That’s sometimes the price we pay for speaking out. It’s not an easy price to pay, but let’s not kid ourselves that it doesn’t exist.

It exists, and as long as it does, there will remain thousands upon thousands of people out there who never talk about their abuse, but still need some of us out here talking so they know they are not alone.

Resilience comes from the confidence that, even if things go horribly wrong, you'll still be here, moving on. What I think young people are missing today is examples of that. One, because we don't like to talk about the 100 times we struggled with something before figuring it out, but also because we live in a society that mocks people who try and fail at anything. When we go online, how often do we see the perfect finished product rather than the failures someone lived through to get there? And, even if someone shows the failures, how often is the comments section filled with mockery?

When I struggled with ideation, it was the overwhelming feeling that I'd never get through it and no one would care that drove it. This process seems like the kind of thing that would have gotten me to a better place much quicker. I eventually found what helped and the people who knew what to do, but it was a struggle. Having a trained professional guide me through creating that plan while I was in the hospital for an illness would have jump-started that process.

The combination of the stigma of calling in the first place, along with a program that doesn’t meet the needs, means 97% of people won’t bother with it. We should be looking at alternatives, for sure.

To believe we can solve the teen mental health crisis by forcing kids off social media and doing nothing about all these other things is foolish.

Of course, one of the telltale signs of depression and unhealthy responses to trauma, like abuse, is overly black-and-white thinking. Going to extremes, if you will. So, it's easy for many of us to fall into these toxic traps. It's easy to think that we should feel shame about what happened to us or that we can somehow rid ourselves of that shame and anger by simply refusing to do anything but be positive. But neither one of these is real healing. Real healing, like real emotions and real people, is messier than that.

There’s simply no way you don’t know people struggling right now. Whether you want to consider the levels of anxiety and depression a disorder or a natural reaction to the state of the world today, we would all do well with more compassion and grace.

A lot more. People are dying without it.

I've often talked about the importance of connection. It's been mentioned in regard to suicide prevention, depression treatment, child trauma recovery, and just about everywhere else that we talk about mental health issues and abuse. There's a reason for that. It's much easier to feel hopeful about ourselves and the future when we know we're not alone.

Read that again. “Everybody assumes that other people are far more observant than they really are.”

Now, think about how much time we spend worrying about how we appear to other people who are not as observant as we think they are.

It's not therapy, and it won't fix everything, but as he says, "When you listen to someone, you let them know I value you".

This resource seems like something worth sharing. We spend so much time talking about online safety, banning phones until a certain age, or banning social media, and not enough time making sure we prepare kids for the dangers of being online at all. It’s like banning a child from leaving the house without a parent and then sending them to school with no skills for navigating other people on their own. At some point, kids learning about appropriate and inappropriate behavior and having a safe place to talk about it have to be the priority.

These actions aren't just specific actions that protect children; they're the kinds of actions that come naturally when kids have an adult actively involved in their lives every day, the kind of involvement that would notice a nervous pause before answering, an odd comment that seems out of character, a small detail in a story about other people.

We could create a workplace where people could work from the coffee shop and interact with other humans in person. Where they didn’t spend so much time working that they could use that saved commute time to attend community events. We just don’t. Instead, we expect remote workers to be available all the time; we tie them up in meetings for 5-6 hours a day because that’s how we “keep an eye” on them, and still expect them to hit all their deliverables.

As a survivor, I'm reminded that the most important thing you can do to help yourself heal is to know yourself. It's easy for me to sit here and write about what has worked for me, or what has helped, but it might not be all that helpful for you. We're different people, with different issues, and different responses to what happened to us as children. It would only make sense that what helps us would be somewhat different as well.

So, before we start recommending exercise, mindfulness, etc., can we take a moment to ensure people's safety? It's the literal minimum we should offer before we start lecturing on how to make your brain feel safer.

