Ketamine…Again?

Before I sat down to write this today I was planning on doing another Vlog. (Note: I actually wrote this and intended to post it yesterday before I found out that Facebook and Instagram had both crashed!). I thought I needed to maybe hear my own voice again today but I’m just too vulnerable right now and so I wrote my words out instead. 

My Psychiatrist increased my new medication again late last week with the intent to get it to a therapeutic dose soon. It’s an anti-anxiety medication which I mentioned I would be starting a few weeks ago. As of yet I can’t say that it’s really been helping me. So for now I will just add it to the long list of failures.

Yesterday was a pretty bad day all around for me. My anxiety was very high which then turned to panic, crying, rumination and an increased amount of thoughts of death and dying.

As I also mentioned recently my Psychiatrist had put a plan together for me when we spoke a few weeks ago. It included this new anti-anxiety medication and it also included treatment for Ketamine…AGAIN which has been scheduled to start early next week. 

So for those of you who don’t know what Ketamine is I will give you a quick explanation here. For starters, it’s actually a very potent and sometimes deadly street drug known as “Special K”. It is also apparently used as a horse tranquilizer but most commonly it is found in anesthetic.

I’m not gonna bore you or put you through a science class today but people living with Depression are known to have “abnormal brain plasticity”. Continued studies and research have shown that using Ketamine can help to remove the “negative receptors” in our brain and then it like “plants a seed” in your brain which allows for new “neuropathways” and positive neuroactivity to grow and flourish.

Studies have shown that by using Ketamine to treat Depression there has been a 60% success rate so far and unlike anti-depressants it is supposed to work faster and more effectively.

Now let me go back for a second here and explain (for those who may not already know) what I meant before when I said I am scheduled to begin Ketamine treatment…AGAIN.

Several years ago during an inpatient stay at Sunnybrook Hospital I was asked to take part in a Clinical Trial for Ketamine. I had never heard of it before but I was the perfect candidate though because it is used mostly on patients who suffer with Treatment Resistant Depression like I do. I happily and very naively agreed to try it. I figured I had nothing else to do seeing as I was in the hospital anyways.

I filled out a ton of paperwork, spoke in depth and several times with the Psychiatrist in charge of the study. I filled out many questionnaires with his Associates. After I was given approval to begin the study I was scheduled to start the 1st of 6 treatments the very next day.

They told me during the initial consult that the Ketamine would be administered through an IV and that I would have to lay there in the OR attached to an IV drip for 45 minutes and then kept for observation for another 30 minutes following. Before we began the process I asked the Anesthesiologist if I would feel anything. He said you may feel a bit woozy. 

Well woozy was an understatement because for the next 45 minutes I lay on the cold table hallucinating, feeling disassociation and seeing psychedelic images flash before my eyes. It felt like a complete out of body experience with flashbacks as far back as my childhood. 

I hated every bloody second of it and couldn’t wait for it to be over. The next day I met with the Psychiatrist to discuss how it went and we both agreed it was probably best that I don’t continue with the study. Another epic fail.

Now let’s fast forward to March of 2020. My current Psychiatrist happens to be the Medical Director of 2 Ketamine clinics in the GTA and has studied it’s effectiveness on Treatment Resistant Depression for several years now.

Back in February or March of 2020 (everything is kinda a blur now) we began another discussion surrounding Ketamine and he asked me if I would be willing to try it again as with more scientific research and studies conducted it was now available in a nose spray form. And less invasive.

He told me he would administer the 1st dose in his downtown office at the hospital he works out of to ensure I tolerate it and that the following 5 doses could be picked up at a local compounding pharmacy and be administered under the supervision of my husband in the comfort of my own home.

I agreed to try it AGAIN cause well, I try almost everything at least once when it’s come to my treatment or in this case twice.

We were scheduled to begin the 1st treatment on March 15th 2020 at 6:00 p.m. It never happened. And if you have been following my journey very recently I kinda just let things slide from there once the pandemic hit.

As most of you know though I reconnected with my Psychiatrist a few weeks ago at which time he told me that patients were no longer allowed to administer the nose spray at home. The whole idea had been kiboshed over the past year as research had shown that it was a liability and quite dangerous to do so. But I guess it’s OK because since March of 2020 Ketamine is now available in an even less invasive form, a pill which is dissolvable under the tongue but still can only be administered under the watchful eye of a doctor/nurse. 

