Hi friends-

When I scheduled this zoom months ago I did not realize it conflicted with the college football national championship game, but that’s okay! DVR the game, start it an hour late, then zip through the commercials. :)

Come hang out with me tonight at 5:30 PM PT/8:30 PM ET as we discuss “The Body Keeps the Score” by Bessel van der Kolk:

Join Zoom M…

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Hi dear ones-

There’s been so much talk about how we are in an unprecedented mental health crisis. Things were already trending badly with the proliferation of social media beginning in the early 2010s. Then, the isolation of the pandemic threw gasoline on that fire.

I’ve been open about my mental health struggles in the past, and …

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Like many of you, I was watching Monday Night Football when Buffalo Bills safety Damar Hamlin sustained an injury trying to tackle a Bengals player and went into cardiac arrest. We still do not know what happened to the 24-year-old to cause him to collapse, but expert cardiologists seem to believe he suffered a very rare …

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Hi friends-

Come join us on zoom for an hour of uninterrupted creativity at 10 AM PT/1 PM ET . You don’t have to bring anything but yourself, and you can keep the camera off the whole time if you prefer. We’ll talk about things we are working on, encourage each other for a few minutes then we’ll be off on our own. At the end of the hour we will wiggle our arms and legs and let out a few deep breaths and say goodbye to 2022.

As a reminder, you do not have to be a writer to join us, though it’s fine if you are. We have composers, computer programmers, chefs, de-clutterers, painters, therapists, lawyers…. you might even just pick this hour to listen to (or play) music without looking at your phone, or write thank you notes to those who gave you holiday gifts. Come as you are. Be gentle with yourselves.. Do what you need to do. Organize your junk drawer.

This zoom is open to all paid subscribers and the link is below the paywall. Hope to see you in there.

Also, if you can’t make the Lab we are beginning our 13-week Artist’s Way course for paid subscribers on January 9th. Email me if you would like a spot in that group.

Happy New Year!

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Hi my lovelies. Merry Christmas Eve!

We will be meeting in a half hour at 10 AM PT/1 PM PT today for an hour of uninterrupted creativity. Maybe you are wrapping gifts. Maybe you are sorting out your recipes for Christmas dinner. Maybe you are working on the next great American novel. Maybe you just need inspiration from people who are trying to carve out quiet time for themselves away from their smartphones and TVs and relatives so you can be recharged for later festivities. Maybe you are alone and wanna come hang with us because you’re bored.

Whatever your reason, we’d love to have you. If you’re already a paid subscriber, you will find the zoom link below the paywall. If you are on the free list but would like to start joining us for these zooms, you can sign up to become a paid subscriber now:

Subscribe now

In January we will once again do our 12 week Artists Way Course, available for all paid subscribers. I’ll send an email out next week with the details once I sort out what day and time of the week is best. (I’m leaning Monday evening, once again).

I love you all and hope to see you in the Zoom. I know it’s a holiday eve so we might only have a few people today but it doesn’t matter to me if we have 2 or 100, it’s just as meaningful. Hope to see you in there!

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Many of you have been asking about creativity workshops. We will begin another 12 week Artist’s Way Course every Tuesday starting in January. But until then, we will meet over zoom for the remaining three Saturdays in December from 10 AM PT/1 PM ET until 11 AM PT/2 PM ET for an hour of uninterrupted creativity.

These zooms are for paid subscribers. You don’t have to say anything and you can just keep your camera off if you want to.

Consider this like an exercise class but for whatever you want to work on. I don’t care if you are simply going to sit there and start jotting things down you might like to do…a cooking class you want to take, a museum exhibit you need to buy tickets for… Maybe you just want to sit and journal. Come as you are. Since we’ll all be on mute, you could even just sit listen to a whole album of music uninterrupted without looking at your phone and let it wash over you. This kind of focused attention on art might actually improve your mental and spiritual well-being for the whole weekend. So let’s try it!

