Four days ago, my boss said to me “I think you need to take time off work.” I thought he was out of his mind. Turns out his mental status is fine. It is my mental health that is in jeopardy. Truth is I knew it was happening. I know I knew because I have been trying to manage my mental health all the while trying to hide this management from my spouse, my kids, my colleagues, my friends, and my family.

The Slippery Slope

Picture it, the year is 2020, and the world is going to hell in a handbasket. A pandemic is ravaging the world. Sure, I am not sick. My family is not sick. My friends are not sick. But it is out there. My evidence of its existence is the change in my day to day lifestyle.

I homeschooled children for months and now that they are back in school, we have added masks to the morning “Did you remember to pack?” checklist. My husband and I now argue when one of us reheats lunch in the microwave, which cuts out the WiFi, unfailingly in the middle of an important video call. These challenges didn’t exist before.

Fine. We are settling into an unsettling routine. Then protests erupt over injustices against George Floyd, Breonna Taylor and so many others who have been subjected to systemic discrimination. Emotions run high as my passion for a better world for my children takes hold of my every waking hour. I feel a compulsion to get this part of parenting ‘right’ while feeling woefully inadequate and underequipped to answer their questions.

Fast forward toward the end of summer and my mother-in-law has a stroke. She has never been the healthiest. This is the next in a long line of issues, but this time is different. She is in a hospital that is locked down to visitors due to a COVID-19 outbreak. My husband’s access to her medical staff is all but cut off. He is in a position of helplessness trying to navigate his mother’s life.

While this is happening, I am doing my best to take care of myself. I take the time to get a routine mammogram screening. Except it turns out not to be routine at all. The results show a small, likely benign mass, lurking in my right breast. This will require further follow up. I do see the word “benign” on the medical report but in the back of my mind, I have the results of an emergency appendectomy from 9 years ago that brought forth a result of a malignant carcinoid tumor. “We got all of it,” the surgeon said, “You are cured.” What if it has come back?

Then a week ago I receive a phone call from my mother. “Your father has had a stroke,” she says. “He is fine. We are at home, but he has lost his vision in his left eye.”

Mentally Unwell Means Mentally Ill — Right?

Wrong! Let us step back to my boss telling me I needed to take time off for my mental health. This was a tough concept to comprehend. I remember a colleague asking me, only a couple of months ago, “How do you remain so calm all the time?” I felt a sense of pride that I was keeping it together when so many others seemed to be struggling. I was getting the job done. Therefore, I could not possibly be having mental health issues.

I realized I needed to re-establish my understanding of what we really mean when we are talking about mental health. Only then could I begin to address my challenges.

“When we talk about mental health, we’re talking about our mental well-being: our emotions, our thoughts and feelings, our ability to solve problems and overcome difficulties, our social connections, and our understanding of the world around us.” — Canadian Mental Health Association

This is vastly different from a diagnosed mental illness.

“A mental illness is an illness that affects the way people think, feel, behave, or interact with others. There are many different mental illnesses, and they have different symptoms that impact peoples’ lives in different ways.” — Canadian Mental Health Association

My employer has a strong belief that mental health is equally important to your physical health. We review the signs of good and declining mental health frequently. We are encouraged to refer to authorities such as the National Alliance on Mental Illness, which identifies no less than 17 signs to watch for in declining mental health. Henceforth, we shall refer to this as “The List”.

• Excessive worrying or fear
• Feeling excessively sad or low
• Confused thinking or problems concentrating and learning
• Extreme mood changes, including uncontrollable “highs” or feelings of euphoria
• Prolonged or strong feelings of irritability or anger
• Avoiding friends and social activities
• Difficulties understanding or relating to other people
• Changes in sleeping habits or feeling tired and low energy
• Changes in eating habits such as increased hunger or lack of appetite
• Changes in sex drive
• Difficulty perceiving reality
• Inability to perceive changes in one’s own feelings, behavior or personality
• Overuse of substances like alcohol or drugs
• Multiple physical ailments without obvious causes
• Thinking about suicide
• Inability to carry out daily activities or handle daily problems and stress
• An intense fear of weight gain or concern with appearance

Warning Signs Are Not as Obvious as “The List”

The list seems simple and self-explanatory. I promise you that nothing on this list is obvious when you are living it. The most important thing I have learned about “The List” is that these do not appear all at once. They take place days, weeks, or even months apart.

