Tuesday, January 27, 2015

The Anarchist Soccer Mom Goes to Washington

I hope Congress can give themselves a facelift and pass mental
health reform legislation that will help children and families!
Lessons in Speaking Up—and Listening

I’m a mom. What that means for me, as it means for so many moms, is that I rarely think of myself first. When I have to choose between hearing the President of the United States speak in my hometown or picking up my kids from school, I pick up my kids. When I’m cooking dinner, I fix their favorite canned tuna and white rice instead of the lamb curry vindaloo and brown rice I would prefer to eat. Rather than spending money on spa treatments for me, I buy soccer camps or ice skating lessons for them.

But this week, I did something all for me. I bought a last minute plane ticket from Boise, Idaho to Washington, D.C. and flew into the outer edges of Winter Storm Juno to attend the presentation of the well-deserved Treatment Advocacy Center E.F. Torrey Award to Representative Tim Murphy (R-PA), a man I and many other families of children with mental illness view as a hero.

Two years ago, in a gut-wrenching response to the Newtown tragedy, I told our family’s painful story on my formerly anonymous blog. My essay was picked up by Boise State University’s The Blue Review and retitled as “I Am Adam Lanza’s Mother” (thanks, @paleomedia). Overnight, I became an accidental advocate for mental illness, speaking up for families and children everywhere who could not find anyone to listen to their stories. Then I wrote a book, The Price of Silence, telling some of those families’ stories, describing the numerous barriers to care that we face, and identifying solutions that already exist in some communities.

Now, it seems that lots of people are talking about mental illness, and that’s a good thing. But I wonder if people are listening.

Every day, there’s another tragedy in my Twitter feed: a father (or mother) tosses a child from a bridge, a mother attempts to kill herchildren, an estranged boyfriend kills a woman and her daughter, a police officer shoots a 17-year old girl. Every day, hundreds of thousands of people with mental illness suffer on the streets while millions more languish in prison. Meanwhile, states slash mental health budgets, and families continue to live onthe brink, as they did 15 years ago.

Today in his acceptance speech, I heard Representative Murphy offer, once again, a vision of hope. He talked about the need for better options, from early intervention to peer support to assisted outpatient treatment that can keep people with serious mental illness in the community and out of prison. As National Institute of Mental Health Director Thomas Insel and American Psychiatric Association President Paul Summergrad looked on, Representative Murphy encouraged research into new treatments that can help people with serious mental illness live productive, happy lives. He talked about ending discriminatory regulations that prevent people with mental illness from seeing a physical doctor and a mental health specialist on the same day and about expanded inpatient treatment options (instead of jail) for those who desperately need them.

I have to admit that one thing made me especially glad: in discussing his proposed new legislation, it seems like Representative Murphy is listening. And that’s important. But has one advocate noted, the voices of people who have serious mental illness are important too.

How do we hear the voices that serious mental illness has silenced? How do we ensure that we do not merely “bring back the asylums,” as one recent provocative JAMA article proposed, but that we create comprehensive services for individuals, families, and communities?

The word “advocate” means to speak up for something you believe in. But sometimes, advocacy also means respectfully listening to people who disagree with you. That’s a lesson our current Congress needs to learn. I hope that the Capitol’s denizens can repair their rifts (as the building itself gets a facelift) during this next session. It has become very easy in this world of fast information to tune out voices that disagree. But as a scholar and as an advocate, I prefer to surround myself with the voices of people who think about these complex problems in different ways. I do not feel threatened by other advocates who see these problems—and their solutions—differently than I do.

But one thing I think we all agree on is this: the current mental health care system is broken. We see the proof in our suicide and incarceration rates. Barriers to mental health care—however you define it—are massive and omnipresent. As one of my opposition-minded friends noted, whatever you think of Representative Murphy’s proposed legislation, at least he got us all talking about the problem. No bill, however well-intentioned, is ever perfect. But I applaud Representative Murphy for rising once again to the challenge of bringing our different voices together in a clarion call for change and hope. Let 2015 be the year we can listen to each other—and by listening, learn to help each other and those among us who suffer most.

