Beyond the Medical Model with Neesa

Beyond the Medical Model with Neesa
A Column by Neesa Sunar, Peer Specialist, Transitional Services for New York, Inc.
Changing the Language That is Used to Describe Us

Many of us who find ourselves in the mental health system have shared experiences as to how we got there. To speak on my own experiences, I first displayed “maladaptive,” saddening symptoms as a teen, which then led to my first hospitalization at around my fourteenth birthday. I was diagnosed with clinical depression and medicated with Zoloft. Upon returning to school, I labeled myself as “depressed,” which elicited within me a negative worldview amongst my classmates. My experiences with mental illness seemed alien to them, so my label further served to summarize my failures in forging meaningful friendships.

My condition turned for the worse when I developed schizoaffective disorder in my early twenties. Again, this diagnosis became a box I fell into, deeming me a “schizophrenic.” Adopting this label as a self-descriptor caused me to feel broken in mind and character. And even as I remained compliant with medications and psychiatric appointments, I continued relapsing, causing me to believe that my schizophrenia would haunt me for the rest of my life. Thus, the label seemed inescapable, thus sadly accurate.

My inability to work caused me to file for disability, which was an incredibly freeing experience. I began openly disclosing my illness to anyone who would serve as an audience, and even felt proud that my struggles had a name, instead of being some amorphous spiritual curse. At the same time, the label of “schizophrenic” still caused people to distance themselves from me. Perhaps my label served as a threat, indicating that I had lying dormant within me a sense of criminality.

When discovering the peer movement in 2014, beginning as a student at Howie the Harp Advocacy Center, I learned that I had been entrenched in the Medical Model for my entire mental illness “career.” I realized that I had completely internalized and unconditionally accepted the top-down dynamics of the therapeutic relationship between practitioner and consumer. I absorbed that my mental illness diagnosis served as a label that indicated who I was and the future trajectory for the remainder of my life. And that all this was an injustice.

I became appalled that I had never even heard of the Recovery Model as a counter to the Medical Model. Even in this massive city of New York, brimming with resources, I had never encountered peer specialists or Recovery Model enthusiasts. How could this be? Many of the peers I have since met proudly disown their diagnoses as descriptors, instead using more affirming language such as, “I am a person with schizophrenia,” or “I have past lived experience.” The peer community is a group of vibrant people with dynamic personalities, free from such labels. Bearing this perspective, we flourish and grow in our own recovery journeys as we influence and support one another.

Many of us peers are compelled to take action as mental health advocates in our communities. When we fight for widespread awareness of peers and the Recovery Model, we hope to challenge people in reevaluating their perspectives of those with mental illness. Part of our advocacy efforts should also include the request for creating alternative language that is person-centered, trauma-informed and affirming. A person “suffers from” or “experiences” mental illness and is not the illness itself. And what defines mental illness anyway? Descriptive words such as “crazy,” “insane” or “dysfunctional” also serve to obscure the personhood of one suffering. When insensitive language is used, a person can internalize this and develop a sense of shame and fear. This can prevent a person from reaching out to friends, family, and/or professionals. In the worst of situations, such silence can end in immense and irreversible tragedy.

As we advocate for change in language, we must also recognize that each individual has their preference for how they should be regarded. Some people prefer to be called “disabled,” while others eschew the term. Other terms can be preferred as well, such as “mentally ill,” “other-abled,” “neurodiverse,” “chronically ill,” “in remission,” or simply “a human being.” In the same way that the transgender community has fought for preferred pronouns, so too should we demand that mainstream society develops interest in engaging the mental health community with respectful language.

We each have our individual journeys towards recovery, as we leave behind our pasts to walk towards a bright future. The hope and vision that guides us in this process can be the foundation on which we stand, as we fearlessly share our stories of recovery. Part of our stories can include how we have reclaimed our lives by adopting affirming language. If we are able to incite curiosity in our audiences, we may enjoy immense success in this endeavor.

Beyond the Medical Model with Neesa

A Column by Neesa Sunar, Peer Specialist, Transitional Services for New York, Inc.

Advocating for Clients Can Require a Team Effort by Peer Workers
Many of us peers in New York City are incredibly passionate about what we do. We work at agencies where our consumers desperately need our services, giving voice to their concerns in the face of other less- or non-sympathetic psychiatric professionals. We act as a go-between, giving credibility and weight to our consumers’ needs and requests. We give their voices legitimacy, and we stand strong in the face of dissent.

