Sunday, August 20, 2017

"It takes an ocean not to break."

Honestly, I'm not entirely sure where to begin. I'm angry and broken and jaded.

It's been a hellish two months. Near the end of June/beginning of July, I began spiraling down into a major depressive episode. Nothing new, the old "been there done that" at this point. I'm no stranger to becoming bedridden during these episodes, void of any feeling or motivation. It's voluntary, of course; nothing is keeping me from moving, I'm neither physically bound to the bed nor incapable of moving my body by myself, but the emotional deterioration at that point manifests itself as a physical weight. My psychiatrist described it as "psychomotor retardation." But this time... this was a different beast. Four days in bed refusing food, followed by two weeks of not showering, then becoming a day-by-day occurrence of no appetite or desire for personal hygiene. Though my therapist told me it was an important mark of progress that I reached out to her, she was concerned that I wasn't really associating it with a depressive episode. The majority of my life has been spent in a constant state of suicidal ideation and, as I grew older, an attachment to self harm as a means of regaining control. As this episode grew and mutated, as it chipped away at the pieces of my humanity, I wasn't having those dark thoughts. I wasn't having ANY thoughts, so I figured maybe, I was just tired? Maybe I was playing a bizarre game with myself, withholding basic care for... fun? She had to spell it out that no, this wasn't normal. A complete disregard for taking care of myself wasn't attributed to a healthy mental stability. And then things got worse.

Chaos was amping up in every aspect of my life. Triggers have been exploding around me this year, and while they rattled me to my core, I was working so hard to learn how to confront them, accept them, and move forward with these major changes. There was a straw that broke the camel's back and I slipped into that darkness I was so familiar with. I needed that familiarity and comfort, something that made sense to me, and because I've convinced myself that no one who understands my breaks with reality would be there for me, I believed I was doomed to handle this on my own. In that moment it's the brief calm before the storm, when the very air around you seems alive and vibrating, then all hell breaks loose. I have the slightest breadth, the last bit of rationality where I can choose to reach out, but blink and it's gone. The demons come roaring back in and I no longer know where to turn, who to trust, how to escape. I resort to a basic primal instinct to survive. Because these breaks feel like an entity wholly detached from myself, an invading presence, all I know to do is fight. The self harm began as a means to an end, and it's remained my most immediate and dependable shock back to reality. I fought through it, but what greeted me on the other side was despair. The emptiness and lethargy sank their claws into me and I had no strength left to push them away. The void inside me began filling with a snarling anger, and the weight felt as though it was physically crushing me. I tearfully tried to express how close to my threshold I was again, that I couldn't take on more, raising my broken hands in defeat, but I had no choice other than to soldier on. I would put my hope in a means of relief only to have it taken away. And again, things got worse.

With bipolar type II, depressive episodes are more frequent and manic episodes are much more mild; hypomania lasts only a few days, and with less intensity. When I thought I couldn't be dragged lower, I started feeling a lightness. Within a day or so, the lightness felt warped. It wasn't right it wasn't right I didn't feel right. But I was so relived to be out of the depths that I rejoiced in the renewed energy. I took on too many projects; I couldn't slow my mind down enough to articulate, resulting in such rushed, garbled speech; I still wasn't sleeping or eating but now it wasn't because I couldn't bring myself to care, it was due to the fact that I just had TOO! MUCH! TO DOOOOO!!!! It's a wild, discomforting, and unpleasant sensation but I can't stop myself. I only experience these a handful of times a year (with the exception of a nearly full-blown manic episode after the psych ward prescribed me the wrong medication ratio: too much of an anti-depressant and all of a sudden I was OFF TO THE RACES!). Sure enough, it tapered off over the course of a few days, though instead of coming down to level out, I just kept going. Back to the bottom. Desperate for anything, anything at all to shut out the tumult and the shouting, I began to fantasize "I could try heroin, just the one time, what if it helps?" After witnessing people in my own life battle their addiction, who the fuck was I to ignore everything they've been through and tell myself it could be my savior? But I was spent, exhausted by the emotional rollercoaster of extremes that I was more than ready to give up again. If hell is wailing and the gnashing of teeth, then I have been in hell my entire life.

