MASH can take a toll on your mental health. It can impact you cognitively, too. I developed a condition called hepatic encephalopathy, which is loss of brain function when your liver can't function as it should. It affects almost half of people with advanced liver disease.

“If you acknowledge your feelings, you can then find a space to put them away so that you can focus on your upcoming medical appointment.”

Here are some points for talking to your doctor if you're worried about your mental or cognitive health.

Let the office know that you have concerns. If you want to talk to your doctor specifically about your mental health, let them know in advance. Many doctors are focused specifically on the medical issue in front of them – in this case, your liver – and aren't necessarily thinking of the big picture. This way, they may be able to have a social worker, or a compassionate nurse practitioner, sit in on the visit to talk to you.

You may feel tired or foggy-headed from your liver disease. Or it could be due to depression, or it could be from both. Your doctor can help you tease out causes.

Your mental and cognitive health is just as important as your physical health. Yes, most liver clinics are packed with patients every day. Your doctor should still take the time to sit down and talk with you.

You may feel mentally and physically exhausted after your doctor's visit. Once you've recovered, here's what you need to do:

Make any follow-up appointments. If your doctor has recommended that you see a mental health specialist like a psychiatrist or psychologist, make that appointment. If you've been diagnosed with hepatic encephalopathy, your liver specialist will want to see you for treatment.

Take some time for yourself. You spend so much time focused on MASH, it actually can be hard to focus on you. Try to do something that you enjoy. It can be as simple as going for a walk or watching your favorite TV show.

Follow up with support. If you have a friend or neighbor that you feel comfortable confiding in, schedule a time to talk. Or check in with your support group peers. It's important to keep in touch with other patients with MASH, whether it's through in-person contact or online.

Engage in advocacy. One of the most important things you can do when you feel disempowered is to find ways to empower yourself. That's why I got engaged in advocacy work. When you have MASH, you can sometimes feel like the lead characters in Thelma & Louise. Except at the end of the movie, instead of driving off the cliff, you stop the car right before it goes off the edge and figure out another way to get across.

If you do feel like you want to hurt yourself, call the Suicide and Crisis Lifeline at 988, or call 911 for help right away.