Our sentiment for individual advocacy can take a natural turn towards systems advocacy as well. We as peers desire change in mainstream society regarding its awareness of mental illness. Understandably, opinions on how to achieve this differ from person to person. Some of us are of an anti-psychiatry and/or anti-medication sentiment, advocating for steps towards disavowing the traditional Medical Model altogether. Others among us take a pro-choice stance, where we figure that each person can self-determine their treatment plan and goals for wellness. Still others strive to strike a balance between the Medical Model and the Recovery Model, valuing the opinions of non-peer psychiatric professionals. There is of course overlap, and many of us embrace more than one perspective to varying degrees.

As advocates, we peers can come up against people who do not understand the scope of professional services that we provide. As we work with clients, remaining true to peer principles, our supervisors and coworkers may judge our techniques as something unprofessional. Even though principles such as mutuality and person-centered treatment are evidence-based practices, professionally corroborated by modalities such as Intentional Peer Support, we are still questioned. This resistance we run into only fuels our fire, compelling us to courageously continue staying true to our cause.

It still stands that many employers do not fully understand the roles of peers. Given that peer services are only now being integrated into service delivery programs in New York City, agencies are finding themselves hiring peers for the first time. Since peers are new, job descriptions and responsibilities are uncertain, and employers do not have the expertise or resources to provide sufficient supervision for peer staff development. It may not occur to supervisors that peers serve as agents of change, who purposely go against the grain of office culture to support consumers. On the contrary, supervisors may require peers to conform to the existing culture of the office.

This expectation can prove incredibly detrimental to peers, forcing them to compromise the integrity of their work in order to keep their jobs. Peers may be forced to use their mutuality to forge a trusting relationship with a consumer, and then use that trust to make the person comply with a top-down, Medical Model treatment plan. Or, if a peer communicates a consumer’s message to staff, that peer can be shut down and told that the person is not lucid, and therefore cannot determine goals for themself. At the very worst, a peer may find that the rest of the office does not have faith in a consumer’s capacity for recovery.

It is beneficial when a peer works with an employer that has hired multiple peer staff. Peers can support one another, and can band together to impart suggestions to employers on how their agencies can adopt a more recovery-oriented perspective. When peers work together, they can also assist one another in making sure that everyone remains true to the values and mission of the peer cause. Compare this to the peer who finds themself as the only peer at their office. It can be difficult for an isolated peer to remain motivated, especially in situations where a peer’s legitimate comment is the only voice against the unanimous voices of the rest of the office.        

Peers can find camaraderie by venturing outside of the workplace and into the community, and New York City has current initiatives that can aid in this process. There are committees with the New York City Department of Health and Mental Hygiene, including the Office of Consumer Affair’s Consumer Advisory Board (CAB), a committee comprised of peers that reviews and offers feedback on upcoming city mental health initiatives. The DOHMH also has the Regional Planning Consortium (RPC)’s peer steering group, which also allows for peers to join and offer critique on upcoming initiatives. The CAB accepts board members by application, while the RPC has an open invitation for those interested to join at any time, provided that they are a Medicaid recipient of mental health and/or substance use services.

There is also the Peer Workforce Consortium, a committee of peers who are currently making strides towards creating a professional organization that represents the priorities and welfare of peer specialists, both working and aspiring. The Leadership Committee of this group meets monthly, and large “summits” commence quarterly. Topics covered in summits will include educational seminars, presentations and opportunities for networking.
There are also annual conferences that peers regularly attend. Within New York State, there is the NYC Peer Specialist Conference typically held in mid-July at the Kimmel Center in Manhattan, and also the NYAPRS state-wide conference, typically held in mid-September in Kerhonkson, NY. The former is free to attend, while the latter requires a registration fee in conjunction with hotel and travel, depending on where one lives. 

We must recognize that the values of peers are worth fighting for. One way for us to express the effectiveness of the Recovery Model is to live it ourselves. By reaching and striving towards recovery in our own lives, we can peacefully inspire the people around us, creating within them a sense of curiosity that compels them to wonder…how did they do it? How did they achieve the impossible?

But more importantly, living a life of recovery aids in inspiring the people we work with. We create a spark within people who have been beaten down and discarded, giving them a chance to ignite it. With such chance comes the opportunity for blossom and growth, enabling a person to move not only forward but upward.