So, how is running around talking about how anyone who abuses a child deserves to be killed in horrible ways going to help a child feel safe and secure about telling? Are we not handing an abuser a manipulation tool to be used against our own kids? (”Look, if you tell, your parents will kill me, and you don’t want to be the cause of someone’s death, do you?”)

What if you did know this was the last time you would get to talk to someone? What would you want them to know? What would you want to say to them?

Leave them with an impression that lasts a lifetime, just in case it needs to.

If you’re like me and don’t want to engage in lengthy conversations with strangers, this article is good news. Even small connections- a smile, a nod, or a pleasant “hello,” have mental health benefits.

It might also remind us of the humanity of the people around us. There are worse things.

It’s not that we shouldn’t look at the individual cases; we should. But we have to address the systemic harm done to mental health by these issues. We have to stop pretending that economic issues don’t create mental health risks and ignore the real harm we do when we do nothing to lift people out of poverty or end racism and economic deprivation beyond calling anyone who wants to do those things a socialist.

It’s not working. It’s not solving the real problem.

As Whitney says, and I agree, the real work is in the complexities. That goes for our own mental health issues, healing from abuse, and social issues regarding these topics. We aren't going to solve the mental health crisis by getting people to exercise more. It might help some people, but that one explanation will not work for everyone. We are all much more complex than that simple "fix" would lead us to believe, but believing it reduces the cognitive load of figuring out how to help millions of individuals. Get more exercise, or get off social media, are well-meaning bits of advice, but the mental health crisis in the US is more complicated than that. We need programs that reduce financial insecurity, violence, and hatred and offer support for all the various ways we've all been traumatized in our lifetimes.

When businesses tell people to keep their identity out of the workplace, they are causing mental health harm. Period.

The effort to hide, the message that they should be ashamed of who they are because coworkers are uncomfortable, isn’t just about being kind; it’s a real workplace mental health issue. The question isn’t about whether it causes harm; it’s about whether you, as an employer, care that you are causing harm.

This is why that quote above rang true for me. You can’t act rationally if acting doesn’t feel safe, and many of us grew up never feeling safe. To our mind, staying silent and still was the rational choice. Doing something different could have been more dangerous. It was also the natural reaction because we were simply overwhelmed.

The kids and phones thing was always an easy excuse, but the real mental health issue is much more complicated:

As a survivor of childhood abuse, I don't know if these being in place would have changed whether I reported it. For many of us, where abuse happens within the family, that's a very complex question. What I do know is that those three things did not appear to exist, and that guaranteed I would not tell anyone about it until I was an adult, let alone report it.

That's why when people approach me with ideas for how to prevent childhood sexual abuse, the only two things I focus on are education and honesty. I didn't even know I was being abused because I lacked any education, and I didn't talk to anyone because there were no safe adults for me to talk to.

Cecil's post is specifically talking about situations where kids who were already being abused were easy targets, as if they were wearing a sign, but it goes deeper than that. Kids who are "defenseless and lonely", kids with no stable family to turn to, kids starved for any kindness or attention, are the kinds of kids that predators look for. They are the ones who can be manipulated, have no one to confide in, and are vulnerable. If we really wanted to do the hard work of protecting children from predators, and in turn also raise adults less likely to be victimized as well, we'd do everything we can to make sure we do not raise kids who are walking around wearing such signs.

There was no gift involved in child abuse, no silver lining, and no reason for it to happen. It was abuse inflicted on me by another person. Period. That experience is part of me, but not nearly the sum of who I am. I refuse to let anyone define me that narrowly.

We blame the very people who have suffered the most for upsetting the nice little world we've made up in our heads, and we dare to talk about that being about safety.

I think anyone who has ever suffered from depression can recall those days. The days when you really just get overwhelmed by the smallest little thing, and then feel like a failure because you couldn't even do that little thing without getting overwhelmed, which leads to feeling even more overwhelmed, and so on and so on.

