Sidelines

Yesterday, I heard an opinion that those like me who live with mental illness won’t suffer as badly during the pandemic as those who are used to being happy and productive.

The logic goes like this: we’re used to feeling bad, we’re used to sitting on the sidelines and not being able to do much, so how is this different?

I didn’t know how to react when I heard this. I wanted to talk about what it’s like to be seen as a constant liability to the world. I wanted to point out that right now a lot of mentally ill people are trying extra hard not to be a burden on an overloaded system. When their symptoms torment them, the knowledge of the crisis feeds their shame and lowers their resistance to judgment and stigma.

There is no time to be mentally ill while the world burns, the thought repeats. So what if they’ve run out of their meds, or if the only thing keeping them going was that therapist they can’t go see now.

They will not ask for help. They will try to cope as best they can. Some will fail to make it through.

Sick Squared

Being sick is depressing, sure. For me, though, being sick is clinically depressing.

Maybe those of us with mental health issues are more sensitive than usual to the tiniest changes in our brain chemistry. If we’re on meds, maybe illness changes the way our bodies metabolize them. Whatever the reason may be, even a minor illness seems to guarantee a sharp depressive dip for me.

It was just a bad cold, for heaven’s sake. Severe congestion, touch of fever, no huge deal, only lasted three days…but I’m clawing my way out of leftover mental fog, compulsively pessimistic thinking, and hair-trigger anxiety.

Yesterday was the first day I actually thought about my writing projects again, and it wasn’t pretty. Every gloomy, nihilistic, they’re-no-good-and-even-if-they-were-it-wouldn’t-matter thought I’ve had about them came cascading down at once.

I know what to do; what I’ve had to do thousands of times. Baby steps. Little things like this. Do not try to tackle everything that has piled up, or I’ll end up crawling back under the covers.

I want my brain back to its best functioning now–but what I’ve got is a blog post and a sink full of clean dishes. And that’s probably it for today.

Inspiration or Hypomania?

Both of them present the same way: I have an idea. An amazing idea. The best idea I’ve had in a long time. My head begins to whirl with plans for executing it, alternative plans, and alternatives to the alternatives. I sleep even less than usual because the ideas keep chasing themselves around in my head.

Eventually, one of two things happens: If it’s just inspiration, I question it obsessively, but (hopefully) eventually overcome procrastination and insecurity to take some step toward carrying it out. If it’s hypomania (a symptom of my condition, Bipolar II) I just whirl and whirl until I eventually burn out and crash. After I come back from whatever self-destructive crap I might have done while crashing, the idea seems ridiculous or lackluster.

But what if it’s not either-or? What if it’s a little of both?

The large-scale planning of my book continues. It’s reached the next level after a recent attempt at rounding out a chapter instead of focusing on shorter segments. For several days, I could tell my brain was in high gear, no matter what I was doing. I did mindless things quite often in an effort to slow down and relax, but while I was doing said mindless thing the thoughts were churning in endless circles.

Then a breakthrough seemed to happen: I had a vision for a new way of organizing the chapters that would be more blended and less choppy. It calls for changes about what goes where, using the 90,000 words I have so far as raw material but not necessarily in their current segments.

Evidence on the side of inspiration: I’m already making a lot of notes and at least trying to get the ideas down in some form, which counts as action.

Evidence on the side of hypomania: My brain fucking hurts and I really want to go eat donuts to club it into silence.

My Mind’s Pants Are On Fire

Once again my mind is lying to me. It often does. Logical arguments don’t help much, because these kinds of lies are built around a core of reality.

Here’s how it goes: My brain becomes especially anxious. Physically, biochemically, something is going on. No idea why. But my psyche won’t tolerate free-form anxiety. It insists on finding a focus for it.

What to choose? I have many sources of stress in my life. The anxiety zeroes in on one of them and hangs itself on it like a coat on a hook. I begin to worry obsessively about the thing.

Nothing has changed recently with the thing. There’s no new data. But suddenly I’m incredibly worried and can’t stop thinking about it. My mind is lying to me about how serious the thing is, because a day or two ago I was coping with that exact set of circumstances and was much less anxious.

It’s also lying because it’s not necessarily choosing the most urgent of my worries. It just reaches into the grab bag for one. It could have done the same amplification for any of the others.

Even though I know this, it’s hard to argue with it when the core worry is a real one. I can’t tell my brain there’s no reason to worry about it, because my brain will know I’m lying. All I can do is try to stay aware that I’m experiencing an exaggerated version of the truth.

