Is it really OK to never get your period?

Every time I visit my doctor, the same question comes up: “When was your last period?” Considering I actively try to skip it every damn month, I can never remember when I last had my period. When I admit this, I get The Look. It’s the look that’s judging me for skipping my period indefinitely, as if it’s unhealthy. In fact, I get The Look so often I’ve started questioning my decision to live a glorious, period-free life. What if it’s not so glorious after all?

A quick Google search will yield two different answers to this question. On the one hand, article after article has been written arguing that there’s no real need to bleed. However, a handful of other articles give opposing information, telling women not to skip for more than three months. Even the Mayo Clinic website says doctors may suggest women take some time off from skipping. Nowhere does it say, “Sure, skip forever!”

I wanted to get to the bottom of this, so I reached out to several OBGYNs, the Mayo Clinic, and the the American Congress of Obstetricians and Gynecologists (ACOG) to see who’s right and who’s wrong.

ACOG gave me a wishy-washy answer, saying they don’t “have one take on what’s best,” and suggested that it’s a decision a woman make with her doctor. But even so, their response implies that this is a serious medical issue that should be discussed with a professional—as if there might be some unforeseen danger to it.

So I decided to ask some OBGYNs, and guess what? Every single one I spoke to said there’s no medically necessary reason to have a period if a woman is on hormonal birth control—but that many women simply don’t know that.

“We get this question a lot,” says Diane Horvath-Cosper, an OBGYN (who Fusion profiled) and fellow at Physicians for Reproductive Health, a national organization seeking to improve access to comprehensive reproductive health care. “Periods are not fun. People come in and they’re like, ‘Do I really need a period?’” The answer, she says, is no.

“Women have periods because the body is preparing for a possible pregnancy. If you’re on a contraception, you don’t build that uterine lining up,” she says. “There’s no need to bleed.”

So let’s unpack that, shall we? Every month a woman goes through a menstrual cycle (duh). Part of that cycle, which lasts on average 28 days, is the buildup of the uterine lining, which aids in pregnancy—essentially, the body’s welcome mat for the baby. If no baby arrives and a woman isn’t on hormonal birth control, her body will shed that bloody uterine lining (don’t need this anymore!). And that, folks, is a period.

A woman on hormonal birth control doesn’t actually build up a uterine lining. The pill controls the flow of progesterone and estrogen, and “overrides what your body would normally do,” says Michelle Berlin, an OBGYN and co-director of the Center for Women’s Health at Oregon Health & Science University. The “period” you get while on the pill is simply due to a change in level of or lack of hormones during the control week; it’s not a true period.

In fact, says Petra Casey, an OBGYN and the Mayo Clinic’s expert on birth control, there’s more of an argument to be made for not taking the placebo week of pills and continuing straight onto the next pack. This trick can also be done using the birth control ring for four weeks instead of three, or with certain extended cycle pills. Some women who use devices like implants or hormonal IUDs may also experience fewer periods as well.

“There’s no reason for taking a break,” she told me over the phone, “because every time you take a placebo week, you hit the reset button.” And resetting can cause issues since going on and off the hormones is what leads to irregular bleeding.

But this doesn’t mean you’re overloading your body with hormones—another urban legend associated with skipping periods. As all the OBGYNs explained to me, the hormones in the pill are actually less than what your body produces in a normal menstrual cycle, and way less than what your body produces when pregnant.

So if taking active pills continuously is totally safe, then why does the Mayo Clinic advise women to only take them for six weeks in a row?

It’s simple. “Some women want to have periods,” Casey says. “They want to be sure they’re not pregnant.”

But for those who do want to skip, OBGYNs will prescribe patients extra packs. “We’ve been doing that for decades,” says Casey. Other OBGYNs I spoke to said the same thing.

“OBGYNs often say to throw out the sugar pill,” says Berlin up in Oregon.

