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t m c » p u l s e | m a y 2 0 1 6 14 B y all appearances, 35-year-old Houston native Elizabeth Smalling Shulak is a happy, young professional working at Memorial Hermann with her life in order. She enjoys her stable job, has an apartment that she loves, and is surrounded by supportive friends and family. On top of that, she's basking in marital bliss with her new husband, who she recently married in March. However, life was never always this picturesque for Shulak. At an early age she experienced a series of trau- matic events and dark moments that inevitably ushered in her childhood depression. She witnessed her grand- mother's fatal car accident at 10 years old, a suicide at the high-rise apartment building where she lived and her parents' divorce. She occupied herself by playing soccer, cheerleading, practicing karate, creative writing and taking up photography—all coping mechanisms as she went through cycles of depres- sion and mania. Although she knew she needed help, it wasn't until her sopho- more year of college in Colorado that she was diagnosed with bipolar disor- der and obsessive compulsive disorder, a diagnosis that came on the heels of the Sept. 11 attacks and the death of her dog. "I got depressed and even more depressed. I'd drink to cope and end up in the hospital again," said Shulak, who has been hospitalized 15 times in her life as a result of her bipolar episodes. "It's been a road of going to school, doing really well, going to the hospital, doing well at work, and then going to the hospital. It was getting to be way too much for anybody to handle." After spending an intensive 12 years in various mental health treatment cen- ters, and with the help of her dedicated doctors, Shulak finally achieved a bal- anced existence without being defined by her illness. Destigmatizing Mental Health Mental health has long been kept a suppressed and sanitized topic, but individuals affected by mental illnesses welcome a new shift in bringing it to the forefront of discussion B y S h a n l e y C h i e n "It's about going step-by-step with what life gives you and overcoming those challenges and seeing life in baby steps," said Shulak, who recently spoke about her journey at the second annual World Bipolar Day March 30, which was held at The University of Texas Health Science Center Harris County Psychiatric Center and presented by McGovern Medical School's Department of Psychiatry and Behavioral Sciences. "Looking back, I can say, 'Wow, this is how far you've come,' in the bigger picture as I piece these things together." While many people are swept up in grand ambitions and lofty ideas, Shulak—who once hoped to pursue a career as a pediatrician—said she gave up on her long-term goals because of her condition but keeps things in per- spective by appreciating other aspects of life. "I never thought I'd have my own apartment. I never thought I'd be mar- ried. I never thought all of those things, but all of those things happened," she said. "I really try not to set big dreams anymore, but I just try to think about how to make each day better and focus on the small days because they end up being really great things." According to the National Institute of Mental Health, bipolar disorder is the sixth leading cause of disability in the world, with 2.6 percent of the U.S. population diagnosed with the mental illness each year. While Shulak is one of the 5.7 million American adults who are We need to be shepherds of decreasing stigma, as well—even by recognizing the bias amongst physicians toward patients and mental health disorders. — NEIL PURI, M.D. Staff Psychiatrist at the Menninger Clinic and Assistant Professor of Psychiatry at Baylor College of Medicine Neil Puri, M.D., engages in a conversation in the Menninger Clinic's meditation garden, where he and patients can visit during their sessions.