How to Get an Emotional Support Animal

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Any laws listed in this post apply to the U.S.A. only. If you are not from the U.S., check your local ordinances to see if you are eligible for an Emotional Support Animal (or however your country may identify them).

Have you met the latest addition to our little family? Or followed him on Instagram (@mrschanandlerdog)? My one-year-old Border Retriever Chandler is not only a perfect, zoomy ball of fluff with the world’s floppiest tongue. He’s also a superhero, because he’s my Emotional Support Animal – or ESA for short.

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If you’re anything like me, what you know about ESAs probably boils down to that one friend in college who pretended to have anxiety so she could sneak a dog into her dorm room. Unfortunately, the rules about ESAs –¬†especially¬†on college campuses – have tightened quite a bit thanks to those who give the animals a bad rep.

While it’s true that an ESA does not require special training, it’s NOT true that ESAs are “fake service animals,” or simply an excuse for letting dogs go where they may not have been allowed otherwise. ESA dogs are pets, but they’re also companions, therapists and coping tools. For those of us with mental illness, or another medical condition that makes certain aspects of life psychologically difficult, ESAs can be literally life-changing.

Unlike a service dog, Chandler cannot open doors, flip light switches or fetch items from the fridge for me. He does, however, have an intuitive sense about people. When I am crying, he climbs in my lap and licks my face until I feel better. When I’ve hurt myself, he licks my wounds. Even though we’re completely different species, Chandler doesn’t see that. Instead, he sees a friend and a companion whom he can support simply by being himself.

As someone with a mental illness, you may have toyed around with getting an ESA before. Maybe your apartment does not allow pets, but you’ve suspected a pet could serve as a positive distraction from the stressors in your life. Or, perhaps you already have an animal who serves as emotional support, but you want to make it official. You may never even have heard of an ESA before, but thought that you or someone else you love could benefit.

As I went through the process of adopting my ESA, I found it difficult to find reputable sources of information. In fact, it was near impossible to find a tutorial that didn’t come from a fake ESA certification website! But now that Chandler is home – and making me smile every day – I’ve become an expert on navigating the ESA system. And, because I don’t want the process to be as confusing for you as it was for me, I’m here to share all the lessons I learned along the way!

Who knows? By this time next week, you could be cuddling wth an ESA of your very own ūüėČ

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What Is An ESA?

As mentioned previously, ESA stands for “Emotional Support Animal.” There are many things an ESA is, but it’s also important to note the many things an ESA is NOT. For example, an ESA is not….

  • A service animal
  • A psychiatric service animal
  • A “fake” term

First, let’s note the differences between an ESA and a service animal. Like service animals, ESAs serve people with disabilities that impair their everyday life. However, unlike an ESA, service animals receive training to do special tasks the disabled owner would not be able to do on their own otherwise. Similarly, a psychiatric service animal does the same, but specifically for a person whose disability is psychiatric in nature.

An ESA does not require special training, does not require a vest identifying it as an ESA and therefore cannot enter public places where service dogs are allowed (assuming pets aren’t allowed there, either!). But an ESA is also not “fake.” While many people abuse the privileges of the ESA designation,¬† I’d venture that more people out there could benefit from an ESA than are gaming the system to get a “fake” support animal.

Though not as many as service animals, ESAs do have some special rights. For example, your place of residence must allow your ESA to reside with you – even if there is a “no pet policy” in place. Your landlord also cannot charge you pet fees or pet rent, nor can they subject your ESA to size, weight or breed restrictions. So, if your ESA is a pit bull and your apartment has banned pit bulls, they must still require your ESA to live on the premises – assuming you can provide the proper documentation. (More on that next!)

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How To Get An ESA

So, you think you could benefit from an ESA and you’re on board with getting one. Now what?

Not so fast! Don’t adopt an ESA dog without first visiting your mental health care provider. This can be any licensed medical provider with knowledge of your mental health situation: your primary care doctor, a nurse practitioner, a psychiatrist, a therapist (LICSW or LPC) or another mental health professional. They will need to write you a letter of prescription guaranteeing your right to an ESA.

In order to claim your right to an ESA, your mental health provider must confirm you have a disability that interferes with your everyday life and that the ESA has been prescribed to alleviate some symptom of that disability. If you aren’t already seeing a mental health provider, I recommend you seek out a professional with knowledge of the ESA system. A provider who has helped a patient obtain an ESA in the past will know exactly what they need to do, allowing you to avoid any snags along the way.

Once your mental health provider has evaluated your condition and determined that an ESA will benefit your health and well-being, they must write you a letter prescribing the ESA as part of a coordinated treatment plan. If your doctor or therapist has never done this before, please direct them to a sample letter Рsuch as this one Рfor an example of what they must write. Once you have your letter, neither landlords nor airlines can challenge your right to be accompanied by your ESA. You can also use the letter to get reasonable accommodations at work Рfor example, if you want your ESA to come with you to the office.

Your landlord may also give you a form to fill out in addition to or in place of a letter. (This was the route I took – since I did not plan to bring Chandler on an airplane and we were in a rush to adopt him, I only had my therapist fill out my landlord’s form, rather than write a full ESA letter.) This letter typically asks your mental healthcare provider to confirm your disability and that the disability interferes with your daily functioning. Your landlord can use this paperwork to confirm your right to an ESA, but not to contact you or your provider about sensitive medical information.

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What Are My Rights?

As long as you can provide official documentation – a letter, a form or otherwise – that you have been prescribed an ESA, you have the legal right to own your ESA, as well as a few other rights and protections you should know about. Additionally, your landlord retains some rights, so it’s imperative to understand where the line between your rights and your landlord’s rights is drawn, in order to make the best case for yourself and your ESA in the event of a complaint.

You retain the right to house your ESA under your roof, regardless of your landlord’s “pet policy.” As mentioned previously, your landlord cannot subject you to any kind of pet fee, nor size, weight, breed or species restrictions. Even if your apartment only allows cats under 15 lbs, your 45 lb Doberman is still allowed to live with you according to the Americans with Disabilities Act, as well as the Fair Housing Act. They can, however, hold you liable and charge you for any damages your animal does to the unit while living there.