Turns out the pill is built the way it is because of men and religion. “[I]n the 1950s, when the pill was being developed, people were more comfortable with faking a normal cycle,” says Horvath-Cosper. More specifically, developers of the birth control pill felt it would be an easier sell to the public—and more importantly the Catholic Church—if contraception felt “natural.” Which is why a week of placebos was built in to simulate a period. John Rocks, a developer of the birth control pill and a Catholic, “thought if women had a period, the Pope would buy it,” explains Berlin. “That’s the only reason it’s there.”

So, ladies, if you don’t want to have a period anymore, feel free to skip it using your monthly hormonal birth control pills or the birth control ring without stressing that you’re somehow screwing up your body. You’re not.

Bottom line: The time for bleeding is over.

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Is it really OK to never get your period?

Why so many mothers of color are dying in the U.S.

America is one of the only developed countries with a rising maternal death rate. And it’s even higher for women of color.

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Why so many mothers of color are dying in the U.S.

Do I Have HIV?: Early HIV Symptoms

Learn about the early stage of HIV and the symptoms that may be experienced during it.

HIV cannot be diagnosed based on symptoms alone. The only way to know for sure if you have HIV is to get tested for the Human Immunodeficiency Virus. There are three stages of HIV: The early stage, the latency stage and the late stage also known as AIDS (Acquired Immunodeficiency Syndrome), all of which can be accompanied by their own symptoms.

Some individuals who have contracted HIV may never experience symptoms, or may experience symptoms that are similar to other illnesses like the common cold or flu.

The Early Stage of HIV

The early stage of HIV (also known as acute HIV) starts upon contracting the virus. During this stage, some people may experience symptoms that are similar to the flu approximately 2-4 weeks after becoming HIV-positive. While many do experience symptoms in this stage, some people may never experience any signs or symptoms of having contracted HIV.

Early Symptoms of HIV

When early signs of HIV do occur, they are likely to present as one or more of the following symptoms:

• Rashes on the body


• Fever


• Swollen lymph nodes


• Malaise (a general feeling of body weakness, discomfort and/or lethargy)

According to the Centers for Disease Control and Prevention (CDC), these symptoms above (which are known as acute retroviral syndrome) are seen in 50-80% of newly HIV-positive individuals. They are often overlooked as they are common symptoms of many illnesses and people do not suspect these non-specific symptoms to be related to HIV.

Additional symptoms that may occur during the acute stage of HIV include:

• Nausea and/or vomiting


• Night sweats


• Headaches


• Sore throat


• Aching muscles and/or joint pain


• Fatigue


• Ulcers that occur in the mouth


• Ulcers that occur on the genitals

It is important to start treatment for HIV as soon as possible since the virus replicates and begins to destroy important immune cells. This is why it is so crucial to get tested after potential exposure, even if you are not experiencing symptoms. HIV is highly contagious during the acute stage, and because this stage occurs during the first few weeks after contraction, it may not show up as a positive test result this soon unless the test taken is an early detection test.

HIV Incubation Period

Incubation periods (also known as window frames) vary from person to person, so while one HIV-positive individual may be able to take an HIV test and show a positive result 15 days after contracting it, another HIV-positive individual may take 40 days to develop enough antibodies to result in a positive test result. The average incubation period for people to develop antibodies to HIV is 25 days to two months, however it can take some people as long as three months to develop a sufficient amount of antibodies to the virus. If you get antibody testing done before this time frame has elapsed, it is recommended that you get tested again to confirm your results once the incubation period has fully passed.

HIV 4th Generation Antibody/Antigen Testing

If you think you may have been exposed to HIV, you can get an FDA-approved HIV 4th Generation Antibody/Antigen test. It can accurately detect HIV antibodies as early as 13-42 days after exposure. This HIV 4th Generation test also detects HIV P24 antigens, offering two ways to detect whether or not you have the virus. P24 antigens are proteins emitted by HIV that the immune system detects as a foreign substance and attempts to fight off. Antibodies are proteins that the body produces as a response to pathogens like bacteria and viruses; this test detects the antibodies the body creates to attack the HIV virus.