Beyond the Medical Model with Neesa

Beyond the Medical Model with Neesa

A Column by Neesa Sunar, Peer Specialist, Transitional Services for New York, Inc.

The Vital Profession of the Peer Specialist

For the past couple of years, I have been employed as a “peer specialist.” A peer specialist is a mental health professional who has personal lived experience with mental illness. Because peers have suffered themselves, they are able to understand and empathize with the people they work with. This type of experience cannot be learned in university. Thus, peers have expertise that doctors and social workers do not.

I learned about the peer profession when I was in a psychiatric day program in 2012. Once I heard about it, I wanted to work as a peer myself. I applied to the peer specialist training program at Howie the Harp Advocacy Center (HTH) and was accepted. I attended classes at HTH five days a week for twenty weeks, totaling to 500 classroom hours. A 12-week internship followed.

Howie the Harp Advocacy Center is named after one of the first pioneers of the peer movement. Howard Geld was psychiatrically hospitalized as a teenager in the late 60s. At seventeen, he left New York and relocated to the west coast, where he became involved in the Insane Liberation Front. During his life, he was involved in mental health advocacy efforts on the east and west coasts. He earned his moniker of “Howie the Harp” because he was a street performer on the harmonica. In 1993, he became the Director of Advocacy for Community Access. He garnered funds to start a peer specialist training center, slated to open in 1995. Unfortunately, he passed away two weeks before the school opened. The school was named after him in his honor.

While at Howie, I learned about the Recovery Model, which is in stark contrast to the Medical Model. Typically, when one is physically ill, s/he will go to the doctor. The doctor prescribes a medication, and treatment is determined successful when the person’s symptoms are eradicated. Yet with mental health, absence of symptoms is not enough. Side effects can make the “cure” as bad as the mental illness.

The Recovery Model goes beyond this. Everyone is entitled to living a fulfilling life. People should be encouraged and supported to reach for complete wellness, no matter how “severe” their condition may seem. They do not have to submit to the limited expectations that standard providers have. In the past, I held jobs where I hid my diagnosis, only causing additional stress. Now as a peer, I can use my experiences as a strength which can help others. No longer do I feel “broken” and a “danger to society.” Instead, I have developed a sense of empowered pride. I have risen from the ashes of profound disability.

About two years ago, I began working full-time at Transitional Services for New York, Inc. We offer apartments in the community, as well as active case management services. Whenever I meet a new client, I immediately disclose myself.

“Hi, I’m Neesa! I am a peer specialist. Do you know what a peer is?”

Oftentimes, the client does not know. Thus I explain:

“A peer is a person who has mental illness themselves. I myself am diagnosed with schizoaffective disorder. I’ve been hospitalized seven times. I have been on disability since 2011. I know how this system can wear you down, trying to juggle public assistance and Medicaid and psychiatrists…I’ve lived it. I’m here so that I can relate to you. I know where you’re coming from.”

At this point, I always feel like this invisible wall melts between me and the client. My hope is always to strike a chord within the person, wherein s/he can feel safe and open. The greatest fulfillment I experience as a peer is developing that one-on-one relationship with the client. In this therapeutic partnership, I encourage them to determine their own path towards wellness instead of dictating to them how “I think how it should go.”

The peer movement specifically strives to create awareness about mental illness akin to a civil rights movement. So often, psychiatric clients are stripped of their rights, whether it be in institutions or with an outpatient psychiatrist. People are forced into treatments they don’t want for themselves, intimidated by doctors. And then there is also stigma, that pervasive societal attitude that discriminates against those who have a diagnosis.

My hope is that there soon will be widespread awareness about peer specialists. We are able to reach clients in ways that doctors and therapists cannot. We are able to stand as examples of recovery, and we inspire one another to reach higher and further than the negative prognoses from our providers. The work of peers is the future, and we must create awareness to make this happen.

How a Peer Support Training Program Transformed My Life

How a Peer Support Training Program Transformed My Life

By Emily

Peers Understand Where You Are Coming From

I always had this feeling that I was not good enough, despite putting my all into school, gymnastics, running, and art. In fact, I felt I must be bad and needed to be punished. That’s when I started hurting myself.

In retrospect, I excelled at sports, was on the honor roll and received special awards at graduation. Somehow, I was never satisfied with my accomplishments. I graduated high school hiding everything. But the summer leading up to college was when things started falling apart. Whatever was “my fault” led to self-harm and inner-pain. I made it to college, but only for a short while. Soon after heading off on my own, I was sent to the hospital and that was the end of that. So began my life as a patient.