Your landlord is allowed to confirm only two things: first, that you have a disability (visible or invisible) that impacts your daily functioning and second, that your ESA relieves some symptom or challenge of that disability. They may NOT request any further medical information from you or your provider. You are NOT legally required to disclose your diagnosis or treatment plan, but your landlord can request that your provider sign a form or that you provide a copy of a verifiable prescription letter for an ESA.

Your landlord cannot deny your request for an ESA simply because their insurance does not cover pets. Additionally, they may not require your ESA to have any special training or wear any type of identification marking it as an ESA. (However, in my experience, getting your animal a tag or vest that says ESA helps curb some of the questions and complaints by cranky neighbors.)

The ADA and FHA do protect many of your individual rights, but your landlord does retain a few key provisions under these laws as well. Those provisions are:

  • The right to deny your ESA under certain conditions.¬†Rest assured, there are very few cases when someone can deny a disabled person a reasonable accommodation, such as an ESA. These cases include buildings with four or fewer units (where the landlord occupies one unit), single-family housing sold or rented without a real estate agent, hotels and motels (which are not considered dwellings under the FHA) and private clubs.
  • The right to evict you if your animal is not under your control.¬†You must have command over your ESA at all times. If your dog is unruly or aggressive and cannot be brought under your control, you lose your guaranteed right to housing and may be evicted. Therefore, although special training is not required for an ESA designation, I recommend strengthening your animal’s basic obedience skills to lower the odds your ESA falls subject to complaint by neighbors.
  • The right to charge you for damages done by your ESA.¬†As mentioned previously, your landlord cannot charge you pet rent or fees, but can charge you for damages to the property done by your ESA. Legally, your ESA must also be housebroken, minimizing the potential for damage. Additional training may prevent your animal from chewing, scratching or soiling carpet, walls and other parts of your dwelling.

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What If My Rights Are Violated?

You’ve gotten your ESA prescription letter. You’ve adopted an ESA. And your landlord or flight won’t accept your documentation – or your neighbors have complained. What are your next steps? Well….

  1. Identify your ESA.¬†Landlords cannot require ESAs to wear identification. However, if your neighbors are challenging your right to an ESA, putting a tag or vest on your animal may help quiet these complaints. I bought Chandler’s ESA tag from Amazon for $10. The tag reads “protected by federal law,” which we’ve found is enough to dissuade our neighbors from raising too many uncomfortable questions about our ESA dog.
  2. Check legal precedent.¬†Most ESA cases protect the right to “reasonable accommodation” under the ADA. Size, weight and breed restrictions, no-pet policies and college dorms have all been challenged successfully in the court. Sometimes, all it takes to resolve a complaint is to cite one of these cases. Most landlords, upon hearing mention of a court case, can be scared into compliance with the law.
  3. File a housing complaint. Complaints regarding landlords who refuse to recognize your right to an ESA when there is clear documentation of your disability fall under the umbrella of the U.S. Department of Housing and Urban Development. Click here to file a formal complaint against your landlord Рor to bookmark this page just in case.
  4. File an airline complaint. Airlines may try to refuse passengers who bring an ESA on-board, regardless of their documentation. Discrimination and disability complaints directed at airlines can be filed with the U.S. Department of Transportation Рclick here to file a complaint.
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Gut Health Update: Colon Cleanse + My First Endoscopy

Disclaimer: This post is my personal experience and is NOT intended as medical advice in any way. I am not a doctor, so please consult with a medical professional if you have any concerns about your overall health and take what I say with a grain of salt!

I’ve been on quite the journey since my last gut health update – and wow, what a journey it’s been. I’ve seen two different gastroenterologists, embarked on a colon cleanse and even had my small intestine biopsied to test for celiac disease. (Yes, that again.)

I’d be lying if I said that having my stomach pinched, poked and prodded by doctors and scopes all the time wasn’t stressful. But, I don’t regret it at all. Because of what I’ve survived this year, we’ve discovered that I almost certainly have IBS, relieving my worries that my gut health issues could be due to something more sinister than a spastic colon.

Since relocating to Cleveland, I’ve been receiving the bulk of my care at North Shore Gastroenterology under Dr. Mohamed Naem. Dr. Naem has done more for my colon health in one month than all of my previous doctors put together – but that doesn’t mean that my big move hasn’t been littered with challenges for my gut and mental health alike.

Below, I write about undergoing a colon cleanse, getting my first endoscopy and all the treatments, medications and procedures that led me to this point. Most importantly, I write about how they made me feel Рbecause as we IBS patients know, our emotions are half the battle when it comes to our gut.

Before the Big Move

Back in Boston, I finally got into a gastroenterologist’s office at Boston Medical Center. I was impressed with the quality of care I received, but disappointed that my testing failed to reveal answers to what might be making me sick.

At that point. I had already been to an emergency room in Erie, PA while visiting with my boyfriend on winter break. I also visited an NP in Cleveland, Cheryl Brinley, who ordered a CT scan that failed to reveal anything (though we did discover a severe vitamin D deficiency that could be contributing to my low mood through the winter months).

My doctors at BMC ordered a fecal calprotectin test as an alternative to doing a colonoscopy, since it is essentially just as accurate and far less invasive than a scope. The test required me to provide a stool sample to the lab, who analyzed it for markers of inflammation.

This measurement told them with some certainty that I did NOT have IBD. Regardless, I still felt doubtful. My doctors took my symptoms seriously, but my results certainly did not alleviate my anxieties about my gut health. So, when I came to Cleveland, I decided to get in with a gastroenterologist ASAP – not only to establish care in my new city, but also to hopefully find some answers once-and-for-all.

The Colon Cleanse

Upon visiting Dr. Naem for the first time, he immediately suspected IBS-C – the C standing for “constipation type.” Despite the fact that I’d suffered from diarrhea in the past, my doctor suggested that this may have been “overflow diarrhea” from an underlying problem of constipation.

I finally had my answers – but what was a girl to do about them? According to Dr. Naem, it was time to flush out my colon and start over with an empty gut. And that meant laxatives. Lots and lots of laxatives.

For the cleanse, I purchased a bottle of magnesium citrate, which I’d been instructed to drink alongside two Dulcolax tablets to help flush out my colon. It only took about 90 minutes before I began to experience the symptoms of these laxatives.

The results lasted about 48 hours before my gut finally began to calm down and return to normal. But, arguably, my colon has been at its most “regular” since before I suffered from IBS at all.