If you are already a paid subscriber you will see the zoom link below. If you are not a paid subscriber you can sign up to get the zoom link below. See you soon!

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Hi friends-

I wasn’t planning on turning this newsletter into a weekly update of how I’m doing medically, but that’s where we are for the time being. I thought I’d feel well enough to write about the Yankees and Dodgers and Mets and Cardinals and Orioles and Blue Jays and Padres and Braves and more this week, but amid doctor’s appointments and fighting with my insurance company, caring for my dog, taking slow walks, brushing my teeth, and showering, the only energy I had left was for napping.

I never used to be much of a napper. Now? I sleep from about 9pm to 7 am, then again from 11 am to 3 pm. And I only get up at 3 because Georgie (my dog) has decided he will left me nap for three hours—but he draws the line at four.

Here’s where things stand right now: my cardiologist gave me a seven day sample of a heart medication called Corlanor a week ago to see how I liked it. And oh, I liked it. While I am still exhausted, I feel steady on my feet. The light-headedness and the brain fog and the nausea are gone. On short walks my heart rate no longer spikes to the point where I feel like I might throw up. Corlanor was originally developed to treat heart failure (which I do not have). But after so many people started developing POTS (which I do have) post-Covid, somebody had the bright idea to throw Corlanor at it to see if it helped people with POTS get out of bed. It did.

So, all good, right? I got a diagnosis quickly.

The vomiting stopped.

The spinning stopped

I could remember enough words to do a Wordle puzzle without throwing my phone across the yard in frustration.

I’m no longer at risk for blacking out from my blood pressure dropping like a semi truck off Niagara falls when I stand up, which means I have been able to be alone and I can now drive a car at short distances. I went to the library and checked out two books. All good, right?

Well, here’s the problem. I went to fill my Corlanor script at CVS on Wednesday and they told me my insurance company doesn’t cover it. The out-of-pocket cost for a month’s worth of the drug? $600. I took a deep breath.

A twitter user told me these manufacturer’s really want you to take their drugs, so they offer what’s called a co-pay card—even for those who don’t show dire financial need (read: are homeless). You just have to be paying for a private insurance PPO which I do (to the tune of $700 per month). I applied for the Corlanor co-pay card and was approved. I printed it out and went back to CVS. The lady behind the counter looked at me like I had four heads.

“You need to go through your insurance first for this to work,” she said.

“OK but we just tried to run it through my insurance and they said they don’t cover it,” I said, my face contorting into a sweaty question mark.

“Have your doctor call your insurance company and pre-authorize it and then we can see if they approve it or deny it and we can go from there."

Pre-authorize? Isn’t my doctor prescribing me a heart failure medication in writing a pretty formal authorization that I might need it?

I guess not!

This is a reader-supported independent newsletter. Both free and paid versions are available. The best way to support me and my work (and my medical bills) is by taking out a paid subscription now. But, hey, even free subscriptions help! And we do have a lot of fun here. In addition to our Monday night creativity chats and our Sunday night baseball chats, I’m also planning to add a monthly book club soon for paid subscribers!

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So after the CVS debacle, I went back to my cardiologist for an echocardiogram on Wednesday, and I told the lady in the office who deals with medication about my Corlanor plight. I asked her if she had any more free samples. She looked in the cabinets and said she did not, with less compassion in her voice than I regularly hear from Starbucks baristas when they tell me they’re out of bacon and gouda breakfast sandwiches. Something about the easy breezy way this heart medication lady told me that she was out of the drug that was keeping me functional in society, and that I was basically fucked, caused me to burst into tears.

I told her what the CVS pharmacist told me, that I needed my doctor to contact my insurance company and pre-authorize the drug. “Oh, of course,” she said. “That will be a $75, and they’ll ring you up at the front.”

Uh, what? It sounded crazy. But I was already in tears and had no energy to ask why on earth any good doctor would further gouge a sick person.