HIV RNA Testing

We also offer an FDA-approved HIV RNA Early Detection test which can detect HIV as soon as six days post-exposure in some individuals. This test has very high accuracy rates after 9-11 days (which are even higher after 28 days post-exposure). RNA is the genetic material of a virus, so HIV RNA tests are detecting the presence of the Human Immunodeficiency Virus itself, therefore it does not have to wait for the body to produce a high enough level of antibodies for detection since it is not looking for antibodies at all. This HIV RNA test is the best option for detecting HIV as soon as possible.

Following the acute (early) stage of HIV is the asymptomatic stage, during which no symptoms are exhibited for months or even years.

The CDC recommends getting testing for HIV at least annually, however it is important to get tested anytime you participate in high-risk sexual activities or intravenous drug use.

The post Do I Have HIV?: Early HIV Symptoms appeared first on STD Exposed – Sexual Health Blog.

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Do I Have HIV?: Early HIV Symptoms

8 ways women can protect their pussies from Donald Trump’s America

Elena Scotti/FUSION

The realization that Donald Trump and Mike Pence will be moving into the White House this January has caused many women, and their uteruses, to feel under attack—and for good reason.

Throughout their presidential campaign, Trump and Pence were open about their desire to restrict women’s reproductive health care by overturning Roe v Wade, defunding Planned Parenthood, and repealing the Affordable Care Act, which grants millions of women access to both contraception and preventative care. As a result, women are starting to fear what their health care will look like under the president- and vice president-elect, who seemingly want to take a time machine back to 1950 when birth control consisted of women putting an aspirin between their knees.

In light of this fear, I reached out to experts to learn what women can do now to protect themselves and their reproductive organs down the line.

Figure out a contraceptive game plan ASAP

The Affordable Care Act mandates that all insurance companies must cover the cost of contraception: Since Obama signed the act into law, most women have not had a copay for their birth control. If Trump repeals the law, many women will struggle to afford contraception.

“If the ACA is dissolved and women don’t have private insurance, contraception prices can go up,” says Kristyn Brandi, a family planning specialist at Boston Medical Center who specializes in abortion and contraception. “If you’re paying out of pocket for it, it’s going to be expensive, especially for low income women who don’t fall under Medicaid.”

Thus, experts advise that women visit a doctor or women’s health clinic now to discuss contraception options before Trump takes office. “I would urge women to consider the best contraceptive that fits their needs and not to delay getting that,” adds Donna Crane, the vice president of policy for NARAL Pro-Choice America, one of the country’s leading reproductive rights advocacy groups.

Consider getting an IUD

An intrauterine device, or IUD, is a long-acting, reversible form of birth control that comes in both hormonal and non-hormonal varieties. As the name implies, the device is inserted into a woman’s uterus; depending on the model, it can prevent pregnancy for five to 12 years (as long as it remains in the body). It’s a great option for women who don’t think they want to have kids for a while, or ever.

If Trump repeals the Affordable Care Act, insurance companies could stop covering IUDs—and the device may start costing women from $500 to $1,400. That’s why women should consider taking advantage of their current insurance and get an IUD now, say women’s health advocates.

Boston Medical’s Brandi, who is also a member of the advocacy group Physicians for Reproductive Health, says she’s already treated patients who are either seeking an IUD for the first time or asking to have their IUD replaced (to increase the span of its coverage), since Trump was elected.

Stock up on birth control pills

As I mentioned, the Affordable Care Act grants women access to birth control pills at no additional cost—and if the law is repealed, that coverage could go away. However, even if Trump is unable overturn the law, Vox explains, Trump could use a regulatory maneuver to end birth control coverage.

In preparation for any cost increases down the road, women who rely on birth control pills can preemptively ask their pharmacy for more than one month at a time. While some insurance plans put a limit on how many packs you can pick up at once, try calling your insurance company and asking if the cap can be raised. Planned Parenthood, meanwhile, supplies up to a year’s worth of pills at a time.

Get emergency contraception now, even if you’re not having sex

Access to all women’s reproductive health care services could become more restricted under a Trump administration, which is why advocates recommend purchasing emergency contraception now, just in case it’s needed down the road. “If other contraception goes away, it would be important to have,” says NARAL’s Crane. Luckily, Plan B One-Step, one of four emergency contraception products approved by the U.S. Food and Drug Administration, is currently available without a prescription, so you can pick some up today.