So I guess as they say, three times a charm as I have agreed to try it…AGAIN. The six sessions are to be completed at a clinic in Toronto (there is also a clinic in Mississauga too). Each session will take between 2 to 3 hours from start to finish to complete and I am not allowed to drive home afterwards. They actually recommend you don’t drive for 24 hours following. The sessions will take place twice a week for two weeks and once a week after that.

Although I’ve agreed to try it again given I feel like I’m running out of both viable options and steam, but I have been told by my doctor that I am very likely to still feel those same hallucinations and disassociative feelings that I don’t like. I’ve done many other treatments and have tried many hallucinogens over the last several years. I don’t like feeling as though I’m tripping out on LSD.

I’ve been consumed with very negative thoughts for several days now (surprise, surprise) since booking my treatment. I’m experiencing extreme anxiety and feelings of overwhelming guilt and lets not forget those feelings of being a burden that weigh me down too. I’m questioning my decision to do this again for many, like OH MY GOSH, too many reasons.

For one, it’s still very new and likely not to be a forever cure from what the current research shows. I will very likely need to continue on some type of maintenance program after the six sessions are done. But like how long term? And does anyone even know what the long term effects of it could be, especially cognitively. As it is, I did ECT (Electroconvulsive Treatment) several years back. Probably the most invasive and scariest treatment I’ve done. The eight treatments I did fucked me up royally. It fried my short term memory, my ability to recall many things and I find myself often forgetting what I was talking about mid…sentence.

But at the same time Psychedelics seem to be the wave of the future for treating mental illnesses and especially for people like myself who are treatment resistant. I’ve even tried “shrooms” in a pill form, but couldn’t tolerate the hallucinations it caused, although my Psychiatrist is also currently working on many new studies and its amazing effects on Treatment Resistant Depression as we speak.

I’ve tried so many different treatments over the past seven years and how I see it, I have failed them all, many of which have cost a shitload of money because they were not covered by either Ohip or insurance, Ketamine now included. I wish I could understand why if there is such a need for these treatments and Ketamine for one has one of the highest success rates among all treatments including anti-depressants then why has it not yet become part of the mainstream health care system so that more people can have access to it? I know, dumb question.

It’s an expensive treatment, especially if it becomes ongoing. It’s an expense we really can’t afford at the moment and just adds to the extraordinary guilt I already live with on a daily basis. The “what if” I’m not part of that 60% success rate, the “what if” yet another attempt fails and we throw away even more money that we don’t have. How can I live with that on my conscience?

The answer is, I can’t.

I’ve carried on and on AND on the last few days with all the other reasons as to why I also shouldn’t do it as well and feel like a burden yet again to my family by having to take me and sit with me for 2 to 3 hours (plus the 30 plus minute drive there and back) while I have my treatments.  

These are very real struggles for me which of course my Psychiatrist tried to remind me the other day as I rambled on about all my reservations that I’m having that it’s my Depression talking and that my Anxiety is happily cheering him on. I can’t let them win.

But it’s so fucking hard though and the noises in my head are loud as hell. It’s literally killing me.

They keep telling me I don’t deserve to live a life free of chronic Depression, debilitating Anxiety and daily thoughts of Suicide. They keep telling me I’m just gonna fail at this attempt too. They keep telling me to give it up already and that I’ve already used up my many chances at recovery over and over AGAIN. Like why would this time be any different?

Thanks for listening to me today. I so appreciate the extra set of ears. Somedays the best medicine is just knowing that someone is there listening to my very real and terrifying emotions with only the purest of intent.

#ketamine #empathy #education #treatmentresiatantdepression #mentalillness #mentalhealth #depression #anxiety #itsoktonotbeok #youareenough #maskoff #psychiatrist #psychiatry #acceptinghelp #threetimesacharm #selfcare #youmatter #youareenough #yourmentalhealthmatters #mentalillnessawarenessweek

Nap Time

To chronicle my sleep patterns in a word I’d best describe it as haphazardly. 

In short, it lacks any type of direction, it’s random and very disorderly.

I’m up until all hours of the night wandering aimlessly, worrying and anticipating doom. 

My body seems to have made the necessary adjustments needed for someone living on minimal amounts of sleep each night but still it continues to urge me to get some rest when I can.