The part of me that's kept me alive these 28 years kept control long enough to reach out to my treatment team. We're continuing to examine why I engage in the self-sabotage of never contacting them until the worst has passed. My psychiatrist was immediately laying the groundwork for a medication switch: the trauma and overwhelming, unrelenting stressors were enough to finally override my medications. Now she's wanting to introduce lithium. It was the first mood stabilizer discovered and has been in use for decades. It's effective... and it can fuck. you. up. As long as you consistently monitor it, there shouldn't be much cause for alarm. Your psychiatrist, who is in fact a medical doctor, will be able to see warning signs and adjust accordingly. But the way you monitor the lithium is through frequent blood work. If you know me at all, you know how NOT about that I am. For perspective, the first time I had an IV I attacked everyone in the room (albeit high on laughing gas, I would die to see footage of that, but alas it doesn't exist) and it took six or seven adults to restrain me. And it's not like I was a little kid or anything, I was 20 !! I trust my psychiatrist though, and I'm so grateful to have found her as I feel like she's a perfect fit. She errs on the side of caution to a fault and for someone as anxious as me, it's wonderful to feel so thoroughly taken care of. But the uneasiness lingers and I can't shake it; the confusing, frustrating, inexplicable fear or needles, and the terror that this will not work. That terror long made itself a home within me and relishes every opportunity to slither back into my thoughts. What if this last hope fails me? What then?

All of this to segue into why I'm so angry now. I spent the last two months in a nightmare; dragged down into the mud to be slingshot into space and then plummeting back to the ground. Every morning I awoke in pain. The nights would pass with either night terrors or of dreams of a life I've always longed for, a life so complete that when the dream ended all I could do was sob. My appetite is feebly returning; a few days ago was the first time in months that I got out of bed with my alarm and more importantly, managed to eat more than one meal. Throughout the course of this cycling, my body has acclimated to the denial of food. (Those with eating disorders: I have only felt a fraction of your pain, and I am devastated that you've had to deal with it. Your courage and strength to fight and heal is beyond measure.) I can't seem to reconcile my mental state with my physical; it's as though they're two separate identities that exist on completely different plains and I'll spend the rest of my life running in circles trying to bring them together. I want to fix things, and every slip-up pierces like a blade. A reminder that I've failed yet again, and will continue to fail for eternity. I have no natural control over my mood episodes, and I'm so worn down by being violently jerked around. Relief has been achievable through responsible medication, not in a way to sedate and ignore myself but to clear the debris from my mind. We didn't go into too much detail but my doctor explained that with every mood episode, your brain is physically effected. I don't really know what happens but there are actual cognitive repercussions. Side note: the wonderful thing about lithium is that it PROTECTS your brain! That's amazing. 

But after spending almost the entirety of my existence at the mercy of a hereditary chemical imbalance isn't something I wouldn't wish on anyone. It's not a death sentence, it doesn't mean my life is valueless, but it can mean that at times, it's a heavy, debilitating burden. And recently I've seen a romanticization of mental illness; showing off shiny badges of "depression and anxiety" when no professional diagnosis has ever been given. Lately it's been countless, casual mentions all around me of "well *such and such* happened so now I'm manic!" "I didn't sleep last night, I'm manic!" "I'm so sad and then I get happy, I'm so bipolar haha!" My diagnosis is not something I take lightly, and it sure as fuck is not a magical cool label you can slap on yourself. It's not a two-emotion happy vs. sad scenario. There are also the professions of "hmm, feeling dissociative!" "oh you know just spending my day dissociating!" I have nearly an entire week of my life that I can't recall due to dissociation. I was mentally suffering so much my mind detached itself from reality in order to cope. There are faint memories leading up to it, but people have to fill in the blanks for me up to the point where I'm able to remember what happened after. Too often people are confusing external influences that would rightly cause someone to feel nervous, depressed, or hysterical, but those on their own are normal human emotions and unless they meet specific criteria laid forth by the DSM-V, they are not a disorder. Yes, there truly are those out there with mental illness who have their own reasons for not having sought help quite yet, but it's not something you work through in isolation. It's not something you read online and say "sounds like me!" It just isn't. 

I didn't know how to start this and I don't know how to close it either. Like I said, I'm tired and angry. Exhausted after rapid cycling, enraged that someone would dare treat an illness so flippantly. It's examples like that that make it so hard for people like me to be taken seriously sometimes. The unceasing torment breaks me down, and I try so hard to build myself up from the remains. That can physically drain you of everything you have left, but I fear taking time to myself so I can heal because what if I lose my job? What if people who were counting on me see me as unreliable, a leech, someone who runs for cover when they're feeling sad, boohoo. I want to encourage people as best I can that they're deserving and worthy of feeling healthy and sound, but now I'm so fed up with watching it become a battle for the spotlight. I'm tired of seeing someone outspoken, with an audience, pushing wildly unhealthy coping mechanisms, misrepresenting their disorder and putting the notion in people's minds that oh, I totally have that too! Please take care of yourselves, but also take care of each other. If you truly believe something in your head isn't right, I'll do my best to find the best help I can through as many organizations as possible, regardless of where you live or what you can afford. I'll give it my all to help you to the healthy and whole state that you deserve to be. And please, please know while I'm upset with those who make the broad statements mentioned earlier, I don't wish them ill. I want them, need them, to reach out to a professional. Because even if there are not underlying disorders, just knowing that someone with all that might and knowledge is supporting you and has your back through whatever life throws at you, that's an incredible feeling. I'm lucky enough to have two of those badass women! Not super lucky for my wallet, but ya gotta do what you gotta do.