Learn your rights

Even though Plan B is available without a prescription, some states still make it tricky to access by allowing pharmacies to put it under lock and key—or allowing pharmacies to deny selling it outright. Thus, it’s more vital than ever that women know their rights, says Gretchen Borchelt, vice president for reproductive rights and health and National Women’s Law Center.

The Food and Drug Administration has made it clear that Plan B can be sold over-the-counter, that it should be easily accessible to customers, and that pharmacies don’t have to check customers’ identification to purchase the drug.

“There are no point of sale restrictions, no age restriction—any individual can purchase it, and there’s no limit to the [quantity] you can purchase,” explains Borchelt.

If a pharmacist refuses to sell you emergency contraception in a state where doing so is illegal, let him or her know it’s your right to purchase it, then complain to a manager. “Take it up the chain,” she says. If that doesn’t work, you can file a complaint with your state’s Board of Pharmacy or reach out to organizations like the National Women’s Law Center for help.

Research abortion in your state

Trump has vowed to appoint a Supreme Court justice who will work to overturn Roe v Wade, the landmark 1973 court decision that made abortion a constitutional right. On Sunday, Trump told CBS’ 60 Minutes that if Roe is overturned, abortion’s legality would be decided on a state-by-state basis—and if a state wants to restrict women’s access, women could simply drive to another state.

While Roe won’t be overturned overnight, it’s never too soon to start researching your state’s abortion laws and options. “I would urge women to become much more aware of where their clinics are,” says NARAL’s Crane. She adds that many states—including Louisiana, North Dakota, and Mississippi—already have “trigger bans” in place, so the moment Roe is (theoretically) overturned abortion would become nearly illegal.

Even states that are currently abortion-friendly may not stay that way. “That is the height of ignorance, to suggest that women can go to another state,” says Crane of Trump’s remarks on 60 Minutes. “If the Supreme Court has [the] votes to roll back [Roe], it also has the votes to criminalize abortion nationwide.”

Make an appointment with a health care provider today

Given how tenuous the future of women’s health care appears to be under a Trump administration, consider making an appointment with a doctor or clinic today, to get a jump on any broader health care needs. “[Women should] take full advantage of the health insurance [they] do have now,” says Crane.

Not to mention, the president-elect has vowed to defund Planned Parenthood, which millions of women rely on for general healthcare, including STD testing, cancer screenings, and maternity care—not just abortions. “We absolutely think Planned Parenthood is at risk,” says Crane. “Get the care that you need now.”

Planned Parenthood has vowed to keep its doors open despite Trump’s plans, and NARAL says any efforts to defund the organization or others like it won’t happen without a fight.

Make your voice heard!

Now more than ever, it’s vital for women to fight for their reproductive rights. Women can do this by reminding their local lawmakers that taking away reproductive rights does not reflect the will of the American people, and will not stand, says Crane. Indeed, 56% of Americans think abortion should be legal in all or most cases, and 67% think employers should be required to offer birth control coverage.

“Women need to know who their elected officials are and tell them in no uncertain terms that we will not stand by and watch our rights be dismantled,” she says, adding that there will be a “political price to pay” for any elected official who doesn’t stand up for the rights of women.

So how can you do this? Crane says to literally pick up the phone and call your elected officials. Write them a letter. Donate to organizations like Planned Parenthood, NARAL, and the National Network of Abortion Funds. Join Facebook groups like Pantsuit Nation. Volunteer at clinics. Offer to be an escort at abortion centers. Participate in marches. But most importantly, don’t sit back and just let this happen.

“Spend as much time as possible reaching out and making your voice heard,” says Crane. “Let [lawmakers] know this is so out of sync with our values, and there is no credible line of thinking that this is something the American people will support.” Who’s ready for battle?

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8 ways women can protect their pussies from Donald Trump’s America

Please stop trying to sell me special gym makeup

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Apparently women can’t do anything without makeup. While perusing Facebook this past weekend, an ad popped up on my feed for Sweat Cosmetics, a makeup line made specifically for working out. I had never heard of this company or their products, but anyone who tells me to wear makeup while I work out is not my friend.