Most days it loses that argument because even a short catnap feels burdensome to me. My mind fights the urge to nap but certainly not for lack of trying that is.

Napping is good for your mental health. Experts will tell you that taking a short afternoon nap can help clear the chaotic thoughts and burnout from your mind, it can improve your cognitive ability and even boost your mental agility.

But still, napping gets a bad rap.

People perceive napping as laziness instead of seeing it for its many health benefits. 

I wish I could nap more often. I feel guilty as it is when I can’t get out of bed most mornings. But it’s okay to nap, or even lay in bed a little bit longer if that’s what your body and mind need. 

Sometimes doing nothing is the best thing we can do in order to recharge. It’s not a waste of time if your body and mind are begging you to do so.

Do you find having a quick catnap when you can rejuvenating?

Thank you to everyone who continues to reach out to me, check up on me and leave beautiful messages of support this week as I continue to try and get through this very difficult time*

#napping #catnap #recharge #mentalhealth #mentalwellness #negativethoughts #burnout #mentalagility #siesta

Monday Motivation: Crushing Your Dreams

Two years ago today, August 16th,  2019 was one of the happiest and most fulfilling days of my life when the first ever copies of my brand new, hot off the press children’s book “Where Did Mommy’s Smile Go?” arrived on my front porch. 

I had just spent the previous year and a half working on it from start to finish which included writing, editing, working with my fabulous illustrator and finding the “perfect” and most patient company to help me self-publish it. 

For the next four plus months I worked non stop trying to get my book into as many hands as possible. I attended one event after another, reached out to  Mental Health Advocates on Social Media, got it on the shelves of some independent bookstores in Toronto, sold it at large retail chains, made several National Television and Radio appearances, was interviewed by local Newspapers, gave book talks at Preschooler/Mommy & Me programs and I had just begun filling up my calendar for the new year with book talks on Mental Health at Elementary Schools as well. 

And I had endless possibilities still up my sleeve.

I met so many incredible people along the way. I also had such incredible support from so many fantastic friends, family, acquaintances and strangers alike.

It felt like my dreams were coming true. I felt like I had purpose and I even felt like royalty somedays, especially when I attended my fabulous book launch party that Fall in my honour, hosted by a friend and her husband.  

And then, BOOM💥, 2020 hit and it hit hard. I got a concussion on day two of the new year which put me out of commission for close to a month and then the Pandemic hit us all in March and then in June of 2020 I found out, just by dumb luck that my Publisher had closed his business after 35 years, without any warning to his clients or a simple courtesy email or thank you.  Instead he disappeared without a trace and took with him, several thousands of dollars of Grant money which had been gifted to me by a prominent Mental Health Organization along with any additional inventory of mine they had held on to for safe keeping for my personal use and my Amazon account.  

To say I felt defeated is an understatement. One obstacle after another left me feeling purposeless again and very broken. It was the final blow. My dreams felt crushed.

I wanted to give up completely. I didn’t see any point in continuing.

How was I ever going to move forward from this especially knowing I now needed to somehow find a way to republish my book. We were in the midst of a global Pandemic and money was extremely tight.

But how could I give up on my dream that I’d worked so hard for and wanted more than anything? How could I let anyone dull my sparkle?

Surrendering to my current situation was difficult to accept. The “what ifs” controlled my every waking moment, making it even more difficult to forgive myself and somehow find the strength to move forward. 

I took some time to figure out if I could somehow save my dream even though it felt too crushed to repair. 

I leaned on my support system for encouragement and reassurement even more. I didn’t want to give up on my dream even if it felt crushed beyond repair and that my anxiety and depression had taken over my ability to pivot my way through this, especially during a global Pandemic. 

I began slowly trying to rebuild my dream by learning how to use technology I’d never even knew existed before in order to keep my book relevant. I knew that with each passing month of the Pandemic there were more and more people in need of my voice and my book.

I kept reminding myself this was not my fault. 

I am still actively looking to republish my book when I am ready and able to and this time I plan to take everything I have learned through this process into account when choosing a new publisher to work with. I am wiser now.

I am also so grateful to still have copies of my book in my possession which has allowed me to continue promoting it in the meantime. And of course with the help of technology and social media I’ve found so many new and innovative ways of doing so during a Pandemic through guest spots on Podcasts, Book Talks and Conferences on Zoom, pre-recorded story times, Google meet-ups with Non-Profit Organizations and Facebook/Instagram lives.

