When fighting a mental illness, sometimes it’s not all just in your head but it turns physical as well. This is especially true when dealing with medication changes.

My mood has been stable for about two weeks (yay!) and I have started taking Lamictal, an anti-epileptic drug used to treat bipolar disorder. Starting Lamictal is a slow process due to the risk of a life threatening rash. It’s extremely rare, but still psychiatrists start the drug slowly. Increasing it every two weeks until optimal levels are reached.

However, while still getting used to the Lamictal in my system I am also starting to reduce the Zoloft and Seroquel that I’m taking. I hadn’t realized the dependence I had on these drugs until I started reducing them. Drugs that alter the chemical composition of your brain are also highly addictive. And because of this, the slightest reduction in dosage cause extreme physical side effects.

In an attempt to quicken the pace of my medication changes, I agreed to lowering Zoloft and Seroquel at the same time. I’m hoping to return to work at some point in the New Year, but before I can do that, I need to have my medication squared away.

After lowering the dose of both medications, I anticipated a temporary mood change. I anticipated anxiety. I anticipated not being able to sleep well. However, what I didn’t anticipate was the physical toll reducing the medication would have on me.

On Friday, I could barely move because my joints were throbbing and my whole body felt achy. It was all I could do to find a comfortable spot on the couch. My entire body felt like it was being tortured. Yesterday the vertigo started. Every time I stood up, I had to steady myself as the world started to spin. Couple that with extreme fatigue and finding the motivation to do anything was difficult. Even writing this post is hard. My cognitive abilities are diminished. I have to coax out my words from hiding and try to string them together in some coherent sentence.

The positive side of this is that my mood has remained fairly stable throughout this process. And ultimately, that’s what I’m aiming for: stability. Since these past few weeks have been good for me, I have started entertaining the thought of returning to work. It no longer seems like a terrifying prospect. Instead, it’s a goal I’m actively working towards. I want to get my life back to normal and part of that normal is working. When you start to feel well, those really bad weeks or months seem so far away that you start to wonder if they were even real. Was I simply just blowing everything out of proportion? Who was that person who was so depressed? Why am I off of work if I’m doing well?

And then, you do something as small as making medication changes and you suddenly realize why you’re not working. I would not have been able to work with all of these physical side effects happening. I would have been useless to my employer.

It’s not easy fighting a mental illness, but I’m getting there.

You can read more about reducing Zoloft here and Seroquel here.

What role does social media play in preventing suicide and the promotion and glorification of self-harm and eating disorders? This is something that I started thinking about when an acquaintance began posting troubling information to his Facebook page, including a statement that he was planning to take his life.

I’ve only met this person in casual group settings. I don’t have his phone number or home address, otherwise I would have tried other avenues than social media to reach out. Since I had no other contact information, I sent him a direct message that included numbers for crisis hotlines and let him know that I was there for him as a comrade in mental illness. When I didn’t hear back, I was still determined to act. So I decided to try Facebook’s suicide reporting program.

After a quick Google search, I found its “Report Suicidal Content” page. I filled out the required information and pressed submit. Immediately, a pop-up appeared that said something like, “Your request cannot be fulfilled at this time because of a technical difficulty.” This is like a suicide hotline saying, “Your call is important to us, but all of our operators are busy at the moment. Please hold.”

After a few angry tweets and Facebook posts, I did some research. It seems that Facebook’s Report Suicidal Content function is only available to its US users. Nowhere on the page did Facebook alert me to this fact. Here I was thinking that Facebook had failed, but I just hadn’t read the fine print.

For a global social media giant, it seems irresponsible for them to not let people know, in a direct capacity, which features are only available to American users. To date, Facebook has yet to announce when the feature will roll out to Canadian and other international users.

With all of this being said, Facebook hasn’t completely left its international users without resources. Through its Help Center, an individual can find out how to support a friend who is struggling with their mental health and how to prevent suicide. They even have a specific Network of Support for the LGBTQ community. However, it’s worth noting that none of these resources are very easy to find.

So how do other social media platforms stack up against Facebook? It seems as though anyone on Twitter, US or internationally, can report a user who has expressed an intention to self-harm or commit suicide. After Twitter receives a report of self-harm or suicide it says it “[Will] contact the reported user and let him or her know that someone who cares about them identified that they might be at risk. [Twitter] will provide the reported user with available online and hotline resources and encourage them to seek help.”

Twitter also offers its users a quick guide to recognizing the signs and symptoms of self-harm or suicide and also offers resources for users who may be experiencing thoughts of self-harm or suicide. Twitter also has a great list of global trusted partners that they work with, unfortunately Canada doesn’t make the Mental Health list.

As good as Twitter seems in terms of reporting and offering mental health resources, it does get a major fail in letting hashtags like #Cut4Bieber and #Cut4Zayn trend. When both of these hashtags trended globally, Twitter allowed graphic images of self-harm and posts promoting suicide overload users’ feeds without interceding.