So I did what any annoyed person on the internet does and I googled some s**t. It turns out Sweat was founded by ex-professional soccer players whose dream in life was to show that women could be “both strong and beautiful.” I never thought those two concepts were mutually exclusive, but then again, I’ve never felt the need to wear lipstick on a treadmill, either.

Sweat’s promo videos feature the gaggle of blonde women who work for the company powdering their faces while running, snowboarding, weightlifting, and riding a stationary bike. In one video, a soft voice-over says that the modern woman is “brave, powerful and strong, but above all else she is beautiful.” In another, one of the founders says, “We wanna tell every woman that uses our product that we see your struggle.” Um, what struggle is that exactly? The struggle to be beautiful every second of every day, even when I am sweating my ass off? Yeah, I didn’t actually think that was even a thing until I saw your ad, but thanks.

Here’s why this product is infuriating: If you are a woman (or man) and want to wear makeup to the gym, wear makeup to the gym. People have worn makeup and worked out for quite some time: gymnasts, dancers, women hitting the gym on their way home from work, and that chick on the treadmill taking 5 million selfies. It’s cool. Be you. But what I don’t like are companies acting like they are building women up, when really, they’re trying to create a need that never needed to be filled. For decades, beauty companies have told women they are not pretty enough, or skinny enough, or feminine enough, and that they need some product to fix what’s wrong with them. From corsets to diet pills to high heels, these products are supposed to help women look better (for empowerment!) when in reality they keep us in uncomfortable—and often unhealthy—chains.

Now, that racket is bleeding into the gym, the one place where women can get dirty because they’re supposed to be dirty. The space where bleeding is a sign of strength and not weakness. Indeed, athletics is one of the few spaces where, ideally, being respected has nothing to do with how you look and everything to do with how well you perform. Call me crazy but I don’t want to give that up just yet.

Before you roll your eyes at me, I understand that not everyone is as serious about working out (or feminism) as I am. Not everyone goes to the gym for the same reasons I do. I know that some people go there to blow off steam, or find dates, or meet up with friends. And I get that some women just love makeup and want to wear it all the time, like a favorite scarf or necklace. But all of those options are still available. You can wear makeup to the gym already. No one is stopping you.

But if “workout makeup” ever becomes a thing the way high heels became a thing, women will start feeling pressure to wear makeup to the gym, which means we’ll have to buy cosmetics for work and for Saturday night and for spin class. What’s next? Makeup for the shower? “Hate how gross your face looks when it’s wet?” the commercials will say. “Yuck! Buy this special shower makeup so no one has to look at your unvarnished face ever again.” It’s too much.

Unfortunately, that future is actually possible because Sweat isn’t the only company trying to make “workout makeup” happen. Birchbox, a monthly subscription service that mails makeup to your door, now offers a beauty brand called Arrow designed for “badass women who lead active lifestyles,” according to a press release. And others have slowly but surely begun popping up, too.

The truth is companies call us “badass” and “strong” to grab our attention but, instead of actually trying to empower women, they ask us to spend our cash on even more beauty products. And that hypocrisy comes with a cost.

Research compiled by the New York City Girls Project shows that 40% to 70% of girls are dissatisfied with two or more parts of their body by middle school, in large part due to the images they see on magazines and on TV. According to a 2010 study conducted by the Girl Scout Research Institute, although most young girls (63%) think images represented by fashion models are unrealistic, 60% still say they compare their own bodies to those models.

The point is that what we say and represent in advertising and marketing seeps into girls’ minds at an early age. If we start sending the message that women need to be pretty while playing sports, we’re doing something wrong. So instead of telling girls they can be strong and beautiful—you know with some magical sweat-proof makeup—we should be saying that strong is beautiful. And that should be enough.

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Please stop trying to sell me special gym makeup

What my Jewish, immigrant father taught me about the American Dream

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Hatred is not a new concept to Jews. We’ve been on the receiving end of it for more than 5,000 years, and our fear of violence and terror is as ingrained in our culture as gefilte fish, Friday night prayers, and self-deprecating jokes.