P.S. Thanks to a supportive and amazing spouse who got the kids to school, fixed their dinner, and supported me in this once-in-a-lifetime opportunity. Love you, Babe!

Monday, January 19, 2015

5 Reasons I Wish We Would Stop Talking about "Recovery" for Serious Mental Illness

And the word I wish we would use instead

My heart hurts today. My friend Laura Pogliano has lost her 22-year old son Zac, who had paranoid schizophrenia. Both Laura and Zac were tireless and passionate advocates for ending the stigma of mental illness. Their story was featured in USA Today's "Cost of Not Caring" series, where Laura described herself as a "fortunate" mother--fortunate because despite personal bankruptcy, she had been able to obtain treatment that seemed to be working for her son. This tragic turn reminds all of us mothers just how fragile life is for our children who have serious mental illness. As a parent of a child with bipolar disorder, my worst nightmare is what happened to Laura and her son.

There's a popular quote floating around mental health advocacy circles: "Mental illness is not a choice. But recovery is." I know people will disagree with me, but today, I'm tired of that sentiment, and I wish we would retire the word "recovery." When local and national mental health policy is shaped by high-functioning consumers who have been able to manage their illnesses rather than by the sickest patients and their families, it's the equivalent of only allowing stage 1 cancer survivors to drive the narrative and take most of the funds. While their courage is admirable and their struggles are genuine, too often, we lose sight of those who are suffering the most. They become invisible to us, marginalized on the streets or in prison. Or they die young, like Zac.

I wish we would stop talking about recovery and replace it with a more useful, less stigmatizing word: hope.

Here are five reasons I wish we would stop using the word "recovery" for serious mental illness. 

  1. Not everyone recovers. The word "recovery" has become central to mental healthcare, from the top down. In fact, the Substance Abuse and Mental Health Services Administration's stated mission is that "People recover." With serious mental illness, that's not true. People recover from head colds. They recover from chicken pox. They recover from situational depression. They even recover from trauma. But some diseases are lifelong. Like diabetes, or Parkinson's disease, or multiple sclerosis, serious mental illness is a lifelong, chronic health condition.
  2. Recovery and its partner phrase, behavioral health, imply that mental illness is a choice. Mental illness is not a choice or a character flaw. The focus on "behavioral health" unintentionally stigmatizes the very people that SAMHSA is meant to help: those with serious mental illness.
  3. The word "recovery" suggests that people need to return to a "normal" state, rather than embrace their differences. What does a person with bipolar disorder or autism need to "recover" from? When people realize they are not their diagnoses, they can start to find things that actually work to help them live successful and productive lives. That's hope, not recovery.
  4. The concept of recovery increases stigma, both within and outside the mental health community. Again, if people recover, why aren't you recovering? It must be a choice you are making, or something you're doing wrong. Some people tell you the medications you take are preventing you from recovery. Others tell you that your choice to stop medication is preventing you from recovery. Who is right? Hope is a universal concept that embraces a wide range of possibilities. Recovery seems dependent on a prescribed set of treatments that may not work for everyone.
  5. Recovery is an unrealistic standard for any chronic illness, including mental illness. We would never apply the blanket expectation of recovery to any other chronic illness or disability. With cancer and autoimmune disorders, we use the term "remission" to describe a life-threatening systemic illness that with luck and treatment has been stopped in its tracks. With other chronic illnesses like diabetes, we talk about managing the illness. But with mental illness, we expect people to "choose" recovery, even when they are experiencing psychosis, or when their disease steals their ability to make rational choices.

