#i thought i was getting better turns out i'm just hypomanic again

[cloudy-em]

realizing i feel "better" on my new mood stabilizer not because it works but because it just hasn't gotten to the right dosage yet

[obstinatecondolement]

Having kind of a post-NaNoWriMo dip in mood re: the fic groove I have been in tbh. (mental illness and insecurity bullshit, mensturation mention cw)

I do still feel Very Strongly about the ideas I have and I do want to write them/continue working on them in the case of the two WIPs I started this week, but without the external structure of the event it's harder to thinking about sustaining that, especially given that I was making so many glaring mistakes that I feel looked very amateurish (I know it's an amateur hobby, but whatever, I expect very ridiculously high standards of myself in almost everything that I would never hold anyone else to and it's always crushing when I inevitably fail to meet them, lol).

The things I was getting wrong were mostly basic spelling errors, using the wrong word in common phrases that turned things into the uncanny valley of that phrase that didn't not make sense but weren't how anyone would say that particular thing naturally, accidentally flipping word order (or not rephrasing the rest of a sentence properly after copying and pasting things around, etc.), and just, like ... random gibberish typos that only became obvious to me after I posted, despite trying really hard to self edit myself carefully.

It's very difficult for me to have the focus to be able to do that sort of detail oriented task when things are in fast-brain mode. And, like, attention to detail is something I am typically very good at, so it's deeply embarrassing to me, especially in a new fandom where I'm creating a first impression.

And like, more generally I also feel like the shine has kind of gone off me and, I know that this is just my literal mental illness distorting my perception of Everything, but it feels like the fandom is already kind of over me because I'm too much. This is all very much a me problem and I don't think it's true or that anyone has treated me badly or done anything that would reasonably create this impression to a person who was not Going Through It (hence the read-more and, like, also: if you are a recent Ghosts follower you have done nothing wrong and have been nothing but nice to me and I don't want you to reassure me*, I'm just insane and I need to get a grip/have serious mental health issues and need to be better at distress tolerance and not being so insecure in how I'm perceived and prone to assuming that people are sick of me.

But, anyway, I think that part of this is just like... also pretty normal? Hypomanic episodes can last up to months, but usually they do fizzle out much sooner than that for most people most of the time, so I think that I just have kind of run out of steam and now I'm going low again having been pretty high for a sustained two-ish weeks and the very obvious external end of the line signal given by NaNo ending has kind of naturally triggered that downturn.

And I am like, speaking pretty approximately here? I think I probably have mixed episodes more than pure hypomanic episodes, for the most part? But, yeah, I don't know. I think the rollercoaster is coming out of a corkscrew and it's just going down now. Which, you know, does suck but it also won't last forever, so that is some comfort. I also still think I might be premenstrual, which does fuck with my head a lot, so, y'know. TL;DR, I'll be fine, but I am having a hard time. ¯\_(ツ)_/¯

*Like, genuinely, please don't. This is a Me problem and I think it would be bad both for me and for my relationships with others if I were to make the people around me feel that they had to constantly protect my feelings by showering me with attention and reassurance, or whatever. And also, like, I'd feel Very Bad if I thought other people felt guilted into doing that because I made a vent post about my irrational feelings that I know full well on an intellectual level are not reflecting an objective reality, because other people do not deserve to feel personally responsible for the bullshit my brain pulls on me.

[haptureratch]

Being on wellbutrin (WHEN IT'S NOT TAKING YEARS OFF MY LIFE BY MEGA MARIO STAR RAINBOW RAVE BOOSTING MY ANXIETY) is so funny

Like I'm reading an old idea for a fanfic in my Samsung notes and lighting up punching the bed because DAMN THAT'S SUCH A WILD GOOD IDEA AND I -SEE- WHAT YOU DID THERE

Like.

Chill you goofy hypomanic binch XD

I'm comforted by the fact that these sleepless nights will end eventually because the psych plan has shifted to bringing my anxiety down and letting me sleep. I guess I can kind of enjoy extra verve now that I'm not thinking about the implications of it, and knowing that it got as bad as it would and the professional said "no worse". And that there's no work in a few hours (huge relief bc I obviously can't stay home while trialing meds but they do have the ability to impact work). But this is still soooo not normal lol. It's almost 2am. I was so ready for bed and then nope I started singing again and here we are. It's the music and the singing that fire me the fuck up lately.