My cardiologist wasn’t in, so the woman who handles the medication told me she would have to wait to ask him if I could go without the meds for a few days or if he would switch me to another (cheaper) med. I must have been crying pretty hard because my mom (who was with me, because she has been driving me everywhere, because I now have a heart condition from Covid-19 that makes me too exhausted to drive and also vulnerable to passing out and hitting my head) decided to go back there and have a word with the medicine lady. My mom was nice to the woman, but didn’t get any further than I did, except that she retained the information listed in the first sentence of this paragraph when I could not because I was crying too hard into my n-95 mask.

A word about crying here. It turns out when you are as sick as you’ve ever been in your life, and you are worried you might not ever be well again, and then you think you are beginning to get your life back, anybody who delivers you a setback—no matter how small—and acts blasé about it, becomes your mortal enemy.

My mortal enemy—who is actually totally nice, by the way, I think— called me later in the afternoon and told me that the doctor does not want me to skip a pill, or switch to another medication. She suggested I go back to CVS and see if I can pay for a week’s worth of pills out of pocket instead of the full month while my doctor and the insurance company fight this out.

The lady at CVS (an actual angel) saw how much I was paying for a week’s worth of pills and looked like she was about to faint. So she pulled up some app called Good RX to comparison shop seven day’s worth of my drug at every local pharmacy. “Well it’s $2.19 cheaper at Costco but that’s 4 miles away so probably not worth the gas,” she said. An angel. And I wasn’t making my mom drive me to Costco anyway because we were both too tired. So I agreed to pay $150 for 14 pills, which will (hopefully!) arrive on a truck at 11 am today because CVS didn’t have them in stock. I’m supposed to take them twice a day and I haven’t had any in 24 hours so I’m a bit loopy as I type this but it needed to be written.

am not a special snowflake. I recognize my privilege. I am able to afford to pay $700 a month for a health care plan, even if it doesn’t cover what the drug I need to function right now. I have a mom who is retired and willing to take care of me and drive me to a sad carnival of medical appointments all over Los Angeles where no doctor validates parking. I don’t have a case of POTS so bad that I’m bedridden. I haven’t been disabled by this scourge for years and years and years. I didn’t die of Covid or wind up on a ventilator. Unlike millions of Americans, I don’t have to choose between medicine and food.

My mental health is hanging by a thread, but I’ve been in therapy so long that I at least have basic tools to survive the day to day (e.g. I know what a panic attack is and how to breathe through it).

I’m writing this post because it’s absolutely INSANE that a sick person in the richest country in the world has to jump through all these hoops to get life altering (and in millions of cases) life-saving medications because our health care system is so broken. We are the only first-world country that does this to its citizens. A twitter user from LA who helped me get diagnosed with POTS because his wife developed it post—Covid actually moved to Australia (she’s Australian) because their medical bills in the states would have bankrupt them here. She’s on Corlanor. It costs $39 a month there. My good friend from Belgium figured that if she got the medication there (60 euros) and used miles to fly round trip to LA to give it to me, I would save $440. I may wind up having to get my drug from Canada, where it is also $60 a month.

This price gouging is especially brutal given the recent windfall my insurance company, Anthem, enjoyed. It reported $1 billion in profits in the fourth quarter of 2021, largely due to so many people signing up for coverage during the pandemic. It would stand to reason that millions of people now need extra medical care they did not require before due to the fact that we are in year three of a global pandemic. Anyhem could certainly afford to give me heart medication for a condition caused by that pandemic for free. I pay them $8,400 a year for insurance so that I can access medicine and care when I need it. Well, I need it. It’s the least they can do.

In 2021, Anthem CEO Gail K. Boudreaux was paid $19,348,241. I’m guessing she does not have issues obtaining medication she needs, when she needs it. I bet she can get Corlanor for free, because rich people always get free stuff. The average Anthem employee, however, might be out of luck if they need this drug. Anthem’s median employee salary is just $51,000 a year, which doesn’t buy a lot of gasoline to drive around town comparison shopping a $600 bottle of heart medication her company won’t cover.