I entered a program that was supposed to help me, yet I was isolated, medicated and told that everything I was doing was wrong. This worsened my condition. “I’m bad, I deserve to be punished” was my motto.

I went through one hospitalization after another, until the day I was told I needed 24-hour supervision and was sent to Pilgrim State Psychiatric Hospital. I felt I would never be ‘normal’ again.

After months of one-to-one supervision, medication and everything else that came with being hospitalized, I decided to shut up, comply and act like a ‘good patient’ in order to be released. I was let out and sent to a group home. A few months later, after a suicide attempt, I was back at Pilgrim Hospital by court order.

At Pilgrim, I was often forced to take medication to make me more docile. If I didn’t comply, I was restrained in the seclusion room and given a shot to “calm me down.” I was always on one-to-one and experienced anxiety attacks every time I was naked or needed to use the toilet in front of the stranger assigned to me, so I avoided showers and bathrooms at all costs. Their most degrading and memorable solution were laxatives.

When they felt the medications weren’t working, I was told I needed electroshock treatment (ECT), and that, since I was too young to make decisions about my treatment, they made the decision for me. I was 21-years-old.

The ECT caused brain damage. I developed epilepsy and still have learning and memory problems. Along with the loss of some painful memories went the loss of recalling a great deal of the wonderful people, things and experiences throughout my life. Was it worth it? While at Pilgrim State, I witnessed forced treatment, neglect and confinement. After my two-year stay, I went back to a group home, day treatment and more meds than you can count on your hands and feet.

I resigned myself to the fact that I was a full-time psychiatric patient. I cut and burned my body until there was only scar tissue. I overdosed and ingested anything toxic, hoping it would be the end. I planned and attempted suicide on multiple occasions. Like clockwork, I would be in and out of the hospital every few months. I felt alone. I was dependent upon medication, couldn’t hold a job and had trouble in school. I had a terrible self-image. Then came the stigma. I was no longer Emily. I was an illness: major depressive disorder, bipolar, schizoaffective. Whatever they labeled me, I became.

My metamorphosis began while I was interviewing to get into a class that trained peer supporters. I anticipated not being accepted into the class and began perfecting my suicide and how I would be presented at my funeral. My doctor was worried about me and sent me to the hospital as a suicide risk. I was there for two weeks and while I was there, found out that I was accepted into the class. I was discharged from the hospital and the next day started my class.

My new friendships, relationships and experiences all began to matter to me. The real Emily buried beneath the darkness began to emerge. I was breaking out of my shell, playing music, singing, dancing and socializing. I learned so much sitting in a small room all day with peers who understood where I was coming from. They helped and inspired me. I discovered that I was not alone. If I chose to, I could use my experiences to help others, which I did and have continued to do. Everything I went through was not a waste of time—it was precious knowledge I could pass on to someone like the old Emily, who thinks she's a bad person, who thinks she can’t do something, who needs a voice.

The world works in strange and mysterious ways. I went through hell so I could appreciate the wonderful things I have now and all that I’ve worked for. These days I’m a peer supporter, an advocate and a member of society, not the system. I’m living with my wonderful boyfriend, have a job, volunteer, and am an independent woman doing things on my own. I’m finally unstuck and still moving forward. Recovery is a bumpy road with many potholes, but it’s much better than being stuck in the ditch I thought I’d never climb out of.

Pullout: “I’m finally unstuck and still moving forward. Recovery is a bumpy road with many potholes, but it’s much better than being stuck in the ditch I thought I’d never climb out of.”

Bipolar, With a Side Order of Psychosis

Bipolar, With a Side Order of Psychosis

By Jason Matlack, CPS

How My Illness Was a Blessing In Disguise

It's amazing how sometimes the worst things in our lives can become our greatest assets. It isn't the cards we're dealt but the way we play our hand. Who would have thought having mental illness would become the exact thing that has made my life worthwhile.

I never did well in school. When I was young they didn't have all of these diagnoses and tests to discover what was what. Maybe that was a good thing. Even though I always felt like I was failing at a lot of things in my life I never seemed to give up. Without a diagnosis I did not have an excuse to give up.

Growing up I experienced sexual abuse at an early age. I don't know how much of that played a part in my mental illness. That experience and my inability to keep up with my peers in school always made me feel inadequate. Sometimes I would fail tests that I would have passed because I didn't meet the time frame.