"I used to think it would sleep. I used to think, as I aged with time, it would shut its eyes and just let me be." Crime In Stereo

Saturday, December 31, 2016

Nothing left to live for.

Oh, 2016, what a year. What a fucking year. Basically everybody died and then everybody else died some more. From where I'm standing, globally and personally and everything in between it was an absolute train wreck. One of those "at least it can't get any worse!" AND THEN IT DOES. Let's sort through the shit together, shall we?

I started off the year with my BPD in full swing. The paranoia and the splitting, the anger and harsh accusations, purposely dragging down the few closest to me because if I'm not in some dramatic turmoil, they have no reason to stick around, right? If I'm not the damsel in dire need of saving, they're going to save someone else, right? The fear of abandonment dictated my life so entirely that when the one person I loved more than anyone or anything was preparing to move across country for a job opportunity, I shut down. I was in my somehow unknown five-month major depressive episode (after nearly a decade with this diagnosis I still found ways to convince myself the episodes weren't really there, I was just in an unusually good mood with lots of energy! I was just tired, I worked hard, I needed to sleep more than the 11 hours I was getting!). It reached its fever pitch when I started hallucinating. I didn't sleep or eat for a few days, and at night I was terrified that everything from my furniture to my neighbors to some mysterious "they" were coming to get me. If you've been following my story, this is where I checked myself into the psych ward.

Fast forward. I was out of the hospital, taking my meds, making strides with my treatment team. I felt good! But... it was time to realize that my partner, my best friend, would soon be physically out of my life. His presence was what kept me feeling sane in the midst of all my chaos, his patience with me was what gave me the little hope I had left. Losing that physical connection and knowing I would no longer get to see him every day broke me. Just like when I lost my cousin, I felt worse than abandoned. It was as though I were standing in the ocean, feeling the intense pull of the water as it receded from the shore ready to come together in a massive tidal wave. I can feel it building, building, building, but I can't turn around to face it. I'm too afraid. Finally accepting this heartbreaking loss pushed me back into that headspace and I dealt with it the only way I knew how: self harm and suicide. Except for the first time, I had an audience. I wanted him to hurt the way I was hurting, so staring him in the face I poured an entire bottle, 60 pills to be exact, into my mouth. It never occurred to me in that moment what I done to him, only that I had nothing left to live for and nothing left to lose.

Right around that same time, my aunt died. She was the only sister my dad had, and she passed away on his birthday. We were close, or as close as we could be living so far apart. We had the same crooked teeth, the same weird growth spurts in college, the same creative drive to seek something different from the world than what the societal norm tells you to do. Our last visit had been years ago when she made the trip out to Ohio. She was nervous about going out in public without her wig, but she decided screw this, I'm a cancer survivor, I'll do what I want! It was a good visit: we bonded over art and the beauty and calm of nature, and since she had no daughters of her own, she gave me a ring that her father had given to her. It's the first and only family heirloom I have and I'll treasure it until the day I die. We swapped emails and promised to keep in touch... only I kept forgetting. "One day I'll reach out and say hi," I told myself. But that day never came, and the cancer came back. The guilt I felt threatened to overwhelm me- I was already so damaged and fragile from trying to repair myself, and then losing someone before I had the chance to really say how much they meant to me because of my own laziness was unimaginable pain. "It can't get any worse," I thought, "it can't, you'll be all right, you can get through this."

And then my dad nearly died. He had stomach issues that put him in the hospital immediately, and his white blood cell count was so low the doctors feared for the worst. Visiting him right after he was admitted was almost traumatizing, you could just tell something was horribly wrong. It wasn't my dad, it was a frail wisp of a person shuddering and barely able to move or talk. It still shocks me when I think back on it, how quickly I could've lost one of the most important people in my life. Thankfully, miraculously, his numbers were back in a safe range nearly overnight after a long and terrifying weekend. But all of this happened two weeks after losing his sister. It made me wonder, how can life give people such shit hands sometimes?


Yet after all of that, there was light starting to creep back in. My job starting offering me more opportunities to learn and grow and be part of very important photo shoots that no other local assistant had before. I started to feel more valued, an important part of the team. It was a good feeling, especially after having to have fought so hard to make a career in the creative field. They don't call it starving artist for nothin, I can tell you that, but after years of blood, sweat, and tears, it felt like it was all finally worth it.

