If you were to go back to the very beginning of this column, you’ll find that I used to write about many more of the modalities of wellness. For the past year I’ve focused on exercise, diet and other physical components of health. In other words, it’s been fitness and “working out.” There isn’t anything wrong with that; however, I’d like to bring some balance to this column and speak more often about “working in.”

Several years ago I did a better job of addressing the wider concept of wellness. Physical health is comprised of its own modalities, but it is still only a portion of your general wellbeing. Wellness is a complex balance of your physical, intellectual, psychological, emotional, social, financial, sexual and spiritual selves. I want to share my thoughts about the modality I have never yet discussed in all these years: Psychological.

In 2016, when a devastating relationship put me into the hospital after a botched suicide attempt, I was finally able to receive the treatment I’ve needed practically my entire life. In 1999, while I was 22 years old and experiencing the rigors of graduate school in Los Angeles, Calif. while living with an alcoholic boyfriend, I had a breakdown and was diagnosed with Bipolar Disorder II. In retrospect, I know I began developing the symptoms from the age of perhaps 10 years old and definitely by 12.

The problem is that our health system is already bad enough to navigate when you have acceptably sympathetic illnesses like cancer, Parkinson’s or Cystic Fibrosis; however, two categories of disease are demonized and treated with shame. Specifically, I’m talking about sexually transmitted infections and mental health disorders. It was literally impossible for me to get effective, long-term treatment until I was 40 years old.

What you may not know is that you generally need a referral by your main practitioner for practically everything, but the one glaring exception is mental health. For that you must self-refer, and because you’re not likely a licensed expert, you aren’t qualified to diagnose and refer yourself. As I was descending deeper and deeper into depression from mid-2014 until mid-2016, I told my primary doctor multiple times what was happening. A week before my latest suicide attempt, I pleaded with him to give me a referral. His reply stopped me cold: “Call 911, if you think you’re going to off yourself.” Then he walked out the door. My five minutes were evidently up.

That was sobering.

Over the course of the next week, the situation with my boyfriend and my apartment lease deteriorated worse and worse, until a series of terrible coincidences aligned simultaneously, and I attempted “to off myself.” But some small, quiet part of me had enough rational thought left to call a friend with a background in psychology, and to explain calmly to him what I was in the process of doing. In turn, he calmly told me what to do to prepare myself for the arrival of the ambulance and police.

This was the impossible situation: I had to do the work of contacting over 200 psychiatrists and therapists (all of whom were listed as in-network by my insurance), but not a single one of them would see me. All those with independent practices focused on teens, battered women, the homeless or whatever other specialty. All those attached to hospitals couldn’t see me until I was in the system for their particular hospital or group of hospitals. I couldn’t get into their hospital systems until I showed up in the emergency room, but I couldn’t show up in the emergency room unless I tried and survived a suicide attempt. In retrospect, I think the small, rational part of me who called my friend was also the part of me who decided to take a gamble on getting into the system via the emergency room. His bet paid off, so my luck held out for that spin of the roulette wheel.

I’m sharing this to make a point (or three). If you know you need help, do not put off doing the work of getting seen. It’s a purposefully confusing labyrinth, but you have to start navigating it while you feel well. You will not be able to get through it while you’re in crisis, unless you get lucky like I did. Also: Our medical system is a failure, pure and simple. I don’t care if it offends you for me to say it. We’re sacrificing our people to this behemoth, and it must be fundamentally changed. And lastly, mental health is not something to blame people for developing. If I could “just snap out of it,” don’t you think I would? Don’t be mean. We’re all imperfectly wired machines, and we each break down in different ways. For some that means brittle bones, for others it means brittle emotions.

I want to finish this off by saying that since I left the hospital in May 2016 I’ve been properly medicated, I have access to a behavioral health clinic and I’ve established a relationship with a therapist. I’m doing the hard exercise of “working in” as much as I do the “working out.” I’m much better for now. I have bad days, but they’re manageable. There is one problem that remains: My insurance still doesn’t cover the doctor or the therapist. I have to pay for those out of pocket, but both providers have generously agreed to see me for a wildly reduced cash copay. My meds are covered by BlueCross/BlueShield, but I have an ongoing reminder each month that I am still at precarious risk. As with building muscle for the long haul, I’m also building a stronger sense of self — one exercise at a time.

For more information, visit my YouTube video at youtu.be/Ee0uec52jwg.

info: Jack Kirven completed the MFA in Dance at UCLA, and earned certification as a personal trainer through NASM. His wellness philosophy is founded upon integrated lifestyles as opposed to isolated workouts. Visit him at jackkirven.com and INTEGRE8Twellness.com.