I discovered alcohol and marijuana at an early age. When I drank and got high all those feelings of inadequacy went away. In fact, with a little alcohol I became self-confident, or so I thought. I never drank like regular folks from the start. I drank too much and too often.

When not drinking, my self-hatred surfaced and I would say horrible things to myself in the mirror. Sometimes I would do things to hurt myself. I thought about suicide often. Drinking to oblivion was my only release.

I began to drink to the point of blacking out and became violent when drinking. At 19-years-old my verbal abuse turned into an attempt to beat up my girlfriend. I finally sought help in a 12-step program. I was raised in a loving family and thought female abusers were the bottom of the barrel. I moved out on my own, partially blaming my unhappiness.

I couldn't remain sober because of the secrets of the abuse and dysfunction in my childhood. I ended up in rehab and stayed sober for eight years with the help my involvement in a 12-step program. Even then I still didn't fit in. I was able to curb the anger and dealt with my childhood by finding peace and self-forgiveness. But the bipolar mood swings were a constant battle. While in my mid to late twenties I began to experience psychotic episodes. After indulging in the instant gratification of mania, I would then experience great guilt.

Once the psychotic episodes began, I would go super spiritual and hear a voice I thought was God. The business that I had started and ran for fourteen years began to fall apart due to my inability to cope. My wife couldn't take it and we ended up divorcing.

I started drinking again every now and then since my episodes isolated me. But I did not drink much. Instead, I would smoke marijuana. I didn't realize it, but the smoking prevented my psychotic episodes from occurring. Unlike alcohol, marijuana did not cause me to black out or become violent.

By my mid-thirties I lost my business. I went through some sales and management jobs, but manic episodes only caused more compulsive decisions.

When the economy crashed, the time share company I worked for as a marketing manager laid off 50% of the work force. I went into a psychosis that lasted about a year, thinking I was the second coming of Jesus Christ.

When the psychosis broke, I admitted myself to a psychiatric hospital. That was where I was diagnosed and started to receive proper medical care. It is also where I had my “Patch Adams” moment. I knew I wanted to get into the mental health field and help others like myself.

I had a difficult time coming to terms with the guilt from the damage I had caused others with my manic episodes and psychosis. I experienced a lot of anger about being born with this condition and became angry with God. Thoughts of suicide continued to plague me regularly.

I continued in sales, which I hated, but it was the only skill I knew would earn me enough money to survive. After getting laid off from a job selling cars, my therapist told me about a Certified Peer Specialist job, which is someone with a mental health diagnosis who helps others recover from their mental illness and create a better life for themselves.

I have been a Certified Peer Specialist for almost a year now. It is the best thing that has ever happened to me. I thrive on the personal satisfaction of helping others and witnessing their progress. This job is what I was looking for my entire life but was unaware of it. Every day I go to my job with great enthusiasm. If I wouldn't have gone through hell, I would have not found heaven.

All I can say is that to those of you who think you can't, you have to know that you can. To those who are our supporters, do not sell us short. It is through your support and encouragement that we will soar to new heights.

The common threads to those that find a quality life are those that have support, whether it is family, friends or professionals. No one can do this alone. If you do not belong to a support group please find one. There are some that meet in person. If that isn't possible, there are tons of them on the internet. I belong to a few myself. There are also support groups for our supporters. I love you all and good luck on your journey!

A-Slam- The Quiet Room, A Powerful Hip-Hop Musical Interpretation of Lori Schiller's Book The Quiet Room

A Prison of One: Another Look

By Larry Drain

A woman came recently to one of our support groups for the first time. She had never been to one before. More than anything she talked about isolation. In the midst of family and "friends" she had never—not once—opened up and talked about the issues she was struggling with. She talked about the fight to get out of bed. She talked about the pain of being alone in a crowd. She talked about the pool at her apartments and how she watched people go and wished she could go to. And she talked about how often she wanted to die.

She was alive because she thought her death might inconvenience other people. She talked about trying to find a month when no one had a birthday or there wasn’t a holiday or a special event. She didn’t want to make something good into something bad. She was thoughtful to the max, but didn’t think she was worth a thought.

She talked. Then she cried. Then she talked some more. I think she really surprised herself with how much she had to talk about. It is hard to have faith in yourself if no one around you has. It is hard to treat yourself as important if no one else does. Isolation isn’t always about how many people are around. Sometimes it’s about how you are around people.