Behavioral health is an important concept for everyone. We should all focus on our behavioral health: on diet, exercise, mindfulness, good sleep habits. But behavioral health is not mental illness. Mental illness is physical illness. For people with serious mental illness, behavioral health alone will not "fix" or "cure" the chronic condition, and for us to expect otherwise is unrealistic and cruel. We need to focus on effective treatments, not inaccurate judgments about what we "believe" or "feel" mental illness is. It's a very real health challenge, with real and sometimes devastating consequences for those who live with it and their families. 

Let's keep talking about behavioral health for everyone. But let's stop talking about recovery for serious mental illness and start celebrating people whose brain disorders cause them to live with health challenges comparable to those experienced by cancer patients. The word we need, in the face of so much loss, is hope. Mental illness is not a choice. But hope is. Even in the face of tragedy, today I choose hope.

Thursday, January 15, 2015

A Modest Apology

Three suggestions for kinder, gentler, more accurate social media posts

Wise words from a man who never said them.
Did you know James Franco is dead? Or that Idaho Governor Butch Otter thinks poor people are genetically inferior? Or that British author Jonathan Swift thinks the solution to world hunger is to eat babies? None of these stories is true, but the first two fake articles from a satirical content producer called City World News made the Internet rounds in the past few weeks and baited more than a few readers. I was one of them. I made the very public and easily avoidable mistake of believing (and worse, tweeting) the story about Governor Otter.

Satire has a long and colorful history, one that has been particularly prominent in the discussion of the tragic terrorist attack on Charlie Hebdo. While hardly anyone would defend shooting cartoonists, for a surprising number of people, the answer to the question, “Can’t you take a joke?” seems to be “no.” In the case of Governor Otter, I didn’t see the satire, perhaps because I spend a significant portion of my time trying to defend the rights of people that society just doesn’t care about. Many of the real news stories that cross my Twitter feed every day—people with mental illness shot and killed by police, or dying in solitary confinement, or being refused treatment in emergency rooms, or facing the death penalty for actions that were a result of their illness—are true.

Anyway, I screwed up. It was mea culpa, and a few of my friends very kindly pointed out my mistake. But one friend was a little less kind. She wrote: “People who blindly promote satire as truth risk diminishing their own validity.” 

At first, I thought her comment was a little harsh. I mean, I work full time, take care of four kids, and in my so-called “spare” time, I’m buried in dissertation research. You know, too busy to check my sources, right?

Wrong. My friend was right. And the thing is, validity and credibility really matter to me. So here are three suggestions I’ve come up with for myself to ensure that going forward, I tweet more responsibly.

  1. Don’t send late night tweets. When I read the Otter story, it was at the end of a long day. Work was intense. The kids were fun—but exhausting. It’s entirely possible that I was unwinding with a glass of cabernet when I read the outrageous “article” I retweeted without checking my source. I should have turned the phone off when I got home and enjoyed a good book instead. Lesson learned: No more late night tweets.
  2. Always check your sources. As Abraham Lincoln famously did not say, “The problem with Internet quotes is that you can’t always depend on their accuracy.” www.snopes.com is my favorite source for fact-checking urban legends. Lesson learned: It takes ten seconds to check a story on Snopes. But if you tweet something that isn’t true, you may look like a fool on the Internet forever.
  3. Be charitable in correcting people who tweet inaccurate information. The challenge with information these days is that it’s moving so fast. My friend’s comment struck me as harsh—but it reminded me that I’ve made similar “You really should have checked your sources” comments in the past on other friends’ posts.  Lesson learned: You don’t always have to be right. Sometimes it’s okay to be kind—to yourself and to others.

We all make mistakes. And though I regret my inaccurate tweet, I don’t regret standing up for the rights of people who are treated unfairly. I’ll continue to tweet about social justice, while following my own advice about slowing down and checking my sources—and hopefully my followers will not feel that my validity and credibility are too tarnished by one mistake. 

(And with respect to Governor Otter and City World News, props to the person who got me to tweet a false story that points at a larger uglier truth! Jonathan Swift would be proud!).

