Mail: trapped by mental illness.

I’m behind on answering emails, so there will be a lot of that today.  Some of them will find their way onto the blog.  The first comes from Hank (name changed).

I’ve been following your blog since I saw your talk at [my school]. When I saw the video of your talk at Skepticon 4, it felt like the push I needed to start looking for help. After that, I read every post on your blog with the mental illness tag in order to build up the motivation/courage/trust to write this email. I am so glad that you and everyone else have made your stories public. If it wasn’t for reading those, I probably would end up suffering in silence for who knows how many years. You have helped me realize that I want and need help. Thank you so much for that.

However, I still don’t feel ready to make an appointment and see a professional who can actually give me treatment. The idea of going and setting up an appointment scares the shit out of me. Even writing this email is causing a strong fight or flight response. It has been two weeks by now of writing and rewriting this email both in my head and on my computer, and I still don’t know if I will be able to send it.

I think the best option for me at least in the beginning is to see one of my school’s free councilors and have them work with me to figure out what I should be doing for treatment. This is why I am emailing you, I am hoping you can help me to make my first appointment and get started on fixing my brain. I expect you’ll say something along the lines of getting a friend to help me make the appointment and make sure I actually go to it. I would rather not do this though as I don’t think I’m ready to “come out” to any of my college friends about this. I’d rather at least get a start on treatment of some sort before I tell them. If you can think of anything else that might help me take that first step of making an appointment, I would love to hear it.

At this point I’d like to tell you a little bit about my problems. I would appreciate it if you read through the rest of this, but it is not necessary if you think you can help me at all based on what you already read.

I guess the “core” of my mental issues is the depression. It doesn’t seem to be as bad as a lot of what I have read, but it definitely still impairs me on a daily basis. By this I mean that I don’t spend time just crying or unable to get out of bed, but I almost always feel sad and apathetic and it seems like I am living in a fog. It was in my freshman year of high school that I noticed this (5 years ago), but I think I was probably suffering from it even earlier in my life.

One of the two scariest problems for me is my suicidality. I think about killing myself nearly every day. If I make it through most of a day without any suicidal thoughts, I will often notice and these thoughts immediately take over my brain and are generally much stronger than they normally would be. There have been a number of times I think I would have attempted suicide, if my current choice was immediately available. By current choice, I mean that I usually have one or two methods of suicide that I obsessively think about and these methods change or evolve over time. I only remember two times where I had my preferred means of death available and I was very close to going through with it. The first was three or four years ago when I was in San Francisco with my family and we were walking on the Golden Gate Bridge. The second was a few weeks ago when I spent about two hours trying to decide between doing homework and attempting to hang myself from my bed with my sheets. Thank the FSM that I didn’t go through with either of these. I first noticed these suicidal thoughts about half a year after the depression and since then I don’t think I have gone a week without thinking about killing myself.

The other of the two scariest problems is a few terrifying and disturbing fantasies. I seriously hope they are part of a mental disorder, because if these kinds of thoughts are normal, there is something seriously fucking wrong with the human brain. I am not going to go into detail, simply because they are far too fucked up to willingly share. I don’t think I am in danger of attempting any of them, but I would really like these thoughts and ideas to go away.

Next up is something that I suspect is similar to anorexia nervosa, but not quite the same. I don’t know if reading this could potentially cause problems for you with your own illness, so feel free to skip this paragraph. In my mind, I see myself as being quite fat, even though everything else says the opposite. I am 5’ 9” or 5’ 10” and weigh about 140 pounds. Through a variety of online tools, I estimate that I have between 10 and 13 percent body fat. Since I started lifting in September, my stomach has gone from ever so slightly pudgy to the point where I almost have a six pack just because there is nothing left to cover it. I haven’t really been able to monitor the fat on the rest of my body, because there wasn’t much to begin with. Despite this and the mirror showing a skinny, somewhat muscular guy, and my friends calling me a twig, I still feel fat and can’t shake the feeling that I am very overweight. I have never starved myself or forced myself to vomit after eating, but I subconsciously tend to prevent myself from eating more than 1200 or 1400 calories most days. There are times when I eat more (being at Skepticon was especially bad as I was eating at restaurants twice a day) and then I feel bad and angry at myself for the rest of the day. I don’t know when these feelings started, but it was definitely sometime in the past three years. Also, I have never actually been overweight, I am currently the heaviest I have ever been which is about 5 pounds more than I weighed before starting weightlifting. I am surprised and pleased that my brain is able to tell itself that this weight gain is purely muscle.

