Bipolar1Blog

Brain Study Seeks Roots of Suicide

A clinical trial will look at the neurological structure and function of people who have attempted suicide

 Researchers hope to elucidate the brain mechanisms associated with the impulse to kill oneself.

Suicide is a puzzle. Fewer than 10% of people with depression attempt suicide, and about 10% of those who kill themselves were never diagnosed with any mental-health condition.

Now, a study is trying to determine what happens in the brain when a person attempts suicide, and what sets such people apart. The results could help researchers to understand whether suicide is driven by certain brain biology — and is not just a symptom of a recognized mental disorder.

The project, which launched last month, will recruit 50 people who have attempted suicide in the two weeks before enrolling in the study. Carlos Zarate, a psychiatrist at the US National Institute of Mental Health in Bethesda, Maryland, and his colleagues will compare these people’s brain structure and function to that of 40 people who attempted suicide more than a year ago, 40 people with depression or anxiety who have never attempted suicide and a control group of 40 healthy people. In doing so, the researchers hope to elucidate the brain mechanisms associated with the impulse to kill oneself.

Zarate’s team will also give ketamine, a psychoactive ‘party drug’, to the group that has recently attempted suicide. Ketamine, which is sometimes used to treat depression, can quickly arrest suicidal thoughts and behaviour — even in cases when it does not affect other symptoms of depression. The effect is known to last for about a week.

To some researchers, such findings suggest that ketamine affects brain circuits that are specific to suicidal thinking. But John Mann, a psychiatrist at Columbia University in New York City, says that abnormal brain chemistry and genetics could also predispose a person to attempt suicide in times of great stress, such as after a job loss. “They’re part of the person, they’re a trait,” Mann says. “They just get more important when the person gets ill.”

Written in the genes?
There is evidence that genetics influences a person’s suicide risk. For instance, biological relatives of adopted children who kill themselves are several times more likely to take their lives than the general population.

Fabrice Jollant, a psychiatrist at McGill University in Montreal, Canada, suggests that this genetic influence is related to impulsivity and flawed judgement, rather than a specific mental illness. He has found that close relatives of people who killed themselves were more impulsive than a control group when playing a gambling game designed to test decision-making. “It seems that this is something transmitted,” Jollant says.

Other researchers are seeking biomarkers that would allow clinicians to spot people most at risk of suicide. Alexander Niculescu, a psychiatrist at Indiana University in Indianapolis, and his colleagues have identified a set of six genes whose expression is altered in the blood of people who have killed themselves. The team has found that combining these biomarkers with data from an app that tracks mood and risk factors can predict, with more than 90% accuracy, whether people with bipolar disorder or schizophrenia will eventually be hospitalized for a suicide attempt.

And Mann is using positron emission tomography to track the best-studied biomarker, for the signalling molecule serotonin, in the brains of people who have attempted suicide. Their altered serotonin patterns are similar to those seen after death in the brains of those who have killed themselves, says Mann.

Although serotonin levels are altered in people with depression, Mann has found differences between people who attempt suicide and those who are depressed but have no history of suicide attempts. He has also shown that serotonin levels are altered to a greater degree in those who make more serious suicide attempts — such as taking an entire bottle of painkillers — than in those whose attempts are less drastic.

Ethical challenges
Researchers hope that a better understanding of the biology underlying suicide will lead to more effective treatments for suicidal impulses. But studies such as Zarate’s present difficult logistical and ethical challenges. Researchers must consider whether a person who has just attempted suicide can make informed decisions about whether to participate in research.

Michael Minzenberg, a psychiatrist at the University of California, San Francisco, knows these concerns all too well: he studies suicidal people with schizophrenia. Many of these people struggle with basic life skills, such as keeping a job or finding housing. “They’re a challenging group to treat, let alone to study,” Minzenberg says.

He and other researchers who study suicidal people say that they treat them with special care — and that the overall benefits of such studies outweigh any risks. “In most clinical trials, people at high risk of suicide are excluded, so we don’t know how to treat them,” Jollant says. “We need to assess this population, not just say ‘exclude them from trials’.”

Negative Symptoms

SCHIZO

This is a graphic for negative (meaning things that are absent or missing, such as affect, pleasure, speaking, and activity) symptoms of schizophrenia, but these very symptoms are also present in the depressive phase of bipolar disorder. And these can also be erroneously attributed to laziness, “just not trying enough”, or unwillingness, but they are due to illness.

