lived.

In ‘The Denial of Death’, Ernest Becker talked about the creative person and how they can see the reality and pain of the world for what it is. What saves them from the neurosis that this awareness brings is their ability to take it into themselves, and then spit it back out in a new form through their art. After reading this I thought that the repression of my own creativity must have contributed to my depression and personality disorder. Once my creative outlet was put away, I was denying myself the only tool that could counter my over awareness. Ironically, I may have also put it away because it reminded me too much of my mortality, I think that is another post for another day though.

For years, I have not considered myself to be a creative person. I thought that all I did was take other people’s ideas and put my spin on it, or even just copied them. After recent experiences I feel like this thinking has shifted. When I focus, I know what I want to hear, see, feel and experience. I can draw on connections at any time and create the moments I choose to. Creativity isn’t in the end result, it is in the experience of the moment. That is what I felt as a child who was fearlessly creative.

I'll leave you with this quote from diarist Anaïs Nin, which I felt is a fitting ending to mark the start of where my own journey will be taking me next.

“I am more interested in human beings than in writing, more interested in lovemaking than in writing, more interested in living than in writing. More interested in becoming a work of art than in creating one. I am more interesting than what I write.”

Returning to work after mental health leave

It has been four weeks since I went back to work. This week marks the fifth, and I am awake far too early because I have Monday morning anxiety. I have to be fair on myself though, I didn't just go back to work four weeks ago, I also started group therapy and DBT, began art classes and threw myself in the deep end with a full schedule after three months of down time.

November was a big month. I have both achieved and struggled, so instead of researching and finding facts, I want to give an account of returning to life after a mental breakdown.

The three months I had off were not a lovely holiday break. I spent much of the time hoveled up in my room crying, staring at nothing, and trying to make sense of myself. I toyed with the point of going on and let myself act on urges. I saw very few people and canceled most of the social plans that I did make. I yelled and screamed at my parents over things unrelated to them and then sobbed in their arms from the confusion of why I just did that. I watched all of Parks and Rec over again in the space of two weeks. I also saw therapists- Doctors, Psychologists and Psychiatrists. I broke down in their offices repeatedly. I resisted their advise, I fought to be in control of my situation. I talked to friends, I cried in their arms, I slept in their beds. I went home and did it all again.

Gradually, the fog started to lift. I started waking up a bit earlier each day and felt rested. I picked up pencils and started drawing. I began talking to my parents about how that darkness had felt, and conversations with therapists moved from surviving to problem solving. I went outside, went on walks, enjoyed time outside of my room. I used my time to go to the gym and start some new healthy habits. I followed through on plans with friends, stopped beating myself up when I needed to cancel, and even initiated some social activities. I talked to friends, enjoyed their company and explored my inner world with them.

Assessments, discussions, plans. Acceptance to the DBT program, starting art class. Accepting myself and my needs through therapy. I built a routine for my days that moved around self care and my goals. I felt like I had a life to live. Then it seemed that I needed something more structured and the idea of returning to work was a possibility. I wanted to earn my own money and take steps towards ownership of my life again. I had discussions with therapists and work and negotiated a return to work plan. Returning two days a week for three weeks, then bump it up to three days. Only three days work for the foreseeable future, work load on my terms, with DBT one day a week. This was a very good plan in my mind, and a better one than I had hoped for. I was ready.

First day back and I was shaking as I walked in the door. All the interactions I had with people were calm, but I was on edge and very anxious. The day was hectic due to staffing and more than once I wanted to run out and admit I had pushed myself back too soon. Day two wasn't much better as circumstances triggered feelings of 'not being good enough' and comparison with others. The next day I had my first group therapy session, I was a heightened mess and could barely talk. The week finished with my new art class where I struggled to grasp concepts due to high anxiety from the week. I walked away feeling worthless and untalented.

The whole week was an unexpected slap in the face. I had felt so ready, I had done so much work and really took time to plan and make my return to life go well. It was like I had been in a lovely dream world of support, worth, confidence and fluffy cushions, then suddenly woke up in a grey concrete world of cold, hard reality. It wasn't that work had even pushed me too hard, they were very gentle and checked in with me often. I was all me, and I considered myself a fool to ever believe I could go back. Thoughts of worthlessness and inability to ever have autonomy took over and I felt myself slipping into familiar worlds that I had been in thee months earlier. However, I took stock over the weekend, utilised therapy, took it easy and tried to accept that my feelings were reasonable and would pass.