I hope I'm okay when it's out of my system. I feel okay now. I feel lighter in some ways (heavier in others like my headache and tight carotids and EVEN MORE hyperactive startle response and reflexes). I feel the self-amusement side of me is turned up. I'm better at writing (that TORRENTIAL MESS I wrote on....Sunday? No one is allowed to read it unless they are a mentally ill girlie on the internet. Y'all are allowed. Y'all will understand.) I feel more at ease around people and non-autistic (conversation just comes, I don't care if I'm doing it wrong I just do it). Life around me tastes good (instead of .... what's a word .. jarring? I thrive off the vibrancy and possibility. I see the lights and I want to explore where they lead. IS THIS HOW HE LIVES???? Like a stabilized form of this?? FuKc)

I think this med just takes everything I already am and heightens it. Deepens it. Maybe I'm prone to insomnia and it's just so much worse. I do have a natural rhythm of getting fatigued and my body is ready for bed but if I stay up through that I get a second wind. That's kinda what's happening on this med just INTENSELY so. And music is my shit, I feel it so deeply. It moves me. I love it.

I'm so chatty.

I ted talk all by myself but, again, this med cranks it up quite a bit. I'll need to share the positives of this med with my psych so maybe she can get me something with a similar mechanism or like....she'll do her double board certified thing and COOK.

I'm glad I was able to accept my mom needing to go home. The first instinct was to feel abandoned and scared but something in me got brave and accepted it.

Is this all divine timing? Is the med at some kind of level that's helping me (but, again, taking years off my life by stealing me from my sleep) and I was able to polish off the fear veneer [[I swear to god I'm cooking so hard .. note to self go absolutely OFF on wellbutrin, get deliciously hypomanic, and write a BOOK MY DUDE]] -- anyway, am I going through a period of growth right now?

Side thought: if I already worked through my touch issues with Amy and had all those epiphanies, why am I still struggling with issues under that umbrella? I went back to being weird and feral about touch which is a basic human need. I didn't incorporate daily platonic touch. I didn't connect with others. I can think back to that bedroom in Galveston and I THOUGHT I had my whole life laid out in front of me and I saw it and understood it. But here I am. I'm not drowning in grief over it currently, I am just genuinely curious. Why did I forget it all over time and just revert back? Not to attack myself but to GENUINELY WONDER

Oh thank god I might be getting a wave of sleepiness

HA HAAA nevermind beech we back.

Maybe this experience can make me braver. Look at that. PAUL RUDD MEME LOOKATUS. I trialed a med and had super difficult relationship stuff and got into a bad physical state (weight/nutrition) AND went to work and did the work. Wow. I should be proud. I survived a difficult med trial along with all that. I wish that alone, that realization, could cure this core nagging negative thought that I am too weak to make it.

I just get so caught in that feeling of extreme anxiety. There are stronger words to say but my mind is slowing and my eyes are growing heavy

Sleep please take me

Carry me off and steal me for 10 solid hours

No I had to get up and use the restroom. And that gabapentin... I FELT THAT. Swaying around searching for ANY HINT OF PROPRIOCEPTION to maneuver myself to my bathroom. Meds are a fun experiment when they aren't terrifying. It's interesting to feel the science in your own body. Brings the reading and the research to life. Real kinesthetic learner style type shit.

No, yeah. This staying up because I have a stream of thoughts isn't outside the realm of expected Jess. I've done this with my creative writing. And read over it a million times late into the night trying to perfect it. But I think the medical response is still back off that med. Hypomania can still be bad for you even when it feels good. I need to be able to sleep. I wonder if this is just a reflection of how unstructured I am outside of work. Wait. Oh my god. OH MY GOD THIS IS JUST LIKE WHAT I DEALT WITH IN MED SCHOOL. REBECCA TRIED TO GET ME TO STRUCTURE MY DAY AROUND STUDYING AND HOBBIES AND I DIDN'T.