I think the last set of issues I am having is a small number of delusions that I know are wrong, because they are contradictory to my rational worldview. The first has existed in one form or another for as long as I can remember. It is this idea that I am the only “real” person in the universe. I believe that I have the only working mind and every other human and animal is essentially a robot that was created specifically for my existence. If you have ever read Breakfast of Champions by Kurt Vonnegut, this belief is very similar to that of Dwayne Hoover. The next delusion is that the universe is actually a simulation, most likely a video game being played by some advanced race. I don’t know if it is single player and I am being controlled by some being playing this game or if it is like our MMORPGs and everyone is just an avatar being controlled by these beings. I realize that these first two can go together or be entirely contradictory, but either way, they both seem true to me. They also go against my atheism, but somehow my brain is able to say that there is no god and the universe and life evolved naturally and that the universe is a simulation/video game and that I am the only thinking being in the universe all at the same time. The last delusion I have is that there is a huge conspiracy against me, possibly involving every human alive today and maybe even every human in history. I don’t know why or what the intent/goal of this conspiracy is, but I am sure that it exists. I am also very confident that you are going to use this email to aid the conspiracy in some way. I realize how crazy that sounds and that you are hopefully going to use this information to try to help me, but I can’t shake the idea that you will instead use it to harm me. This is a major part of why I have had so much trouble seeking help in the past and why it took two weeks to get this email into its current state.

So hopefully you see why I need help and you have some ideas or advice for me. Even if you don’t have any way to I really appreciate everything on your blog about mental illness, it has been extraordinarily helpful to me. I think between reading your blog and writing this email, I may be able to seek help on my own, as it definitely seems many times less terrifying than it did just three months ago.

Thank you for anything and everything,



First, thanks for giving me permission in subsequent emails to respond publicly.  Believe it or not, you are not alone in the way you are feeling, and there may be others who benefit from seeing the questions on their mind asked by you.

I know you don’t want to come out to anybody, but you need to.  Part of having a mental illness is realizing that you cannot trust yourself sometimes.  I know that’s a tough pill to swallow, but it sounds like you already acknowledge this.  When you can’t trust yourself, the only remaining option is to trust others.

So trust me: tell a friend.  Show them this response from me:

You need to see a doctor.  Trust me on this.  This is how you get to feel better.  You also need to trust someone else closer to you than I (though I’m touched you felt you could trust me).  If you are a friend of Hank’s reading this, please sit by him as he makes the appointment and go with him.  I know this situation is uncomfortable for you and Hank, but things can return to normal and it starts with treatment.

Hank, sometimes it hurts to be healed.  My father always used to tell me that advice is what people ask for when they know what they need to do and they don’t want to do it.  I know you want any other way to be healed other than ways that make you feel like a burden to others.  Sadly, that’s not really an option with minds like ours.  I’m not going to lie and say that people around you aren’t burdened by your affliction.  I’m not close enough to you to know that and, frankly, I know that mental illness burdens everybody around us, even when we’re trying to hide it.  Just realize that friendship means sometimes there are burdens, sometimes heavy burdens.  Just like you’d want be there for others in your life when they are struck with misfortune, trust them to want to help you become better.

And besides, if you want those burdens to stop, then get help.  Don’t try to hide them, that never works.  Work to get better, that’s how the tension ends.

Your brain is creating every horrible scenario and presenting them to you as probable outcomes.  But they’re not.  You need to trust people like me who have an objective view of what’s going on.  Take this email for example: of all the worry you had about how I’d react, do I seem even the least bit put off?  I hope not, because I’m not put off in the least.  I’m actually more impressed with your fortitude than anything.  I accept you not as someone who is weak, but as someone who is suffering.  Trust others to have the same reaction.  Sadly, some will not understand, but others will understand and you need them right now.  Find them and trust them to interpret reality for you.  :)

It’s like I always say: if doing the right thing were easy, everybody would be a good person.  I know this is hard.  Email me and keep me updated and take the first step.  Tell a friend.  Tell a doctor.