Week two began with little sleep and anxiety which caused muscle cramps and nausea. Work wise, it was calmer and more productive than the first week, I felt that I had contributed and did well. But the anxiety was too much and I hit a breaking point. I had cried all night before the first day and had not slept. I told my parents I was fine and put on a strong act, but once I was alone thoughts of self-harm were vivid and persistent. Proudly, I can say I did not follow through, mostly because I didn't want to jeopardise my place in the DBT program.

Then the breakthrough came. The night after the first day of week two my negative thinking was increasing and I could feel myself loosing grip. I lay in my dark room sobbing and tempting those thoughts to overtake me, and then I had a thought- I didn't want to be alone through this, and I shouldn't be. I got up and went out to be with my parents. When they saw my distress, they did all the right things. I cried and sobbed and lost all sense of reality, but I had them there to take care of the reality for me so I could have the feelings I needed too. I was able to have all the feelings I needed to have in a safe space, which meant I could explore them in their entirety. After hours of sobbing and gibberish on their shoulders, I made it through the emotions. I was exhausted, they were exhausted, but I made it through.

I woke up the next day tired and puffy. I went to work, I had to give it another try. I made it through the day and felt calm afterwards, then spent the next few days sleeping and recovering. I debriefed in my group therapy and with my psychologist. While the experience of returning to work had been a shock, it was also what I wanted. I needed to work through why I reacted the way I did rather than rule out my capability to work. Week three went better, week four was almost easy. Coming into week five and I feel the stability of routine building so I have a space where I can deal with the emotions and still perform my job.

For anyone returning to work after a breakdown, my message would be this- It will not be easy, but that is not your fault. Be gentle with yourself, give yourself time and let yourself draw on your support networks till you settle in. If it doesn't work, it doesn't work, your wellbeing is more important than a job. But if working is what you want to do, then keep your mind on your goal and use the skills you have learnt in your time off. You are capable.

DBT, Mental Healthcare and all the other Possibilities

Coming off the back of Mental Health Week, I am finally dredging up and editing a rant that I wrote well over a month ago. At the time, I was struggling to get my head around what steps were needed for me to recover from a 'breakdown' (I don't know what else to call it). I felt frustration towards and confusion about the system that I was being tumbled around in. It was meant to help me, yet it seemed to be intentionally getting me nowhere. 

Flash forward to the present moment and I have been accepted into a DBT program (Click here for info) starting next month, and am attending regular therapy. I wouldn't say I feel happy, but I do feel like I have more control of my life, rather than being victim of my emotions. I also feel like I have a better understanding of what my needs are and what it means to take ownership of them. I'm returning to work part time next month, a plan which I took charge in negotiating with my employers.

The road to get here was not a well marked path. I have been in and out of therapy, and on and off medication, since I was 19. Usually I would attend therapy in crisis mode as part of the 10 sessions offered through medicare in a 'mental healthcare plan'. Either the therapy would stop after those 10 free sessions due to cost, or I would stop attending because the crisis would die out and I no longer knew what to do with the therapy. At the moment, I have been seeing my current psychiatrist for over a year, along with regular G.P. visits. It wasn't until 3 months ago, when I became a genuine suicide risk, that I was given a Personality Disorder diagnosis and directed to a more appropriate course of treatment. 

I brought this up in one of my assessments for the DBT program. I wanted to know why my psychiatrist hadn't referred me there earlier? Why it took me ending up in hospital and being assessed by a psychiatrist there to be referred to this program? Even then, I needed to specifically seek the referral to the program, it was not offered independently. Her response was that I was lucky, most people will be admitted to hospital, with suicide attempts, multiple times before they find their way to a program like DBT. 

As I said, I was classed as a suicide risk, but did not attempt. By the numbers she gave me, I am beyond fortunate to ALREADY have been directed to DBT. To think that some people had to attempt to take their lives more than once to find a program like this was unbelievable to me. That I had to find myself in hospital from a risk of suicide before getting this support should be the height of unacceptable situations, but instead I find myself in a world where I am the lucky one.