On that same creative note, I was finding new ways to care for myself and make myself recognize the beautiful, unique person I was (and am!). I can scream it from the mountaintops all day for anyone else, but I never once saw myself as a person, let alone someone who was worth anything. I started having fun with makeup, which I'm still pretty iffy at, and all I know is I loveeees me the shiny and the glittery. I also started reaching out to some badass photo ladies to be *gasp* in front of the camera! And it was SO. MUCH. FUN. Even though I have Resting Morrissey Face aka looking like my mom left me at the mall. Getting to see myself through someone else's lens, figuratively and literally, made me really appreciate who I am exactly the way I am. Plus, it doesn't hurt that my tattoos make me see myself as an actual work of art- bonus!

And even though we're almost 2000 miles apart, it feels as though I've grown even closer to my partner now. I miss him terribly, but I know without any doubt I would do anything for him. I will support him and put his needs before mine no matter what, I'd go through hell and back if it meant one less burden for him. Having him cheer for me as I make milestone accomplishments with my therapist is honestly the greatest thing I could ever ask for. We find ways to surprise each other, he makes me laugh all the time, and he loves me more than anyone ever has before. I wish I could be by his side, but I have to be patient. Besides, I'd wait 1000 years and cross the entire world for that handsome goon, aaaw, sappy lovey bullshit, deal with it!

Does this mean I don't struggle anymore? Aaabsolutely not. In fact, today in my therapy session I realized I've been in a depressive episode for a while now. Could be related to the change of the seasons, could be anything, really- I'm just managing it so much better now. I had a few days of manic episodes sneak up on me this fall, but it's almost like I'm viewing it from outside of myself. I can recognize it sooner now that I've been working so hard in my recovery. The only bummer is some of the bipolar psychosis is making its way back in, but I have hope that I'll continue to use the skills I've built with my treatment team and finally start learning how to live my life on MY terms, not my illnesses'!

"No one saves us but ourselves. No one can and no one may. We ourselves must walk the path." Buddha



Monday, October 31, 2016

Regression.

*Trigger: entirely focused on self harm + BFRP

There are few things in the recovery journey that feel worse than taking those backwards steps. You work so hard to move forward and heal, only to feel like a failure. With any invisible illness, many people can't understand your ups and downs. You feel confident in your progress, and then suddenly everything is seemingly collapsing around you. 

I will carry my scars with me for the rest of my life. Some are shallow, some were cut deep. They became almost a badge of honor in a way, something I wasn't proud of but had accepted as part of my story. When I was a competitive swimmer, I had limited areas for self harm. So I started cutting my stomach, and I didn't care with what. Knives, thumbtacks, scissors. Carving the verbally abusive words I was repeating in my mind on a constant loop: bitch, unloved, fuck up. I would press a knife into the soles of my feet until blade couldn't go any farther. Somehow only my forearm remainded scarred, which I'm grateful for- fewer explanations to be made. When the words were fresh, people began pointing it out. When they saw the words on my arm, I wasn't asked if I was ok. I was ridiculed. When I confessed to a friend I wanted to kill myself, I was told to shut up. I'm hesitant to be too harsh on them in retrospect, maybe that's how I would've handled the situation in their shoes. But at the same time, I don't think I would have. No one came forward then to confront me or an adult; I was left to suffer in silence. They were content to sit back and watch my life derail. I'm sure I was the subject of jokes, the freak put on display, unable to get her shit together. Or even worse, I was simply ignored. 

Recently I had someone mock my scars. I was asked if I went home after work and started cutting myself, as though I were bored and that was my favorite hobby. It may have been a dry, sarcastic sense of humor, but there I was again, nothing more than a joke. I can't describe the feeling of relief I would get from the self harm, it could be similar to that of shooting up or taking a hit, but I've been pushing myself so relentlessly to adapt better coping skills. Yet in that moment, I wanted nothing more than to take a blade to my skin. Bad Carissa. Bad, bad. Stop fucking up. Stop ruining things with your immaturity. Punish yourself because that's what you deserve. And I wanted to so badly. And then I wanted to hurt that person. I wanted to beat them mercilessly, to understand my pain they so casually tossed aside. But my conscience won't let me; I can rationalize hurting myself for whatever reason but not innocent people. As much as they enrage me, I can't hurt them. I can't. So I channeled that anger. I punched a wall, got in my car and screamed in fury. It still may not be the healthiest coping method but I didn't cut myself. Small victories.

