by Juliet Lam Kuehnle
Wouldn’t it be nice if mental-health struggles existed in clearly defined seasons: a breakdown, followed by a pause, reflection and then a clean return to normal life? There is sometimes an assumption that “healing” requires retreat that allows us to step away from our responsibilities, regroup and then reenter the world fully renewed. But for most of us, that simply isn’t how it happens.
As a therapist, I do not define healing as an end goal, a box you check that means you’ve taken all the “correct” steps and have therefore achieved complete relief. The process of moving through and processing one’s emotions while finding growth and balance is all healing. Trusting oneself to do so is healing.
Life doesn’t slow down when you’re grieving. Deadlines and tasks don’t wait when anxiety spikes. Parenting doesn’t stop when depression hits. Work, relationships, creativity and expectations continue to demand our attention even when we’re struggling.
Many times, I have had the pleasure of speaking with actress Chryssie Whitehead. Her life’s work, in the current season, has been performing a deeply vulnerable creative project about her own history with mental illness — while the rest of her life continues on. What stands out to me is the resilience required to keep going amid pain, alongside the continued healing and growth.
As a therapist, this is a familiar dynamic. But sometimes, this is especially common among high-functioning, achievement-oriented individuals.
Many people are incredibly skilled at continuing to perform, produce and show up while unraveling inside. They are praised for their strength, admired for their composure and rarely asked how much effort it takes simply to stay upright.
Juliet Lam Kuehnle
This is where our cultural language around mental health begins to fail us. We have to understand that functioning is not the same as being well, as this is one of the most damaging assumptions we make. If someone is working, parenting, socializing or achieving, we conclude that distress can’t be that serious. But, clinically, we know the opposite is often true.
High-functioning distress is frequently more difficult to identify, more likely to be minimized and more dangerous to carry alone. People who appear capable on the outside often delay seeking support because they don’t feel entitled to it. They tell themselves that others have it worse, that they should be able to manage, that this is simply the price of ambition or responsibility.
The nervous system, however, doesn’t measure pain by productivity. It responds to sustained pressure, lack of safety, emotional suppression and overload. You can meet every obligation on your calendar and still be deeply dysregulated.
It’s important not to perpetuate an unspoken expectation of composure. Success, stability and access to resources can create the illusion that emotional struggle is either unlikely or self-indulgent. The message then becomes that difficulty should be handled quietly and efficiently.
Trauma, mood disorders, grief and anxiety do not discriminate. What differs is how comfortable people feel acknowledging distress and how long they wait before addressing it.
Elevating the conversation about mental wellness means allowing for nuance. It means recognizing that someone can be both successful and struggling, privileged and overwhelmed, deeply capable and deeply exhausted.
Instead of asking ourselves, “Can I get through this?” which is a question that implies endurance at all costs, I often invite clients to consider asking what their nervous systems might need in order to move through this with less harm.
This shift acknowledges reality without demanding collapse. It creates space for care, even when stopping is not an option.
When stepping away from responsibilities isn’t feasible, regulation becomes about containment rather than escape. Here are some protective strategies to practice:
Name the reality clearly. Saying, “I am doing something demanding while I am emotionally taxed,” reduces internal conflict. It replaces self-criticism with accuracy.
Shrink the time horizon. Overwhelm escalates when we try to carry the future all at once. Focus on what is required in the next hour, not the entire week or outcome. The nervous system responds better to manageable segments than vague endurance.
Build in micro-choice. Choice restores agency, even in small ways: Decide how you show up, when you stop for the day or what boundary protects your energy.
Separate identity from performance. This is especially important for those whose sense of self is intertwined with competence or achievement. You are not defined by how well you hold things together. Productivity is not proof of wellness.
Create one place where you do not perform. Whether it is therapy, a trusted relationship or solitary reflection, your nervous system needs at least one environment where nothing is expected of you beyond honesty.
Remember that you do not need to fall apart to deserve care. You do not have to reach a crisis to justify slowing down. And you do not have to wait until everything is finished to tend to your mental health. While healing often does not arrive with a pause button, it does come through better language, clearer boundaries and permission to acknowledge what is actually happening. One of the most self-respecting things you can say is, “I’m still showing up and this is harder than it looks.” All of this makes room for a more humane way of living. SP
Juliet Kuehnle is a therapist and owner of Sun Counseling & Wellness.
EDITOR’S NOTE: Juliet is hosting a Benefit Cabaret for Dancing with the Stars of Charlotte with Chryssie Whitehead — plus other local and Broadway performers — on March 31 at the Long Room. Proceeds benefit The Katie Blessing Center, Novant Health Agnes Binder Weisiger Breast Health Center and Go Jen Go Foundation.