You Don’t Say?

So, my psychiatrist thinks I am depressed.

More than usual, I mean; my general diagnosis includes a type of depression. But just because I told him about how often I’ve been thinking about death lately, and how much I’ve been struggling with food and other self-destructive behavior, and how much time I spend in circles that talk a great deal about the dark aspects of all our futures on this planet…he thinks I need more help with depression.

So out he comes with this particular health care organization’s chart of meds and starts suggesting things to add to my regimen.

Poor man. He means well. But either he hasn’t been taking notes at our previous sessions, or he hasn’t been looking at them.

The names of the meds are listed in little boxes by group, and as he proposes things I have to keep shooting him down.

No, we can’t add anything from this box. I’ve tried many of them, and they increase anxiety to a dangerous level. No, I don’t care if this one is new, I’ve seen the chemical formula. They moved a hydrogen atom so they could get a new patent, that’s all.

No, we can’t add anything from this box. They’re all addictive. I know my addiction history is in my chart. I made a point of putting it there.

Dear God, no, we can’t add anything from this box. Two of them almost killed me when I tried them; I’ve told you that before. You cannot give me any of these unless I’m an inpatient under close supervision so I don’t walk into traffic.

We could try a slight increase in this one med I’m already taking, or we could try one from this tiny box here…or maybe we could get me a therapist I could see more than once every six weeks.

Ha, ha, just kidding, I know that’s not going to happen.

Seeing Strength

I spend a lot of time making sure I am aware of my weaknesses and limitations. Not (most of the time) in a self-critical or self-defeating way, but out of the necessity for managing my conditions responsibly. No one is helped if I take on too much and end up unable to do anything. So, through the years since the last time I needed hospitalization, I have worked hard on this.

Last weekend, though, I got reminded that it’s okay for me to take a moment to see strength. For the first time in nearly ten years, I attended my local Unitarian Universalist church. I used to sing in the choir there, and met some wonderful people…and, eventually, slunk away because of my insecurity and my worsening mental health issues. Already near-suicidal, I came away from every sermon more ashamed and more depressed, the calls to action and social justice reminding me how little I was doing for the world as I struggled just to stay here in it. 

I had considered trying again for a while, and on Sunday I got to see that things have, indeed, changed in the last ten years. The old tapes did play, often, but they did not rule me. I felt plenty of social insecurity, but not enough to make me flee. As I sat and listened to the sermons, I realized that the process in my head was different. Alongside the old tapes, a different track played…ideas for poems, ideas for other ways I might be able to help, a consciousness that, even though I am not doing as much as I might wish, I am doing something.

I came away more at peace with what I am and what I do these days. More at peace with the fact that my battlefield is the psyche, that my focus is on helping others like me escape from prisons inside their skulls–so that, one day, they can be more present in the world and help fight the battles that need fighting.

Blankets Kill

I hear a lot of blanket statements about mental health care these days. The people making them usually mean well, and do not realize the harm they are causing.

In recent years, there has been growing awareness about the overprescription of psych meds, the irresponsible assigning of diagnoses and other toxic aspects of the domination of Western medicine perspectives. This is a good thing.

Unfortunately, however, it is getting translated into a common and frequently aired attitude that ALL psych meds are bad and anyone taking them is some kind of a) ignorant victim in need of enlightenment or b) lazy, compliant sheep unwilling to face their feelings without some kind of crutch.

Blanket statements about ANY group of people are dangerous. When the group of people is at constant risk for serious to fatal behaviors, blanket statements can kill. They can kill by increasing stigma and decreasing the tendency to get help.

Anyone managing a mental health issue has been on the receiving end of so much stigma and judgment already that your words have incredible power.

So you’ve got opinions about this issue. So you think Big Pharma is evil and out for money. Fine. But quit with the black and white thinking and admit you don’t understand the contents of everyone’s skull. Open your mind to the idea that there can be people who have tried many things and found a responsibly managed meds regimen to be the least of evils. People, like me, who choose it because it allows them to be more present in the world, to help their families and others, to stick around instead of hurting themselves. People who find it a useful tool to add to the psychological and emotional work they ARE doing.

You want to help? Advocate for making competent help available to all, so people aren’t getting these meds from unqualified doctors. Advocate for making competent psychotherapy and counseling available to the non-wealthy, since we know that with or without meds this is a huge need. Advocate for a general decrease of stigma.

And stop judging us. Somebody, somewhere, committed suicide today because they were caught in a web of shame and saw no road out. Blankets kill.