Oh my lord, my sweet lord this must get solved.

I'm glad Rilley got me into handling it mode. Instead of backing away in fear mode. I don't think I'd be doing all this life analysis now had we not had the hard talk earlier. I love and trust her so much. She is truly an incredible individual. She would make the absolute best therapist. She's basically there, she's so close. Fill her up with some training and I swear to god she'd blaze to the top.

[suometar]

Power song of the day: Wake up by Smash into Pieces

You can not resist, like a moth to a flame -- You know it will burn, but sometimes you enjoy the pain

This is your favorite game -- But you're gonna be defeated -- And you're never gonna beat it -- Controls you like a slave -- But you gotta stop pretending -- You won't get a happy ending

(Chorus) Someday you're gonna wake up -- Gonna wake up -- From a life in fantasy -- Someday you're gonna wake up -- Gonna wake up -- And realize it's not meant to be -- You stumble in the dark cause you close your eyes -- Guided by the sweet talk lullaby -- But someday you will wake up -- You will wake up From a life in fantasy -- Wake up!

You try to cut everyone out of your life -- So no one can question how you can believe the lies

This is your favorite game -- But you're gonna be defeated -- And you're never gonna beat it -- Controls you like a slave -- But you gotta stop pretending -- You won't get a happy ending

(Chorus)

You're in the fire, what do you do? -- You wake up -- The final round is waiting for you

(Chorus)

Why? Well...

I'm coming down from mania.

Which sucks. And here's a glimpse into my 30 or so years experience of this nonsense.

But before I say more I want to say to everyone who I have been venting during the last month or so:

Please don't think that you have contributed in making my situation worse. You haven't. The fuel for all of it comes from within myself. I am nothing but crateful that I have had a chance to vent to someone because otherwise it all would've just clumped inside me and that would've made the situation worse.

And besides, not all venting has been caused just by mania. When I'm manic it doesn't remove the normal thoughts and feelings I have.

When you're stuck in a tar pit created by a certain person for who knows how many years in a row it's obvious it's not just the mania. I think you guys know what that's like :D

Coming down is like a really really really REALLY bad hangover

Except that you can remember every single thing you've done, the things you've felt, the things you've planned, what you thought of. EVERYTHING.

And you KNOW they're all just a result of the chemical imbalance of your own brain.

Coming down doesn't mean necessarily that I'm now depressed. It's just getting back to your normal state from mania.

But the bad hangover is real. If you've experienced that you know what it's like. Regrets after regrets.

What's mania like

That ecstacy of mania is an immense rush you don't really know unless you've experienced it yourself.

It's difficult to describe, but I think falling in love really hard and fast is the closest that describes it best. You have butterflies in your stomach all the time, you're hyperfixating on that one person and you feel invincible, like everything in your life is finally perfect and you're in control like never before.

Or even better: It's like being on speed, except without the drugs. Overstimulated 24-7-365.

Hyperfixation is typical for mania

In my case the hyperfixation can be basically anything from men (real or fictional, doesn't really matter lol) to any action, hobby or even work, totally depends on the situation.

What I do is I dedicate all my time to that one thing and one thing only even though I know it's not healthy.

Thank god I've learned to control it so that it won't take ALL of my time anymore, but it still is there. And I need to cater it to some extent or I won't be able to do anything.

It's like having a parasite you can't get rid of but you can make it behave if you give it some attention from time to time.

What's real and what's not? That is the question

When you're having mania it's sometimes super hard to differentiate what's a real thought and what is based on the illusion created by your own mind. And even though I am nowadays capable to tell the difference of my real thoughts/feelings and the ones fueled by mania the later ones do have an effect on me even though I try not to react to them.

The tricky thing is that your body can't tell the difference of a so called real/normal thought/feeling and one created inside my head fueled by mania.

A manic person wants nothing more than get more of the dopamine that fuels the ecstacy. Which easily can lead to a psychotic episode/period.

The saddest part is that manic person usually looks and behaves exactly like any normal person. You can't tell from outside if someone is having mania unless they choose to show it. Psychotic then usually is clearly psychotic and erratic and behaves totally out of character.