People who love me are telling me not to take on this fight right now while I’m still so sick, and that instead I should just focus on getting better. That’s a fair point. But I have to put my anger somewhere and I owed you guys an update anyway. Plus if I’m not going to use the platform I have to bring attention to how broken our health care system is, then what’s the point of having any platform at all?

If you are interested in reading about the government’s massive failure in researching the effects of long covid and what a catastrophic burden it will put on all our systems, Zeynep Tufecki has an excellent substack post here. And she also wrote a wonderful NYT Opinion post yesterday here:

But solving this puzzle could be revolutionary, unlocking the door to understanding many conditions that cause much human suffering.

The 1971 National Cancer Act changed the way scientists deal with disease, pouring money into prevention, detection and research.

Scientists battling debilitating, chronic conditions like long Covid and other postviral conditions deserve this sort of commitment in leadership, funding and recruitment to get the best minds in the fight.

We need a National Institute for Postviral Conditions, similar to the National Cancer Institute, to oversee and integrate research. Neither academia — prone to silos and drawn to work that leads to notable publications, which can leave important questions underexplored — nor the private sector — focused on profits — is up to the task alone.

With such an initiative, we could honestly tell so many looking for answers that help is on the way.

I really hope we do pour billions of dollars into studying our collective health post-Covid. But as with everything else related to this virus, something tells me that the people who never even bothered to acknowledge that Covid-19 was anything more than the flu are driving public policy decisions now, too bored with the disease to keep talking about it, and too callous to give a shit about the millions who died and the millions more who are and will become disabled because of it.

I hope I’m wrong.

Hi friends-

At some point I might write a longer post about the medical trauma I’ve endured over the past month, but I’m not ready to do that today. However, I couldn’t just return to my happy little newsletter without offering at least the Cliff’s Notes version of why I’ve been mostly AWOL since I first tested positive for Covid-19 on July 22. Basically, despite being double vaccinated, boosted, and taking Paxlovid three days into infection, my cardiologist (I have a cardiologist now because of this mess!) says I appear to have won the Covid lottery.

After ten days of feeling the horrible flu like symptoms everyone else with Covid gets, things started to improve, then got rapidly worse. I couldn’t stand up without vomiting. The world was spinning off its axis. I couldn’t look at computer screens, my phone, or a television without feeling like I was going to pass out. Sometimes my vision would go black for no reason at all. Walking unassisted was not possible. Being alone was not possible.

In the span of four days I went to urgent care, the ER, my ENT, and the ER again (because I vomited uncontrollably in my ENT’s office and he said I looked 110 years old and needed to be hospitalized immediately). I’ve been incredibly blessed with excellent health my whole life, and I’ve always been aware of how fortunate that makes me. I’ve lived five minutes from the Cedars ER for 11 years and I’ve never seen the inside of it as a patient.

Two different times last weekend I thought I was going to die, and sobbed while I held nurses hands. (I was never close to dying. They ruled out a stroke, a blood clot, and an aneurysm. My lungs showed no evidence of disease. My blood tests indicated I might live to be 100). Yet everything was spinning and I couldn’t stop vomiting. They thought it was vertigo (no). They put me on an antibiotic for a sinus infection (no). To stop the vomiting the second time I was in the ER, they gave me IV benadryl (good!) and IV reglan (so horrible I screamed and almost ripped the IV out and had to be held down).

Then they sent me home, and told me to hydrate, having found nothing wrong.

This is a reader supported newsletter. Both free and paid versions exist. The best way to support me and my work (and my medical bills) is by taking out a paid subscription now:

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I went to my primary care physician. He noticed that when I went from sitting to standing my blood pressure plummeted. He referred me to a cardiologist.