We told her how she deserved more and how she was worth more and how much courage she had. She is not used to good news and although I think she liked what she heard I think it made her uncomfortable. She is sadly comfortable in the theater and feels awkward at the thought of being part of the movie.

I hope she comes back. I think she might. She at least said so. Mental illness for her has meant being alone. Always. She was married for a long time, but even then was alone. She talked about her husband for a while. "You know," she said, "We were together for years. I never even knew how much he made...."

Chronic isolation is a form of death before dying. For too many with mental health issues it is a death too easily found. Remember God gave us hands for reaching out to others. Say "hello" to someone today.

Larry Drain runs a blog for mental health recovery that can be found here: http://hopeworkscommunity.wordpress.com/

I Have Been Through the Valley of Death

By Akash Chat

Coming out alive and now benefiting others

My older brother believed in me, and my mother smothered me (usually in a loving way), but others could see that I was a little “off.”  My father was a rage-aholic. I later realized that he loved me in his way and maybe his anger towards me was due to fear that I would suffer because of my awkwardness. I don’t know if it was his violent outbursts or just a fear of living that made me sink further into my inner fantasy world. My mom says I would tolerate other kids for a while and then go hide. In front of any authority figure, I would freeze in fright. I couldn’t get a haircut because I would tremble at the sight of the barber, afraid to ask for his services.

Because I was so helpless, my mom and brother would guess my needs and take care of me. I grew accustomed to this treatment and had even less of a desire to create normal relationships or assert myself. I was afraid to sleep because of the terrifying dreams that haunted me nightly.

My mom went to college, my brother got involved with girls, and I hit puberty. Confused by my newly discovered sexual impulses and the abandonment by my caretakers, my fantasies took a darker turn, and I turned to voyeurism. I also stared off into space for hours while my peers played, studied, and dated.

I won a full scholarship to college, where I blossomed into an alcoholic. I had run-ins with the police, hospitals, and mental institutions, either after cutting my wrists, breaking and entering, or committing arson.

Hard drugs took me to sordid places, and I caught many diseases from prostitutes, but when I was selling drugs, I felt like a man for the first time. People were coming to me and I had what they wanted. My brother died with a needle in his hand, bought by the money I had made selling drugs to others. I, myself, was beaten unconscious and left for dead on the street. Despite losing my sense of smell permanently, I recovered most of my brain function, and then I picked up a book on meditation.

I started attending spiritual and addiction recovery groups, where I was driven by terror, contempt, and infatuation towards the senior members. As a kid, I had a different personality for each family member. I still reverted to a child-like state in front of women and I froze up in front of male authority figures. I had tried therapy but it brought out a rage that I couldn’t contain. Some members of my religious community liked my dedication and wanted me to become a formally ordained member, while others were afraid I’d kill myself at any moment. Amid the chaos around my ordination, relationships shattered and before attacking myself or anyone else, I went to a trauma program at a mental institution.

I wrote down everything I could remember. Until then, I was juggling my memories and couldn’t see the whole picture at once. The doctors asked me if I ever played with other kids growing up, or if I ever dated anyone, and I cried when I realized I was different. I later learned that many people are different in some way, and each person has a unique beauty too.

I started seeing that in addition to all my pain, I was also loved more than I had realized. I learned to appreciate moments of connection with others, and to tolerate the persistent discomfort. People asked me to mentor them, which made me feel special, but after a while I realized that I was putting myself above others instead of making a real connection. I still mentor others, including prisoners, but I try not to take myself too seriously. When I do, someone usually knocks me down and reminds me to chuckle at myself.

I have some happiness today because I’m determined to tolerate the pain of being with others, for the modest benefits that come from it. It’s hard for me to get any help when I’m hurting, because I don’t relate well to people, even when we share the same experiences. But I pick up the phone, pray, attend groups, write, meditate, read, walk, and listen to music, and somehow the support seeps in, even though none of the above are as satisfying as I would like.

I’ve been diagnosed with PTSD, schizoid personality disorder, major depression, generalized anxiety disorder, sexual disorder N.O.S., impulse control disorder, and chemical dependency; with “rule out” diagnoses for mood disorder N.O.S., dependent personality disorder, and antisocial personality disorder. I get overwhelmed easily and my mind turns to dark places. I’m also determined, caring, resourceful, and funny. I work as a research scientist. I write and perform skits and songs for kids and adults, which are amusing and educational. I make a difference.