Triggers for mania

Anything can basically be a trigger for mania and they vary from person to person. For me it's usually one of the following:

an extreme negative change in life (such as death, divorce or other big things like that),

finding a new crush,

intensive concentration on some activity,

social media, or

as surprising as it might be: music. Especially any with a faster tempo.

Usually though I have already been somewhat hypomanic before the real mania hits. Hypomania though is very hard to notice because I'm somewhat easily excited and impulsive already by nature.

But I've lived with this so long that I know when it's going overboard. My manic mind just usually chooses to say it's nothing and I believe it like a fool - because it feels so good.

This time the trigger for me was intensive concentrating on writing. While the writing was crucial in easing my general anxiety this time it had this unfortunate side effect.

Nonetheless, I'm not quitting writing. Because the anxiety has eased significantly from when I started. I probably need to change the subject for a while and not to write daily or limit it just for 30 mins a day.

How a new crush can happen when you're married, you ask?

Oh, easily. See, with a manic mind a marriage is nothing but an obstacle. Nothing is but an obstacle that is designed to limit you. Because you're omnipotent. And obstacles - well, they're made to be conquered or plowed through.

In my case I've chosen to keep my crushes online and physically as far away from me as possible. I've made a mistake of crushing into someone irl and that was UGLY for all parties involved.

Thirsting over someone from afar online while remaining happily married is by far a better option.

How to control mania or turn it off

Yes, you can turn it off. The problem with that is that usually manic person doesn't

feel like something is wrong, and

doesn't want to get down from the high.

But there are things you can do to get it end sooner.

Log off from all social media. Seriously. Don't just turn notifications off - LOG OFF.

If that's not enough, remove all the social media apps from your phone. You can always install them again.

Turn off your phone if it's possible.

Don't use computer unless it is absolutely necessary - like for paying bills. You don't need to find out what age Barbara Streissand is at 2:30am - or, well, ever.

Social media is by far the biggest contributor for mania. The apps are designed to give us a dopamine rush each time we scroll down any feed and see a new post. That's how they keep us stuck on them.

When you already have an issue with the dopamine rush using social media just makes it worse.

You won't miss anything if you log off for two days or a week. SERIOUSLY. But it will improve your well-being tremendously.

The absolutely best thing you can do is to create as dull environment to yourself as possible. That there's nothing artificial you can drown yourself into. Best place to be in mania is in the middle of the woods without any mobile signal - trust me.

Take up an activity where you do something with your hands. Hands-on approach is crucial.

Doing things with your hands will root you into the real world.

It doesn't matter what it is: cooking, cleaning, handcrafts, drawing or painting (NOT on a computer or ipad but with real pencils/crayons/paints/brushes/etc).

Remember not to do just that though. Go out (without your phone). Enjoy the nature. Listen to the sounds of the outside world. Don't close your senses with headphones. Read. Watch out of the window. Stare at the wall. Watch the paint dry.

LET YOURSELF GET BORED.

Just stay away from any electronic devices.

The hangover is horrible but it'll pass. And you will feel better afterwards when you're functional again.

------

It's not easy. None of us chose to live with bipolar. It's always inherited. But there are ways to work through it.

I hope this helps at least someone.

Thank you for coming to my TED talk.

[lemonadebloodsworld]

Tw: ED (??), sh, depression, suicidal thoughts, abuse (??)

So yeah,

It feels weird to come back here even if it's a more recent account. The first time I made a tumblr account was when I was 13 and back then I was already really depressed because of trauma, my relationship with my parents and the fact that they were always saying that I faked being depressed and was just being dramatic and other shitty stuff.

Back then they thought I was a gay girl too but yeah I'm a bi trans boy and it makes everything so damn harder because everytime I try to talk about my mental health my mom just says that it's JUST because I'm trans and I should just be patient and wait to be 18 to start a transition while yes, dysphoria and the fact that my family isn't really supportive make me sad but my mental health has been getting so damn bad.

I've never really been a happy child, my parents divorced when I was 3-4, my mom found my stepdad who has always been an asshole to me and my little brother because we are not his "real" kids and would always yell at us and hit my brother and my mom has always been depressive and mentally ill (Ed, depression and trauma) so she is scared of him ig, anyways, she just never said anything about it, even when she noticed that we were really scared of him.