The biggest regression came in the form of another self-destructive habit: skin picking. Body-focused repetitive behaviors can manifest in different ways, but mine has always been picking at scabs, either real or non-existent. When I was stressed, anxious, angry, or just going about my day, my hands would be constantly at my face or legs. Rubbing at clear skin until there was a blemish I could dig into. Once there were scabs, it was game on. I pick at scabs like they're a disease I need to remove from my body immediately. Often times even minor wounds won't heal for months because I won't let them. The dark marks and scars litter the target areas. I'm 27 and still dealing with acne paramount to a super rough puberty, all because I've led myself to believe that picking my skin is the solution to my problems, the only way to feel better. Coupled with the self harm, it's as though I want to remove my skin entirely. I had made two months of progress and my skin cleared up like I'd never seen, and one cruel remark sent me back right to the beginning. Without the cutting I needed a release and apparently old habits really do die hard. I scratched and scratched until I had wounds to pick. It made me feel incredibly relieved in the moment only to be replaced by shame later on. The shame is overwhelming and I've spent the past few days telling myself I deserve the picking; I need to feel as ugly on the outside as I do on the inside. 

Now, I don't know where I am. I suppose I'll bounce back from this, but not anytime soon. All I can feel is the darkness closing in and working up the will to push it back yet again. I'll make it out and then have to fight again and again and again. It's times like these I feel so exhausted that I want to give up, so I suppose if you're feeling this way as well, you're not alone. I had an old therapist tell me that recovery didn't mean everything was going to be perfect because there would still be setbacks, but it was how we push through the setbacks that defines our strength.

"This is for the hearts still beating." Converge 

Thursday, August 4, 2016

Adventures with my legal drug dealer!

That's a normal nickname for your psychiatrist, right? Since I had already established a relationship with a therapist and the hospital obviously started me on medication, it meant I had to find a psychiatrist solely in order to keep being prescribed the meds. I didn't know much going into this process, mostly because I'd grown up terrified of being dependent on outside help and believed I should be able to handle everything on my own. And lemme just tell you how well that worked out (spoiler alert: it did not).

For whatever reason, when I started seeing a counselor at 16, I also had to make monthly visits to a psychiatrist. If that was part of a master plan to get me on meds, then thank god I was a minor and my parents could weigh in. When my dad was in the Air Force, he briefly worked in a psych ward for the returning veterans with the worst-of-the-worst PTSD and addictions. He watched as the nurses forced pills on them and basically they became medicinally lobotomized. The patients shuffled around mindlessly like zombies, he recalled, and that's something he wouldn't stand for when it came to his daughter. Granted, that was the late 70s/early 80s and psychiatric medicine has come such a long way, but we had no familiarity with the field and it just didn't feel right then. I don't know if the psychiatrist was personally affronted by this decision but he sure as hell wasn't happy with me. I remember him being very cold and dismissive of me, which let me clue you in, dear anyone working in mental health: NOT A GOOD WAY TO DEAL WITH PATIENTS. Short of abuse, it has to be one of the worst things they could do.

After a while, my counselor decided I was in a good enough place to terminate the sessions, and I really felt like I was. When the violent mood swings resurfaced, I felt so much shame at the thought of having to continue therapy, but it was my distrust of psychiatrists that kept me from returning. Fast forward a decade and I found myself checking in at a treatment facility where medication is essentially mandatory. You can refuse to follow the doctor's suggestions or medication plan, but that results in an AMA (Against Medical Advice) and that will almost certainly lead to your insurance company not covering your stay because there is "no active treatment." Which, to the tune of $700/day at the hospital I chose, hahahahaha no.

So there I was, fresh out of my eight-day stint in the loony bin, with two brand-new medicines pumping synthetic chemicals through my body and some pretty intense reactions. Being bipolar, you have to carefully monitor the ratio of anti-depressant to mood stabilizer (the fancier name for anti-psychotics, so fancy!) and when it's off, oh, you'll know. I was thrown into an actual manic episode when the worst I'd dealt with were the hypomanic ones and at the same time, I started experiencing akathisia- think restless leg syndrome but in your whole body. Not awesome, 0/10, would not recommend to a friend. But I had a mission to find myself a psychiatrist, and dammit I was gonna do it by the next day! No problem!

... Except so many problems. So, so many.

My insurance may not be super great, but they still provide a decent network. I called and emailed every. single. doctor covered under my plan and only ONE emailed me back, because she actually takes time out of her schedule to respond to potential new patients, but unfortunately I just didn't feel a connection with her. In fact, I even called one number to find out it was a facility not even related to mental health but for whatever reason, insurance companies kept listing it. So fun! Now I had expanded my search to any affordable psychiatrist in the Cincinnati area. I felt most desperate when I called my last hope, a hospital with a behavioral therapy wing, only to find every last one of their doctors was booked indefinitely. Knowing I'd soon be dishing out a crazy amount of money, I finally asked my therapist for referrals. With a manic episode refusing to cease and hysteria escalating as quickly as my prescriptions were dwindling, I began leaving slightly frantic messages explaining my situation and could they please, please at least return my call to let me know if they were even accepting new patients. Silence. It wasn't until the next day that a psychiatrist fiiinaaallyyy called me back, but I hadn't even heard of her. She was previously involved with private treatment facilities and was now taking on patients of her own, working at an office with several of the doctors I'd called and heard nothing from. After over two weeks of searching, that was the most wonderful, joyous relief I could've ever felt.