  • Twirlgrl

    Hank, I don’t know you but you have my support. I hope you are able to get the help you need. You will be so glad you did. Wishing you peace and strength. ♥

  • JohnH

    Hank, treat this like any potentially life threatening illness. You have nothing to fear from seeking help. You owe it to yourself and the people who love you to do your best to treat your illness by seeing a doctor. Whatever you do, include daily exercise. It’s factually better than any anti-depressant.

  • Adam

    I’d like to say as someone who is just on the other side of that barrier that you are facing, it is worth it. whatever anxiety or fear or embarrassment it costs, its worth it. Six months ago I was at the bottom. Suicide wasn’t just an option it was an inevitability. I knew that I would probably not be alive a year from now. My next major depressive episode would have likely been my last. out of desperation I sought help. it was hard, real hard, but worth it. I am now medicated and in regular therapy. Im not well yet, but I am more optimistic about my future now than I have been in a long time. Also your school councilors are a great place to start. they may not be able to provide everything you need, but they can help connect you with people who can.

  • Rovin’ Rockhound

    JT’s advice is, as usual, right on the dot. You don’t need to tell a friend before getting formal help, though – when I first started therapy I was not in a position to share the details with someone who was a regular, public part of my life, and I didn’t have any friends who would drag me to a shrink without trying to solve my problems themselves. Going at it alone was the best choice for me.

    Many college and universities, at least in the US, offer free mental health services at their health center. Many also have counseling services through the office of student services (and it’s often the same people). I would highly recommend you skip student services and go directly to the health center. It takes a lot of guts to first walk into these places and then sit in front of someone you don’t know and tell them everything – you might want to avoid having to do it twice (once to the student services counselor and once to your permanent therapist).

    Sorry – this is long – but even if it doesn’t help Hank (or someone else) to read other people’s stories, it’s helpful for me to write it publicly.

    I’ve been in therapy for about a year and a half and had (and still have) issues that sound much like yours. It’s been the most terrifying, exhausting, and empowering thing I have ever done. I finally got help out of desperation – the options at that one moment were either walk home and quit grad school, knowing I would eventually kill myself, or walk into the health center and make an appointment. So I walked to the health center (I couldn’t get myself to call). The man at the desk was so nonchalant and friendly about a ghost-white girl, shaking like a leaf and laughing nervously, making an appointment that for once I felt moderately safe – if he wasn’t worried about me, I couldn’t possibly be such a hopeless case. The only person I told (via chat – couldn’t do it in person) about making an appointment was one of my labmates. I needed someone to keep me from canceling, and he has a forceful enough personality I wouldn’t be able to argue my way out of it. I met with my shrink a week later, and while it was incredibly difficult, there was also this amazing relief of having someone else carrying some of the weight (and then I went home, ran 10 miles way too fast, and puked, but hey, it was good). He is just the right combination of empathetic and no-nonsense to keep me honest, he’s fully secular (thank dog), and he plainly (and sometimes brutally) places what I’m saying into a scientific context (it’s painful to see it labeled, but it’s very useful to step back and observe it objectively – there have been many “holy sh*t!” moments). For the first few months it was clearly CBT, but he’s gradually switched to DBT as the issues have changed. Somehow I got placed, basically randomly after walking into the health center, with the absolutely perfect therapist for me (and because it’s through my university, it’s completely free).

    If I could do it without fully outing myself, my dissertation acknowledgements would be to him for three paragraphs, and then everyone else in the last few lines. He’s the only reason I’m going to graduate, I’m not going to leave my field, and I’m not moving into a cave to become a hermit and abandon the world.

    TL;DR -> Hank, just walk to the health center and make an appointment. Lots of us have been there, and it will get better.