After the cleanse, my doctor instructed me to begin mixing a capful of Miralax into a drink – my morning coffee, he suggested, though I’ve since begun to drink it with Gatorade so as not to ruin the sacred experience of coffee – each and every day. This practice has maintained the results of my colon cleanse for the past 2-3 weeks, and produced a radical difference in the quality and frequency of my bowel movements.

As I understand it, colon cleansing is a controversial topic in the medical field. While I don’t recommend you perform a colon cleanse without first talking to a qualified professional, I can certainly attest that my colon cleanse worked wonders for my IBS.

Frustrated gastro patients will try anything once Рand for all the evidence behind the low FODMAP diet, this simple bowel regimen worked much better for me!

My First Endoscopy

Only, there was a catch: thanks to a twist of events in my gut health journey, I could no longer rule out celiac disease, despite previous tests that showed my IgA and IgG antibodies were normal.

My mom’s doctor began to suspect celiac disease in her, leading me to seek out the advice of a gastroenterologist as to whether I should be worried about my own gut health.¬†Initial test results did not show evidence of celiac, but they¬†did¬†show that I was at high genetic risk, which could only mean one thing: my diagnosis (or lack thereof) must be confirmed via upper endoscopy.

Needless to say, I was terrified. Who¬†wouldn’t¬†be afraid of gagging in front of your doctor – or worse, experiencing the awkward discomfort of having a tube placed in your esophagus? In my case, I was most afraid of undergoing anesthesia, which I’d never done before – and, quite frankly, never expected to need to, outside of the standard wisdom tooth removal all my friends had undergone as teenagers.

To make matters worse, my endoscopy was scheduled far in advance, giving me plenty of time to worry prior to the procedure. The night before, I watched tons of YouTube videos to prepare myself for what to expect. I also could not eat for eight hours and could not drink for four hours prior to the scope.

When I arrived at the hospital, it took about an hour after my scheduled appointment time before the nurse called my name. Once she did, however, the procedure moved quickly. As usual, they took my height, weight, blood pressure and pulse. Then, they had me change into a gown and lie down on a bed.

As they placed IV fluids in my arm, I was so anxious that I began to quiver in fear – but the two nurses by my bedside did an extraordinary job talking me down and reassuring me that the process would be simple and painless.Then, it was go-time: the nurses wheeled my bed into the endoscopy room.

There, I got to quickly wave hello to my doctor and meet the NP who would be handling the anesthetic before being asked to roll onto my left side for the procedure. I barely remember anything past the NP inserting the anesthetic into my IV and the nurses asking me to bite down on a mouthpiece that would be used to insert the tube down my throat.

The next thing I knew, I had woken up in the recovery room with my boyfriend waiting by my bedside. Dr. Naem came to tell us that he had not found evidence of celiac and was 99% certain I did not have it – though technically, we had to wait for the biopsy results before we could be sure. (In fact, just yesterday, I received my results confirming I definitely do NOT have celiac disease!)

For the hour after the procedure, I felt a little woozy. David took me to get a milkshake, which I eagerly devoured. After that, I lost my appetite for most of the afternoon. About two hours later, the numbing anesthetic wore off and my throat began to kill. Luckily, the pain only lasted about a day. But, overall, the procedure was quick, relatively painless and more than worth it to relieve my anxiety and definitively rule out a diagnosis of celiac disease.

Gut Health Products + Resources

As usual, I’ll end this post on a positive note by sharing some of the products that helped me get through this stage of my gut health journey. Once again, I’ll share links so you can purchase some of the staples that saved my life (metaphorically, of course) during my experience with IBS!

  • Suja Digestive Wellness Shot.¬†($50 for 15, Suja Juice)¬†When I recommend this shot, I do¬†not¬†recommend it for the taste! The shot contains a spicy burst of cayenne pepper, so it burns the whole way down (and trust me when I say, cayenne and pineapple juice make a horrible combination). That being said, these shots got my digestive system M-O-V-I-N-G! When your gut goes stagnant and you need to kick-start your metabolism again, I highly recommend these shots as a quick fix for your gut health woes. Just treat them like medicine, rather than a drink, and you’ll be fine. (My tip: they’re called shots for a reason – so pinch your nose and suck it up, buttercup! The faster you can throw it down, the easier the recovery.)
  • Robyn Youkilis’s Guide to Magical Digestion. (Free with Email)¬†I’m not one for impractical, woo-woo wellness tips – but when a gut health practitioner shares evidence-based advice, I find it best to listen! Robyn’s free guide is full of common-sense tips you may not have thought of (for example, when’s the last time you paid attention to how thoroughly you’re chewing?). Robyn shares a delicious recipe for an aloe vera shot for soothing an angry, inflamed digestive tract. (And, for my fellow ED recovery warriors, I especially love that she points out that “I’m bloated” is often used as a synonym for “I feel fat,” expressing discomfort with our bodies rather than physical pain.)
  • The FODMAP Friendly Kitchen¬†by Emma Hatcher.¬†($20, Amazon) I discovered this delicious cookbook of low-FODMAP recipes at my local library. Since I recently quit being vegan (post on that later), I appreciated the reintroduction to the vast variety of things one can enjoy on an IBS-friendly diet! My favorite recipe? Polenta with Burst Tomatoes and Mozzarella, which reminds me of my childhood spent frying polenta with my Polish-Italian Mom and Grandma. Mmm, mmm, mmm!
  • Rao’s Homemade Sensitive Formula Marinara Sauce.¬†($9, Rao’s) I finally splurged for the $9 jar of marinara that everyone with IBS has been talking about – and man, was it worth it. Quick, easy meals are hard to come by when you typically can’t eat anything that comes out of a box. Luckily, Rao’s Sensitive Formula is made without onion or garlic: two of the worst offenders when it comes to sneaky high-FODMAP ingredients! Mix it into some gluten-free pasta with parmesan or spread on a gluten-free pizza crust for a simple dish your whole family will appreciate.
  • Nature’s Fusions advanCBD Tincture in Mixed Berry.¬†($40, Nature’s Fusions) Before accepting my new job, I was a brand ambassador for Nature’s Fusions – and I can honestly say that their mixed berry flavored CBD tincture is 100% pure, THC-free and delicious! Though I take CBD for my anxiety, those of us with IBS know that the two often go hand-in-hand. In the event that your stress causes an IBS flareup, a couple drops of this edible CBD tincture will help your racing mind calm down naturally.