Tumblr, which was notorious for self-harm and pro-anorexia blogs, finally interceded in 2013 with new guidelines for users. Now when you search Tumblr using terms like “suicide” or “self-harm” it automatically redirects to a screen that asks, “Are you okay?” with resources. Or, if you look at their Community Guidelines they have an easy reporting system that allows you to directly report the URL on their site.

Some people may say that businesses and social media platforms have no role or responsibility in interceding in their customers or users personal lives. However, in an age where we’re sharing more and more of our personal lives online, it just seems like a no-brainer to me.

This post originally appeared on Ravishly.

When you think of someone with a mental illness, what comes to mind? Is it a bedraggled homeless person in the street? Is it someone wearing a straight jacket screaming bloody murder in a padded cell? Is it someone who goes on a shooting spree at a high school? If that’s the case, then you’d be wrong.

What if I told you that someone with mental illness is more likely to be your neighbour whose kid plays with your own? What if I told you that your barista who remembers your complicated coffee order had schizophrenia? What if I told you that your cousin has bipolar disorder?

Movies, news outlets, and other media have conditioned us to think about the “mentally ill” in very specific ways. As someone who suffers from bipolar disorder, I often think about what the public thinks mental illness looks like. I’ve spoken in the past about how I’ve been told by multiple doctors that I don’t look like someone with a serious mental illness.

However, more recently I’ve been thinking about social media and how we curate our lives. The photos I post to Instagram and Facebook are very specific moments in time and create a version of my life that isn’t necessarily reflective of reality. They are carefully chosen moments in time that I want people to see. From the outside, you would never think that I have a serious mental illness that has incapacitated me for the past two years. So, today I’m lifting the veil and revealing what was behind that photo I shared.

This is my husband and me Christmas 2014. At this point I was off of work for three months because of my mental illness. We had traveled from Montreal to Toronto to spend time with our respective families. I spent a large majority of this time racked with anxiety. I felt so guilty having to excuse myself from situations to go and sleep because the anxiety had completely wiped me out.

This is my husband and me in February 2015 at the premiere of the Clara’s Big Ride documentary. I was one of the subjects chosen to speak about my mental illness for the film. A few days prior to this photo being taken, I was informed by HR that my job would be posted and they needed to take my work cell phone back. I was so petrified that I was being replaced at work I decided to return instead of continuing my sick leave and taking care of myself.

This is a selfie I took while riding a shuttle between university campuses. I was back at work (I work in media relations for a local university) and I was helping a film crew scout locations for a movie they were hoping to shoot in the summer. I was miserable at work and was hanging on by a thread. I had just started taking Lithium and was dealing with horrible side effects. But doesn’t my hair look awesome?

This was a selfie I took with my sister downtown Toronto May 2015. I was only in Toronto because my husband was presenting at a conference and I was so suicidal that he was afraid of leaving me alone for the weekend. A few days prior to this photo being taken, my boss had called HR because of my odd behaviour at work and I was forced to go back onto disability. Not exactly the picture perfect scenario.

I’m going to say something that you’re not really allowed to say because it sounds like I’m bragging BUT I really like this selfie of me. I was extremely depressed when it was taken. It was the summer and I was in the middle of an out-patient hospital program. Lithium was making me extremely sick and I had been suicidal on-and-off. I was also struggling with thoughts of self-harm. I took the picture to show off my red lipstick that I had just bought in an attempt to make myself feel better. The lipstick looks great, but I felt like shit.

This photo was taken only a couple of months ago at a book signing event with Clara Hughes. You wouldn’t know from my smiling face but the crowd of people at the event had caused me a massive anxiety attack. It was so bad that I thought I was going to have to leave before I could hear Clara talk.

Finally, this photo was taken only a few weeks ago during Thanksgiving. My husband and I were all dressed up to go to a family dinner. I’m fairly certain that before this photo was taken I hadn’t showered in a few days. I was dreading the thought of going out because I was so depressed. Instead of bailing, I put on my mask and took a family photo with our new kitten.

I hope by telling the stories behind each of these photos, I have helped you rethink what mental illness looks like and how we choose to portray our lives on the internet. The next time you see a smiling selfie and think about how happy that person looks, remember there’s more than what meets the eye behind that photo.

In terms of mental illnesses, I think anxiety should be the easiest for people to understand. Everyone’s experienced some form of anxiety at one point in their lives. You’ve probably experienced butterflies in your stomach or tightness in your chest. Anxiety’s that feeling you get right before a presentation at work, a big exam, or even a hot date. These are all normal situations that deserve a small amount of anxiety. Despite all of this, it’s still hard for people to really understand what it’s like to have an anxiety disorder.

Anxiety disorders are a serious mental illness. They occur when a person has persistent or chronic anxiety that causes distress and interferes with their ability to live their life. There are a few different varieties of anxiety disorders, which include: panic disorder, social anxiety disorder, phobias, and generalized anxiety disorder. Common symptoms that people experience when having anxiety are:

• Feelings of panic, fear, and uneasiness
• Problems sleeping
• Cold or sweaty hands and/or feet
• Shortness of breath
• Heart palpitations
• An inability to be still and calm
• Dry mouth
• Numbness or tingling in the hands or feet
• Nausea
• Muscle tension
• Dizziness

Since I’m extremely lucky, I not only have bipolar disorder but I also suffer from an anxiety disorder. This is common in people with bipolar. Psychiatrists refer to this as comorbidity.