Finally, yesterday I received a diagnosis from that cardiologist of POTS like syndrome. Basically, Covid wreaked havoc on my autonomic nervous system—the part of all our bodies that is responsible for taste and smell. It’s also in charge of regulating heart rate. My little internal pacemaker apparently doesn’t work right now. When I stood up in the cardiologist’s office yesterday, my heart rate jumped from 80 (already high for me) to 128 (uh..what?). That’s just standing, not moving. I got dizzy again and held on to his hand.

So now, because of Covid-19, I’m on heart medication. It’s pretty terrifying. But here’s the good news: my doctor says this situation will “most definitely” resolve itself, since I did not have POTS pre-Covid. He seemed very confident, like, Michael Jordan Game 6 confident. I suffer from anxiety, so I am not as confident. Still, I have been feeling a little better and stronger each day. I started the medication yesterday. I go back in a week. Then I go back a few weeks after that. Then we see if the drug is working for me and I stay on it, or we up the dose. I have a free sample of it now (yay!) but I’ve been told it’s quite expensive to fill (ugh) so that’s a potential whole other nightmare. It’s called Corlanor and it’s primarily used for heart failure (which I most definitely do not have). But studies have shown it can provide tremendous relief for people with POTS . So I am holding on to that, and thanking my lucky stars because even though I am scared this could have been so much worse. I’m also supposed to drink 2 liters of salt water a day. (no joke).

Cedars Sinai billed my insurance company $22,050.83 for my first ER visit (LMAO). I am responsible for $1,782.10 (LMAO), and I’ve now apparently hit my yearly “in-network” deductible. But I know my insurance company will figure out a way to charge me just as much for my second ER visit, and probably my urgent care visit, and also the doctor visit, the physical therapy visit, and the cardiology visit this all took to get properly diagnosed.

I should have prefaced all this by saying that even though I’m in excellent health, I pay through the nose for a top tier health care plan so that I don’t go bankrupt if something like this happens to me. The American health care system is broken. We are the only first-world country that punishes sick and injured people with insurmountable debt because they have the misfortune of being sick and injured. My Medicare for All zealotry was already a 15/10 but it’s been pushed to a 5000/10 after this incident.

The disability community has been leading the way in fighting our elected officials for change, often sacrificing their own bodies to demand we evolve past our barbaric health care system and into a sane one where non-rich people can actually access the physical and mental health care they need to exist in the world. The least us able bodied people can do is join their righteous fight, while continuing to let them lead the way.

I’m sure some anti-vaxx wing nuts are going to seize on this post as evidence that the Covid vaccines don’t work. I have two things to say to that: 1. Unless you are an infectious disease expert, sit the fuck down. No one cares about your opinion. And 2. It’s possible that were I not vaccinated I would be dead or on a ventilator. I was sick for a month. But now I am able to sit upright and write this post. I am able to walk my dog. I am fortunate enough that I will be okay.

I had no adverse reactions to the vaccine shots, and I will happily take the next booster when it comes out. I stayed safe from Covid for 2.5 years. I was exposed to the virus at the 2022 All-Star game at Dodger Stadium. I was not wearing a mask because the event was outside. I will wear now wear a mask to all group settings—indoor our outdoor—until this is over. I hope you will continue to live full lives while also minimizing your risk of catching this disease as much as possible. If this can happen to me, it can happen to anyone.

I got sicker than I've ever been in my life or ever hope to be again. And now I’m recovering, I hope. Here is an excellent recent study from the Washington State Department of Health showing that people of all age groups are orders of magnitude more likely to catch the virus, become hospitalized, or die from it, if they are not vaccinated. Please get vaccinated.

I will also note that the people who say the vaccines don’t work are the same people who say Covid is just “the flu” and we should not have shut down society to stop people from getting sick. (Even though we never fully committed to doing that). So if you’re going to use my case as a way to dunk on the scientific community, you are going to have to pick a lane. If you say “the vaccines don’t work because you got really sick!” you are acknowledging that this virus makes people really sick, and that perhaps we should be taking Herculean measures to stop its spread.