Are You Sabotaging Your Mental Health? Here’s How to Stop

Sometimes, mental illness goes dormant, only to rear its ugly head again. If you’re experiencing a relapse and can’t figure out why, turn to these unexpected triggers to assess how they might be impacting your mental health.

priscilla-du-preez-kgZFViswqxg-unsplash.jpgDisclaimer: I am not a medical professional. Please discuss any mental health or other concerns with your doctor!¬†If you are feeling suicidal, you are not alone. Call 1-800-273-TALK or text ‘HOME’ to 741-741 to talk to a trained volunteer about what you are experiencing.

Sometimes, mental illness tricks you into feeling better – so much better, in fact, that you forget it exists. But having anxiety or depression is more like having cancer than having a cold: it goes into remission, but it’s never really “cured.”

When anxiety rears its ugly head after months and months in remission, my first reaction is usually one of shock: where did this come from? And what have I been doing wrong?

Many times, the sources of anxiety or depression are obvious. A stressor emerges, such as a major exam or big move. Other times, however, we have to dig a little deeper to find the sources of our inner unrest.

If you’ve examined your life and still don’t know where to turn, the sources of your anxiety may be hidden in unexpected places. Here are five red flags you may not have noticed yet – and why you might not realize they’re sabotaging your mental health.

1. Caffeine

Pounding heart, shaking hands, problems sleeping….to anyone with anxiety, these symptoms may sound familiar – but I’m actually talking about the side effects of too much caffeine!

If your anxiety has felt out-of-control lately, your morning latte may be the culprit. Try tracking how many milligrams of caffeine you drink per day for a week. The FDA recommends a daily limit of 400mg – that’s about four cups of coffee, eight cups of black tea or one-and-a-half energy drinks.

If you’ve got anxiety, you might consider drinking even less. I recommend decreasing your caffeine intake by one beverage per day until you find your sweet spot – that is, the number of caffeinated beverages you can drink without experiencing the drug’s ill effects. For me, that’s 2-3 cups of coffee per day – but since everybody metabolizes caffeine differently, based on their age, weight and even their genes, it’s important to observe your own diet to find out what works best for¬†you.

2. Processed Foods

Ever heard of a little thing called the gut-brain axis? In case you haven’t, you should know that the digestive tract produces up to 90% of the body’s serotonin. In other words, what you eat impacts how you feel – not just physically, but mentally, too.

Harvard Health Blog puts it best: “Like an expensive car, your brain functions best when it gets only premium fuel.” Fresh, whole foods that are low in sugar and high in nutrients are like high-octane gas for your brain: they allow your mind to function optimally, minimizing daily wear-and-tear. In other words, a serving of birthday cake or too much cheese off the party platter won’t wreck your mental health – but eating like that all the time could.

Considering mental illnesses like depression impact our ability to prepare fresh, healthy foods for ourselves, eating too much takeout or too many prepared, frozen dishes may be a subtle sign of a downward spiral. Thankfully, you can rectify the damage by incorporating more whole foods into your diet – and repairing your healthy gut bacteria with probiotic and fermented foods. That way, your body’s serotonin factory can go back to operating like a well-oiled machine.

3. Automatic Thoughts

Some negative thoughts are obvious: “No one loves me.” “I don’t deserve this.” “Life isn’t worth living anymore.” Others, like this doggo, show up in disguise….

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Source: Giphy

Dog or hooman? And does bacon cause cancer? The world may never know. My point is, some negative thoughts are learned so deeply that they become virtually impossible to distinguish from ‘normal’ ones. In fact, you may not even realize that you’re having them – or that they’re hindering your progress toward achieving mental health.

Thankfully, just as you learned these automatic negative thoughts over time, you can also learn to recognize and challenge them. Depending on the severity of your anxiety, this may best be done with the guidance of a mental health professional. Mindful meditation could also help, by making you more aware of your thoughts and giving you a window to disrupt negative thought patterns before they can cause you distress.

4. Nutritional Deficiencies

When’s the last time you had your vitamin levels checked? If you’re anything like me, it might have been awhile. Though many health conditions can masquerade as anxiety and depression, vitamin and mineral deficiencies are one of the most easily treatable causes of new mental health complaints. (Among other chronic diseases, hypothyroidism, Lyme disease and even certain cancers have been linked to depression – so be sure to visit your doctor to rule out these medical conditions if you are experiencing new symptoms of a depressive episode.)

Low levels of vitamins B or D may cause symptoms of depression, such as fatigue or negative mood. As for minerals, iron, selenium and magnesium are most commonly responsible for low energy, depressed mood and even irritability. In many cases, the best treatment for a deficiency is a dietary supplement – but to be diagnosed and treated for such deficiencies, you must visit your primary care provider. He or she will probably conduct blood tests to assess the bioavailability of certain vitamins – and if a deficiency is discovered, prescribe a high-dose vitamin for you to take at home.

One word of caution: be careful not to fall for the causation vs. correlation trap. While depression can be a symptom of low vitamins or minerals, it can also be a cause. Many people with depression experience decreased appetite or low motivation to prepare healthy meals for themselves, which can lead to nutritional deficiencies. So, if you find that addressing nutritional gaps doesn’t improve your depression, you may want to consult a mental health professional – ensuring you don’t fall into a vicious cycle of treating the symptoms rather than the disease.

5. Sleep

It’s common to experience sleep disruptions as a symptom of mental illness. For some, that means sleeping too much and finding it difficult to wake up in the morning. Others may describe a pattern of sleeplessness due to racing thoughts, or waking up unexpectedly in the middle of the night after experiencing a vivid nightmare.

Like dietary deficiencies, sleep disruptions can cause depression, and depression can cause sleep disruptions. Problems sleeping could even be due to medical illness. Your primary care doctor can tell you for sure what the best course of action is for your health – but as for steps you can take at home, effective sleep hygiene is crucial to maintaining good mental health.

So, what makes for hygienic sleep? Limiting daytime naps and stimulants such as caffeine, establishing consistent sleeping and waking hours and avoiding environmental triggers, such as a room that’s too hot or artificial light from cell phones, all contribute to healthy sleep patterns. While a good night’s sleep can’t fix all mental health problems, it certainly doesn’t hurt to arrive at your therapist’s office feeling clear-headed, alert and ready to take on your recovery, one baby step at a time.