How often do we wait until we have the answers, or jump into problem-solving mode when someone admits to struggling, when all they need is to know you care? In my opinion, we'd do each other a huge favor if instead of trying to learn how to solve someone's struggles, we spent more time learning how to care for one another.

It is true that people with plenty of social skills and social contacts can still be lonely. As a survivor, I recognize this in things like the small number of people we can talk to comfortably about our abuse, our healing, etc. At various times in my life, I've had a lot of friends and was very social. I was still lonely. Because no one saw all of me. No one sat with me in my pain. I kept it hidden from everyone. That's lonely.

The logical part of my brain knows that I'm safe. The part that learned how to be hyperalert is busy making sure I stay that way. It never stopped looking for danger. I doubt it ever will. I don't consider that something wrong with me, but it is something I have had to learn to live with.

And this is the core. Mental Health awareness is great, but the political will to solve some of the core issues that lead to increased mental health difficulty doesn't exist. There is ample evidence that poverty, domestic abuse, bigotry, harassment, etc., lead to higher numbers of people struggling with their mental health, and we do nothing to prevent that.

I have said it many times - the reason you don't "know anyone with mental health issues" is most likely because you aren't a safe person to talk to about those issues. More than that, by creating an environment where mental health is not talked about, or is maybe even stigmatized, you are making it less likely that the people you care about will seek out help when they need it.

Be honest, how many people in your life are you close enough to that you could sit down and have a conversation about child abuse with them? How many people do you trust to react in a helpful, non-stigmatizing way? I'm willing to bet that number is small. It's small because, well, some people can't be trusted that way, and because most of the people we know we don't know well enough to know how they'd react. Again, that's a lot of pressure to take on. Maybe it'd be easier not to talk about.

It occurred to me later that this same approach could be helpful as a survivor of child abuse as well. Yes, many of us do not have the types of parents who embody the qualities of the good mothers and fathers we celebrate on these days, but I bet most of us know people in our lives who bring those qualities to their relationships with us. They may not be our parents, but the presence of those qualities of character around us deserves celebration.

Far too many of us are walking through life assuming that no one understands us, that no one cares about what we are going through, that no one else has had to overcome so much. But statistics do not lie. You likely already have a number of survivors among your friends, family, and coworkers. They're all just as afraid to talk about it as you are, but who will be the first?

If healing is a long journey, then there are many details. You don't take a long drive by looking up the destination on a map, setting out, and getting there. No, you have to figure out the route from here to there, where to turn, where to stop, when to take a break, and so on. Each is part of your journey and another step toward the goal. If you don't enjoy the steps or count the small victories, the journey can drag on and on, becoming overwhelming.

What more can I say about this? There are clear connections between improved outcomes for kids who are surrounded by supportive adults, and then we created a society that makes it nearly impossible to create that kind of community. The article talks about small acts of cooperation and inclusion, building the network of trusted adults, but how many of us would even know where to start? How many of us don’t trust anyone? How many of us have friends or non-immediate family members around who our kids can trust?

If you look at the contributors to the mental health damage, though, you see things that are avoidable if organizations wanted to avoid them. Fix poor management, address understaffing, pay people what they're worth, and don't lay off workers just to tweak the stock price. Unfortunately, in the current political and economic climate, I don't see enough organizations that want to do any of that.

We talk a lot as a society about youth mental health, but our actions speak much louder, and the message they send is that we only really care about the mental health care of certain kids. Because if we cared about the mental health of all kids, we'd make different choices about making healthcare available and eliminating the actions that harm teens' mental health.

Reading this review made me think this may be an interesting book to pick up. Sometimes, the darkest subjects can be addressed most honestly with a little humor.

That was a direct quote from me last weekend as we attended JazzFest in New Orleans.

I’m not saying that simply going to concerts is a replacement for therapy. Let’s make that clear up front.

What I was referring to was the healing power not only of music but also of the shared experience with a crowd of similarly minded people.