Schizophrenia, bipolar disorder and major depression share genetic risk factors: Study

DSCN6809

From the article below. Again, immune involvement. “The researchers found strong associations between mechanisms related to immune function and changes in processes when genes are turned on and off. The findings confirm known mechanisms as well as revealing new ones that pertain to the development of psychiatric disorders.”

I know when I am in full blown mania and out of touch with reality, there is no difference between me and a person who has schizophrenia. The thing is that my getting to that point can be prevented by taking Lithium (for me), whereas a person with schizophrenia has a lot more trouble coming out from delusions, hallucinations and back in touch with reality.

http://www.belmarrahealth.com/schizophrenia-bipolar-disorder-and-major-depression-share-genetic-risk-factors-study/

Schizophrenia, bipolar disorder and major depression have been found to share a genetic risk factor, according to a new study. Aside from the recent research, many previous studies also showed a genetic link between all three mental disorders. Below are synopses of the health studies that reveal the connection they all possess.

Study on shared genetic risk factors for schizophrenia, bipolar disorder and major depression

Research published in Nature Neuroscience from the Louisiana State University Health Science Centers revealed a genetic risk factor that is shared between schizophrenia, bipolar disorder and major depression. Lead researcher, Nancy Buccola, and her team examined data from 60,000 participants, including those with schizophrenia, bipolar disorder, major depression, autism, attention deficit disorders as well as individuals without any diagnosed conditions.

Study on shared genetic risk factors for schizophrenia, bipolar disorder and major depressionThe researchers found strong associations between mechanisms related to immune function and changes in processes when genes are turned on and off. The findings confirm known mechanisms as well as revealing new ones that pertain to the development of psychiatric disorders.

Treatments are available for many mental disorders but many patients do not obtain relief from such treatments. Buccola stated, “The PGC is a collaboration of some of the finest psychiatric genetic researchers in the world who are working together to understand the biology that underlies psychiatric disorders. This knowledge is critical in developing more effective and personalized treatments. I feel fortunate to make even a small contribution to this important work.”

Previous study shows schizophrenia and bipolar disorder cause dendritic spine loss in brain

Alternative research has found that schizophrenia and bipolar disorder both play a role in dendritic spine loss in the brain. The findings suggest that the two disorders share similar pathopsychological features.

Dendritic spines play a role in many brain functions. To achieve their results, researchers looked at individuals with schizophrenia, bipolar disorder, and individuals not affected by either disorder.

Spine density was reduced in those with bipolar disorder and those with schizophrenia, when compared to the control group. Furthermore, there was a significant reduction in spines per dendrite in both bipolar individuals and schizophrenics.

Lead researcher, Glenn T. Konopaske, M.D., said, “The current study suggests that spine pathology is common to both [schizophrenia] and [bipolar]. Moreover, the study of the mechanisms underlying the spine pathology might reveal additional similarities and differences between the two disorders, which could lead to the development of novel biomarkers and therapeutics.”

Bipolar disorder is often misdiagnosed as major depressive disorder (MDD)

Bipolar disorder is often misdiagnosed as major depressive disorder (MDD)Research has shown that bipolar disorder is often misdiagnosed as major depressive disorder (MDD). In bipolar disorder, individuals experience intense lows in mood and euphoric highs. In major depressive disorder, individuals experience steady, intense lows in mood. Because episodes of low mood can last for days or even weeks in those with bipolar, it can lead to a misdiagnosis of major depressive disorder. Researchers are closing in on an objective to help distinguish between the two conditions in order to reduce misdiagnosis.

Current diagnostic methods involve interviews with the patient, but this can be subjective and misleading. Researchers decided to combine techniques together in order to create a more accurate diagnostic method. The techniques used are gas chromatography-mass spectrometry and nuclear magnetic resonance, which analyze the urine of patients with MDD and bipolar disorder in order to uncover biomarkers of each disorder. These biomarkers will allow doctors to improve diagnosis by 89 to 91 percent.

Depression in patients with schizophrenia

One study found that a quarter (25 percent) of those with schizophrenia also have course-related depression. Depression in schizophrenia patients is related to a reduction in social and vocational functioning and also increases the risk of a psychotic relapse.

Depression in schizophrenia often has poor outcomes; patients have more suicidal thoughts, suicide attempts, and suicides.