My bio father was supposed to take us at his place every weekend but after a year he stopped coming and dissappeared for 9 years. At the same time I started to get bullied at school by older kids and some kids in my class and I didn't have any friends because it was a shame for them to be friend with me.

At 11, I have been sexually assaulted by an older kid (he was 15 or something) leaving me with trauma.

At 12 I changed school and found friends, I was so unused to it and ashamed of my past that I spent my time lying to them so they'll like me and think I'm cool, I also started to smoke and drink in secret because I felt so much pain and the intrusive thoughts started to get loud.

At 13 my bio dad came back in my life because he owed a lot of money to my mom and wanted to use us to make my mom feel bad about it. I started self-harming lightly and depression started to settle in but I wasn't really understanding what was going on because the "hypomanic" phases and intrusive thoughts were getting more present causing me to lose the only friends I had and yeah I just didn't understand what the hell was going on. I tried to talk about my mental health to my parents but they told me that I was being dramatic and it's a normal thing to feel bad because I was an adolescent and questioning my identity (I came out as a lesbian back at this time) and decided to just punish me and take my phone away because I was spending too much time alone in my room and didn't do the chores.

At 14 I started to have a lot of anxiety and panic attacks while being in depressive episodes, I started an ed (feeling shameful for eating even a little amount of anything and purging, I don't want to give it any name because I have been diagnosed and yeah), I also began to self-harm more and deeper (still not bad, I don't want to lie for that type of stuff xd), I broke down one day and told everything to my parents (sh, depressive tendencies, smoke, suicidal thoughts etc) and once again they were like "yeah nah it can't be that bad, you just lie to have attention and have an excuse to stay in your room and just being stupid" but my mom saw my arms and thights and then was okay for me to go see a psychologist. So for a year I had the opportunity to talk with a professional who was really amazing, she prescribed me light sleep pills because of my insomnia while in depressive episodes and "hypomanic" (don't have a diagnosis but I have all the symptoms but then again I don't want to self diagnose because it could be wrong and be something else) ones but my mom always refused to give them to me. At the end of the year she wanted an appointment with my mom to talk about my mental health and the importance for me to go see a therapist to be diagnosed (bipolar disorder 2 (she was still questioning it) , anxiety disorder and depression or whatever, she just wanted me to have the help I needed) but then again my mom said no because I was surely just faking it all and I just had to make efforts to be happy. I was so tired of everything and just wanted to feel better so I started to steal my mom depression medication (mostly Xanax and calming pills).

At 15 I met my first serious girlfriend, I fell in love so hard with her and for the first month she really helped me to stop sh, pills, drinking and everything was great until she started to verbally abuse me using my dysphoria and fragile subjects I told her about (she would say that I'm annoying and selfish for always feeling bad and that u was too sensitive and not a real boy if I cried) once I wasn't agreeing with her, slap and hit me if I said something she wasn't okay with or when I would have anxiety attacks or talk to her about my suicidal thoughts while in depressive episodes and yeah she used me like if I was a dog, if she wanted something or think in some way I would have to give her or do whatever she wanted or I would get threatened, insulted or ignored for a long time or other icky stuff. After 6 months of making me feel guilty for not letting her touch me in a sexual way she one day decided to start taking advantage of me while I wasn't in the appropriate head space or without my consent and then making fun of my body and making comments about the way I look. She in fact, made me really anxious and feel bad and it made me start to binge eat, at the end of the year my weight was 78 kg, before our relationship I was 59 kg, people noticed it but just told me to stop eating and go on a diet.

At 17 (this year) I finally broke up even if she asked me to do it because she didn't want to be seen as the mean one for letting me while I was clearly depressed. It was hard but I could finally meet new people or get back with people she didn't wanted me to talk to (especially my amazing actual partner and my bestfriend) who helped me a lot realizing all the shit she did to me and they have been amazing at making me feel loved and cared for and to be honest I don't think I would be there if they weren't in my life right now.