This past Wednesday, November 9th, marked the 78th anniversary of one of our most pivotal and tragic moments. Kristallnacht, or “Night of Broken Glass,” was a massive, state-sponsored act of terrorism in which synagogues, Jewish-owned businesses, and homes throughout Germany and Austria were burned and vandalized. Some historians point to it as the “official” start of the Holocaust, but, more accurately, it was the moment when expressing long-festering hatred became normalized and was allowed to blossom out in the open.

The early hours of Wednesday the 9th were also, incidentally, when Donald Trump, a candidate known for tweeting anti-Semitic imagery and inciting violence against minorities, was elected the 45th president of the United States. Almost simultaneously, a store in Philadelphia was vandalized with Swastikas and other Nazi references, along with hastily scrawled pro-Trump graffiti. I would like to explicitly say that I am not calling Trump a Nazi or a fascist, as some writers have. Only history can decide that. I am merely stating the facts, and the fact of this incident is that it was abhorrent but not shocking. For Jews, well aware that we are still reviled in many places in the world, it just felt like history repeating itself.

As Wednesday trudged on, I heard about more hate crimes across the country and felt scared, so I called my father. Born in the shadow of the Nazi regime, an immigrant, but also the best embodiment of the American Dream I can think of—who came here with literally nothing but a weakened immune system and a legacy of trauma and rose to an exceptionally good life—I wanted his words of wisdom. I asked if he thought we were safe; if we needed to move.

Instead, in the calm, Buddha-like manner I’ve come to expect, he told me not to be terrified. There’s a minority in this country that’s filled with hate and rage, he said, emboldened by the Internet and endless media coverage. They are trying to intimidate and bully others into fear and passivity, but that’s not the real America—and you can’t let them rattle you and keep you scared and silent. That’s what terrorists want. We’re a nation of immigrants, he reminded me—one of the most heterogeneous in the world, and our hope and values will sustain us.

That my father, who should have so many reasons to be angry, nervous, resentful, and nihilistic, could retain his optimism made me feel ashamed for my own fearful thoughts. It also made me feel something I didn’t think was possible right now: pride.

In 1948, my father—before he changed his name from Shlomo to Michael in order to assimilate—was born in a small German town near Munich. After the end of WWII, it had been transformed into a makeshift displaced person’s camp by the U.S. military in order to house folks, mostly Jews, who could no longer safely return to their countries. (Imagine France’s refugee port of Calais, with even less food.) My grandparents had lost their entire families, but miraculously met and fell in love in this strange European purgatory. My dad was born there, surviving despite the lack of proper healthcare facilities or pre-natal nutrition. Because of latter, he would have health problems for the rest of his life, including rheumatoid fever, encephalitis, and a heart murmur all before the age of 10.

Courtesy of Yad Vashem

My grandmother, Ida Pearlman (farthest left with the black bob), is shown here protesting a planned deportation to Cyprus with fellow activists at her displaced persons camp in Pocking, Germany. She got to go to Brooklyn instead.

When he was still an infant, through an act of benevolence and a lenient immigration policy on the part of the U.S. government, he and my grandparents were allowed to come here and resettle in Sheepshead Bay, Brooklyn.

It wasn’t a fairytale. His parents were broken from what they’d experienced in Europe—especially my grandmother, who’d seen her brother die of starvation. Little things, like an extra portion of dinner she was too full to eat, would make her convulse in sobs. They were haunted by the knowledge that people, even neighbors, might want to kill you for your religion or ethnicity; that sometimes you can’t keep the people you love safe. But they also believed you should never stop striving, and sometimes all you need is a sliver of kindness to survive. As my grandma, my zayde, used to tell my father, “In every group there are both good and bad people. There were kind Germans who helped me, and fellow Jews who undermined me.” The real danger comes from lumping whole groups together as deplorables or saints.

Though my grandparents were incredibly poor, they somehow made sure my father and my aunts had food and a clean house, and felt loved. “I had Coney Island, friends, and family,” my father told me when I asked him if his economic status ever wore him down. “I was a train ride away from art and culture—what else did I need?”