It can be difficult to diagnose depression and schizophrenia separately as the “negative” symptoms related to schizophrenia can present themselves like depression. Negative symptoms refer to social withdrawal, low motivation and energy, difficulty experiencing pleasure or having interests and an impaired thought process; all symptoms seen in depression as well.

For the many similarities presented in both schizophrenia and depression, not only is distinguishing between the two difficult, but depression can often be seen in many schizophrenic patients as well.

From all the presented studies we see many links and associations between schizophrenia, bipolar disorder and depression. By continuing to make these links, we can obtain a better understanding of these mental disorders, which could greatly assist in developing more specific treatments that could offer more patients greater relief.

How many times before

We institute any kind of gun control? How many people dead, before we institute gun control? How many prayers and condolences do we send out to families before we institute gun control? Look at Australia and Great Britain, they have cut their mass shooting rates down by instituting strict gun laws. For goodness sake, we must do the same. This year, there have been more mass shootings than days that have passed! How can the politicians continue to let this happen without laws that control who can buy a gun and who can’t? How can background checks not be required? Life is precious. Are we not a civilized society? Are we just going to allow anyone to get their hands on a gun and do with it as they like?

Close call…

computer

Got off the plane, went to the restroom. Had my purse and my Macbook Air in a bag with me. Spotted a Starbucks, oooh coffee, went and got some. went to a natural foods place and got a sandwich. Went to the bookstore, browsing… suddenly realized my computer bag was missing! Heart skipped a few beats, broke out in a hot sweat… crap… went all the way back to the disembarkation gate in Concourse B from A, went back to the bathroom, no computer, went back to Starbucks, no computer, stopped on the way at a gate and asked agent to help me. She said to go to the police office. On the way to the police office, stopped at bookstore, no computer, last chance, stopped at the natural foods restaurant… and there it was, my gray bag, with my Macbook Air, sitting propped up against some soft drink dispensers. I laughed and laughed and said thank you and gave the girl behind the counter a great, big hug! Said thank you again and walked all the way back to my gate for Buffalo.

Wow! We don’t know how precious something is until it’s lost. Human nature, I guess. I mostly thought of my pictures on my computer, about 2000 of them, those are what I would have missed the most.

So lucky! So lucky! Hanging on tight to my computer bag.

Just sitting here, thinking.

IMG_0079

I should be in bed, with a bag of ice on my head, but I sit here, with a nauseating migraine, looking at the graceful remains of the thanksgiving flower bouquet that I had so lovingly arranged, still beautiful, in its languorously droopy way. I am on a self prescribed lithium holiday! With the blessings of my psychiatrist, yes, really.  Still on Seroquel. And don’t worry, I’ll go back on the necessary, yet difficult to swallow, lithium soon, very soon, tomorrow in fact. My right hand, which shakes like a leaf when I am on 900 mg of lithium, has finally started shaking like a flag in a mild breeze. Only my right hand has tremors, not my left hand, and yes, I am right handed. My friends remark on it with horrified eyes, I tell them this tremor is the least of my worries. I tell them they should peak into my quaking brain when I am in the midst of mania or depression. Unfortunately, this mostly passes by, unregistered,  un-understood. But I can’t really blame them, they, and how fortunate they are, have no frame of reference with which to understand my statement.

My mind is awhirl. Going to Buffalo tomorrow for my son’s birthday 🙂 He is 25 years old! I gave birth to him a quarter of a century ago! How did that even happen! My adorable, blue eyed baby turned into my handsome, loving, adored young man!

ARAL 5 mos and meAral, 5 months old!

Aralster and me!Aral, 24 years old!

Then, I’m going to Pakistan at the end of this month, I will be seeing my aunt and giving her all my love. Can’t believe it’s December already. How time just takes upon its wings and soars. And we are left standing, graying and wrinkling, in its dusty wake. Oh come now, you are alive, you are healthy, yes, healthy, you want for nothing, you have family and friends whom you love and are loved by in return! What more can you ask for?

Well, I have to go pack for my trip now. I’m hoping this unforeseen and thoroughly unwanted migraine takes flight soon, before I have to get on my flight.

DNA Repair Protein BRCA1 Implicated in Cognitive Function and Dementia

BRCA1 in neurons_2130x1198

Wow! The BRCA1 gene, mutations in which lead to breast cancer, has now been implicated in cognitive functioning, dementia and the development of Alzheimer’s disease!