Economic stress isn't the only factor when it comes to mental health issues. We all know people with plenty of financial resources who struggle, just like we know professional athletes who exercise all the time and still struggle. That being said, we would be stupid not to acknowledge the increased risk.

This is an important caveat to the idea of having mental health resources in schools. Not all schools are the same, and within a school, not every student is the same. Schools in poor areas where students are likely to be dealing with instability at home and poverty all around them have different mental health needs than kids living in a wealthy suburb. Programs designed to help families in poverty should be part of school mental health programs. As I've said many times, you can't meditate or exercise your way out of poverty. A full-service mental health program would recognize the impact that something like poverty has on kids.

In any competitive or demanding career, admitting to a mental health struggle is to be perceived as being less capable, and being seen as less capable is a career-killer.

This week, the world of sports gave us another example:

Jarren Duran’s experience with fan abuse shows there’s still risk in athletes being vulnerable

My favorite takeaway from this is that self-care is an everyday thing. It’s not something we plan to do; if the stress gets bad enough, it’s the actions we take every day for ourselves. Think of it like brushing your teeth. You do it every day because it keeps your teeth healthy; you don’t wait until they are dirty enough that they need a dentist’s attention to decide now is a good time to start brushing them.

Find ways to take care of yourself every day, and do them. Those are the tools that will help you when times are stressful and anxiety-inducing. You are worthy of that.

What are the ways in which you take care of yourself regularly?

So yes, healing is hard, and it takes time. After all, you didn't get the way you were overnight. It takes everyone their entire childhood, and then some, to become the adults they later are. When that childhood development is robbed from you by abuse, you are simply getting a later start. It can be challenging to learn all the skills that make for a happy adult life and to overcome the fear that plagues us from our previous experiences.

Just because something is a challenge, though, doesn't mean it's impossible or not worth doing.

Trying to take my life was a desperate attempt to escape my pain. It was not well thought out. It was something I hacked together late at night while sitting in my car along the Pacific Ocean, where I only had access to what was in the car with me, which turned out not to include any effective tools to take my own life. When it didn’t work, I started looking for other ways to escape the pain, landed in therapy, and eventually got to a better place.

If there had been a gun in my car that night, there’s a 90% chance these words would not be written.

None of us has the power to fix everything right now, or to even predict what is coming. That uncertainty is hard. But we all have things we can do, so let's focus on the small things we can do today, and maybe even some bigger things we can do going forward, instead of being overwhelmed by what we can't do or don't know.

To put it bluntly, while I don't regret the healing that has taken place in my life and where I am now, I have to also acknowledge that getting here was messy. I'm not the same person I was in this photo. None of us is the same person we were back then, but for survivors, there is a particular challenge that comes with healing. You have to be willing to change, and if I know anything about change, I know it can be messy, too. Change requires us to leave behind things that are not good for us, which just so happen to be the things we've gotten quite comfortable with.

I’m glad she was able to get help. I’m glad she is here and able to give this interview. How many kids aren’t because they didn’t have the option to go 11 hours away to receive the kind of care that would keep them here? Why is treatment for serious mental health issues so limited and hard to find?

It’s easy to talk about supporting mental health, but is it too much to ask that we fund the resources needed to provide that and allow them to exist in our neighborhoods?

It shouldn’t be.

When men display anger, anxiety, and irritation, we tend not to think of it as depression, but it very well can be.

This study taught me something, though. That kind of depression, which we refer to as “masculine,” is not something that only men can display, so we ought to consider how many people across the gender spectrum may be suffering from depression and not recognizing it.

Schools in poor areas where students are likely to be dealing with instability at home and poverty all around them have different mental health needs than kids living in a wealthy suburb. Programs designed to help families in poverty should be part of school mental health programs. As I've said many times, you can't meditate or exercise your way out of poverty. A full-service mental health program would recognize the impact that something like poverty has on kids.

I love the idea that healing can be messy. Most truly human things worth doing are messy and chaotic. We weren't made to only do easy things, but we are made to grow and heal.