Monday, January 12, 2015

Lost in Transition

The author in Budapest, 2007
I performed three Bartok folk songs yesterday. With the performance came this memory.

One rainy evening in early October 2007, on a winding residential street in Budapest, Hungary, I got lost. I pulled out my notebook, squinting at the greying street signs as I tried to decipher something about my location. “Utca,” I mumbled, looking at the hastily written glossary I had begun building the day before: “Alma=apple. Gyorgy=health. Ut=street.” So “utca” must mean lane or little street.

I was illiterate, surrounded on all sides by new construction, hastily built stucco and plaster mansions for the nouveau riche who were coming to the formerly Soviet country in droves. I had a sudden vision of my body, violated and strangled and tossed by Russian gangsters in one of the many blue dumpsters that held construction-site waste. The gruesome vision quickened my pace as the rain stung my face and bare arms in the fast encroaching dusk.

I was afraid and alone. I felt in that moment that if I disappeared, no one would miss me.

My then-husband and I were in Budapest so he could compete in the Rubik’s Cube World Championships. We had taken a romantic Danube cruise earlier that afternoon, admiring the soaring span of the rebuilt Elizabeth Bridge, the reconstructed Parliament building, the bleached white Fisherman’s lookout.

“I want to go for a walk,” I told him after the cruise. I hoped—how foolish!—he would offer to come with me.

“Fine,” he said. “I’ll meet you back at the hotel.” I was too proud to ask for help, too proud to admit how lonely I felt. So I walked away.

Now, cold and unprepared, I shivered, seeing the spider cracks in our foundation, spreading and threatening to destroy the entire edifice of our marriage. Our perfect marriage.

My cheeks were wet, though I couldn’t tell the tears from the rain. I thought of Thomas Wolfe: “A stone, a leaf, an unfound door, of a stone, a leaf, a door.” Where was the door that would set me free?

Then I heard the violin music. It was Bartok, a simple folk song, with words I had learned as a child to sing in English: “Give to me the roses red, two I said! One alone would die forlorn, e’er the morn. Oh, no no! Off you go! Both of them are mine.”

I had stumbled in my peripatetic folly upon a music academy, and I listened in delight to the clean, crisp, rhythmically surprising songs of the Hungarian composer I’d studied when I was young. The music filled me with the joy of childhood discovery, the sense that things were possible.

I climbed the nearest hill, the music receding into the twilight. Searching for the lights that glittered along the Danube, I saw my way back.

When I entered the hotel lobby, drenched, shivering, my husband did not look up from his varicolored cube. I stumbled to our room and collapsed into a merciful, dreamless sleep. When he told me the next day, “You don’t love me like you used to,” I looked away, remembered Bartok’s roses.

Tuesday, December 23, 2014

What Would Jesus Sing?

Maybe It's Time for Some New Christmas Carols

I was raised by Mormon hippies. In addition to traditional Christmas carols like “Hark, the Herald Angels Sing” and “We Wish You a Merry Christmas” (my father was especially fond of the “figgy pudding” verse), we learned the complete canon of 60s protest anthems, including one of my favorites, as sung by Peter, Paul, and Mary, “If I Had a Hammer.”  The song was written by Pete Seeger and Lee Hays in 1949 to reflect the progressive labor movement and experienced a “second coming” as a civil rights era anthem in the 60s. 

Remember when people could protest bad stuff and change the world?

It’s that time of year again—the time when media professionals take advantage of unusually quiet offices to compile their annual “Top Ten” lists. Most 2014 lists will likely lead with the tragic deaths of Michael Brown and Eric Garner (and perhaps of Brooklyn police officers Rafael Ramos, and Wenjian Liu)—manifestations of the same civil rights tragedies that my parents used to sing about 50 years ago. In fact, the past few years have seen several stories of marginalized people protesting privilege and power.