    • Rovin’ Rockhound

      Holy cow, that’s long. Sorry about that. In my defense, I recently (late last week, after 23 years of formal schooling) got diagnosed with ADHD and just started new meds. It turns out that they work quite well. Yesterday, my attempt to write my name in sharpie on my new coffee mug ended, four hours later, with a very cool looking henna-like design over the whole thing. A quick reply to JT’s post ended in this.

  • ewok_wrangler

    Although certainly “Hank” should start with his school’s clinic as being easily accessible and free, you might mention in case he wants to find further help.

    Also, especially with regard to those “terrifying and disturbing fantasies”, the biggest benefit of learning mindfulness meditation is that you acquire the understanding that fantasies are simply what minds do, and it is perfectly possible to just sit quietly and watch them form and (this is key) watch them pass away again — like clouds on a summer day — leaving you unchanged. “Hank” may not be in a place just now where he can learn or enjoy meditation, but later on, with immediate crises stabilized, it could be a useful tool to have.

    • Sarah

      I sat in a cognitive behavioural therapy group class as the instructor explained that those vivid images of yourself doing bad things were part of OCD and every single person in the room visibly relaxed becase we’d all thought we were latent psychopaths.

  • John Moriarty

    As one of those lucky hard-asses that fight and fight and has won against lesser pain than you, just get to a doctor NOW.

  • John Horstman

    Hank, you’ve already conquered what was the toughest part of therapy for me: wanting to get better and asking someone for help getting treatment. It’s really the first step and far and away the most important, since even the best therapist can’t do a whole lot for someone who doesn’t want help. Congratulations!

    I just wanted to add my voice to those agreeing with JT’s advice and let you know that you’ve already done something I found really hard, in case you’re feeling or get discouraged. We’re rooting for you, and make sure to keep in touch with JT and the WWJTD community here.

  • Mara

    ::hugs:: Good luck, Hank! It’s definitely difficult to ask for help and admit the crazy things going on in your brain, but you can do it. You can, I swear.

    BTW, if you’re worried about those fucked up things in your brain, keep in mind that you don’t need to walk into your first appointment and announce “I think about fucking sheep all day!” (Or, y’know, whatever.) Ask for help with the suicidal thoughts and depression and later you can get comfortable enough to tackle the other issues. You don’t have to bare your every secret immediately as long as you get the process started as soon as you can.

    Hang in there and get help so you can get back to being a college student.

  • neatospiderplant

    Internet hugs to Hank. I wish I could do more than offer my best wishes over the internet.

  • Liz B.

    As a bipolar girl who was raised being told that only crazy people go to shrinks, I know how hard it is to walk into an office and get help. For me it was my doctor’s office. I told him I was depressed and within a half an hour I was in the psychiatrist’s office getting help. It was so quick because they didn’t know how depressed I might be. If you can’t bring yourself to walk into the campus health center, maybe you can go to your doctor and tell them. They can refer you to someone who can help you as well. It’s scary as hell and I was shaking like a leaf talking to the psychiatrist afraid he’d judge me and tell me that, boy was I crazy. Being diagnosed was actually a relief because it meant they knew what was wrong and could fix it. I cried from fear that there was something fundamentally wrong with my brain while I was telling him what was wrong and from relief when he told me what it was. I am on 3 medications right now for the bipolar and anxiety and I am living a normal life. I didn’t even know what normal looked like from inside before and I was a little scared to let go of the obsessive thoughts and manic highs because I didn’t have any idea what the world might look like without them. It felt like being stripped down to the essential me. I am who I always was just without the distractions of the illnesses. It won’t take anything away from you but the bad stuff that you hate. You’ll be a better version of yourself and able to focus on the things that are important to you instead of aways being sidetracked by scary thoughts and fantasies and fears. That first step is scary but you’ve done one scary thing and nothing bad has happened. Your psychiatrist and counselor won’t judge you, I promise. Get the help you know you need and see the world around you as a new and beautiful place, without the fears and helplessness and hopelessness you feel now. It’s not an overnight thing but it’ll happen and it’s amazing.

  • Hank

    Hi everyone, this is Hank. Thank you all so much for your support. I just emailed my school’s counseling department requesting an appointment next week. I also talked to a friend who said she will make sure that I go. I’m scared as hell, but also excited to be getting started on fixing my problems.

    Thank you so much,