BRCA1 is a tumor suppressor gene, this encodes a protein that repairs DNA mutations. If these mutations in the DNA were not repaired, the cell would become cancerous. So the repair of these mutations suppresses tumor formation, hence the term tumor suppressor gene. If there is a mutation in BRCA1, the mutations in DNA will not be properly repaired and can lead to oncogenesis.

What’s very surprising is that these genes, first discovered in relation to breast cancer, have now been seen to have an important role in neurons! In post mortem studies, it was seen that BRCA1 was 65-75% lower in patients who had dementia than in normal controls. It was found that ÎČ amyloid (the proteins that accumulate in brains of people with Alzheimer’s,) depletes BRCA1 in neurons. Faulty DNA repair was known to occur in the neurons of people with Alzheimer’s, now with the involvement of BRCA1, it makes perfect sense.

BRCA1 is involved in Alzheimer’s disease, wow! Could it or some other DNA repair proteins be involved in mental illness?

As I said in another post about why elephants don’t get cancer (https://bipolar1blog.wordpress.com/2015/10/11/wow-this-is-the-reason-why-elephants-dont-get-cancer/), elephants have 40 copies of a particular tumor suppressor gene called p53, whereas humans have two. I wonder if overproducing BRCA1 in neurons, either by increasing the number of its gene or by delivering the BRCA1 protein in nanoparticles into the neurons of people with dementia, would that halt dementia, or at least slow it down?

Curiouser and curiouser… it is all interconnected!

Breast cancer proteins seen in dementia; neurotransmitters, neuronal messengers, seen in the gut and muscles; interleukins, immune cell molecules, present in the brain…

http://gladstone.org/about-us/news/dna-repair-protein-brca1-implicated-cognitive-function-and-dementia

 

Loneliness May Warp Our Genes, And Our Immune Systems

Loneliness. Sometimes I like to be alone, but I never like to be lonely. I am happiest surrounded by my loved ones, laughing, doing, cooking, like at thanksgiving just a few days ago. I am always talking about living in a community where all my family members are my neighbors. There is no one closer than family, but our Western culture espouses individualism, so much so that community and extended families are nonexistent. And that makes me feel alone. And being alone is really bad for us, we intuitively know this, during caveman days, being alone meant being eaten by lions, tigers, or bears! The article below also offers scientific proof about our immune systems, more prevalent illnesses, that explains why being alone feels bad and is bad for us. I love my family and my friends and I love to spend time with them, building community is also important. Long live human associations!

http://www.npr.org/sections/health-shots/2015/11/29/457255876/loneliness-may-warp-our-genes-and-our-immune-systems?utm_source=facebook.com&utm_medium=social&utm_campaign=npr&utm_term=nprnews&utm_content=2055

Loneliness has been linked to everything from heart disease to Alzheimer’s disease. Depression is common among the lonely. Cancers tear through their bodies more rapidly, and viruses hit them harder and more frequently. In the short term, it feels like the loneliness will kill you. A study suggests that’s because the pain of loneliness activates the immune pattern of a primordial response commonly known as fight or flight.

For decades, researchers have been seeing signs that the immune systems of lonely people are working differently. Lonely people’s white blood cells seem to be more active in a way that increases inflammation, a natural immune response to wounding and bacterial infection. On top of that, they seem to have lower levels of antiviral compounds known as interferons.

That seemed to provide a link to a lot of the poor health outcomes associated with loneliness, since chronic inflammation has been linked to everything from cancer to depression. The human body isn’t built to hold a high level of inflammation for years. “That explains very clearly why lonely people fall at increased risk for cancer, neurodegenerative disease and viral infections as well,” says Steve Cole, a genomics researcher at the University of California, Los Angeles, and lead author on the study published in the Proceedings of the National Academy of Sciences on Monday.

But it still doesn’t explain how or why loneliness could change our bodies. To find that out, Cole and his collaborators tracked 141 people over five years. Every year, the researchers measured how lonely the participants felt and took blood samples to track the activity of genes involved with immunity and inflammation. They also tracked concentrations of the hormone norepinephrine, one of the two main signals during the flight-or-fight response.

Cole noticed that when people felt lonesome, they had significantly higher levels of norepinephrine coursing through their blood. That could explain all the other immune changes that happen when people suffer from social isolation.