Anyway, if you are a paid subscriber to this newsletter, please accept my deepest gratitude. You are quite literally paying for my health care and my medical bills right now. This is my full-time gig. Some people have to choose between food and medicine. I understand my privilege that I will not be forced to make that choice. If you would like to support my road to recovery, the best way to do that is by taking out a paid subscription to this newsletter now. You will receive all my stories plus access to weekly 30-person creativity zooms with me, every private Sunday night baseball live chat, daily live chats during the MLB playoffs in October, plus you get to comment on all my posts. Come join the fun!

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Thank you for your patience. I’ll be back shortly with a baseball post as I attempt to grapple with everything I missed (Tatis Jr. suspended for steroids! Yankees collapse! Dodgers sideline guy breaks his wrist and cracks six ribs on Bernie Brewer’s slide in Milwaukee!). Also, I’m recording a podcast with my pal Joe Posnanski later today.

It was scary not to write for two weeks. I was worried I’d lose you. But you’re still here. Thank you for having my back. Thank you. <3

One day at a time.

Love you guys.

Molly

When I first wrote about my struggles with anxiety and depression back in August, I told you guys I was doing pretty well but that I’d always be honest with you if I hit a bum…

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I didn’t think I’d be writing about mental health again so soon but your overwhelming response to last week’s post on getting help has made me realize there are so many important things I left out. As always, I will never tell you what to do or how to feel while you navigate anxiety and depression. I am not a doctor, and even if I was, mental heath treatment is not a one-size-fits-all endeavor. Medication, CBT/DBT therapy, and exercise work for me. But so does forcing myself to socialize, making sure I have balance in my work and personal life, and sleeping when I’m tired. If I don’t have social interactions, balance, and sleep, then there’s no amount of therapy, drugs, or exercise that can make me feel better.

If you are feeling stuck and you don’t know where to start, head over to Psychology Today to find a therapist near you. It will take some work and some phone calls to figure out who takes your insurance, as the lists on health insurance websites are often out of date (and unfortunately many therapists don’t take insurance at all). You should probably call at least five different prospective therapists to get a feel for who might be a fit. Therapists don’t usually charge for a five minute phone conversation, and you can usually narrow down who you like and who you don’t like in that short of a window. It’s important to find someone who specializes in the issues you are dealing with. If you’re a woman and you want to work with a woman, the sit allows you to filter by female therapists. If you are a member of the LGBTQIA+ community, be sure you find someone who works with others like you. Maybe you need someone older? Maybe you want someone who does EMDR? These are all valid criteria you need to identify before you begin your therapist search.

If you can’t afford therapy, I feel you. It’s an abomination that health care is tied to your job in the United States, and barbaric that it isn’t free at the point of service like it is in every other developed nation. But you can still google low cost therapy and try to find someone in your community who offers counseling on a sliding scale. If all else fails, your GP can always prescribe your antidepressants, which will probably be a lot cheaper than paying out of pocket to see a psychiatrist.

In my last newsletter on getting help I mentioned how much Max Strom’s breathing technique has helped me manage my anxiety. It’s gotten to the point where I don’t even need to be having an anxiety attack to breathe this way. I do it in traffic and when I can’t fall asleep and it always helps to relax me. The best book I’ve ever read on anxiety is Hope and Help For Your Nerves by Dr. Claire Weekes. The best book I’ve read on understanding trauma is The Body Keeps the Score by Dr. Bessel van der Kolk.

I use Headspace for guided meditation. If you can’t afford a subscription to that service, you can always listen to Tara Brach’s talks and guided meditations. I think she is the most gifted spiritual guru alive today, and I’ve learned how to practice self-compassion by listening to her weekly talks for years.

If you are struggling with self-compassion, Kristen Neff’s work is invaluable.

The Long Game is a reader supported newsletter. There are paid and free versions. Those who want to support me and my work are encouraged to take out a paid subscription.

