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Not OK? That’s OK

Normalizing mental-health struggles

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Elizabeth Smalling, Mike Shulak

Elizabeth Smalling says she and her fiancé, Mike Shulak, understand each other’s issues. “He gets me even when I drive him up the wall,” she says.

Elizabeth Smalling puts people at ease with her kind eyes and a disarming smile. She is an engaged, professional woman in her 30s who also happens to be diagnosed with bipolar disorder.

Elizabeth has experienced enough hardship for two people, but you wouldn’t know it by looking at her. After 10 years of struggling with mental-illness symptoms, she is aware of her triggers and coping mechanisms. Her ongoing treatment includes an array of doctors and therapists as well as medication management.

Elizabeth speaks with self-awareness. “I’m not bipolar, but I have bipolar,” she says. “I have to know myself in order to overcome that, to know what I like, don’t like, what offends me and what bugs me.”

Although Elizabeth is at a stable place in her life now, it has not always been that way. Traumatic experiences in her youth contributed to thoughts of harming herself and preoccupation with her own death at a young age. Elizabeth remembers writing letters to God at age 13. “I was asking God why my grandmother died in the car accident and I didn’t.”

Her manic behavior increased as a teenager. “My dad would often find me playing soccer in the living room at 2 a.m. My coping mechanism at the time was to just stay busy. I did every sport and activity,” she says.

Once Elizabeth moved out of state to attend college, her manic behavior rapidly increased. In her psychology classes she began to learn about mental illness and gained more self-awareness about her own symptoms. Her erratic and sometimes reckless behavior led to a number of hospital stays, one lasting a couple of months.

“Being 21 and living in a hospital, now that’s traumatic,” she says. After years of doctors, medication management, in-treatment programs and a strong support system, Elizabeth has found stability in her everyday functioning and life.

At this point, Elizabeth has an episode about once a week. “Recently, I had a work day that ended in stress, and then had to drive in traffic across town to meet a friend for dinner. By the time I got there I could barely order my food. My thoughts were out of control. Sometimes I think I won’t be able to make it home. And sometimes I don’t remember how I got home.”

Her fiancé, Mike Shulak, adds, “She initially gets overwhelmed by reality and then quickly overwhelmed by random, unreal and obsessive thoughts.”

Mike says he knows that if Elizabeth says she is not feeling well she needs an hour or two to relax and calm down. “She has that zombie look, like she’s not present. And sometimes asking too many questions can make things worse,” he says.

For Elizabeth, recovery is accepting who you are, being proud of your successes and learning from your mistakes. She finds comfort in her support system. “My dad is really good with boundaries and has a really kind heart. He’s there when I need him,” she says. And her mom knows when to check in, when to give her space and when her fiancé has it covered.

“He knows my story and I know his. He understands mental illness,” Elizabeth says of Mike. “He gets me even when I drive him up the wall.”

Elizabeth attributes her wellbeing to continual self-awareness and self-education and knowing that she has resources. She says she knows if she has a bad day she can turn it into something good. When told she is inspiring, she smiles and says, “I’m just a normal person.”

Stigma around mental health issues often results in an uncomfortable silence. Admitting to seeing a therapist unfortunately prompts a laundry list of assumptions and judgments. Maintaining privacy about one’s health is appropriate, but embarrassment or shame shouldn’t be attached to the courage it takes to seek help.

“Mental illness is a part of life. If someone doesn’t have it, someone you know does. It’s out there, and we need to do something for people to feel safe,” Elizabeth says.

The topics of depression, anxiety and mental disorders are gracefully danced around among family and friends, but the reality is that you can throw a stone and hit several individuals who are experiencing mental-illness symptoms. According to the National Institute of Mental Health, about 1 in 5 people over the age of 18 have experienced an anxiety disorder over the past year.

How many times have we flippantly said, “She’s gone postal,” or, “He’s so bipolar?” We don’t always know who is in our company and the struggles being faced. We can choose to stop contributing to the stigma around mental illness and instead talk about normalizing it.

Knowledge strips away mystery and misconceptions. Elizabeth is doing her part by running a weekly women’s recovery group focusing on relationships. “Hearing others’ stories helps with my own recovery. Being of service gives me an outlet. I don’t feel stuck in my own head,” she says.

She recommends the National Alliance on Mental Illness (NAMI) as a resource for information. “In order to understand mental illness,” she says, “you have to be educated.”

Editor’s note: Writer Allie Burrow is a licensed clinical social worker who works in mental health.

Common mental-illness symptoms include:

  • Feelings of helplessness and hopelessness
  • Loss of interest in daily activities
  • Appetite or weight changes
  • Loneliness
  • Inability to enjoy pleasure
  • Excessive guilt
  • Lack of concentration
  • Repetition of thoughts
  • Sleep changes
  • Anger or irritability
  • Loss of energy
  • Self-loathing
  • Feelings of panic, fear or uneasiness
  • Nausea
  • Shortness of breath
  • Feeling keyed-up

While these symptoms don’t cover the breadth of mental-health struggles, they are especially common with depression and anxiety.

Coping skills are unique to each person, and a strategy that works now may not work forever. Sometimes the best way to keep coping skills effective is to mix them up and utilize several.

  • Deep breathing exercises
  • Progressive muscle relaxation
  • Medication management
  • Walking
  • Exercise
  • Yoga
  • Diet modification (ex: amount of sugar intake)
  • Guided meditation
  • Positive self-talk
  • Time in nature
  • Journaling
  • Increasing social interaction
  • Talking to a trusted friend or family member
  • Hitting a punching bag
  • Engaging in a creative activity: drawing, writing, photography, painting
  • Engaging with your five senses: forces you to be in moment and out of your head
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