Launching into this new phase of my recovery was wild. We talked about my meds and adjusted the dosages. Even though she wasn't particularly thrilled with my combination, she was hesitant to switch them just yet. However, the mood stabilizer gave her some concern, since it's known to cause heart problems in some people. Off to urgent care I went to get an EKG test read just to make sure there were no issues. Free and clear there, but we still weren't comfortable with the potentially damaging long-term effects (it did jack up my cholesterol). So we introduced a new mood stabilizer that has to be gradually built to the full dosage over the course of a few months to ensure you don't die. Literally. The tell-tale symptom is a rash most commonly found on the torso, but could appear anywhere on the body. If it shows up and you continue taking the pills, you're dead. And here I am, fairly heavily tattooed including a good chunk of my stomach, trying to keep my rising panic from making me run screaming out the door. Swallowing the massive lump in my throat, I agreed. Fun fact: it was initially developed to treat epilepsy and somewhere along the way scientists realized it was effective in managing bipolar disorder, what a world!

But along with this new medication came a new side effect. Insomnia. I tried for several weeks to naturally fall asleep, like keeping up with my melatonin, increasing the dosage to over 20mg. Making sure I wasn't watching tv or checking my phone right before bed. Taking baths. Working out. All of this to no avail. I wasn't sleeping, it was causing an enormous physical strain, and so the only option became sleeping pills. I'm now officially on medicine for my medicine. I've been at my final dosage of mood stabilizer for a few weeks and am feeling incredibly stable. We may or may not have to adjust my anti-depressant again, but we're just playing that by ear. The sleeping pills are absolutely necessary; after a few days of intense physical work I'd fall into bed exhausted as soon as I got home and without fail, just like it used to be, I'd wake up around 3am and stare at the ceiling for hours. While the pills don't knock me out cold, they help me to stay asleep, but I started noticing that once again it was becoming increasingly difficult to get out of bed. And again, we made another dosage adjustment. When my horrifying panic attacks-meets PTSD-meets psychotic breaks started creeping back in, we threw in more pills, a mild sedative that for now I only have to take as needed. Fingers crossed the changes made at this most recent appointment will be the ones to unlock the magical combination.

I've been on my psych med journey for five months. I'm incredibly lucky to have made this much progress this early on, but I'm guessing it has something to do with having avoided medication for so long. Aside from the mood stabilizer, my doses are very low and my doctor makes sure we're only focusing on non-addictive, effective solutions. I only see her for 20 minutes once a month, but I absolutely cherish her and I'm so happy I ended up as her patient. No matter what kind of mental health professional you choose, the very most important thing is to have a connection with them. I can't emphasize that enough! If you don't trust the person you have to be completely 1000000% open and honest with, you are not going to like it. Even worse, it will be wholly non-beneficial to you. 

There are only a few more things I want to address and then you can get back to playing Pok√©mon Go or making memes or whatever it is you do on the interwebs. The only difference between a therapist/counselor and psychologist/psychiatrist is the former are certified professionals with or without degrees while the latter have received advanced degrees, almost always doctorates. Also, psychiatrists are required to be medical doctors and because of that, they're the only ones who can write prescriptions. It's best to let your mental health guide you to which professional you choose- for serious mood disorders, medication is almost a must. Maybe you feel like simply talking and having a mentor there to help you sort out issues is best. Or go the route I did! I'm thrilled with my treatment team and wouldn't change anything. I have my weekly sessions with my therapist and monthly med check-ins with my psychiatrist. But keep in mind: it's going to cost. A lot. If you're one of the chosen few, your insurance may cover everything. Thankfully, incredibly, my meds are covered but the session fees are all out of pocket. Typically psychologists and psychiatrist are a wholeee lot more expensive; it's an absolutely necessary cost, but it can add up quickly.

