<h2>My Story</h2><p>I remember the first time I had a thought of suicide. It was June of 2012, and I was finishing up seventh grade. I had just finished reading the 100th of 500 messages of the most cruel and awful things my peers at school could say to me online. It was through a Facebook-like anonymous platform of Sarahah, and I teared up, wondering if life was worth living if so many people hated me. If so many people would rather have me gone. I questioned my life at that moment. I considered death.</p><p>It would be only a few days after being cyberbullied that I would have my first suicide attempt. I would go on to have many, many more attempts of suicide before my life transformed for the better. Looking back, the one thing I regret is not accepting the therapeutic help sooner.</p><h2>My Experience with Treatment</h2><p>I have spent most of my life in therapy, and multiple special education schools of mine featured therapists that I was required to see weekly at minimum. I have attended group therapy since I was 11, as well as been at wilderness therapy programs, residential programs, intensive outpatient programs, and the whole nine yards. However, it took me reaching and acknowledging rock bottom to accept the help that had always been in my life. November 3rd, 2018, I had reached true rock bottom. I admitted being at rock bottom during my time at a wilderness therapy program the next month, and yet, I did not believe that I was deserving of help. Other people had it worse than me, or so I told myself.</p><p>Yet, in August 2019, I sat in my therapist’s office, demanding to move to the final stage of the residential program with minimal success. I knew I had done none of the work, and he knew it too. I did not believe that treatment could do anything for me. I did not think that I was deserving of healing and recovery. That was why he sent me a long text after our session, telling me that if I wanted to graduate from the residential program, I had to put in the effort to accept the help in front of my face. I screamed and cried. I threw my glasses. A staff member at the program came in, put my glasses on my bed, played my favorite song, and then said, “You don’t have to live like this,” before walking back to the main room. I realized that she was right. I was finally sick enough of the cycle and pain to do something about it.It was at that moment that I began to start accepting the help that had been offered my whole life. I began to build a life worth living.</p><h2>Recovering</h2><p>Now, at 24, I am proud to say that I have mostly recovered from my mental health, with it being rare that I have a suicidal thought. It took a while, and switching therapists as necessary, but I have a life that brings me joy. Little 12-year-old me would be shocked to find out that I graduated college with a bachelor’s in psychology, and magna cum laude at that. Little me would be overjoyed to find out that I transitioned and that I have friends. Little me would be shocked to hear that I am living alone, about to attend graduate school. He would feel empowered through my mental health advocacy and my strong resume. But most importantly, he would feel hope when I radiated joy and calmness, showing him that life got so much better than I could have pictured then. I would feel regret for that kid. I would regret that I thought I had to hit rock bottom to be worthy of change.</p><p>If there is one thing I wish other people to know through my experiences, it is that you do not have to hit rock bottom to accept help. It is okay (and super important!) to seek a therapist and to make changes in your life before you hit rock bottom. You do not have to be suicidal, harm yourself, or do drugs to accept help and make a change. If you’re like me, you may not know where to begin. That is why therapists exist! It is also why it is important to implement their feedback and guidance outside of sessions. The healing truly begins outside of sessions. And you are worthy of a life that is worth living. Here are some tips and tricks that I learned along my healing journey to help you find the appropriate care:</p><ul><li><strong>Ask questions at consultation and intake sessions</strong>! You are interviewing your therapist to determine if it is a good fit, like they do the same to you. At my last intake session, I asked my therapist about social justice topics and communication preferences (can I reach out to her in between sessions? What does that look like?). I asked her about working with those who struggle with thoughts of suicide (does she call the police? How does she deal with imminent risk?) and understanding trauma. I also asked her about insurance or superbills and if she worked with those who had my diagnosis. I also asked her about her modalities and how she implements them. Modalities can be a huge factor in the success of treatment. This goes for all levels of care, especially when filtering out the type of care you need.</li><li><strong>Understand Imminent versus Ongoing crises. </strong>An imminent crisis – such as a suicide attempt or being seconds away from attempting, in psychosis, or other severe symptoms – would lead you into the psychiatric wards of your local area. Ongoing crises – such as severe depression or anxiety or struggling with trauma – may lead you into a Partial Hospitalization Program or Intensive Outpatient Program, depending on availability and severity. Depending on the ongoing crisis, it could also lead to a Residential Treatment Program before moving down to a PHP or IOP setting.&nbsp; An example of this is someone with anxiety who can hold down a job for a long time yet may struggle to build friendships.</li><li><strong>If you feel worse after a therapy session, it could be time for a new therapist</strong>. After a therapist of mine broke my boundary twice, and we had multiple sessions in a row where I left angry at him, I realized it was time for a change. Changing therapists could have been one of the best things I did for my mental health. I healed in new ways by switching therapists and even more so once I had moved out to New York to finish school. Therapy should never leave you infuriated at your therapist. And your therapist should always respect your boundaries. Likewise, if after a significant time, you feel you are not healing or are getting significantly worse, it could be time for a higher level of care (which does not always mean the psychiatric ward!).</li><li><strong>Determine your time commitment.</strong> Psychiatric wards should be viewed as stabilization units. They are short-term (rarely more than a week or two), with groups and constant supervision. Residential treatment programs are generally heavily supervised and longer-term (usually around 30-90 days, though some may be more than six months, depending on what they treat). At both psychiatric wards and residential treatment programs, you live, eat, and sleep on campus, so your time commitment is 24/7 until your discharge date. Partial Hospitalization Programs and Intensive Outpatient Programs can vary between 8 weeks and 90 days or until your therapist and you decide that it is time to graduate. PHP is generally 8 hours a day, five days a week, while IOP programs can vary between 3-5 hours a day, three times a week. PHP and IOP programs are outpatient, meaning the supervision ends the moment you leave the campus and live independently. Individual therapy is one-on-one, once or twice a week, and generally ongoing until your therapist or you decide it is time to graduate.</li></ul><p>Determining the type of care can be complicated, and it is best to speak with those around you to help you make the right decision. The important thing to remember is that it will always be celebrated when you accept help. And you deserve to heal from your pain. Whatever it looks like, you deserve a life that feels worth living.</p>

John Matthews

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