When professionals have discussed DBT with me, it often comes with very positive phrases like 'this program works' and 'it has been proven effective for many mental health conditions'. I rarely hear anyone speak with such certainty as I have with regards to DBT (I'll let you know if these are true statements for me once I've done it). To take an evidence based approach, here is a study conducted in Berlin from 2014. This study showed that after a 1 year DBT cycle participants experienced reductions in self-harming behaviours, hospital admissions and the severity of their symptoms. To top it off "77% of the patients no longer met criteria for BPD diagnosis". Looking locally, this abstract of a similar Australian study from 2011 indicates similar results in regards to self-harm, hospital admissions and improvement in depression and anxiety symptoms (Unfortunately, I couldn't get the full study). The authors conclude that "providing DBT to patients within routine public mental health settings can be both clinically effective and cost effective".

After my reading, I am amazed that this program is not being better utilised, especially if it is both "clinically effective and cost effective". To consider why it is not, there are certainly reasons that it would be problematic if it were rolled out the way, say Cognitive Behaviour Therapy is. Firstly: DBT is a 1 year commitment. Understandably, it would be very difficult to guarantee or enforce attendance for that amount of time, most people barely utilise the gym memberships they are paying for. Imagine trying to attend something every week, especially if it were government subsidised and didn't leave you out of pocket? This leads to the second point: to gain results you have to put in effort. If a person is not willing or ready for life changes, they will not get much out of the program. They could even do the opposite and prove disruptive for other participants. This is why I underwent assessments, to determine if I am ready to commit and if I really want it. Attendance has to be driven by a willingness to change. Other issues which could arise are things like cost, personal support networks available and the risk of putting people into the program who are not suitable or not ready. There are probably countless others that I am not qualified to even invent. No doubt there would be many little details that had to be nutted out before it was pushed as a high priority recommendation or even government subsidised, but surely it is a possibility that would be worth considering 

The issue is that our system wasn't designed with mental health built in. It was designed around physical illness- it is difficult to fit mental illness into this system because it presents uniquely in each case. In an interview with Hack, the the federal health minister, Sussan Ley said that reforms to the mental health system are "long overdue". How these reforms will look is currently anyone's guess, and that is why the public discussions that happen during times like Mental Health Week are so important.

This sentiment, of why our health system treats mental health the way it does, was voiced very well in an interview with Hanna Pickard on "the Philosopher's Zone". Perhaps it rang more true to me because she was talking about people with BDP. Often patients will attend a session presenting with self-harming behaviour, suicidal attempts, depression, anxiety or many other symptoms. She explained that these symptoms can be interpreted as a loss of control and the attending professional may stop viewing the patient as a person with the ability to change and will move to the role of rescuer.

Rescuing works very well with a medical model. Medical models identify an issue and then take measures to fix it. For example, you have a broken arm, I will put a cast on it. You have bronchitis, I will give you medication. We can do things to help healing along, like resting, eating healthier foods, or increasing fluids but the bulk of the problem is solved by medicine- which is utterly amazing when you really think about it!

A large part of psychological intervention is the belief that all people have the ability to make positive change, and it is important to not only believe in them, but to help them believe in themselves (Google 'Person-Centred Therapy' if you want to learn more). As mental healthcare is part of a medical based system, it is geared towards fixing people, not supporting them to fix themselves. I should clarify here that this does not mean I am against medication or medical support for mental illness. I believe medication can be vital and effective, but can be more effective when used as a tool rather than a cure. The reprieve and stability that can come from the correct medication and medical care can provide a space of clarity where new skills and ideas can be nurtured. This may mean needing medication for a lifetime or a few months, it may mean needing therapy for a lifetime or a few months. Everyone is different, there cannot be one set procedure for dealing with all mental illness. 

At this point in my original rant, I opened into a glorious tale of a wonderful furture that would need 'Imagine' by John Lennon sung in the background by a choir of multi-ethnic children wearing the clothes of their heritage. I find that unnecessary because my idea of an ideal will be different from yours. What I do want end on is this- What I have outlined here is just one possibility for different ways we can move forward in treating mental illness. Possibility is where discussions can happen, ideas can emerge and plans can be made. We are at a unique point in the mental health arena in Australia where how the future system looks can be decided by the people. Keep the conversation going and the kind of change we want will happen.

You MTHFRing vegan

If you have read any of my recent anything, it should come as no surprise that I am in therapy. As I may be starting DBT in the near future, I thought it would be important to find a therapist who I feel I can work with long term, so I have started 'shopping around'. My experience with my current therapist and the health goals it has lead to have turned out to be beneficial, even if they were indirect.