This last bit is huge and I don't think I can stress it enough. When you are prescribed medication, know that it will be a process. Be completely honest with your psychiatrist. Some people receive prescriptions from their primary care physician which isn't necessarily a bad thing, they may not know! But those doctors only have a limited knowledge of mental health and it casts too wide a net and lumps too many disorders into general groups. Or even worse, deciding to take someone else's prescription because "they have depression and I have depression and it must work for both of us, right?" NO! Wrong, so wrong. Everyone reacts differently to medication and it must be something you start under the supervision of a doctor! Also, I've heard too many in the healthcare field adhere to, "well if there's a pill to make it better, why not?" Long-term side effects aside, the point of psychiatric medicine isn't to erase your disorder completely. In an ideal world, your prescriptions help you become ready to delve into your treatment with the end goal of recovery and being able to manage on your own. But sometimes the best treatment means you may be on medication for life, and that's ok! It's a piece of the puzzle that is immensely helpful when you integrate it with therapy, drawing on resources and mindfulness to build yourself back up from the foundation that mental illness works so hard to destroy. When you feel you've reached that point, it is highly, highly important you discuss this with your doctor so you can begin tapering off.  I can't tell you how many people I saw in the hospital who take their meds, feel great, decide they're ready to quit, and end up being admitted as a patient yet again. It broke my heart to see them so confused in their regression, so that's why I'm fighting so hard to educate anyone and everyone. Through being vulnerable, as uncomfortable and terrifying as it can be, we share our experiences and come that much closer to fostering a community and showing the rest of the world we are not our diseases: we are fantastic, remarkably strong humans with such potential!

"Don't be ashamed of your story, it will inspire others." Unknown

Sunday, June 5, 2016

Livin' sober with a mood disorder.

How I've managed to escape addiction is an actual miracle. I mean, I can count on two fingers the times I've tried alcohol! (Beer, which tasted like sweaty gym socks, and a glass of wine at a cousin's wedding.) I used to joke that I was simply born without any desire for mood-altering substances, but the older I get the more I've come to realize I survived by the skin of my teeth because some small part of me knew from early on what hell I would unleash if I ever turned to substances. And though I've been lucky, I would never count myself above anyone who isn't also sober, as I've fought my own battles with other, different addictive behaviors.

Many with mood disorders (bipolar, schizophrenia) turn to drugs and/or alcohol in effort to escape the never-ending nightmare that is being unable to trust your own mind. The line between reality and delusions often becomes blurred, and for some it's on a daily basis. After years, months, even days of that sort of terror, wouldn't you do anything for relief? Even though I've lived sober throughout my issues, that's not to say I've never felt that pull. There are times I want to down as much hard liquor as possible and if I haven't drank myself to death by the next day, wake up and do the whole thing over again. Wash, rinse, repeat until the delusions pass. It's such an inviting notion to be able to calm the storm in my head, but in those dark moments there was one lone voice frantically urging me to push past it. I would fantasize about the lengths I would go to in order to cope, and then this mental slideshow would start playing. Sure, drinking myself into oblivion sounds wonderful, but later on, there I was an alcoholic. Shoot up and feel painless and content, but without a doubt overdose within a few short years. There would be no casual, recreational use with me; I can have an obsessive, addictive personality, and to invite anything destructive like that into my life would have been a death sentence.

My therapist and I have talked at lengths about substance abuse and how, if I had started when the episodes did as a child, I would've been dead before making it out of my teenaged years. It's a chilling thought, one that's constantly lurking in the back of my mind, but it keeps me alive. And again, the one experience with THC was enough to eradicate any lingering doubts: if my mind is this fucked up sober, the literal absolute last thing I need to be doing is be altering it in any way. Some days I'm unable to tell the distinction between what is actually happening and what my diseases are fabricating, and it's that small voice that keeps me from losing it entirely. Regardless if I have a harmless glass of wine or smoke something to relax my nerves, once my inhibitions are lowered that sane, rational voice will get smaller and smaller until finally, the insidious voices take over. I would be angry, violent, destructive, and completely uncaring. I would want to cause as much pain as I've felt, pain that went ignored for so long it started to rot inside me and turn parts of me into a cold, calculated sociopath with no feelings other than the rage. To be able to recognize that and avoid it at all costs comes with a monumental price, though, but it's one I will pay time and time again. Part of therapy is working on beneficial coping skills to replace the self-destructive ones, and because I've avoided substance abuse, mine manifest themselves as self-harm. Depending on whether I need a release or a quick jolt back to reality, I would either see it as punishment or what I've referred to as an "offering to the voices," essentially. Because self-harm can release the very same endorphins drugs do, you can begin to link the behavior to the euphoric feeling of relief. 

But I feel like my self-awareness alone wouldn't do the trick; I have been enormously fortunate to have avoided what has so easily ensnared so many others. Good, kind people who have suffered and were pushed to their breaking point. People who are preyed upon by those greedy and lusting for power and wealth. And to everyone struggling with addiction of any kind, my heart breaks for you. It breaks for everyone who has been dealt an invisible illness and is tying to navigate the unchartered territory the best they can. I met some recovering addicts while I was in the hospital and their determination to get clean was nothing short of awe-inspiring. It is my hope that we all find the same courage in our journeys towards recovery, and know that there really is hope. Some days it might be far away, and other days feel as though it's entirely gone, but please believe I am cheering you on and that with each other's support, we're going to make it.