The True Cost of Low Self-Esteem

Close to $15,000. That’s how much my low self-esteem cost me, anyways – not including my student loans (or my parents’ loans) for the $70,000 tuition at the expensive private university I chose for fear of being perceived as “dumb.” But that’s a post for another time.

For three years, I ran a successful college lifestyle blog called Haley Marie Blog. I initially started blogging as an outlet to talk about my mental health, but quickly fell into the trend of blogging about beauty and fashion I couldn’t afford. Fast forward three years, and my hustling had landed me dozens of national brand partnerships, hundreds of dollars’ worth of free product….and, oh yeah: about $15,000 in credit card debt.

After I heard the powerful story of how one millennial drove herself into debt trying to become an Instagram influencer, I felt inspired to share another side of the die: how poor mental health played a role in my debt story.

More and more people my age are acquiring debt – and more and more of us are becoming brave enough to speak out about it. And as someone who’s always seen herself as smart, responsible and capable, I get it: debt, especially credit card debt, feels like a shameful secret.

Especially¬†when the reason you went into debt wasn’t because you were buying a house, or a car, or because you didn’t understand how a credit card worked, talking about your debt feels like admitting, “Hey, I’m stupid and can’t be trusted to spend my money responsibly!”

Well, here’s a newsflash for you: smart people have credit card debt, too. The average American under 35 carries about $6,000 in credit card debt.¬†We all have, or have had, debt at some point in our lives.

In fact, that was part of the reason I couldn’t face my credit card debt for so long. I was a Dean’s List student, with a prestigious scholarship, attending an expensive private university. Admitting I had fallen into debt would have shattered the “smart girl” image I had spent so long trying to cultivate – which, funnily enough, was how I got myself into debt in the first place!

Personally, I feel that if more of us spoke out about the burden of debt and the role it’s played in our lives, fewer and fewer Americans would continue to spend above their means. So, let’s talk about my credit card debt – because I’m NOT ashamed of it.

To me, my credit card debt is a marker of how far I’ve come and how much I’ve grown as a person. It’s a slow-healing wound from one of the most difficult times in my life, mental health-wise. But it also transformed my self-esteem, the way I view myself and the way I relate to others.

By no means do I recommend getting yourself into debt as a self-help strategy – but as I’ve started to focus more on paying down my debt, I’ve become far more comfortable in who I am.

Rather than acquiring “things” to make myself feel worthy, every item I own is carefully curated to fit the life I want. I no longer hang out with friends who need me to spend money to fit in, but instead spend my time with people who love me the way I am.

My self-esteem contributed to my credit card debt, but my debt also contributed to my self-esteem. Low self-esteem cost me close to $15,000 – but learning to grow my self-esteem as I’ve dug myself out? Priceless.

What’s the most important lesson YOU have learned about money?

Let me know in the comments below!

Can You Go Vegan in Eating Disorder Recovery?

I am more than five years into eating disorder recovery – so you can imagine how scary it was when I thought to myself the other day, “Maybe I’ll just go vegan again.”

To provide some background, I have been eating on the low FODMAP diet for IBS for the past several months. I’ve discovered a (genuine, medical) lactose and gluten intolerance that already makes it difficult for me to sustain my eating disorder recovery. And I recently started being vegetarian again after six months of eating whatever I wanted without question. So, when I recently ran out of lactase pills and thought “Hmmm, maybe I’ll just stop eating animal products altogether,” it brought my day to a screeching halt.

Surely, a radical statement that calls for cutting out entire food groups deserves some curious self-examination on my part. But does it warrant saying I’ve “relapsed” and seeking treatment for my eating disorder once again?

I did some research – for my own sake, and for my future clients’ – to find out what the answer was. Unsurprisingly, I found that there isn’t really a textbook, one-size-fits-all approach to going vegan in ED recovery.

Based on what I’ve read as well as my own experiences, here’s my take on going vegan in eating disorder recovery. I hope this helps you find peace in your own decision “to be or not to be” vegan – whatever that choice may be!

My Story

black and white dairy cow on green grasses during daytimeI first tried going vegan my senior year of high school, after watching the documentary Cowspiracy with my best friend and learning what a profound impact raising livestock has on our environment.  Before that, I had been vegetarian for six years, beginning when I was thirteen.

At those points in my life, my choice not to eat meat or animal products had nothing to do with my eating disorder. When I was fifteen, I adhered to a strict diet in an attempt to get down to my “goal weight” of 105 lbs. I cycled between orthorexic periods of restriction and “cheat days” where I would binge until my stomach hurt.

But I never questioned my decision to eat meat or not to eat meat: my love for animals was a part of who I was, and I thought my decision to be vegetarian/vegan said a lot about who I was.

In college, I quit the vegan diet, only to start it again my second semester of freshman year. My decision to go vegan the second time was deeply linked to my lactose intolerance and my GI symptoms, which you can read more about in my health update here.

You see, I also developed IBS sometime in high school, around the same time that I was dealing with my eating disorder and my decision to be vegetarian/vegan. However, my symptoms would not become intolerable until earlier this year, my third and final year of college, when I would finally see a GI doctor and get diagnosed.

After keeping a food diary, I discovered that a lot of my stomach issues were tied to my decision to start eating meat again as a second-year college student. So, I became vegetarian again, occasionally breaking with that choice at restaurants or family dinners, and found that it helped my IBS symptoms tremendously.

However, I still struggled with my lactose intolerance. Lactase pills helped with the maldigestion and symptoms I experienced when eating dairy products, but they were expensive and made me feel limited in my food choices. I felt like if I went somewhere without my Lactaid, I wasn’t “allowed” to have dairy.

And that’s when the thought popped into my head: “What if I just went vegan again?” I’d save the hassle of buying Lactaid pills every month – and feel like my avoidance of dairy was my “choice,” rather than a product of my IBS. Which is exactly how I ended up starting a vegan diet again – and exactly how I wound up writing this article!

The Facts

As I mentioned previously, I was honestly a little bit frightened when I found myself considering a vegan diet again. After all, I was already worried that eating low FODMAP was causing me to fall into restrictive eating patterns – and I didn’t want veganism to be a “sign” that I was relapsing.