Now my mental health is just fucked. Like I said when I broke up with my abusive ex I had gained almost 20 kg and it reminded me all the bully I've been through as a kid (they most of the time used the fact I was overweight to bully me) so I started to starve myself or purge if I felt like I ate too much (I started to count calories) I was at 78 kg at the start and in 2 weeks I was at 65kg, it was during quarantine so i didn't have any friend or people noticing what I was doing or see me fainting. I started to drink almost everyday and smoke a lot.

In June I got in a relationship with my actual partner and to be honest it's the only good point I can find this year. They (genderfluid) are an angel and I just don't know what I would do without them, they help me a lot even if they are struggling with mental illness themself and anyone has ever cared for me and made me feel so loved before. Today it's been 4 months officially and it makes me feel happy and I just want it to never stop. My mental health is at its worst, I've been having a lot of intrusive thoughts, i have a self destructive comportement, in September I started to sh again (a lot deeper) after 2 years clean, I often call them in the middle of the night (well in the middle of the day for them cause I'm in Belgium and they are in Texas) because of really bad dreams and suicidal thoughts, I am bullied and made fun of by the people in my class for being trans and having a different style (alt-grunge), I barely eat or purge if I try to have a meal, I have these "hypomanic" phases that make me getting really angry at nothing and do a lot of stupid shit because I feel invincible and better than anyone, almost godly and yet they never made me feel like I was a burden or like I should just stfu or like I was being dramatic and they are actually the first person believing me and not saying I fake everything.

I am struggling and it becomes so damn hard to live but I will do my best not to give up and just keep on fighting for them and maybe try to recover and seek for help when I turn 18. I already try to make little steps and stop self harming, drinking too much energy drink XDD so yeah let's just try and be positive I guess.

Sorry its actually so damn long hhh I don't even know if i will post It one day or keep it as a draft eheh I hate venting

[dxmedstudent]

Hey dx. Hope you're well. I don't know if you remember this ask, but I'm the anon who asked a few months ago about supporting a friend in med school with depression and finding it a bit much. A lot has happened since then. She's sadly left med school and has been diagnosed with bipolar disorder. Currently she doesn't really have stable periods and is either high or low. I got kind of ok with having boundaries with texting etc/meet-ups only when actually able to. Part 1

Part 2. Anon supporting friend here. Recently she’s been high and has been messaging me nearly all day every day/asking if I’m there if I take time to reply/constantly updating me on what she’s doing/sending me all her family pictures. I’m finding it really stressful and overwhelming, tried turning off my notifications yesterday but still keeps going. My own anxiety is flaring up and I’m stressed hugely with workload.

Part 3. Anon supporting friend. I’ve told her I take time to reply because I’m stressed/overwhelmed and yet the messages keep coming. I know she’s hypomanic/manic so she probably sees things in a different perspective atm and forgets that it’s too much. I’m wondering whether it’s worth asking her to please message a little less as I find it overwhelming to get so many messages each day, or whether it will just not work as she isn’t in her right mind. Part 4. She has got professional help in place. She’s fallen out with her other friends because they don’t message her when she’s low etc/her best friend has distanced herself from her because she doesn’t know what to say. I don’t want to not be friends but I need to work something out! I’m trying to remember she’s ill but I’m starting to feel unwell too. Any advice?! PS. I know this is an extremely long ask and that you’re very busy, so please take your time if you need            

Hey, I’m glad to hear from you again. I’m so sorry for my late reply; I rread your ask at the time, and thought about it a lot. But I had to take some time to process my own life problems and mental health, and I couldn’t really give most of my asks the time or energy they deserved, so I had to leave them until they could. Which is kind of the theme of this ask, ironically. But I hope late is better than never.  Thank you for your message at the end of your ask, it’s very much appreciated :) I’m so sorry that your friend’s going through a rough time, and that you are, too. I’m so sorry to hear that she left med school; bipolar is a truly difficult illness, she has been on a really tough journey.  I’m glad she has professional support; that’s always a huge deal because the right treatment and support can revolutionise people’s lives. I’ve seen it, and though I don’t think the way we treat mental health is perfect, I do think we can do so much good by acknowledging mental illness and treating it properly. And taking people seriously. I’m glad to hear you started to work out some boundaries that worked for you; it’s tough, but it’s good to hear that you made some progress, even if it doesn’t always work out as  well as you hope, it’s still progress. You’re right to put your own wellbeing first; it’s hard for us to support others if we’re being brought to a mental breakdown ourselves. It’s a hard lesson for us to learn, but you can’t serve others with a broken/empty cup. I think it’s a really fair idea to turn off notifications to avoid overloading yourself. She can keep going; thats OK. You can’t control your friend’s mania, or how ‘full on’ they are; perhaps not even they can. Unfortunately, that’s part of the illness. And it seems you understand that well, deep inside. She might process things differently, and I think you’re an excellent friend for doing your best to support them, and understand what they are going through. I’m putting this under a cut because it’s long.