Until he was in 5th grade, his first language was Yiddish, with only a smattering of English. Today, he frequently schools me on New Yorker articles with an unplaceable accent. I have no idea how he did it, but the son of a window washer put himself through college, and earned two Master’s degrees, becoming an engineer. As he entered adulthood, anti-Semitism persisted in this country; there were certain jobs he knew he was barred from attaining, or whole swaths of the country, sometimes controlled by the KKK, that “you just couldn’t visit.”

Despite his Eastern European heritage, he looks Latinx and would sometimes, accidentally, get a taste of that particular flavor of discrimination. He never got bitter, but he did get to work. His philosophy was to start small and stay focused on whatever was in front of him, whether it was learning English, applying to colleges, or attempting to join corporate America during the tech boom. He married a musician and they moved to the suburbs, where they had two loudmouth, opinionated daughters who would spend afternoons running and screaming through a lush, green yard.

My dad, Michael Feinstein, as a teen, living on Avenue Y in Brooklyn, New York.

Growing up, sometimes I would get frustrated at the injustices of the world, as most teens do. I would rage over income inequality, war, sexism, or even my own petty concerns. Why can’t I have a new car like my classmates? Why can’t we travel? Why do we always have to share fries at McDonalds? My father never let me indulge in these feelings. “America is the best country in the world,” he would say, as I rolled my eyes. “It’s the best place for immigrants, for opportunity. We have so much here.” He let me know that America was a place where, even if you faced adversity, you could rise above. It’s built into our Constitution. He never explicitly said this, but I always felt that if he could do it, there was no reason I couldn’t either. Even today, after so much has changed in the U.S. in terms of upward mobility, he still believes that in America, an outsider, a marginalized population, can raise themselves up—and points to the many disgraceful ways immigrant groups have been treated abroad.

My own life experiences have led me to believe there are those who will try to hold you back, hold you down, for no reason. They will tell you you’re less than; that this is as good as you can expect from life. But they’ve always, consistently been wrong. Change doesn’t happen overnight—it happens bit by bit, small action by action. It cannot evolve in a bubble. You need other people, the warmth of a community, and just the smallest sliver of light to crawl through.

On Wednesday night, as it sunk in that a Trump presidency was a reality, I couldn’t bring myself to go home and eat that whole pizza I was craving (ironically, as part of my “self-care,” I just keep eating junk food). My brain felt like it was on a rush hour train, flooded with rage and ideas and fear all pushing to get out at the next stop. Instead, I went with friends to Union Square to check out a protest I’d heard about on Facebook. It had started with a few hundred, but by the time we arrived there were thousands, shutting down 5th Avenue and marching like a liberal army toward Trump Tower.

During my morning commute the city had taken on a funereal cast, as people openly wept in silence. Now, I saw New Yorkers happy, singing, and holding hands despite honking cars and overhead helicopters. I don’t think anyone at that rally expected to change the outcome of Tuesday’s election. Trump came to power democratically, no matter how flawed our system may be. But it wasn’t about radical revolution, at least not in my mind. It was about hope, that you can move the dial of progress, even incrementally. That there will be setbacks and hardship, but you’re not alone if you have optimism. That those across the country expressing hateful sentiments are just a minority in a nation filled with all kinds of people: wonderful, hardworking, awful, petty, amazing, complicated, striving people. That there is no “us versus them,” there is only us versus us. No one person, or election, can decide the fate of such a diverse country. These setbacks are real, but temporary, and there’s always tomorrow. These, among many other thoughts, are the lessons my father taught me.

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What my Jewish, immigrant father taught me about the American Dream

How to cope with the bottomless grief you’re feeling

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As I approached the sidewalk outside the White House in the early hours of Wednesday morning, the white glow of street lamps lit the faces people milling around, awaiting the final call. When I got closer, I spotted a cluster of the unmistakable red hats—“Make America Great Again” emblazoned on the front—perched on the heads of young white men moving jubilantly to “Jump Around.” House of Pain, indeed.