So, to make sure what I was doing was safe, healthy and, above all, right for me, I embarked on a little bit of research about being vegan in eating disorder recovery. In that process,¬†I found that as with anything else, there are both pros and cons to going vegan in eating disorder recovery. Namely….

Pros

  • When done right, veganism is a moral and ethical lifestyle choice, NOT a fad diet. Almost 3x the number of people who go vegan for “health reasons” go vegan for moral concerns about animal rights, according to a global survey conducted in 2019. And it’s no wonder, given the dire living conditions of livestock raised for slaughter in the meat industry!
  • An additional 10% do it for the environment, according to the same survey – which makes sense when you think about it. If you’re passionate about the environment, a vegan diet offers reduced land and water consumption and a smaller carbon footprint. In fact, one medical study shows the vegan diet’s environmental impact is 40-80% smaller than a traditional, omnivorous diet.
  • “Vegan” is NOT a synonym for “healthy” or “low-fat” or “low-calorie.” Duncan Hynes chocolate frosting, Oreo cookies, Fruit by the Foot, Lays Original potato chips, Sour Patch Kids and Ritz crackers are all vegan foods, but not exactly nutritious. Thus, you can still challenge yourself with “fear foods” by seeking out vegan versions of your favorite junk foods or “accidentally vegan” products you already love.
  • For those of us whose eating disorders have been linked to eating vegan in the past, embarking on a vegan diet again, under the advisement of a therapist, can be a way of shunning false “comforts” and ceasing to correlate veganism with your ED. With a little soul searching and a lot of hard work, you can break your mental association between a vegan diet and a restrictive eating pattern, so that veganism is no longer viewed solely as a means of controlling your weight.

Cons

  • Being vegetarian or vegan is a socially acceptable reason to turn down “fear foods.” Alternatively, openly choosing to starve oneself may raise concern from friends and relatives. There is some evidence to show that some people with EDs may adopt vegetarian or vegan labels as a way to avoid certain foods offered to them in social situations.
  • There is a community of researchers who think vegetarian and vegan diets may “mask” ED behaviors, though it is hard to say if they are objectively “right.” One study¬†found that self-reported vegetarianism in college-aged women is a marker for restrictive eating behaviors.
  • The vegan community can be triggering for people recovering from EDs. Jordan Younger, author of¬†Breaking Vegan¬†(who is vegan again, by the way), puts it perfectly when she calls it “vegan bullying, elitism and judgment” as well as “radicalism.” If you “slip up” or leave the lifestyle for any reason, the PETA worshipers will always be there, ready to chew your ass out.
  • It’s difficult to gain weight on a vegan diet, which tends to be high in carbs and low in protein in fat – which is why I¬†DO NOT¬†endorse a vegan diet for anyone who is underweight, in residential treatment or hospitalized for an eating disorder. In those initial steps of recovery, your focus needs to be on your physical state. You can worry about saving the animals when YOUR life is saved!
  • Many residential treatment programs will not allow you to maintain a vegetarian or vegan diet, so it may be difficult to find a professional who will work with your restrictions. Usually, this is not because your vegetarianism or veganism causes an eating disorder, per say, but because the restrictive nature of a vegetarian or vegan diet may be triggering for some of the other individuals utilizing that program. Still other patients may ask why your restricted eating patterns are tolerated, but theirs are not – thus hindering their own recovery process while in treatment.

My Advice

adult golden retriever taking a bathAfter hours of research, my conclusion about whether or not you can go vegan in eating disorder recovery is….it depends.¬†“On what?” you might be thinking. Well, I’m no doctor – but here’s my take on when you should (and shouldn’t) consider a vegan lifestyle in ED recovery:

  • DO have a clear reason for going vegan.¬†If you’re feeling a strong urge to go vegan, but can’t clearly articulate your reasons for doing so, it might be fueled by an unconscious ED mindset. Alternatively, if you have a clear reason for going vegan that isn’t motivated by weight or body image control – for example, ethical concerns for animals or the environment – focusing on that goal will prevent you from spiraling out of control and into a restrictive eating pattern.
  • DON’T go vegan if you’re not in remission,¬†or if you’ve had a recent relapse. Unfortunately, the opinion of many experts is that you should not embark on a restrictive eating pattern until you have been stable in your recovery for many months, or even years.
  • DO allow yourself flexibility on a vegan diet.¬†In my opinion, there’s nothing worse for ED recovery than hard-and-fast food rules. That’s why many recovery warriors turned vegans shy away from the “vegan” label, and instead choose to call themselves “plant-based” or “vegan-ish.” In other words, I believe that if you’re craving a Wendy’s Baconater, the healthiest option for your mental state is to eat the damn Baconater and move on with your life – and your vegan diet – the next day!
  • DON’T engage with radical veganism.¬†Basically, stay away from animal rights marches, PETA events and the comments section of literally any vegan YouTube video or social media post ever. There is a small, yet significant subset of the vegan community dedicated to tearing apart anyone who questions or “cheats on” their vegan lifestyle. As someone in ED recovery, you may be more vulnerable to this type of radical language – so instead of training yourself not to fall for it, I say just avoid the “vegan shaming” altogether. After all, most people who love animals or care about the environment aren’t willing to go vegan – so you’re already making more of an effort than most by eating vegan 80-90% of the time! (And vegan or not, you certainly¬†don’t¬†deserve to be cyberbullied.)
  • DO keep a food and mood journal¬†like this one, at least for the first few weeks of your vegan transition. Keep a careful watch on how selecting vegan foods affects your mindset. If you begin to notice old thoughts or behaviors cropping up as you transition to a vegan diet, it may be a sign that you’re not at a good point in your recovery to go vegan, or that going vegan may be too triggering for you to undertake at this point in time.
  • DON’T go vegan without telling your doctor or therapist.¬†Finally, you should always make your healthcare team aware of any choices you decide to make in your diet – especially if you are in recovery. Your therapist and doctor can both help you decide if a vegan diet is right for you at this point in your ED treatment. Plus, they can hold you accountable by paying attention to your thought patterns and weight respectively, in order to alert you if they feel your vegan diet may be triggering a relapse.

What are your thoughts on adopting a vegan diet in eating disorder recovery? Tweet me your thoughts @cozycounselor!

Social Work Study Materials to Bookmark Before Grad School

Hi, my name is Haley, and I am a last-semester senior who can’t wait to start social work school! So, how do I pass the time between study breaks?