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Finally, if you are reading this not because you are suffering but because you love someone who is, there is plenty you can do to help. I know it’s hard to understand depression or anxiety if you’ve never been through it. Trust me, I feel crazy even describing what it’s like, because it doesn’t make any sense. The first thing you can do to support a loved one going through a crisis is to remain calm. The world is very scary right now to the suffering person, and you acting like the situation is a five alarm fire will only make things worse. If your loved one is anxious, maybe they are scared to be alone. If they are depressed, maybe they need their space. It’s crucial that you ask them what they need and then react to what they say without judgment. Maybe they need to hear that things will be okay. You can give them that. Maybe they need help finding a therapist and navigating their insurance. Your brain is working properly, so you can help with that. Maybe they need to go to the hospital. You can drive them there, re-assure them that this is not an embarrassing situation but a courageous step in feeling better.

All this being said, if a loved one is battling depression or anxiety and using it as a crutch to abuse you, that’s never okay. If substance abuse is involved, please consider looking into Al-Anon or CODA meetings. These are free, virtual meetings that you can join from anywhere. Melody Beatty’s book “Co-dependent No More” is the gold standard on this topic.

On a personal note, I have to thank you all for supporting my mental wellbeing. I was not in a great situation mentally or emotionally earlier this year. Starting this venture has given me a huge lift. And none of this would be working if not for you guys. So, thank you. Thank you.

If you are having thoughts of harming yourself or someone else, please close your Internet browser and dial 911 or walk into your nearest emergency room.

Every day is a battle. I open up a Word document and try to write before the voices flood in telling me I’m not good enough or what I’m writing is dumb and/or not worth more than a sentence let alone a full article or newsletter. Sometimes these voices are hard to detect because they’re not always outwardly negative or mean. Often they belong to the “what’s the point?” family. I tell myself I’ll write tomorrow when I have more to say, but I rarely have more to say. So I push through and force myself to write because if I didn’t then I’d never write anything.

I don’t believe I’m special. I’m telling you this not so that you’ll feel sorry for me or tell me how great I am. I’m writing this because I’m guessing that there’s some part of your life—or maybe many parts of your life—that make you feel the same way. Insecurity masked as procrastination. Fear disguised as “what’s the use?” I don’t know anyone who isn’t being held back in some area of their life by counterproductive or masochistic feelings. I’m writing this post for me, but also for all of you. Naomi Osaka and Simone Biles are the best in the world at what they do. They both recently withdrew from major sporting competitions because they weren’t right mentally. Their courage to be open about what they were dealing with will save lives. I write this post with the hope that it will help someone else, and then the pain I’ve been through in my life will not have been in vain.

I’ve struggled with anxiety and depression since I was 11 or 12 years old when I had my first panic attack. The details aren’t important. If you’ve never had a panic attack imagine being on an airplane cruising at 30,000 feet when suddenly the plane is struck by lightning and goes into a nose dive. Then multiply that experience by 10 or 100 or 1,000—depending on how many panic attacks you endure in a lifetime.

If you’ve never experienced depression, please understand that like anxiety it is a physical illness. When I am severely depressed the first thing I do when I wake up in the morning is vomit. You know those dreams where you’re trying to run but you can’t move? It’s like that. You know that you have to do things like shower and get outside and go to the doctor to get better, but each of these things feels like more activity than you can bear in an entire week.

Depression is like cancer in that there is one name, but that name encompasses infinity different varieties that respond to infinity different treatments. I’ve gotten help over the years. My condition is currently in remission, but I monitor it every day like a diabetic watches her blood sugar. When I’m at my lowest, the thing I do most is google other stories of people who have been through horrible depression and anxiety and how they got better. I hope this post will be a place people can land and come away believing there is help and there is hope. I have also had the good fortune of helping others who climb out of the abyss. I say good fortune because I don’t know if there is a greater honor than helping another person to realize they want to stay here, alive on planet Earth. Treatment is not a one-size-fits-all. But there are some things I wish I knew 20 years ago that I will share with you now:

1. If you are having thoughts of suicide, you are past the point of being able to make decisions on your own. You need to tell a family member, friend, therapist, counselor, priest, nurse, etc. that your brain is not working right and you need someone else to take over the decision making process for you. This might mean being hospitalized for a few days while they sort out your medications. This may feel like an embarrassing situation for you to endure, but you know what? Being dead is worse. If you’ve hit this point, your body is experiencing an emergency and it must be tended to right away. You’d call 911 if someone around you were having a heart attack, right? This is the same thing. Don’t think. Just make the call. Walk into an ER. The goal is to stay alive.