This therapist is a little on the alternate side. In the first session I was informed that she takes a holistic approach and that diet and physical health should also be discussed in our sessions, which I had no issue with. I agree that the body's health can play a major role in mental wellbeing so this seemed sensible to me. In our second session, I was asked a series of yes/no questions about my general wellbeing, both physically and mentally. Long story short, my answers apparently indicated that I may have a MTHFR genetic mutation...

Sounds serious, what does it mean? I was told that this mutation could be identified with a blood test (this is true), but many GPs would probably not know enough to accurately interpret the results (mmm...). I could be referred to a GP who specialises in this issue. While the initial session was pricey ($400), subsequent session were more reasonable. If that was not affordable, a naturopath could certainly interpret the results (warning bells). I said I would do some research and think about my options.

The Basics

I am far from a geneticist, but from what I can gather the MTHFR gene helps turn folate and B12 into something the body can use (Click here to read a more sciencey and correct explanation). According to Genetics Home Reference there are at least 40 known mutations of the gene. I have read different statistics, but it seems a large proportion of people have a mutation (40% seems most consistent). This can have any number of impacts on the body, as you would imagine if your body is not receiving or using necessary vitamins or minerals. In my particular case, it is assumed this mutation would be causing or influencing my depressed mood, fatigue, PCOS and possibly most signs of ill health that I have.

My Research

The first result when you google will be mthfrsupport.com.au. This site offers some simple explanation about what the MTHFR gene and folate does. It lists all the possible conditions that the mutation could cause. They have videos and information available, some for free and some at a cost. For many people who have received the diagnosis, I'm sure the support offered through a group like this is a useful tool in facilitating lifestyle changes.

But that wasn't really enough for me so I kept looking. Generally speaking, there is a lot of information out there which is both interesting and conflicting. The jury is out in regards to how or if MTHFR mutations correlate directly to depression or other mental health issues (Click here for a scientific review on current research). The impact of B vitamins on mental wellbeing is generally accepted (fun fact, folate is B9), so an issue in the body's production is bound to lead to some health concerns- the same as with any other vitamin deficiency. Although nothing I read is as dire as alternate health circles seem to promote, there is a 'watch this space' vibe in relation to the research that is being done. The American Journal of Epidemiology, for example, note that a connection between the MTHFR variant and certain mental illnesses may lead to the use of folate as a treatment and preventative measure. It also may not, but if it doesn't, at least we will know. I love when potential is explored!

Where to now?

Yes, after my research I am open to the possibility that a genetic mutation may be contributing to my currently poor mental and physical wellbeing (family history and past experience also add to my consideration). I am not, however, convinced that this is the root cause of every woe that has or will befall upon me. Humans are an intricate web of biology, emotion, experience and environment. Different triggers lead to different results for all of us, even on a genetic level. I am also far from convinced by the industry that has built up around it. People are spending exorbitant amounts of money to be tested, see specialists and receive treatment. Did I really need to embark on such a journey to get healthy and escape the clutches of the MTHFRing gene?

I've decided on no. According to Science Based Medicine, high homocysteine and low folate levels can indicate a mutation and both can be checked with blood tests. Even if you go the extra mile and get genetic tests, NSW Health state that "there are currently no recommended changes in clinical management based on an MTHFR test result."

Regardless of who you see, the answer to low folate and/or B12 will be supplementation, with or without a genetic mutation. If there is a deficiency in folate or B12, levels should be monitored by a professional because too much can cause as many problems as too little. I'm pretty confident my bulk billed doctor can help with that. The debate is still raging for me in regards to folic acid vs activated folic acid. Methylfolate currently makes sense, but I haven't found much research on it yet. You can google the meanings of that yourself.

A change in diet and lifestyle habits may be just as effective and will have other positive health outcomes. While researching, I found that chickpeas, spinach, dried beans and lentils are top sources of folate, which reminded me of how good I felt when I did the 30 day vegan challenge a couple of years ago. I had a lot more energy, lost excess weight and my skin was so clear. Coincidently, my food staples at the time were chickpeas, spinach and lentils, all the high sources of folate. The positive results were no doubt due to increased vegetable intake and reduction of processed foods, but the possibility that a higher intake of folate helped is not lost on me.

Nom, Chickpeas

So I am experimenting with my body, taking it back to basics and testing how I feel, starting with a 30 day modified vegan challenge (I'm going to eat eggs, don't want to make it too unachievable). I may or may not have the MTHFR genetic mutation, but I am certain that I will benefit from a healthier diet. I will be getting a blood test done next week to see where I am at with folate and B12 and work from there.