In 2011, Occupy Wall Street was declared the most important news story in a year that included the Gabby Giffords shooting by a man who had schizophrenia and the deaths of Osama bin Laden and Steve Jobs. I had a chance to see the Occupy movement for myself when I was visiting friends in November 2011, the weekend before Mayor Bloomberg shut the Zuccotti Park party down. My first-hand impressions were not positive. I talked to the self-proclaimed media liaison, a pleasant-faced union organizer who refused to give me his real name, though he told me he had been bussed in from Pittsburgh. We had an interesting discussion about classism and Marx, the kind you can’t generally have in Idaho. But while I wanted to sympathize with the message of the 99 percent, what I witnessed was less a collection of legitimate movement sympathizers and more an exploitation of homeless people, many with mental illness.

(Aside: 2011 also saw a black man, Troy Davis, executed by the state of Georgia for the 1989 murder of an off-duty white police officer. Davis steadfastly maintained his innocence, and there was no physical evidence linking him to the crime).

In 2012, the top stories were mass shootings: the tragic deaths of 20 first graders, 6 educators, Adam Lanza, and his mother in Newtown, Connecticut; and the Aurora, Colorado movie theater shooting by James Holmes, a young man with schizophrenia. The shootings trumped even the 2012 presidential election and Hurricane Sandy.

(Aside: In February 2012, an unarmed black teenager, Trayvon Martin, was shot and killed by George Zimmerman; according to Pew Research Center, 70 percent of blacks closely followed the story, while only 30 percent of whites cared.)

In 2013, we lost a cultural warrior, Nelson Mandela, and gained another one, Pope Francis. George Zimmerman was acquitted of second degree murder in the Martin case, sparking protests that have simmered and erupted ever since. Princess Kate had a baby, and two Chechen brothers brought terror back to America in the Boston Marathon bombings.

(Aside: The most prominent mass shooting of 2013, Eliot Rodger’s Santa Barbara rampage, didn’t make the top ten news stories, nor did any of the 26 other mass shootings that year. Still, in 2013, we talked about guns, and we talked about mental health, and some of us even hoped we would do something. Representative Tim Murphy introduced a comprehensive mental health reform bill, the “Helping Families in Mental Health Crisis Act.” Despite broad-based bipartisan support, the legislation died in committee this year.)

In 2014, we heard about police shootings (many of those killed had mental illness). And we heard a lot about Ebola. As of December 22, the World Health Organization reported 7,518 deaths in West Africa from the virulent hemorrhagic fever. The World Health Organization reports that suicide deaths globally are more than 100 times more common, with more than 800,000 people dying by suicide each year. In fact, suicide is the second leading cause of death after accidents for people ages 15-29.  

(Aside: We talked about suicide in 2014 too, first in February when Phillip Seymour Hoffman died of an overdose at the age of 46, then with beloved comedian Robin Williams’s tragic death in August. But neither story made the top ten cut, nor did the fact that James Holmes, who is known to have schizophrenia, is facing a death penalty trial, while Scott Panetti, who also has well documented schizophrenia narrowly avoided death at the hands of the State of Texas.)

Which brings me to Christmas.

Forgive me for asking, but sometimes I wonder, when I look at the mess this world has become: what would Jesus do? Yes, that Jesus, the “reason for the season,” the baby god born in poverty, raised in a climate of oppression and social injustice?

Jesus would demand change. Jesus would tell us to love each other. Jesus would die for his truth.

Meanwhile, we buy presents—so many presents!—and bake cookies and sing “Have a Holly Jolly Christmas.” 

We are comfortable with the baby Jesus, lying serenely in his manger while angels watch over him.

We are less comfortable with Jesus in the synagogue, speaking truth to power. Or Jesus on the cross, dying to save people who just don't want to be saved.

I think that if Jesus could choose his own carols, he would prefer Pete Seeger’s call to action: “It’s the hammer of justice! It’s the bell of freedom! It’s the song about love between my brothers and my sisters all over this land.”

