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Mental health, to me, is the dichotomy of everything I wish I could be and everything I already am. It’s the thing that feels impossible—mental health—and an inextricable part of me. Because, the truth is, we all have mental health. Mine is ill, just like so many people’s, but that doesn’t mean it’s not there. That doesn’t even make it bad or wrong—a lesson that was incredibly difficult to internalize. In truth, my mental health—and mental illness—is me. It’s in every single part of me, in everything I do. It penetrates every little bit of my life. There is nothing I do that happens outside the lens of my mental health. And even if that’s hard and consuming, I wonder whether maybe that’s okay?

My mental health is trauma and anxiety. It’s overthinking everything—including writing this. It’s all the things I can’t do, and everything that’s happened to me. It’s the panic in my chest when someone’s energy seems different. It’s plotting, planning, overanalyzing, and mentally tormenting myself. It’s the black holes inside my chest and brain that suck in every good thing and turn them terrifying. It’s exhausted days and restless nights spent worrying about things gone by, those to come, and hypothetical things I’ve decided I need to be prepared for. It’s being convinced I’m seconds away from being yelled at or arrested simply for existing. It’s sobbing on the floor because I can’t take the weight of anything more. It’s being hypervigilant, constantly, and never switching off. It’s the horror of the answer when someone asked me whether I’d rather be hunted by a killer or tell my family how they hurt me. It’s how close I always am to tears.

My mental health is complicated. It’s knowing I’m not alone and feeling bitterly so—partly because, in terms of safety, I always was, and partly because of how much I hold myself back in fear and shame. It’s seeing the community, knowing others face the same challenges, and still not being in a place that allows me to reach out and connect. It was seeing Ami’s post, appreciating what they’re doing so deeply, and still agonizing over whether my voice mattered enough to say anything. It’s relief at writing this, and being convinced I’m doing it wrong. It’s the pounding, terrified, insistent voice in my head that tells me I have to write mental illnesses in my books, even as I’m aware that the more I put in, the more “ugly” and real and messy it is, the more likely it is to divide readers. It’s the battle between wanting to be tidy and uncontroversial, to tell stories people like, and the reality of living with that mess every single day and needing to tell its stories.

It’s also the victory of existing in the world with mental illnesses, in writing these stories where characters battle their own minds, and in making it through every day alive. My characters aren’t me, but little pieces of me live inside them, and, the more one of them is dealing with their mental health, the more of me is likely to be in there. It’s the strength of knowing that and still sharing it anyway, in being that vulnerable with the world. And it’s every single message afterwards from someone who felt seen. It’s the connection in those moments of sharing space with someone who gets it. It’s creating a world where, for the space of a story, they didn’t feel alone. It’s knowing that I’m not alone.

It’s me now, it’s me in the past, and it’s me in the future. I’m dedicated to being better, to finding my strategies, to healing my trauma. It’s exhausting and hard, and, in truth, my C-PTSD and anxiety aren’t really going anywhere. They’ll be more manageable some days, maybe, but they’re me now and always. They’re not all I am, but they’re in everything. Sometimes that’s hard, sometimes it’s filled with love and strength, but either way, it’s me. 

It’s me when I show up to therapy knowing exactly how hard it’s going to be. It’s me when my brain builds entire fantasy worlds as a way of processing my trauma (which, honestly, is pretty incredible when you think about it). And it’s me when I’m breaking down—when the world feels like too much because I’ve been carrying so much for so long, or when I’m shaking and the world feels fuzzy because a loud noise sent me back to a dark place. 

But that’s okay. It’s going to hurt and it’s going to be messy. It’s going to be monsters I fight in my head every day, ones that batter my body and my soul, and make even the most basic of tasks difficult. But it’s also going to be me putting on my armor, facing what’s happened, listening to myself, and living in the world as someone whose mental health is mental illness. And, while I’m doing that, telling stories for everyone who gets it, because we deserve to know we’re not alone.

There’s a lot of shame around mental illness. Long histories of what it means and how we’re treated. That’s real and painful and horrible, but it’s not our fault. There’s shame inside my mind every day. I was trained for it. But, when it comes to owning and accepting that I have C-PTSD and anxiety, I don’t want to pretend they don't exist. I don’t want to suffocate and isolate myself and pretend that I’m okay.

For me, mental health is mental illness, and I am not ashamed.

Jacqueline Ramsden (she/they) is a genderqueer, demisexual author of sapphic stories. She enjoys tea and books.


You can follow them on Bluesky,, and on Instagram and Twitter, @Jac_Ramsden, or sign up for their mailing list on her website,, to stay up-to-date and hear all about new releases, grab free ARCs in exchange for an honest review, and get a free novella.

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