For the past few years, I believed my pursuit for mental wellness had been a success. I prided myself on depression and crippling anxiety as ghosts of my past. Yet, after moving to a new city and completing two packed weeks of being and traveling with family, I came home simultaneously filled and depleted. The ongoing tools that support my physical wellness and emotional health are sometimes harder to maintain on the road to the same degree that I am able to do at home. On that first day of returning back home following the multiple weeks worth of events, I was blindsided by what felt like a wave of inexplicable sadness and depression. My whole body felt weighted, and my mind was overcome with nebulous fog. I was privileged enough to have a light schedule that day and allowed whatever had come over me to do its thing. I hoped if I gave it space, it would make a fast exit.

Just the next day though, I received news that one of my best friends had been diagnosed with cancer while another dear friend, who is battling metastatic breast cancer, had been hospitalized. I felt as if a match had been thrown onto a dry patch of leaves sprinkled with gasoline and faced depression and an enveloping sadness that I had supposed long gone. What unfolded over the following days was a humble reminder that maintaining mental wellness is an ongoing pursuit.

I choose to honor my ever-evolving commitment to physical well-being. So too, I must remember how my battle for mental wellness led up to this latest chapter of my life and the lessons I carry forth from earlier difficulties.

My internal life was knocked off the rails with a shocking cancer diagnosis at age 21.

Physically, or at least in outward appearance, I recovered relatively swiftly, but the emotional fallout took longer to address and heal. I was grateful to be alive, so admitting the anger and sadness that lived side by side with the relief and gratitude seemed selfish and indulgent at the time. I did my best to pretend as if everything was ok, because I believed that to be an indication of success. I graduated from college, moved to Italy to work and continued to function out in the real world, doing and relating as best I could, until the emotional pressure within overtook my ability to function out in the world.

Much of my following years passed by in a blur. The unprocessed trauma led to notable and debilitating PTSD-related symptoms: panic attacks, depression, anxiety and frequent migraines. I did my best to show up for work and relationships, but my mental health, and the related physical struggles, increasingly became impediments to a functioning, full life. When I found myself in the emergency room more frequently than I was at my desk, I knew something had to give. I would make plans with friends and cancel them when migraine headaches struck with growing frequency. I could not leave the house. There was an obvious need for change, and I eventually sought help to deconstruct the untouched trauma and pain that was wreaking havoc throughout my system.

I dove into traditional and alternative therapies to find answers to the feelings driving the anxiety, depression and overall heaviness I carried with me with regularly. Some days there were revelations that offered clarity and hope. Some days there were no clear reasons for the pain, which added frustration to discomfort. I lost faith in my body and began to outsource my happiness and decision-making to others. I became a stranger in my own life.

During this period, I got married and had a baby. With my daughter’s birth, I miraculously tapped into a renewed belief that I could endure more than I gave myself, or my body, credit for based on recent history. I desired to show up more fully and healthfully for this incredible being now in my life. Then, having tested positive for the BRCA1 mutation, I decided shortly after her birth to opt for a preventive double mastectomy and reconstruction. Those surgeries were both empowering and triggering.

As a new mother, I was finally inspired to look within and heal the past that had overshadowed my present. I called my doctor and admitted I needed more therapy. I began writing about my pain in an effort to process what I no longer wanted to carry. I asked for help from friends, family and others. I released myself from the prison of living with pain and trauma, and the related psycho-emotional effects, in silence.

Years and many hours of therapy and healing approaches later, I built a stronger foundation upon which to conduct my life. In time, I recognized that I had made decisions that no longer reflected who I had become outside of the depression, anxiety and trauma. I began to make a series of “last cuts,” or significant life decisions, as I like to call them to create a life that felt like my own. I got a divorce. I moved. I closed my jewelry business. I ended another serious relationship. I changed the way I ate. I started to exercise. With the help of doctors, I went off of prescription medications that had been lifelines in my twenties. I had a hysterectomy. I simplified my life in order to support a different way of living that fed my wellness, both physically and emotionally.

In January 2016, I made the decision to remove the silicone implants I had elected with the preventive double mastectomy. My ongoing self-exploration continued to highlight ways I could deepen my commitment to my mental and physical wellness. The implants had never felt like part of my body or identity, and I was eager to create more congruence between my internal world and external decisions. With the explant surgery, I created the Last Cut Project with my friend and photographer Lisa Field. We attached words and imagery to the process of identifying a disconnect within ourselves, the questioning we do to find a different way of living and the commitments we make to bring us more in line with who we are. Through this last cut process, we seek to embody our true, authentic self and find greater freedom, happiness and wellness along the way.

The changes I have made, and continue to make, have opened up my life in ways I could have never imagined a decade ago. Yet this recent dance with, albeit temporary, sadness and depression has reminded me that our wellness is maintained through ongoing attention and care. This week, I was able to return to some key lessons I had learned about maintaining mental wellness over the last 20 years:

  1. Be honest with myself when I am feeling overwhelmed by sadness, depression or anxiety

  2. Know there is nothing wrong with me if I am struggling and feel like a stranger in my own life. This is simply a sign that further exploration must be done to see how to move through it or get help.

  3. Ask for help. I do not have to go it alone. Finding the courage to voice the pain can feel more insurmountable than the hurt itself, but silence is further isolating. Reach out to a friend. Call your doctor. Call a helpline.

  4. Develop and use my go-to tools (good nutrition, sleep, meditation, exercise, healthy relationships, stress management) in order to create an ongoing environment that supports my well-being

  5. Simplify. Simplify. Simplify. I ask myself, “What matters most to me?” The answer to that questions provides a useful guide to every other decision. When I know the why behind my actions, I feel more connected and inspired to show up for myself and others.

  6. Express the pain. Write. Draw. Sing. Dance. Creative expression helps to move through my emotions.

  7. Remember that no one moment defines me as a person. I am always changing, learning and growing.

Now, a week after returning from travel and feeling off my game, I am certainly better rested, well fed and clearer. I still sense remnants of the amorphous cloud of heavy emotions, but I can breathe a bit deeper. Unlike 22 years ago, upon feeling this wave begin, I almost immediately reached out to friends and family. I tapped into the resources within myself and in my life that I am grateful to have fostered. I gave voice to the weighty feelings that accompany a mental health wave and released any fear or attachment to the idea that this might last forever or define me.

As humans, we are always evolving and changing. There is a constant and ongoing interplay between our inner and outer worlds that affects our psycho-emotional and physical landscapes. As full spectrum beings, we will have a broad range of ever-evolving experiences. This week, I have been humbly reminded that none of us is immune to feeling and processing life’s events in different, and sometimes surprising, ways. Healing takes time and bravery, but with both, there is hope that each time we experience a bump in the road, we are better equipped to handle it. Certainly the more open and honest we are as a society about our mental health, or any personal, issues, the more connected and strong we become.