Why I Made a List of my Mental Health Symptoms.

Ashley Lewis Carroll
6 min readDec 9, 2015

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I just spent two hours emailing my therapist. She asked me to send her the list I’m going to take with me to the emergency room today (maybe, tomorrow) to show the social worker how much I need to be admitted to inpatient psychiatric care.

She got a lot more than this list. As tends to be the case.

I need this list because I present well.

I, also, am a social worker.

I am a mother, and a wife, and a homeowner. I’m average height and have a formally fit (currently rebounding from that) build. I dye my prematurely graying hair platinum blonde and have a trendy undercut. I was born and raised just outside of Portland, Oregon; I have my fair share of stunning tattoo work to show for it. But also, to camouflage the self-injury scars from my teen years.

I’m white. Suburban dweller. Able-bodied. Straight. Immensely privileged.

I have a lot of trauma. I have a sordid past with the mental health system.

And then, this recent triggering in my own highly-political, somewhat-prominent, government position in the domestic violence field.

Social services, let us change you. For those doing the work. For those loving and supporting us through it. And for those being served. Let us also remove the bullshit lines implying we fit into — and stay within — one category or another.

Once an advocate, always an advocate.

I’ve had an intense last year. The thirty-first of an intense life. Lived by an intense person. At least that’s who (what, how) I’m coming to accept myself to be.

Even amidst this intensity — I’ve talked about it.

I started the year out blogging haphazardly — as I’ve done almost half my life.

I depicted my daily (hourly?) ebb and flow publicly on Instagram.

I’ve generally shared the motherhood/life progression of my past nine years to select friends and family on Facebook.

As I walked further down this journey of finding my voice — and breaking myself open — I began to speak more loudly.

I posted #getyourshittogethergirl about my body obsession — a public apology of sorts to women for my having held up an unattainable appearance (implying it was both holier than thou and easy), while simultaneously judging harshly.

Then, I had my first piece published on elephantjournal.com. This was a very public coming out with both my mental health history and the ways this history affected me in my leadership role for a center providing trauma-informed services to abuse survivors.

I also talked about some of the deeply healing and transformative work I was doing while on medical leave. I called it “10 Things I Learned at the End of my Breakdown”. Mostly because we are all suckers to click on a list rather than read an actual article. And so that’s what gets published. What we click on. Holy power we all inevitably carry and control.

The same day “10 Things…” came out, I had a literal depressive break. Vulnerability hangover, much? It wasn’t long before I posted about it on Facebook.

I’ve been slowly coming back ever since. I found manic-depressive cycling to be waiting beneath my well-tended garden of control issues (including: extreme diet and exercise; an ever-busy and driven lifestyle; the relentlessness of parenting; the allure of our cultural norms — and that damn related sense of self-worth and shared exaltation).

I “woke up” to this body I’ve been disconnected from for perhaps my entire life.

Childhood and adolescent traumas I‘d forgotten came flooding back, bringing with them days of abdominal spasms and/or an overwhelm of anxiety (with a pervasive sense of urgency).

It’s been intense. And it’s been a serious struggle.

I’ve managed it. I’ve made good choices, tamed my inner recklessness, and moderated my compulsions. I’ve buffered myself (and my people) with a parade of providers (traditional and alternative), body work, Epsom salt baths, Spotify playlists, settling for takeout, sleeping, sweats wearing, social media posting, serial coffee dates, astrology, energy work, coloring, self help books, etc.

And writing. So, so much writing.

I’ve been gentle(ish) and productive, and busy and bored, and connected and lonely as hell.

My two daughters and superhero husband have both propelled me forward, too often portraying right before me the consequences of my current state — the growing desperation in our familial reality.

This is why I need a list today. Because I present well. And I’m insightful as hell.

I can’t always articulate as clearly as I’d like (thank you trauma brain), but I can usually explain enough.

Like right now. I can say it so it all makes some sense.

I can say it — even if I don’t always believe it— so I’m basically exonerated. And, I’ll present it in a way that you are too.

You’re fucking welcome.

All of this talent and carefully cultivated skill can’t completely cover the fact that I’m struggling. I’ve been struggling for a long time. In a deep and incessant way I hope we all wish people didn’t ever struggle.

My family has been through hell. My daughters have in many ways watched their mother disappear before their eyes. And my partner, his wife.

When I returned to my job after medical leave my mental health experiences — and my speaking out about them — seemed feared and silenced rather than embraced and/or appreciated (or even addressed).

It was not a conducive environment for my long-term success or wellness; I was basically instructed to return to medical leave and escorted out of the building.

Now I’m neck deep in medical expenses and on unpaid leave…and it’s the holidays?

Two days ago I stood in my kitchen and cried to my husband that if this was cancer it would sure look different. People would engage in the struggle. People would acknowledge and support and maybe even fucking help.

I wouldn’t have been shunned and silenced and isolated — and I’m sure judged — at work. My professional reputation wouldn’t be on the line for talking about it. Even in the most diplomatic, trauma-informed, we-are-all-humans-as-we-walk-this-world way.

But it is.

And even though I risk so much by saying this, saying this is who I am. This is who I have always been and must continue to be.

Because I think we all agree I must continue to be.

Whatever that takes. And that I deserve better than this. As my family does. As you and your family do. As we all do.

I wish so much movement against mental health stigma in this country. I wish empathy and understanding for the struggle. I wish hope for the desperate, and motherfucking change for the systems that serve.

We can do better. We can be better.

In the work we do — or the people we are — let us not give up.

Let us not get distracted or complacent. Let us not distance or divorce or become too consistently numb. Let us not judge or dismiss or deny. Let us not blame. Let us not excuse or look away. Let us not hide.

Let us love. Let us see. Let us listen.

Let us connect. Let us unite.

Let us rise up. Let us stand strong.

And let us speak out.

For we are many and we are strong. Let us not be silenced in the struggle.

If, struggle we sometimes must.

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