Maybe we need some new Christmas carols in 2015.

Sunday, December 14, 2014

Two Years to Nowhere

Two Years After Newtown, Mental Health Still Matters, and Most People Still Don't Care

"On the first day of Christmas, my true love gave to me..."
This weekend, on the second anniversary of the Newtown shootings, I took my daughter to see her first performance of the Nutcracker. Unsure of the exact venue, we parked on the street and followed the hordes of blond girls dressed just like my daughter in velvet dresses with satin sashes. I have wanted to reenact this holiday tradition from my childhood with my own now 9-year old for many years. But this year was the first time we could actually go together. Two years ago, her brother was in an acute care psychiatric hospital, and I shared our painful story with the world. A year ago, she was with her father, who talked a judge into giving him full custody by arguing that the younger two children were not safe in a home with their brother. Mental illness affects more than  the individual: it affects the whole family.

This year, two years after Newtown, our family is stable, happy, spending the holiday season the way we imagine families in Hallmark cards spend it: decorating our tree, wrapping presents, drinking hot cocoa, and making up new lyrics to “The 12 Days of Christmas.” But we know how fragile, precious, and rare this gift of Christmas present is.

What changed for my family in the two years since Newtown? One word: treatment. Before Newtown, I was afraid to speak up and demand help for my son. After Newtown, in large part because I shared our family’s private tragedy, my son, unlike Adam Lanza, got the help he needed. A diagnosis of bipolar disorder does not “fix” all the challenges my son and our family still face: after years of maladaptive coping strategies, he—and we—are learning a new normal, where we ask for help when we need it. And we still struggle, as many families do, with access to care. But we have what so many other families still lack: hope.

In the immediate aftermath of Newtown, I felt tremendous optimism that people finally cared and understood about mental illness. Sadly, I was wrong. The simple changes—earlier interventions, more access to care, more support in the school system, day treatment crisis centers—have not materialized. We continue to blame parents—and children—for behavioral symptoms of brain disorders. Worst of all, we continue to sentence people to jail or relegate them to homelessness because of their illness.

Along with other mental health advocates, I’ve watched the responses to the tragic deaths of Michael Brown and Eric Garner with considerable sympathy. People with mental illness, no matter what their race, also face challenges with law enforcement officers, especially in cities where police lack Crisis Intervention Team training. Here is a partial list of people with documented mental illness who were killed by on-duty police officers in 2014:
Here's an idea! We could send an ambulance on mental
health calls, like Norway does. 
  1. Keith Vidal had documented schizophrenia. When his family called 9-1-1 for help with a behavioral episode, the police shot and killed the 90-pound 18 year old. 
  2. Parminder Singh Shergill, a U.S. Army veteran who suffered from PTSD, was shot and killed by police after his mother called and asked for medical help. He lunged at officers with a knife. 
  3. James Boyd, a homeless man with mental illness, was shot and killed in a confrontation with Albuquerque police. 
  4. Matthew Pollow had schizophrenia. He lunged at the police with a screwdriver and was shot and killed. 
  5. A woman in Santa Clara called police to say she was suicidal. When she answered the door holding a baseball bat, they shot and killed her. 
  6. Dontre Hamilton, who had schizophrenia, was shot and killed by Milwaukee police in a confrontation. 
  7. David Latham, who likely had schizophrenia and had been off his medications for a few days, was shot and killed by Virginia police when his aunt called 911 to ask police to help him. 
  8. Jason Harrison, who had schizophrenia, was killed when his mother called the Dallas police to ask for medical help for her son. 
  9. Nick Davis, who had schizophrenia and bipolar disorder, was shot and killed by police when he swung at them with a crowbar. 
  10. Rosendo Gino Rodriguez was killed by police in Midland, Texas when he retreated to his room during a welfare check initiated by his family. 
  11. Michelle Cusseaux was shot and killed by Phoenix police who were tasked with taking her to a mental health facility on an emergency hold. 
  12. Kajieme Powell, a St. Louis man with mental illness, charged police yelling “Shoot me now!” They did, just days after Michael Brown’s death in nearby Ferguson. 
  13. Chelsea Fresh, who suffered from bipolar disorder, was shot and killed by police in Beaverton, Oregon. She was holding a rifle. 
  14. Calvin Peters, a Brooklyn man who had bipolar disorder, was shot and killed after he stabbed a student in the face. 
  15. Thomas Read was shot and killed in New Jersey when he came at police with a knife. He had schizophrenia and had been unable to get his medications because of a problem with his health insurance.
This list is not exhaustive: it’s hard to track how many people are killed by police each year and whether those killings are justified. And the problem works both ways. Just as people with mental illness are killed by police, law enforcement also faces threats: Mental Illness Policy.org has tracked 115 deaths of police officers since 2009 that can be attributed to people with untreated mental illness. 