These obstacles I’ve endured since January 2020 have taught me many important lessons. My dream has never changed. My vision hasn’t either.

It may feel crushed beyond repair but like so many of us have had to do over the last 17 months, I am learning to pivot. Pivots in life do not equate to failure. Pivoting simply allows new doors to open and new dreams to come true.

#crushingmydreams #pivoting #childrensbook #author #dreamsdocometrue #selfpublishing #mentalhealth #mentalwellness #depression #anxiety #failure #mentalhealthadvocate #blogger #youareenough

Monday Motivation: Badge of Honour

I started following a group on Facebook called “Ontario Hiking” soon after its conception last spring that has really helped me to find many new and exciting places to explore on our #summerofrich adventures.

It is run by Lauren Yakiwchuk who spends so much of her free time exploring our great Province and blogging about her personal experiences along her trails.

This group offers many fun and interactive experiences, great tips, lots of beautiful photos and so many helpful and honest reviews of places all over Ontario, some of which are very close to home for me and many more that are hundreds of kilometers away.

Throughout the last 4 years since the #summerofrich first launched (can you believe its been four years) I continue to add many new and adventurous places to my already very lengthy wishlist that I would love to explore one day.

It has become quite a long list and it just keeps on growing. 

Each week I now refer to this wonderful and very informative group of close to 80,000 like-minded members who share my passion for nature, hiking and mental wellness in order to plan our day trips. **I was really hoping that this summer we could take a 5 day hiking trip to the most northern tip of our beautiful Province for my birthday but unfortunately there have been too many obstacles standing in our way this year.

One of the group’s most fun and interactive experiences I’ve enjoyed following most since the group launched last spring has been reading posts from other members who have participated in the quarterly hiking challenges. 

These challenges occur every January, April, July and October. Participants are asked to complete 5 hikes (or walks) during that month. Once you have completed your hikes you can email the 5 locations you hiked during that month to a specific app in order to receive a “digital badge” for “bragging rights” and a chance to win prizes. 

I decided near the end of June that instead of just following other members participating in the upcoming July challenge that I would join in on the #julyhikingchallenge for myself. 

It’s not like we don’t hike several times a month anyways, especially during the summer and I knew that if I participated in the challenge for myself that it would push me (and Rich) on those days when one of us is just not up for it.

We both have such a feeling of accomplishment after our hikes and not only did we challenge each other in July to push through the 5 hikes, we surpassed the initial targeted goal and completed 7 of them instead. That for sure earned us both many bragging rights.

I just received my “digital badge” this morning via email for accomplishing the #julyhikingchallenge and although I may not have won any of the prizes this time around I feel like a baby bird today when they are first born and have no idea the power that their wings have or  how determined they will become in order to learn to fly; and one day maybe even learn to soar.

#mondaymotivation #badgeofhonour #hikingchallenge #ontariohiking  #ontariohikingchallenge #hikingtrails #summertimeselfcare #spiritualhealing #ontarioisourstodiscover #nature #mentalwellness #mentalhealth #babybird #learningtofly #depression #anxiety #suicideprevention #youareenough

Body-Shaming Yourself

A few years ago I opened up about an eating disorder I had in my late teens and early twenties (see blog: https://youareenough712.wordpress.com/2018/09/07/i-had-an-eating-disorder-and-it-still-weighs-me-down-everyday/) and I spoke in great length at the time about how I never really figured out the root cause of it even after I recovered. 

But the truth is that even though I may have recovered initially from my battle with Anorexia and Bulimia in my early 20’s it has never truly left me; it’s just transformed itself in other ways. 

I never battled with my weight before the onset of my eating disorder, nor did I have any issues with my self-image. 

It probably didn’t truly present itself again until I began having children in my late 20’s and early 30’s and it has especially spiraled out of control since my battle with Depression and Anxiety began seven years ago.

Right from the start of my mental health journey and my diagnosis I was treated with over 20 concoctions of antidepressants for a solid two years straight which eventually led me to a further diagnosis of Treatment Resistant Depression and also left me with a weight gain of close to 100 pounds. 