This bears repeating: The signs of declining mental health may not appear all at the same time or with any consistency.

Let me share how “The List” manifested in my life.

Feeling Excessively Sad or Low

Sadness or depression seems like it would be an easy emotion to recognize. It wasn’t. For me, this manifested in tears for no reason that showed up at random times, days, and weeks apart.

The first time it happened was during my nightly meditation. I didn’t even notice the tears start pouring down my face. The meditation was not particularly emotional. If I remember correctly it was a guided meditation on managing procrastination. And yet, tears. Not sobbing. Not crying. Just silent tears.

I remember a hike with my family. My husband, two kids, and two dogs were walking ahead, and I had to stop to catch my breath. I had a great big release of tears. Again, no reason.

The tears would continue to appear off and on. I would finish a meeting at work, and they would begin. I would be brushing my teeth or taking a shower. I never equated them to feeling sad but there they were. They never came with crying. They just slipped out when I wasn’t paying attention.

Excessive Worrying or Fear

This showed itself in obsessively seeking moments of ‘me’ time. I was walking the dogs twice a day. I was having baths with salts and candles. The diffuser was becoming my best friend as I found scents for every moment of the day. I was meditating, rowing, reading, drinking tea, and on and on to find little moments for me.

This was driven out of an excessive fear of letting other people down. If I just tried harder on making sure I was good, then I would prevent my biggest fear of failure for others.

Irritability

This was real. My poor children could not clean the kitchen enough. My husband always had his shoes in the wrong spot. I couldn’t handle it when he used the decorative blanket at the end of our bed as an actual blanket to keep him warm at night. I have literally yanked it off him, refolded it, and placed it back neatly at the end of the bed.

Irritability is easy to rationalize. Every snipe or strongly worded correction could be justified by other people not carrying their weight. If they just followed the rules, did the chores, or remembered the instructions then I would not have to nag or scold.

Physical Impact

I have had a headache for three months. It does not matter what I do. It will not go away. In addition, I have tremors in my hands that come and go. They are not consistent. They can disappear for months at a time and then reappear for one day only.

Overuse of Substances

This was probably the sneakiest sign to see. I do not do drugs. I avoid medications if I can. I do not consume copious amounts of alcohol.

I have decided my definition of substances differs. I believe the point of this bullet in “The List” is to identify a pattern of seeking things for a little pick me up. I don’t think it matters what you are choosing.

I have started to consume more alcohol. I am up to 2–3 drinks per week. I know. I can hear your eyes rolling. This level of alcohol consumption falls within most guidelines for acceptable or at the very least, not an unhealthy amount to consume in a week.

The difference is I am someone who usually only consumes alcohol at big events or dinners. I went from 3–4 times per year to 2–3 times per week. That is a red flag that would be missed in a doctor’s office with the usual “How many drinks do you have in a week?”

I am going to stretch this bullet in “The List” a little further. I like a Starbucks chai latte. In fact, I have a milk frother at home, so I can enjoy them anytime. I was up to 2 homemade lattes per day, PLUS, I was making a trip to Starbucks for the real thing. That is three lattes a day. I am sure doctors would put this on their list of unhealthy habits but wouldn’t necessarily count it as overuse of substance. For me, this was an overuse of a substance to get that little high on the first sip.

Why Didn’t I See the Warning Signs?

Sneak Attack

I started this article detailing the challenges that have popped up this year, COVID-19, Black Lives Matter, mother-in-law’s stroke, my mammogram results, and my father’s stroke. Whoa! That does sound like a lot. How does one miss the toll this might take and the warning signs from “The List”?