In a life-threatening situation, norepinephrine cascades through the body and starts shutting down immune functions like viral defense, while ramping up the production of white blood cells called monocytes. “It’s this surge in these pro-inflammatory white blood cells that are highly adapted to defend against wounds, but at the expense of our defenses against viral diseases that come from close social contact with other people,” Cole says.

At the same time, lonely people seem to be shutting down genes that would make their bodies sensitive to cortisol, which lowers inflammation. That ramps up the defensive inflammation response, Cole says.

Loneliness gif

Loneliness would hit the switch on a defense plan our bodies initiate in the face of mortal danger, Cole thinks, if isolation is somehow truly lethal. “At this point, my best guess was that loneliness really is one of the most threatening experiences we can have,” he says. “Though I didn’t think of loneliness as being that awful. It’s not pleasant, but not something my body should be getting all up in arms about.”

In the world of cubicles and studio apartments, loneliness is everywhere. We find it in both crowds and empty rooms. We change cities and lose friends. Even in marriage, people can be strangers to one another. But things were very different for our ancestors. When humans were evolving in a prehistoric environment, they banded together for food and for protection.

To be ostracized from your tribe was a death sentence, says Charles Raison, a psychiatrist at the University of Wisconsin, Madison who did not work on the study. “Literally they would die. There was no human way to live in isolation,” he says.

Being alone in the wild meant you could be mauled by animals or even other human beings. Then your body would need extra defenses against wounds and infection, but less protection against viruses you get from other people, like the flu. In that case, the stressful response to loneliness would simply be the body’s way of trying to survive exile.

But this fight-or-flight immune response is really nonspecific, says Turhan Canli, a neuroscientist at Stony Brook University in New York who was not involved with the study. Loneliness might not necessarily have to do with ancient survival, he says. Our bodies basically have one panic button, and any kind of adverse condition can trigger this response. “I think loneliness is a kind of psychological stress,” he says. “The change in the immune response is part of biological changes that come with a stress condition.”

What Canli finds really interesting about Cole’s results is that people who felt lonely one year had increased gene activity around inflammation and norepinephrine later on. And people who had increased inflammation felt lonelier the next year. “It’s a two-way street,” he said. “Loneliness predicted biological changes, and biological changes predicted changes in loneliness.”

So the shock of social isolation could fuel inflammation in the body. And the immune system may affect a region of the brain processing fear and anxiety. “Inflammation can change people’s experiences of the social world and what they’re thinking,” says Naomi Eisenberger, a neuroscientist at the University of California, Los Angeles, who was not involved with the study. That could make us more apprehensive about social interaction and lead to more isolation.

If the cycle continues, that could explain chronic isolation and the subsequent depression and illnesses plaguing the lonely. “There are things we can do to get out of a depressed or lonely state, but they’re not easy,” Cole says. “Part of the reason is because these negative psychological states develop some kind of molecular momentum.”

But that doesn’t mean the loop is permanent. “Inflammatory biology is one thing, but it’s not the only thing,” he says. All it does is push our proclivity for social activity one way or another. But loneliness is deep. It’s encoded in our genetics, and it’s not easy to shake.

“5 Reasons Why I’m Not Ashamed of My Mental Health Condition” by Rachel Griffin

This is a great article! I agree with all the points she addresses. I would add one more: How strong I am to overcome this illness and live a life that is loving, kind, helpful, positive and hopeful.

How about you? What do you agree with, disagree with and what would you add or change?

 

 

http://www.huffingtonpost.com/rachel-griffin/5-reasons-why-im-not-ashamed-of-my-mental-health-condition-_b_8483030.html?ncid=fcbklnkushpmg00000063

I used to feel ashamed of my mental health condition, but now I refuse to let stigma and stereotypes dictate how I feel about myself. If you stigmatize me, that’s yourignorance, not my truth. Cool people, who are educated about mental illness and confident in their own mental health, don’t stigmatize. Stigma is dated, cruel and just plain wrong. Get educated about mental illness and come over to the cool side.

People with mental illnesses are not less-than. They are not damaged. They are not what you see on TV, the news or in movies. They are people; brothers, mothers, fathers, daughters… People. They are valuable, vibrant, brilliant members of your community. They are 1 in 4 people, not some freaky monster you’ve never met.