And although half of that weight gain almost disappeared instantly when my husband and I finally made the decision together, along with the guidance of my Psychiatrist to wean me off all my medications, my weight has continued to be an uphill battle for me throughout my journey and just one of the many road blocks in my recovery. It all too often leads me back to those same destructive behaviours I exhibited as my 18 year old self battling an eating disorder. 

I’m struggling alot these days with these tendencies and it seems to have magnified itself by a thousand this past week when I needed to go dress shopping for an upcoming family wedding and I had a panic attack and complete breakdown which left me crying in a sea of dresses on the floor of a department store changeroom.

I know I’m not alone in my negative self-image or body-shaming thoughts and especially lately as we all begin to emerge from our cocoon that has left many of us bearing several extra “Pandemic Pounds”.

It’s no secret by now from all the pictures that I post how much I shy away from the camera. Seeing pictures of myself only sets off a destructive mindset and binge of body-shaming.

It’s a vicious cycle of bullying, negative self-talk, anxiety and suicidal ideations. Self-shaming or the act of body-shaming whether it be towards ourselves or someone else is a real and very dangerous problem which Social Media and the mainstream media have only made 10x worse.

My illness has pretty much destroyed any ounce of self-confidence I once had, it continues to tell me how worthless and helpless I am, it loves to focus on the negative and boy oh boy does it ever hate to hear compliments. 

I wish I were able to squash my destructive mindset once and for all and begin to see the same beauty in me that others do; and to believe that I AM ENOUGH from the inside out.

Tell me one thing you love about your body.

#bodyshamingyourself #bodyshaming #eatingdisorders #anorexia #bulimia #depression #anxiety #suicide #mentalhealth #mentalwellness #mentalillness #youareenough #youarenotalone #itsoktonotbeok #youmatter #selflove #innerbeauty #imperfectlyperfect #mondaymotivation

Monday Motivation: Summertime Self-Care Ideas

Today is the first full day of summer and it just so happens to also be “World Naked Hiking Day” too. 

Summertime for many of us often means more time to enjoy the daylight hours, more time to relax and more time for adventure. 

Summer is also the perfect season to refocus our energy on our mental and physical health which may have been lacking over the previous months as well.

So I’ve created a list of some very simple ideas for ways in which you can incorporate the all too important self-care into your summertime routine. 

1. Go for a long hike or a walk in nature (bring lots of bug spray if you decide to go naked!)

2. Use sidewalk chalk

3. Run through a sprinkler

4. Do yoga outside

5. Pack a blanket and enjoy a picnic in the park

6. Roast marshmallows 

7. Visit a farmer’s market

8. Watch the sun rise

9. Go out for ice cream 

10. Star gaze

11. Bird watch

12. Take an evening stroll at sunset

13. Play with water balloons

14. Have a backyard barbecue with friends and family

15. Make a playlist of music that reminds you of summer when you were a kid

16. Play with bubbles

17. Make lemonade out of lemons

18. Enjoy a good book

19. Drink lots of water

20. Take a road trip

21. Get lots of Vitamin D

22. Bake your favourite summertime treat 

23. Dance in the rain

24. Keep a journal of your summertime self-care

25. Discover a new hobby or reinvent an old one

26. Set new goals

Feel free to add anything I may have missed.

What do you look most forward to about summer?

#selfcare #mondaymotivation #summertimeselfcare #firstdayofsummer #summerishere #worldnakedhikingday #mentalhealth #mentalwellness #yourmentalhealthmatters #youareenough #itsoktonotbeok #bekindtoyourself #beinthemoment #takecareofyourmentalhealth #nature #summerofrich 

Good Mental Health is a Balancing Act

I’m overwhelmed. 

No I’m like freaking beyond overwhelmed right now. 

I’ve reached my tipping point and I’m finding it real challenging to keep my balance in check.

Good mental health is a balancing act. 

It takes a lot of trial and error. 

I know my weaknesses.

I know my limitations.

I know what makes me happy. 

I struggle to accept help from others.

I struggle to set boundaries. 

I struggle to say no.

I’m overwhelmed.

No I’m like freaking beyond overwhelmed right now. 

I’ve reached my tipping point and I’m finding it real challenging to keep my balance in check.

Balancing one’s mental health is “learning to find a way to do the things we have to do and the things we want to do without changing the hours in the day.”

I can’t find my balance right now. I’m tired.

I’m feeling hopeless.

Quick to anger.

Anxious.

Guilt.