People often ask me,  what sets off your anxiety? It can be a variety of things or nothing at all. For example, grocery shopping is a massive anxiety trigger for me. This may sound absolutely ridiculous to you. But the idea of figuring out what to eat, making a list, picking out products, and enduring the actual shopping trip induces extreme anxiety in me. I once had an anxiety attack trying to pick out napkins because there were too many varieties and I burst into tears in the middle of the aisle. Another time the crowd of people was too much for me and I abandoned my cart and resigned myself to take-out. This is the joy of having an anxiety disorder. Things that are simple or no-brainers for others cause me extreme anxiety.

Since anxiety is so much fun, some days I just wake up with it. My whole body is tense and my hands and feet tingle. I get out of bed feeling like I’ve forgotten something important and can’t remember what it is. This feeling can last all day and can make me exceptionally irritated. It makes focusing on tasks difficult and often makes me seem like my head is in the clouds. On these days I also tend to be very edgy.

Besides the symptoms mentioned above, I also get what I call sensory overload when I’m experiencing anxiety. Apparently, as I was doing some research for this post, this is a real thing that’s common in people with anxiety.

Last week I was making my weekly visit to the pharmacy and I realized it was just a bad day to leave the house. My heart was fluttering in my chest and the familiar pins and needles feeling was spreading over my body. Despite the cloud covered day, everything was too bright and I had to put on my sunglasses. Sirens from a firetruck made me jump out of my skin. The overstocked shelves in the pharmacy felt like they were closing in on me in a blur of colours. It was all I could do to make it to the pick-up counter and pay for my pills. My body was screaming at me to flee from the situation of apparent danger because that’s all anxiety is. It’s a reaction to danger. Except in my case, there isn’t any actual danger other than an over stimulation of my senses. By the time I made it home, all I wanted to do was hide under a blanket until my medication kicked in.

This is why living with anxiety can be so difficult. It makes living my life almost impossible at times because the simple act of leaving my house may set off an attack. It’s like the entire world is conspiring to make me feel like complete shit and I never know when it’s going to happen (which in and of itself is anxiety inducing).

So, if anyone ever admits to you that they have an anxiety disorder, don’t ever tell them that they “just need just to relax.” Because if it was that easy, I think we would have figured it out by now.

I was introduced to the concept of “bipolar treatment fatigue” by mental health blogger, Natasha Tracy of Bipolar Burble. Her definition of “bipolar treatment fatigue” is:

[W]hen a patient with bipolar disorder becomes burned out because of all the time and effort it takes to fight the bipolar disorder.

I don’t think this type of treatment fatigue is unique to those of us with bipolar disorder. Frankly, I think it can happen to anyone with a chronic illness.

There are those people out there who think chronic illnesses are just an excuse to be a lazy, parasitic, attention seeking baby. They have no idea how much energy it takes to be sick and how hard it is to fight day after day. It’s just what happens when you’re fighting your body or brain (or both) day after day. It’s what happens when you have so many doctors appointments that if your life was a play the scenery would be a series of waiting rooms with outdated magazines. It’s what happens when you become a medication guinea pig and you wonder, is this all worth it? They have no idea what it’s like to adjust and readjust medication until your brain doesn’t know if it’s going left or right anymore. And it’s not just testing new medication, but it’s also the side effects. The physical cost of coming on and going off so many medication.

We stopped Abilify because it was making me restless, anxious. and unable to sleep. My psychiatrist prescribed Latuda to help with my low mood, but it mixed with the Abilify still in my system and caused the psychotic and paranoid features of my anxiety attacks. To deal with that she then prescribed Propranolol, which didn’t make me feel any different. Now I’m coming off of the Latuda, starting something called Saphris, and reducing my Zoloft by 50 mg. Are you lost yet? I’m losing track of what I’m on and what I’m not. I’m losing track of dosages and what the medication is supposed to be doing. Which do I take with food and which do I take without? Which makes me drowsy and which causes me to be awake?

Right now, I’m fed up and frustrated with medication. There are some mornings that I stare at all the coloured capsules and tablets and wonder: is this really worth it? Some mornings I just want to flush all of my medication down the toilet and let the chips fall where they may. I want to stop seeing all the doctors and therapists and just let my illness take me away into whatever direction it wants to go. Maybe that’s just the nature of things. That’s how I’m supposed to be.

But then the rational part of my brain kicks in and reminds me how bad withdrawal would be. I could actually die if I just stopped taking all of my medications cold turkey. I remind myself of the fact that all of my important relationships would probably fall away as I fell deeper and deeper into the muddy sickness of my brain. I remind myself that I would most definitely end up in the hospital again. I remind myself that being sick isn’t a way of life either.

So for now, I keep taking my pills as prescribed. I keep going to my appointments. I keep doing all of the things that are supposed to promote good mental health and maybe one of these days my brain will cooperate and I’ll be able to reenter the world, healthy and happy.