Even when there are things in the world I cannot change, I use my own words to remind myself that there are things I CAN do. I can look after the people around me. I can add my voice to support mental health, survivors, and marginalized groups. I can find small ways to contribute to making the world a better place while also encouraging others to do the same.

What we see there is that mental health problems can create debt. When we cannot work, our healthcare costs skyrocket, and we can find ourselves in a poor financial situation. That poor financial situation creates more stress and emotional labor, contributing to mental health issues.

Whether the mental health problem or financial struggle came first doesn’t matter. Once we are in the cycle, it will continue round and round.

This is a fine example of behavior that might make sense to us as individuals, but what happens when everyone engages in this same behavior? How do you find fellow survivors to build a support system or a sense of community with when everyone in that community is waiting for someone else to reach out?

It’s worth considering your friends and recognizing that we need all kinds of friends. We need loose connections, and we need tight connections. We need long-term friends, and we need friends for a season of our lives.

In short, we need each other. I’m afraid this has gotten lost in our culture and priorities, and I consider myself as guilty as anyone.

What I read in this matches what I see in real life. Some people spend a lot of time on social media doing things that are bad for their mental health. (Comparing their lives to the ultra-filtered images they see on social media, filling their feed with information that is bad for their mental health, etc.) while others use social media to connect with an online support network.

Given that, the calls to ban social media use for kids seem odd, but they are based on the idea that it is easy. Blaming big tech will never be unpopular, and some people might be better off using social media less.

It’s also unlikely to make much of a difference for the vast majority of kids.

As long as you are alive, there is hope. Hope in a better tomorrow, hope for healing, hope for happiness. I don't care how horrific the abuse was; if you're alive today, there is hope, because the future hasn't been written yet, and it is up to you.

The pity is that I prioritize this so little in my personal life. I’m constantly trying to “squeeze” in time with friends between work and other interests, and then wondering why my sense of personal community seems so lost. I think what Dr. Murthy talks about is part of it. I don’t think about time in this way. I’m always trying to maximize the time I spend with people, instead of just being with them.

The irony, of course, is how often I write about the best way to help people struggling with healing and mental health issues - just be with them. Yet, I don’t seem to realize how important it is to just be with our people regardless of what’s going on in their lives.

Maybe they've stumbled onto the simplest life hack there is for loneliness - become a regular somewhere. Exist in a space where people expect you to be and then be friendly while you're there.

Obviously, this is true in the world of sports, where any perceived weakness can be the difference between a first-round pick contract and no contract, but it’s also true in many of the industries all of us work in. In tech, do you want to be perceived as someone who might not be able to produce at the same level as everyone else? In law, do you want to be seen as maybe not able to hack the billable-hour requirements?

Whether either of those perceptions is true is not relevant; the risk of being seen that way exists. This risk makes asking for help less safe, which makes it more likely that someone won’t be able to do it.

This makes sense. If you believe that society is ultimately fair, then poverty is a personal shortcoming rather than a failure of the system. If being poor is a personal shortcoming, the mental health impacts of living in poverty must also be your own responsibility to be dealt with, not a source of sympathy.

This, of course, assumes that the distribution of wealth is fair, which it is not. But it sure makes it easier to think that way and to stop worrying about finding solutions to the world's unfairness.

It can be difficult to live in uncertain times. That old phrase, "May you live in interesting times," is really more of a curse than a blessing. We can't change the times we live in, and even if we could, there will always be uncertainty. We can, however, ground ourselves in the knowledge and confidence that we will, regardless, survive it.

So do the things that make you happy. Do the activities that help build you up and give you the energy to go on with your life, no matter what they are or whether people on Instagram will applaud you for them. Please do it for yourself because you deserve it, and you are not required to get anyone else's permission to do things you enjoy.