Everyone reacts differently to being told the truth, so only you will know how they might respond. Sometimes we can just tell people ‘sorry, I’m not feeling well so I might not respond much’. Sometimes we invent excused to be kind or because we aren’t ready to talk about the entire story; in my view, in personal* settings, it’s OK to tell white lies not to hurt people sometimes. I’ve told friends I’ve been sick or oncall when I couldn’t attend events because I was physically exhausted or not feeling well, because I really cared about seeing them but didn’t want them to think I was not coming because I was not bothered. However, with close friends I’m honest, and the vast majority of the time, if I say I’m oncall, it’s because I’m actually oncall. I don’t like fibbing, and I don’t like hurting people’s feelings, so it’s a fine line, but I’d rather feel a bit guilty than make others feel bad. It might be OK if you tell her that you sometimes need time to reply because you are overwhelmed; have you ever discussed your own mental health issues with them? Do they get that you get really anxious or overwhelmed? It might depend on how much insight they have into their own state right now, and perhaps it’d be difficult for them to moderate how they act, or how they feel about it.  However, if you find yourself having to take quite a bit of time to yourself, don’t feel shy to just tell them “I’m not ignoring, you, I just wasn’t feeling well and had to take a break, I’m listening now”. Or you could say “I care about all your messages, and I always read them all, but sometimes I can’t reply to them all at once because I’m busy/overwhelmed/tired/unable to process it all”. If they get upset because you haven’t replied, it might help to reassure them that you do care (because this is, deep down, what they fear”, and that you care about their wellbeing, but that other issues in your life have been stressing you out, too. And that you just didn’t want to bother them with your stress, so needed to take some time out. There are ways of discussing it that don’t outright lay the blame on them, or make out that they are the cause of your problems, when it’s not true, and therefore avoids making them feel guilty for things outside of their control. Something can be not the cause of our problems/stress and still be overwhelming, and if you’re able to be honest with them, I think that’s a good way to put it across.  As well as the idea that in order to be truly there for them, and have enough energy and time to be able to support them, sometiems you need to take time out to process the other things in your life. Work, uni, family, love life, etc, whatever it is. Telling someone “I have a lot of thigns in life that are stressing me out, and draining my energy, and sometimes I need to take some time out to process/fix them, and rest before I can chill with you and help you, and be happy with you, because otherwise I’d spend my time with you stressed and miserable and might make you feel worse” makes sense. I can’t say if that would work for your friend, but I feel a lot of people would understand that. In the end, I am sure they care about you, too. But because of their own illness and issues, deep down they are probably terrified of losing you too. They know that their illness can make things harder for them, harder for those around them, and they probably feel really bad about that; we all beat ourselves up over stuff like that. Reminding them that you care, and want to be there, and want to be strong and rested so you don’t bring them down with your own problems is actually a kindness to them. I remember publishing a similar ask/anwer/post by someone else who answered a similar question, because it reminded me of you and your ask. I hope you saw that, it might be tagged under my #mental health and medicine tag. You come across as a supportive, loving friend who is doing their best, please don’t feel guilty if you have to put yourself first. I hope you and your friend take the time you need to heal. * In professional settings, we’re bound by the rules of probity. We don’t lie in medicine. TBH my parents raised us to NEVER LIE, which makes working in medicine easier because I’m a terrible gulty fibber who likes to follow all the rules and who doesn’t even like parking in the wrong place, much less anything exciting.