2. A lot of experts say meditation is a key component of dealing with stress and anxiety and bad thoughts. And while I agree this is probably true— I meditate every day— I’ve never been able to meditate my way through a panic attack. It’s not possible. Nope. Sorry. What you can do though, is breathe. I just linked to the only breathing exercise you ever need to learn to manage stress. I successfully breathed my way through a panic attack for the first time using this technique a month ago, and I can’t recommend it enough.

3. You can’t just manage the symptoms. You have to deal with whatever you’re not dealing with. While you can learn how to breathe your way through a panic attack, if you don’t address what’s causing the problem and try to fix it, it’s just going to keep happening. Last year I experienced the most loss I’ve ever experienced in my life. I held a close family member as she died. I held my dog as he died. I did this in a pandemic when gathering with others for support or even funerals was not possible. I thought I handled it as well as anyone could. I cried a little and kept my life moving forward as best as I could. It wasn’t until this spring that my grief exploded into waves of panic and despair and my life became unmanageable. I got back into therapy and my doctor upped my Lexapro. Within a few months things started to feel a little better. Now they feel a whole lot better. I started reading a lot of Brene Brown, because what she writes about vulnerability and perfectionism resonates with me more than anything I’ve ever read in self-help books (and I’ve read them all). If there is something you know you haven’t dealt with, there is no time like the present. It will never feel like the right time to deal with death, or a divorce, or a rejection, or a job loss, or abandonment, or body image issues, etc. but I guarantee that the longer you wait to deal with what ails you, the harder it will be to sort.

4. Anti-depressants work, but they don’t do all the work. I’ve taken Lexapro for the last eight years. Will I be on it for the rest of my life? As long as the benefits continue to outweigh the side effects, absolutely. I feel no stigma whatsoever about popping a happy pill every morning, and neither should you. It took me a while to get here, though. Before finding the right drug and dosage for me, I tried Celexa, Zoloft, Paxil, Trazadone, Ativan, Xanax, Wellbutrin, and Abilify. I’ve also experimented with holistic and alternative approaches like magnesium supplements, St. John’s Wort, CBD, essential oils, acupuncture, psychics, mythic astrologers, etc. If you’ve tried one (or five) of the above and nothing has worked, don’t give up. There is probably some combination of some drug and therapy out there that can help you. But don’t make the mistake I made and think that a pill alone can fix what’s broken. That’s because…

5. ..the right kind of therapy can be life-saving. It took me a long, long time to figure out what kind of therapy works best for me. I used to go to therapists that tried to get me to remember who my friends were when I was three years old and other useless information. I did this because I did not know any better. If the Freudian stuff works for you, great. But my anxiety and depression were happening in the present moment and I needed solutions and tips to help me get through each day. I found a therapist who specializes in cognitive behavior therapy (CBT), and his method was extremely helpful at managing my symptoms. But whenever I mentioned that I might panic about X because of something that happened to me when I was Y age and asked if perhaps we could unpack that, he got a twitch in his eye like whatever happened before I entered his office was irrelevant. That approach did not work for me either. Right now I have a therapist who works with a hybrid CBT/past process model where we can incorporate both a) why I am so upset in the present moment and b) what might have happened to make me that way.

If you are feeling overwhelmed right now, please know that you are not alone. If you are trying to find a therapist, start https://www.psychologytoday.com/us. There is hope and there is help. There is nothing to be ashamed about. We need you here, alive.