For all those who have had positive results by chasing the MTHFR specialist route, I'm happy for you. If you feel better, have a more fulfilling life and absolutely incredible results, then you should be happy. For those at the start who choose to take that path, I hope you have equally great results too, I do not underestimate the value of support networks when making lifestyle changes. If you are reading this and something resonates with you, don't just do what I am doing either. Go and do the research yourself to find what will work for you. If you think seeing specialists is the best way to tackle the changes you need to make, then do it, but don't just follow their lead blindly. Read, research and take charge of the direction you want your life to go in. The people you pay to help you should be worth your money. I'll be sure to keep you updated on  my progress, because even if it fails it is a lesson learnt.

And of course, discuss! If you have ideas, thoughts or related articles to share, lets do this. Nothing bad can come out of a conversation (unless we make it bad, in which case I'll delete all my posts and comments and run away from the internet).

Ask RUOK? again and again and again

What began as a post to ease myself into some vulnerability about expressing opinions turned into an epic rant (don't worry, below is the edited version, chapter 1). Turns out I have some strong opinions surrounding social structures...that ultimately leads to an opinion of 'but it is what it is'. I wish there was succinct way to express why that opinion is not passive, but as my writing skills are still developing I think it will be have to explained gradually over many posts.

To the point- Today is RUOK day, so it seemed appropriate to begin posts discussing my own mental health. I'm not going to talk too much about my history (you can read a little teeny bit about it here), instead I'm going to talk about where I am with it now.

I am coming to this post following a long period of frustration about how my mental health has been handled. Although not ideal, I also think that I would not be at a point of taking my mental wellbeing into my own hands if it had not been for the spectrum of experiences I have had to date. Like many, I have been in and out of therapy for years. Usually I would land in therapy during crisis, I would stay there until I was functioning again, then I wouldn't know what to do with my therapist after that point so I would leave. This occurred either within the ten free sessions offered under the medicare system, or just after, when the outcome was not justifying the out of pocket expense. Also, like many, I was offered medication during these times and reminded to 'do things I enjoy' and 'get some exercise'. I have no criticism of this process, these are a combination of methods that have been proven effective in supporting people through depression. There were times in my life when this process pushed me through.

However, this has been a cycle where I was being treated for a symptom, not the cause. It has taken repeated trips to many professionals over many years for someone to pull all the pieces together. Now I am starting a process to work on the core issues.

Part of my healing means to let myself express my feelings, and I can't help but feel let down. There are reasons why it has played out this way and logically I know I am very lucky to live in the country I do and have even received the treatment I have had, but I still feel that initial pain of being let down. After all these years of struggling, I have questions. Why was a personality disorder not identified before? Why was I not offered more extensive therapy, like DBT, prior to this? Why was medication always pushed but other techniques were not?

I (like everyone) try to console myself by thinking that I would not have been ready for a program like DBT any earlier, that this timing is right and for it to happen any earlier would have proven ineffective. I can't really know that though, I may have responded well to it ten years ago and could have lead a very different life as a result (oh, but then I wouldn't have met such and such or experienced that thing that made me happy that one time... I love watching my mind try to make me feel better ^_^).

The truth is I am here now, I have this opportunity now, and I want to make the most of it now while I can. I am fortunate (while seething with white middle class guilt) that I have parents who can support me temporarily while things are set in motion. I am fortunate that I have people who have come into my life that are capable of understanding. I have a job where management not only identified that I was struggling, but also have given me the time that I need to get things back on track- for this I am fortunate, but I will take credit in knowing that I work hard, am good at my job and have made myself an asset who deserves to be well cared for by my workplace. I would be a fool to not harness all the aces in my hand during this dark time, but I didn't figure that out until recently.

It has been a lifetime in the making, but I am in a place to get the help I have needed for years because people took the time to ask. They didn't just as once on one day, they asked repeatedly because they saw something was off despite the fact that I kept saying 'I'm fine'. Let today be the first time you ask, but also make it a reminder to keep asking. It can take a lot more than one question to open a door that has been sealed shut.

To all those who asked, even if I lied in response, thank you. Because of you, I am still here.

As I said earlier, my original rant was very insightful (for me) regarding some of my opinions about use of medication in treatment of depression, systems surrounding mental healthcare, socio-economic structures and a few other bits (loooooonnnngggg rant). I have saved the draft and will work through editing and sharing those ideas over the next couple of weeks, there is no way I would bombard you with all that in one post. I have some interesting writing to look forward to.