I should stress here that people with serious mental illness are not likely to be more violent than people in the general population, unless they are untreated. Without treatment, the risk of violence to self and others rises. That has certainly been my experience with my own son. Once we had a correct diagnosis and medications that worked, the threats of harm to self and others stopped. I don’t believe that medication alone is the answer—talk therapy and occupational therapy are extremely important in helping my son to navigate a world that presents him with significant sensory challenges. But lithium changed everything for my son and my family.

I think often of the Newtown families, the pain of that first Christmas without loved ones, of gifts wrapped for children who would never open them, of holes left in hearts that will never fill. And I also think of Adam Lanza and his mother and wish for all our sakes that he could have gotten treatment before tragedy. That’s my wish for every family who struggles with the often overwhelming challenges of mental illness. But we can’t do it alone. We need the support of our friends and communities. We need society to stop blaming us and our children. But most importantly, we need access to care. Without treatment, two years after Newtown, for too many families, Christmas is a time of sorrow and loss and grief. 

Monday, December 1, 2014

Everything I Know about Success I Learned from Failure

Five Life Lessons that Were Worth the Bruises

If you fall out of a standing bow pose, get right back in it!
You've got time.
I got rejected by Huffington Post today. It stung a little; I thought my essay was interesting and insightful, but their editors didn’t agree. Still, even as my lips curled into a slight frownie, I realized I was grateful for the pinch, the little reminder that I’m not going to win at everything, and even more importantly, that I don’t have to.

The rejection email served as a reminder of far bigger failures, not stings but major body blows. I’ve weathered some more gracefully than others. But without a doubt, each significant failure in my life led to important self-knowledge that has shaped me into the person I am today. As a quick aside, I’m well aware that every one of these failures could be hashtagged as #firstworldproblems. I’ve been truly blessed in my life with extraordinary opportunities.

Failure: When I was 17, I got a C in high school calculus.

What that meant in the short term: My poor performance in calculus destroyed any hope I had of accomplishing a major (at that point) life goal to graduate among the top ten students in my high school class.

What that meant in the long term: Absolutely nothing. I still got accepted to my first choice college with a full scholarship. And as an added bonus, I aced the AP Calculus test, so I didn’t have to take a single college math class.

Life lesson: When you give 100% and only earn a 78%, you should still be proud of your efforts. But also, you don’t have to be a rocket scientist if that’s not your calling.

Failure: When I was 25, I dropped out of a Ph.D. program in Classics after giving birth to my first son.

What that meant in the short term: I was so disappointed in myself for being unable to accomplish another (at that point) life goal, in part because of my own shortcomings as a scholar: in all honesty, I do not think I could have passed my Ph.D. language exams without significantly more effort than I was willing to expend. Also, I learned pretty quickly that I was not one of those moms who could “do it all,” juggling the demands of a rigorous academic program with the far more baffling demands of a colicky newborn baby and the attendant sleep deprivation.