Sadness. 

I’m an organizer, a fixer, a multi-tasker. 

But I can’t concentrate.

My brain is scattered.

I can’t complete a simple task.

I’m overwhelmed. 

No I’m like freaking beyond overwhelmed right now. 

I’ve reached my tipping point and I’m finding it real challenging to keep my balance in check.

Good mental health is a balancing act. 

It’s not something that can be achieved in a day.

My mental health depends on it and so does my mental wellness.

I’m deserving of both. So are you. 

But it may take a lot of trial and error in order to get there. 

How do you balance your mental health and wellness?

#mentalhealth #mondaymotivation #mentalwellness #depression #anxiety #balancingact #overwhelm #vulnerability #itsoktonotbeok #yourmentalhealthmatters #youareenough #selfcare #hopelessness #suicideprevention #blogger #trialanderror

Inner Child

Children are curious, dreamy, creative and determined little creatures.

They see the world through much different eyes.

They see the world as beautiful and innocent.

They love fearlessly.

They live in the moment.

They express themselves with sincerity. 

Somedays I just need to talk to my inner child in order to help me understand life again.

#mondaymotivation #innerchild #dreamy #beinthemoment #acceptance #bekindtoyourself #youareenough #mentalhealth #mentalwellness #youmatter #trueself #youarenotalone #soulsearching #selfcare #selfreflection #forgiveness #healing #reflections #nineteenseventysomething

Friendship First

It was 30 years ago today that Rich and I went out on our first “official” date. 

We had already been working together (he was my boss) for the better part of a year but our timing and circumstances just hadn’t quite aligned before then. 

But maybe that wasn’t such a bad thing, maybe it was how it was meant to be and maybe it’s how it should be because during the time leading up to our first “official” date we were building a genuine friendship. 

We were getting to know each other, trusting and confiding in one another and learning things about each other that we may not have otherwise been given the opportunity to do.

By developing a true friendship and bond first before jumping right into a relationship took away all of our exceptions. 

I can barely recall most days anymore what I did 5 minutes ago yet I can still remember every last moment of our first “official” date.

And maybe it’s because we could truly be ourselves around each other and not have to pretend to be someone we weren’t. 

Or maybe it’s that friendship we developed first, the one with no strings attached that has helped us to grow together as a couple and has also enabled us to support one another through the most difficult and challenging times that were still yet to come.

I’d love to hear some stories from your best and worst first dates. 

#firstdates #dinnerandamovie #twentysixyearsmarriedthisfriday #thirtyyearsago #wheredidthetimego #friendship #whattrulymatters #unbreakablebond #youareenough #mentalhealth #mentalwellness #mondaymotivation #nostalgia

Monday Motivation: I Am More Than My Mental Illness (Mental Health Week May 3-9)

The truth is I don’t see it often and to be perfectly honest I mostly only see it when others point it out to me but I am so much more than my mental illness. 

I spend most of my waking hours convincing myself that I am incapable, that I am worthless and that I am a burden to everyone in my life. 

I am forever apologizing for my mental illness. 

I am forever feeling guilty because of my mental illness.

I am forever feeling like a failure because of my mental illness. 

I am forever left feeling broken and suicidal because of my mental illness. 

And I am forever feeling like a prisoner in my own mind because of my mental illness.

Being labelled with a disorder of any kind doesn’t make you any less than the beautiful, amazing person that you already are. 

Labeling someone for their shortcomings can be damaging and we should never let it define us. 

Even though my mind literally has a mind of it’s own, my heart will tell you that I am so much more than my mental illness. It even says so right here on this list.

I AM:

Valuable 

Worthy of respect 

Respected

Kind

Generous

Worthy of love

Deeply loved

Thoughtful

Resourceful 

Smart

Funny

Honest

Ambitious 

Creative

Dedicated 

Skilled at all sorts of things 

Resilient 

Driven by integrity and values

A good mother

A good wife

A good friend

Enough 

I am more than my shortcomings.

I am more than my labels.

I am more than my mental illness. 

And you are too.

What do you see in yourself from this list? Feel free to add more.

I AM…

#mentalhealthweek #mondaymotivation #iam #youmatter #itsoktonotbeok #youareenough #bekindtoyourself #depression #anxiety #mentalillness #mentalhealth #mentalwellness #labels #shortcomings #morethan

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