I call it a sneak attack. You are reading all of these in a shortened time frame laid out nicely on a single page. I was experiencing these things in bursts. Something would happen on a Monday and then nothing would pop up for weeks. There is a misconception that one or multiple of these things are happening every day and it will be obvious.

I compare this sneak attack to boiling a frog. If you put it in a pot with cold water, it does not realize the heat is slowly increasing until it is too late. Not that I have ever actually boiled a frog.

Doing All the Right Things

How could I possibly be having mental health challenges when I have been doing all the right things? I have been voracious in using coping strategies.

• Meditation 10 minutes every day
• Yoga 3–4 times per week
• Rowing machine 3 times per week
• Forest baths — aka hiking in the woods
• Reading 30 minutes per day — for fun
• Hot baths
• Using vacation days to take mini breaks

Did I miss anything? If you Google strategies to obtaining and maintaining good mental health you will find all the above. Logically I should not have any problems.

Suck It Up Buttercup

I became an Olympic caliber athlete at rationalizing. My go-to coping mechanism in times of stress is to put things in perspective. I subscribed to the ‘it could always be worse’ philosophy.

After all, we are financially stable. We have not experienced the job loss or financial insecurity that has hit so many with the coronavirus pandemic. I have supportive family and friends. We do not live in a war zone. Our family is not in any imminent danger worrying about bombs or bullets every moment of every day. Other people are in worse situations than us, so what right do I have to whine and complain?

I had myself convinced that I should suck it up. If I just worked harder, planned better, took a little more ‘me’ time everything would be fine.

This is the crux of why I missed the decline in my own mental health. I kept looking too much to my blessings without giving myself permission to feel the pain that was taking place in my own life. It sounds ridiculous, doesn’t it? But there you have it.

My Wake-Up Call

My daughter woke me up to what was going on. She is 12 years old with a certain spark and insight I envy. I was checking in on her mental health one night. Ever the nurturer I was making sure her anxiety about returning to school and her nonna’s health were manageable. After we discussed her, she turned to me and asked, “How are you doing mom?”

She was holding my face in her hands. I looked her straight in the eye and I lied, as any mother would. I told her I was doing okay. I kissed her goodnight and turned out her light. I didn’t know I was lying to her. It was not until I was getting ready for bed that it dawned on me that I was not doing okay.

Getting Back on Track

The next day I reached out to my boss. I shared with him all that was going on. I told him about my plan. I was going to use vacation days to work four-day work weeks for the next month. That’s when he suggested I take additional time off. I fought the idea. Now I am in the middle of my week off work and it was absolutely the right thing to do.

What troubles me now is how fortunate I am. I am taking the time to address my mental health because I have the support structure in place to make this happen. Not everyone has this in place.

Steps You Can Take for Good Mental Health

1. Seek Knowledge

Make it a priority to research the mental health support organizations in your area, through your employer and make yourself familiar with the signs of mental health decline.

2. Check-in With Someone at Least Once Per Week

Find someone you trust to be your accountability buddy. Keep each other honest in what might be piling up.

3. Look at a Timespan Not a Snapshot

Keep an eye on what is going on in your life over a period of weeks, months, or maybe even years. Too often we look at life as if it is a snapshot. The snapshot does not provide context to the bigger picture.

4. Accept Help When Offered

We keep pushing harder thinking if we make it past the next milestone things will get better. If someone is offering you help it is because your stress is showing. Take the help. They might be seeing something you have not recognized in yourself yet.

5. Being Blessed Is Different Than Being Invincible

This was my biggest hurdle. I needed to understand that having so many good things in my life does not mean the stress can’t get to me. It isn’t a math equation or a balance scale. Having made peace with this realization has started me on the path to recovery.

The work to getting back on track has just begun. I will need to find the patience to create a sustainable healthy mind and not seek a quick fix. Although I won’t turn down a day at the spa if it is offered. I won’t presume this will not sneak up on me again but now I have stronger supports in place to help me recognize it if it does. This is good enough for now.