What that meant in the long term: When I finally decided to return to graduate school at the age of 37, I was ready to study something that really held my interest and fit my skills: Organizational Leadership. My comprehensive exams a few weeks ago were by no means easy—I’m still biting my nails as I wait for the results. But I felt fluent in the language of change management and motivational theory in a way I never was with Latin or Greek. Also, my Classics training was not a waste of time: I learned rhetoric from Aristotle and Plato, and they proved to be pretty good teachers.

Life lesson: Sometimes it’s okay to quit. And you’re never too old to go back to school.

Failure: When I was 35, my 13-year marriage to the man I thought was the love of my life imploded.

What that meant in the short term: To say that I was devastated is an understatement. I’ve always been one of those people who believed that you marry one person, and you make it work. Worse, we had four children, ages 2, 3, 7, and 8. Feeling like I had failed my (then) husband was awful; feeling like I had failed my children was nearly unbearable.

What that meant in the long term: It took me several years of intense personal therapy and hard work to understand that while I certainly played a role in my marriage’s demise, it was not all my fault. I learned to value myself, to communicate more authentically, and ultimately, to love again.

Life lesson: Take a chance on second chances—but take the time to know—and love—yourself first!

Failure: Just a few weeks shy of my 40th birthday, I was fired from my dream job, and I learned I had stage 0 cervical cancer.

What that meant in the short term: On my 40th birthday, I was an unemployed single mother of four children with no health insurance and a cancer diagnosis! This had always been my greatest fear. And to my surprise, it turned out to be one of the greatest gifts I’d ever received from the Universe. I never would have gone to the doctor for a long overdue pap smear if I hadn’t been about to lose my benefits, so in a way, getting fired may have actually saved my life.

What that meant in the long term: For the first time since I became a mother, I had time for me. While the kids were at school, I did 60 days of hot yoga. I started blogging again. I took long walks and thought about gratitude. I had a minor successful surgical procedure. I volunteered in my kids’ classrooms, took my teenagers skiing, and treated the family to lots of home-cooked love. In fact, we still look back on those few months of unemployment with a bit of nostalgia. Now I’m in my dream job again—at a much more ethical organization.

Life lesson(s): Your job, even your dream job, does not define you. Also, if you’re a woman, get regular Pap tests.

Failure: On December 14, 2012, after 8 years of calls to the police, visits with numerous doctors and specialists, jail time, and hospitalizations, my son was in an acute care psychiatric hospital again. I had no idea how to help him.

What it meant in the short term: I was truly and completely helpless. And I did what I have often done, what I am doing now, in fact, when confronted with failure: I wrote it out. I told my truth. No mother wants to admit she can’t help her child. I admitted my helplessness to the world.

What it meant in the long term: We found help and hope. My son was diagnosed with bipolar disorder, and the treatments are working. I also learned that I was far from alone in my perception of myself as a failure, but that in fact, the mental healthcare system was failing me and so many other families. While writing my book, The Price of Silence: A Mom’s Perspective on Mental Illness, I was able to find even more solutions to the heartbreak. I continue to advocate for children like my son and for moms like me.

Life lesson: Never give up on the people you love, even when you’re exhausted. They are worth your best, hardest fight. But it’s okay to admit you are tired and to ask for help when you’ve done everything you can do.

These five are just the big failures. In my life, as in most people’s lives, most blog posts don’t go viral. Most calls for change fall on deaf or ignorant ears. But these five big failures have taught me resilience. I’ve learned to take charge of my own life, to be honest with myself and others, and to ask for help when I need it.

A few hours after the HuffPost rejection, I got a call from a friend. He had just received copies of a new college textbook, The Elements of Argument, which includes essays by Michael Pollan, Hillary Clinton, Henry David Thoreau, and me. Another essay I wrote once upon a time, the one about my failure to help my son, was picked up for my Huffington Post debut under the title “I Am Adam Lanza’s Mother.” Now it will be used to teach Aristotelian argument to students in college courses.

I’ve come full circle.