I Google study aids for M.S.W. students, of course.

Confession: I will not be graduating with honors, or even a stellar GPA. Even if I got a 4.0 this semester, which – let’s face it – I probably won’t, I can’t earn higher than a 3.2 cumulative GPA. A couple of rocky semesters, both for my mental health and my grades, combined with the fact that I’m losing two semesters to early graduation mean that my chances of graduating¬†cum laude¬†are behind me.

…or are they? Confession #2: it’s never too late to bring your grades up! Determined to achieve my longtime goal of graduating with honors, I resolved that I would make this semester my best yet and learn the study skills and habits that will carry me through social work school to (hopefully!) graduate with the GPA I wish I had in undergrad.

One of the tricks I’ve learned along my journey toward raising my GPA is that one must never procrastinate if one aims to do well in their classes. Admittedly, this may have led to a bit of over-eager preparation for grad school – but ultimately, it resulted in this handy list of resources for you and me both to use in our journey through social work school!

I’m sure you’re thinking: after admitting that my grades are average at best, why should you take study advice from me of all people? Because it’s not the natural geniuses, for whom 4.0 GPAs and perfect GRE scores come easily to, who know how to teach the rest of us to study. It’s those of us who have been in your shoes, riding the #strugglebus alongside you, that know how difficult it is – and how much sheer will and determination it requires – to bring up your GPA when you’re just not a “school person.”

My advice for navigating this list is to start with the general study aids I’ve chosen. These are study skills and resources you can start using now to apply to graduate school later. Then, the further you progress in your social work career, the more you can explore and peruse the specific resources that will help you flourish in your chosen field.

Last but not least, be sure not to skip the self-care section at the end! Of all the careers you could have chosen, social work is the one with the highest burnout rate: so be sure to take a break for a 10-minute yoga session (or to do nothing for two minutes) to refresh your mind, body and spirit after a couple minutes of scrolling, thinking hard and preparing for your future.

 

General Study Aids

Social Work Scholar (The Official Cozy Counselor Studyblr!)

My Study Life – School Planner (Web – Also Available on iOS/Android)

Trello – Boards, Lists & Cards for Productivity Planning (Web – Also Available on iOS/Android)

Tinycards – Flashcards by Duolingo (Web – Also Available on iOS/Android)

Printable Exam Checklist (PDF)

Academic Memorization Tips for Different Types of Learners (Tumblr)

How I Use Flashcards (Tumblr)

How I Revise Content (Tumblr)

A Guide to Making Effective Slides (Tumblr)

How to Pull an All-Nighter (Tumblr)

How I Got a 4.0 Last Semester (Blog)

 

Licensure Exam

MSW Pocket Prep App (iOS)

ASWB Content Outlines – 2018 Master’s Exam (PDF)

Study Guide: Licensed Clinical Social Worker Exam (PDF)

2013 Licensing Exam Questions (PDF)

 

Theories

Theories, Models & Perspectives Cheat Sheet (PDF)

Overview of Theories (PDF)

Genograms and Ecomaps (PDF)

Crash Course Psychology #12: The Bobo Beatdown (Video)

Erikson’s Psychosocial Stages of Development Summary Chart (PDF)

Psychodynamic Theory: Id, Ego & Superego (Video)

Freud’s Psychosexual Stages of Development (PDF)

Lawrence Kohlberg’s Stages of Moral Development (PDF)

Chapter Three Summary: The Stages of Women’s Moral Development (In a Different Voice¬†by Carol Gilligan) (PDF)

Piaget’s Four Stages (PDF)

Crash Course Sociology #6: Karl Marx & Conflict Theory (Video)

 

Practice Models

SMART Goal Worksheet – Relevant to Task-Centered Practice (PDF)

Solution-Focused Interviewing Skills and Questions (PDF)

Narrative Therapy Worksheet: Life Story (PDF)

Crisis Intervention and Suicide Assessment (Podcast)

CBT: The Cognitive Model (PDF)

The ABC of CBT Worksheet (PDF)

Definitions of Cognitive Distortions – Relevant to CBT (PDF)

Patient Thought Record – Relevant to CBT (PDF)

Trauma-Informed Care Whitepaper (PDF)

 

Ethics & Case Studies

NASW Code of Ethics (PDF)

Social Work Today: Eye on Ethics (Blog)

2018 NASW Code of Ethics (Parts I-III) (Podcast)

The Red Carpet and the Social Work Exam – Free Ethics Practice Questions (Web)

Case Study Template (Word Doc)

CSWE Case Studies: October 2017 (PDF)

Social Work Case Studies: Foundation Year (PDF)

 

DSM-V & Psychopathology

DSM-V Disorders (PDF)

DSM-V Self-Exam Questions (Google Book)

Pearson Clinical: Clinical Assessment (Web – Links to PDFs)

Psychopathology (Video & PDF Questions)

AFP Patient Handouts (Web to PDF – Select “Psychiatric and Psychological” in Drop-Down Menu)

Developing Treatment Plans: The Basics (Podcast)

The Severe and Persistent Mental Illness Progress Notes Planner (PDF)

Sample Treatment Plan (PDF)

NASW Clinical Documentation (PDF)

Quick Reference to Psychotropic Medication (PDF)

 

Self-Care

MHA Stress Screener (Web)

Compassion Fatigue Awareness Project Self-Tests (Web)

Self-Care Assessment (PDF)

Dealing with Academic Burnout (Tumblr)

Self-Care Tips for Social Workers (Web)

Self-Care For Social Workers (Podcast)

My Maintenance Self-Care Worksheet (PDF)

Emergency Self-Care Worksheet (PDF)

My Support System Worksheet (PDF)

Take Action to Control Stress (Web)

Do Nothing for Two Minutes (Web)

10 Minute Yoga for Self-Care (Video)

Lavendaire (Self-Improvement YouTube Channel)

 

For more social work resources & study aids, follow me @cozycounselor on Pinterest!

What to Pack if Travel Makes You Anxious

When I was a little girl, I thought having a purse was the height of womanly sophistication – so much so, in fact, that I became obsessed with “What’s in my Purse” videos and listicles.

Every woman I knew seemed to be prepared for anything with what was inside her purse, so I thought putting more items in my purse would make me infinitely cooler. While the urge to pack my entire house in my Kate Spade has long since passed,¬† my interest in “What’s in my Bag” videos and blog posts has not subsided.