So, as I think back to my plans to write about how important it is to have something joyful to look forward to as part of our healing, no matter how small it may be, I can't think of a better way to explain it than to share with you the wisdom of my grandmother. Overcoming an abusive childhood is difficult, healing is hard, hard work, full of pain and anguish. If, in the midst of all of that, you can still find a way to have a good time, you are on your way to a great life, no matter how unrealistic that may seem at the moment. Keep at it, and keep enjoying what you can!

Imperfect as our current system is, it manages to keep plenty of people alive who might not otherwise be. Gutting it to cut spending is callous. As I have said many times, solving the mental health issues that plague the US will involve a lot of hard work, difficult conversations, and measured steps to create positive impacts for all of us. Adults need to be adults and have mature discussions about how to help as many suffering people as possible.

Kids who score high for ACEs can get a head start on healing by having more positive experiences where they are safe, loved, and out of vulnerable situations. We should figure out how to help kids have more of that as a society.

So please, just listen. Make the space around you, even if it's virtual, a safe space for your friends and loved ones to tell their stories. Find small ways to help, if you can, but also know that by just listening, just sitting with our stories, you are already helping so much.

I say that because that's how I feel about abuse and trauma. It happened, and I'm still here. I won't promise that I'm always feeling great; I'm definitely not always positive. I have good days and bad days. You won't catch me claiming that my abuse made me something that I'm not, and I most definitely will not be looking for any sort of hero status for surviving abuse. What I did promise then, and continue to promise today, is that I'm here, and you're here, and so we are not alone.

It requires so much more effort to even have basic interactions anymore. We've spent decades designing society this way. It's not just a personal failing; it's the entire system. Changing the system can't be done by one person. But Mandy has some small steps we can take, and if enough people start taking them, maybe we can make some progress and shift the design toward something less lonely.

We shouldn't act surprised when claims of abuse are revealed many years after the act. That's not evidence that the claim is false; it's just the norm.

Do you see the trend? Many of us have gotten more comfortable talking about mental health with people we trust. We do not trust corporate leaders. And, why should we? How many people do you know who’ve been laid off in recent years, not because they weren’t meeting the requirements of the job, or the company was losing money, but because the stock price needed a nudge? It’s impossible for employees to trust that you care about their mental health when you’ve watched them cut staff and make it more difficult on those left behind over and over again.

Supporting your workers’ mental health requires them to feel a sense of safety. That no longer exists in most workplaces.

To put it bluntly, drinking two or three cups of coffee per day may help ward off some mental health issues for some people.

For an individual, it may help, and it may not. It’s important to note that a lower incidence of mental health issues does not mean no mental health incidents. You can exercise, drink two cups of coffee, and get a good night’s sleep every day, and while that is good for you and has benefits, there’s no guarantee that you will not be impacted by mental health issues.

They have proven to me that this is normal and that we can get through this. Simply by talking about how they have.

The stress of financial instability is not something that we can eliminate with positive vibes. Being on the verge of poverty or in poverty is a mental health risk factor unto itself. No self-help apps will provide for you if you're laid off or prevent you from becoming homeless or hungry as the cost of living continues to outpace your income.

The truth is that the ones who survive are likely to suffer from PTSD and/or other mental health issues, and those issues don't always look so pretty. The same is true of abuse survivors. Those innocent children we see in the photos may very well grow up to be troubled teenagers or adults with mental health issues and lacking in social skills. We might well have been a little preoccupied with simply surviving childhood instead of developing at the same rate as other children, so as adults, we may not come across as well.

The amount of courage and effort it took to tell you deserves more than a dismissive comment.

Advocates, if you genuinely want to support survivors, shout to the rooftops about how damaging abuse is and why it should never be tolerated. I support you 100%.

Let’s try to find a way that doesn’t also involve telling survivors that they are irredeemable, alright? We have enough undeserved shame to overcome; don’t add to it.

Not talking about it won’t get us anywhere. But we need to do more than talk; we need to figure out better ways to treat people who need it and make it accessible. That doesn’t happen until all of society understands its importance and is truly educated about it. So, keep talking, but also keep demanding better.