I have an awesome, successful, happy life… and a mental health condition. Big deal. Get over it. Just because I’m different, doesn’t mean I’m broken. In fact, I like being different.

Shame is toxic to the human spirit. I’ve let it go and replaced it with pride and acceptance. You can shame me all you want and have a big ol’ shame party, but it’s my choice whether I attend or not. (I’m always busy with better, more important things to do than sit with shame.) Shaming yourself and others are both exhausting, heavy, soul-energy-sucking things to do. I’ll be by the pool with joy and acceptance if you want to join us.

I hope you’ll also let shame go and move forward with pride. Here are 5 reasons why I’m not ashamed anymore:

1. It’s not my fault. 

I didn’t choose this. It’s genetics. It’s not a character flaw or a negative personality trait. I’m not guilty of something. I don’t have a mental health condition because I’m weak, don’t try hard enough to change, don’t have enough willpower, eat too many donuts, like the attention, or haven’t read enough Oprah. It’s my brain being my brain. (For the record, though, I eat healthy and I’ve read a lot of Oprah. I’m eating cucumbers and having an aha-moment right. now.)

Depression is extremely different from normal sadness. Anxiety is not “just worrying.” People who have mental health conditions can’t just snap out of it. Know the facts.

2. My brain is actually awesome, and I’m in good company.

I’ve grown to love my brain. Ya, I have anxiety, I’m a human sponge for everyone’s feelings, and I’m so sensitive I’ll cry at a cheerios commercial, but the ability to feel so much is also gift. I have an extraordinary amount of empathy. My brain is out to lunch in some areas but it has extra mojo in other areas like creativity and imagination. I am an award-winning composer (writing a mental health musical!) music teacher, Dramatists Guild Fellow, and a published writer. My imagination may take me places I’m not so fond of (but I’m used to that by now) and it’s worth it for the beautiful places I can travel to. I’d rather trudge through mud and then dance in seas of glittery stars then walk on flat, easy plain all the time. It’s who I am and I’m also learning to appreciate the mud.. Hey, mud-pies! Mud-facials! Mud-baths!

People with mental health conditions are not doomed. Their future isn’t bleak and miserable. With treatment, they can live normal, wonderful lives and have happy, successful relationships!

People with mental health conditions are in good company! Think about all the people who made unbelievable contributions to the world who also struggled with mental health conditions! (Lincoln, Beethoven, Mozart, Tolstoy, Michelangelo… the lists goes on and on)

3. We all have weird minds.

Um… everyone’s mind is a little wonky. No one is thinking about unicorns skipping on rainbows (while it rains candy) all day. People with mental health conditions are not super strange aliens from a far off galaxy. (We are more like super heroes from a far off galaxy) We all have problems and struggles in life. No one is perfect. No one has a unicorn mind all the time.

4. I’m proud of how far I’ve coming and how I’ve helped/am helping others. 

It takes a lot of bravery to get help for a mental health condition and stick with treatment. It takes a lot strength to tell your story for the millionth time, advocate for yourself when your care is crappy, try a bunch of medicines until you find the right one (while the cray-cray list of side effects on the commercials plays in your mind) put up with everyone telling you what you should do to get better when they aren’t qualified to do so, have your claims denied by rich insurance companies when you can’t pay your bills, and be treated like a child and talked to in an odd condescending tone when you have a masters degree.

People say hope is right in front of you, but depression is a blindfold. It takes so much strength to keep searching in the dark.

Recovery is sort of like making an huge collage. You are always looking, finding, and pasting things that help you. Your your own work of art, a constant project. It takes a lot of energy and willpower. It takes being bad-ass. I’m proud that I am speaking out (not an easy decision) and trying to help others.

5.  My pain has become my power. 

I’m not ashamed of my pain. I think it’s made me a more compassionate person. I think it’s given me wisdom and inspiration. I believe pain can be like a question mark, asking us, “What will you do with me? Destruct or create?” It’s energy we can transform and put to use. I believe that our struggle and pain softens when we use it to create, and then with our art/work/writing we are able to soften pain living in others.  It becomes our power. It becomes our flashlight to hand to others who are still tripping in the darkness like we once were. I believe when we break down and lose everything, often we rebuild a stronger, wiser, more beautiful version of ourselves. I believe pain can be an asset. High-five, illness!

What are you proud of? I challenge you to #letshamego You have nothing to be ashamed of! You’re amazing.