This “What’s in my Bag” – style post is special, however, because it specifically pertains to those of us traveling with anxiety. Looking back on my purse obsession, my anxiety was definitely a big reason I wanted to make sure I wasn’t missing anything important or potentially useful in my bag.

On top of that, traveling away from home is the¬†last¬†time you would ever want to forget something in your carry-on bag or purse! Which is why I am sharing this post with you in the first place: in honor of my flight home to Boston from spending winter break in Cleveland with my boyfriend David, I’ll be letting you in on all the travel essentials I pack to keep myself from having an anxiety-attack midair.

These items may not be a cure for fear or flying or travel anxiety, but they will certainly brighten your day and make the trip a little bit easier on you, body, mind and soul. So, without further ado, here are the travel essentials I try never to forget as a traveler with anxiety!

Related image

Source: Elle Silk

Sleep Mask

When you’re stuck on a long flight – especially a red eye! – sleep is probably the first thing on your mind. But, if you have anxiety, airplane conditions can make it almost impossible to doze off. A sleep mask is crucial for blocking out all the annoying lights around you, so you can focus on getting the best night’s rest you possibly can. For bonus points, you can also bring or ask for a pair of earplugs, to keep you from focusing on the unseemly whir of the plane’s engine.

Image result for essential oil roller

Source: Rogue Wood Supply

Roll-on Essential Oil

Whether or not you’re convinced by the essential oil hype in the blogosphere, scents have a powerful impact on our mood. A soothing roll-on fragrance, like lavender, clary sage or chamomile, gives your body a gentle reminder to relax, even when the last thing you feel is calm.

Image result for cute pill organizer

Source: Walmart

Pill Organizer

If you take medication for your anxiety, forgetting your meds can put a huge damper on an exciting trip. So you won’t have to spend your entire vacation in line at the pharmacy, try bringing a weekly pill organizer with your medications and dosages already neatly divided and packed. Just be sure to bring your medications in your carry-on bag or purse, so that you won’t worry about missing them if your bag is lost or stolen.

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Source: Urban Outfitters

Portable Charger

When you’re out and about in an unfamiliar city, state or country, your phone is your lifeline. This summer, I spent a week hopping between European countries – I used my phone for everything from translating signage to getting directions when I was lost! That little hunk of metal in your pocket can go a long way toward reassuring you of where you’re going and what you’re doing on vacation. Bring a portable charger and cord everywhere you go, and you’ll never have to worry about it dying unexpectedly!

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Source: Twitter

Dramamine

Thankfully, I don’t get motion sick on planes – just in the car. But, if you do get motion sick on planes, worrying about whether or not you’ll get sick on your flight can cause a lot of additional, unnecessary anxiety. If this sounds like you, I highly recommend bringing some Dramamine tablets along for the ride. They’re made to combat motion sickness, and may even make you drowsy enough to fall asleep during an otherwise anxiety-ridden flight.

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Source: DHgate

Fuzzy Socks

Tight shoes and socks restrict your circulation – which can be dangerous on long flights, especially if you take medication that increases your risk of blood clots (including the birth control pill!). Fuzzy socks will not only keep you warm midair, but they’ll also keep your calves nice and relaxed, enabling blood to flow regularly throughout your legs – and keeping your pesky feet from falling asleep in-flight!

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Source: Crate and Barrel

Comfort Object

You’re never too old to self-soothe, in my opinion – and what better way to feel better than to cuddle a stuffed animal? To me, a warm teddy bear is the next-best thing to a real pet. Since I rarely travel with my furry friends, I never forget to bring a comfort object wherever I go. For me, snuggling up with my Hooty owl-shaped heating pad helps calm me down whenever I get anxious. (Some airplanes have microwaves you can borrow for objects like heating pads – ask the flight attendant nicely and they’re usually happy to help out! This tends to be more likely on international flights where you’re served a hot meal.)

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Source: Yogi Products

Tea Bags

The most soothing, calming beverage of them all is decaffeinated tea. But why spend a fortune on a Starbucks tea when you could pack your own brew from home? BYO empty travel mug through security. Then, ask Starbucks to fill it with hot water – this is usually free, or they may charge you something like $0.15 for the hassle. Finally, dunk your own favorite blend of anti-anxiety teas in the water for a thrifty beverage that’s sure to warm you to your core. My favorite blends for calming down are green tea, chamomile or vanilla – each with a few drops of honey to sweeten them up!

Image result for adult coloring book

Source: Blue Star Coloring

Coloring Book

Adult coloring is more than just trendy: it’s a creative activity that promotes mindfulness and relaxation. When you’re wired from the adrenaline of a frightening flight, it’s the perfect time to practice using coping skills like mindfulness to bring down your anxiety levels. Just remember that some TSA agents will count markers toward your allowance of liquids in your carry-on, so you may want to check your toiletries or consider packing fine-liners or gel pens instead.

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Source: Lulus

Wireless Headphones

I love listening to my favorite playlist when I’m on a long flight, because it helps me drown out the sounds of the roaring engine that make me so anxious. However, I hate those cheap plastic earbuds the flight attendants hand out in-flight! That’s why I always pack my own set of Bluetooth wireless headphones – I use this $25.00 pair of Soundpeats, which have stereo quality at an affordable price point. One advantage of wireless headphones? You can still follow along with your in-flight entertainment if you need to leave your seat! (Note: I am not sponsored by Soundpeats.)

Image result for glee gum

Source: Pinterest

Chewing Gum

Last but not least, ever since I was a kid, I have never gotten on a plane without chewing gum. Growing up, my mom taught me to chew gum when the plane is taking off or landing to prevent the painful change in air pressure. Maybe this is just an old wives’ tale, but I always chew gum when landing, and my ears hardly ever ache when I fly anymore! I am on a low FODMAP diet, which generally discourages chewing gum, as it usually contains a high FODMAP artificial sweetener like sucralose or aspartame. Lately, however, I’ve fallen in love with Glee Gum, a brand that uses real sugar and brown rice syrup in place of artificial sweeteners-¬† both of which are low FODMAP choices! You probably won’t find it in the airport – but you can get Glee Gum online or at your local health food store, such as Whole Foods Market. (Note: I am not sponsored by Glee Gum.)