Weaving through the crowd, I clung to my final shred of hope for the successful election of our first woman president, even as my heart beat out of my chest and I feared these men could turn violent at any moment in animalistic triumph. Moments later, I would read on my phone that the Associated Press called the presidential race for Donald Trump—and in an instant, hope gave way to grief. How will we ever get through this? I wondered. How will I get through this?

As night turned to day, I found myself repeating the same four words: “I am profoundly sad.”

This was all I could muster as friends and loved ones reached out to see how I was grappling with the reality that Hillary Clinton would not be the next president of the United States. They knew I was in Washington, DC, to cover what (in my mind) was supposed to be a night of celebration for the first woman president. Within a matter of hours, my thoughts turned from the future to figuring out how to lift my head off the pillow. I was experiencing, and continue to experience, classic symptoms of grief—and I know millions of others are right there with me.

And so, with the hope of shoring up my own mental health and helping others feeling the same way I do, I spoke with New York City-based grief counselor R. Benyamin Cirlin of the Center for Loss and Renewal. Cirlin both helped me to better understand my feelings of grief and offered a few mental health hacks.

To begin, he assured me that it makes perfect sense for Hillary supporters to feel a sense of loss, and explained that we, as humans, naturally get attached to people and to ideas. These attachments lead to assumptions, and we make connections to these assumptions. When those connections are severed, grief floods in.

“Most of us—with the hope of media and polls—assumed Hillary was going to win. That assumption was broken,” Cirlin told me via phone. “There’s a huge sense of disbelief. ‘How and why did this happen?’” He said people don’t have the “cognitive capabilities to take it in so quickly,” and that’s what accounts for the feelings of shock and sadness.

When it comes to processing grief, we often hear about the “five stages” popularized by Swiss psychiatrist Elisabeth Kübler-Ross. Her stages—denial and isolation, anger, bargaining, depression, and acceptance—primarily dealt with grieving death, but are applicable to anyone feeling a loss. Cirlin shared a different set of tools for dealing with immense loss that are non-sequential—these “tasks” account for the fact that the process of healing isn’t usually orderly and often quite messy.

The first task he shared is coming to terms with reality—one with which I must admit I’m really struggling. “When we lose something, we feel out of control—particularly when there’s no warning. We want to do things to give us control. There’s a psychological dynamic of protest, ‘It can’t be true,’” we tell ourselves. He pointed to the reaction of many who say Trump is “Not my president.” While these protesters don’t identify with Trump or support his policies, in time, he said, they must begin to accept that he was elected to the position.

Another task is to simply recognize and deal with your feelings. Whether it be anger with the outcome, guilt about not being active enough in the days leading up to the election, or anxiety about how his proposed policies will personally impact you—deportation, lack of healthcare, the list goes on—Cirlin stressed how it’s important to identify and put a name to these feelings.

It can also be helpful to figure out how your role in the world needs to change to account for a seismic shift (like the last person you’d ever want as president being elected). “It’s really about figuring out your new identity and realizing, ‘I’m not that same person anymore,’” Cirlin said. “When assumptions are changed or shattered, and you base your life on your relationship with them, you have to ask ‘Who am I now? Who am I going to be in this new world with Trump? Who am I as an American?’”

And finally, we have to ask ourselves, “How do I create meaning in my life knowing that a major loss occurred?”

These are tasks that I’m stumbling through. And yet, I’ve also begun to remember what it felt like be 17-years-old, lying on my bed despondent after George W. Bush was reelected in 2004. I knew that it meant more war and less human rights. The world seemed to pause on its axis as the reality set in, and I wondered how life would go on. But it did.

“It’s really about honoring your grief,” Cirlin said. “Loss does not heal quickly. In American culture, we like to get through things very quickly. This has been a two-year process…it’s only when the disbelief wears off you get some sense of what it means.”

The thing is, many of us already have a sense of what this all means. And that’s why we’re so very scared. No one can tell you exactly how to cope with this unprecedented source of grief, but may you take some comfort in knowing you’re not grieving alone.

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This feature is for informational purposes only and should not be used to replace the care and information received from your health care provider. Please consult a health care professional with any health concerns you may have.

How to cope with the bottomless grief you’re feeling