"Maybe I'm fucking up, but I think that that's ok, just so long as I'm learning every day." Make Do and Mend

Friday, May 27, 2016

"Grew up a screw up!"

That quote from a friend has been bouncing around my head the last few days. Recently I decided to write a book about growing up with mental illness. For me, reading about people's experiences is highly therapeutic, and I've always enjoyed writing (as a kid I wrote newspapers for cats, by cats, so...), and I figured everybody else is writing books now so why not me? But revisiting some of my past, even with the guidance of my therapist, has been proving difficult.

Like many others with mental illness, I have my hand in a fair number of disorders. An old therapist used to tell me, "it's like going to an all-you-can-eat buffet and picking out a little bit of this, a little of that." Having traits of one or a diagnosis of another made no difference to me: I was weird, I was different, and I felt wrong. I felt incomplete, like someone was supposed to flip a switch to give me a normal brain, but forgot. There was always something inside me that was patiently waiting, watching as I suffered through panic attacks as early as age seven and when the perfect storm of life-changing events hit me at age eleven, the monster roared itself to life. My first two suicide attempts came in quick succession, and I spent the next five years convincing myself to get out of bed every morning by whispering, "just make it through today and you can kill yourself tomorrow." Those demons raised me, did their best to break me, and taunted me with hope always just out of reach. I was a shell-shocked child wandering around in a daze, acting out in violent outbursts as a cry for help.

Throughout the following years, I had a few psychotic breaks and knowing that it could be a permanent change one day brings up so many emotions that I just become confused and numb. Knowing that you're not quite insane but very well could become so after one too many breakdowns isn't exactly an easy thing to hear, and not something I can focus on as I'm working towards making myself healthy. But it's always there, in the back of my mind, and some days it's so close I could wave hello. With an indescribable longing, I put my hand up to the glass and watch as my reflection does the same. Feel the pull to join it on the other side, free of any burdens or worries, free to do and say whatever I want. I know that once I open that door, it will be nearly impossible to shut it and there will be absolutely horrendous consequences... But giving up means no more fighting for my life every single day. The voices would cease in their daily torment and maybe, just maybe, they would be my friends. (So, yea, I hear voices. I've dealt with auditory hallucinations most of my life and I simply assumed as a child that everyone else did too, they just kept it secret. Like me!) But those are their promises and I know full well they're empty and hollow, but there are days they're maddeningly tempting. 

The closest I've come to that reality was the one time I tried weed. People swear by it to calm their anxiety and better their moods, and I had nothing left to lose at that point. So I ate an edible, and spent the next two hours hallucinating that I was being skinned alive by a man calmly singing along to the pina colada song. A few nights later, while I swore I was taking a nap on the couch, my boyfriend informed me that my eyes were open and I was looking directly at him while ignoring everything he said to me. I've experienced disassociation before but never quite like that. We turned on the tv and a horror movie was playing. I only made it about five minutes before a scene was showing a girl being choked with a curling iron (Like, I get that she'd definitely have severe burns but is that scientifically possible? Death by hot curling iron to the mouth??)- and that's when it hit. I was watching myself die, I could see my face plain as day on the screen and then, just as suddenly, I wasn't myself anymore. I still saw my face but the person inside, trying to recognize that it was me, was no longer me. Having those two personalities fighting for control and the sheer terror of thinking I was seeing myself die again broke me in a way I had never experienced. I couldn't sleep, I couldn't shake off the dread, and every time I closed my eyes the scene was there, mocking me. I had literally terrified myself to the point of vomiting the next morning (and I still went to set and worked a 14 hour day because I'm no fucking quitter!).

This is just a piece of the puzzle of the bizarre mural that is my life and my invisible illness. Being self-aware is the most important skill I can rely upon right now. Confronting these dark places inside that don't want to be fixed takes enormous effort, and experiencing PTSD that nearly rendered my meds useless is exhausting. The joke's on me because now, either as a side effect or result of the stress, I don't sleep at all. My body is refusing point-blank to fall asleep. If anything is pushing me faster and closer to insanity, it's this. So I'm writing now in hopes of organizing my thoughts that it gives me the strength to push back another day.

This is for you, having fought these demons alone for so long. This is for your friends and loved ones, while you may not relate to their pain firsthand, you're doing the best you can to support them. This is for the ones who recently woke up one day and realized something was very wrong, but didn't have the words to explain it. This is for us: may we take each day as it comes, with strength to continue surviving and persevering, and that while it may not ever go away, or we fall victim to the belief that we're in it alone, know we are never alone and we are stronger together.

"The only people for me are the mad ones." Jack Kerouac