I Fell Off the Wagon.

Disclaimer: This blog post does discuss self harm and suicidal ideation. If these are triggers, please protect yourself.

So I’ve been avoiding writing mostly because I’ve been ashamed and angry with how the past 5/6 weeks have been. I’ve spent a lot of time in my head, and perhaps writing would have been better. Maybe I didn’t want to see it written down. Maybe I didn’t want people to tell me it was going to be okay. But I’m still feeling scared and a bit weak, so I’m going to try and see if it helps. Apologies if some of this is repetitive from previous posts.

Ok, so I’ve been on Klonopin for what, 13 years. This is a controlled substance that you’re supposed to take for emergency panic attacks or maybe for a week or so to help bring you down. That’s because as a controlled substance, it’s highly addictive. Not like I crave it, but my body clearly does. Even if you’ve only been on it for a few weeks, it can take over a month to taper off – so trying to get off of it after 13 years…well it’s a very long process.

The Klonopin doesn’t actually do anything for me, except ensure my body doesn’t go into withdrawal. Since I’m going to London in September and their healthcare isn’t as tip-top in terms of mental health (which is saying a lot given how shit ours is,) I figured if I could get off of it, that would help. It also is known for impacting memory – in fact recently, they were recommending no one over 50 take it. The only comforting thing about this is that it could be one of the reasons why my memory and cognitive skills have been getting worse over the years. Given I’m about to go into an incredibly rigorous academic program, I want to have as much of my brain functioning as possible.

Anyway, I was really pushing my psychiatrist since I’ve been better to start tapering. I guess I was only thinking about the physical side effects of withdrawal and figured I could handle the shakes and sweats and vomiting – whatever happens when you withdraw from Klonopin (I naively based this on movies where people detox.) So I pushed her and we went down by .25. Ok, evidently that’s a LOT. You’re supposed to go down by .125 every 3 weeks or some shit like that. Anyway, I didn’t realize there would be brain chemistry psychological effects and I became very depressed.

It’s been over a year since I have had clinical depression and all of a sudden I felt the weight and pain again. That sucked, but even more so, it scared the shite out of me. It also brought some old depressive thoughts to the surface again. Ok, so after a week, we went back up to my original dosage. But the depression didn’t pass, which I still don’t get, but whatever. So then we tried to give me some extra short release tabs of meds I am on that helped with my clinical depression and they did jack squat. But each day my depression was getting worse and my bad habits came back to town.

Still, after this past year, I knew what it was like to not be clinically depressed and I could differentiate when it was the depression guiding my thoughts and when it was me. I really tried to be compassionate to myself. I excused not going to the gym, or thinking about my future. I allowed myself to not leave the house for days. I don’t know, I suppose I thought if I resisted it, it would just make it worse. But it was like the angel and devil on my shoulders – they were fighting each other. And so the mood swings went from fine to so fucking low I wanted to die. And while in my heart I knew the depression was chemical, it still feels rational and true. And so the same things that before might have made me anxious but excited, became terrifying and pointless.

And then I fell off the wagon. It’s been over a year since I’ve self-harmed.

Looking back on that Friday, I had been in therapy earlier that day. I had been told that there was another life path that might be better than going to LSE which had kind of mind-fucked me since I was already doubting my ability to go, and decision-making is my number one anxiety-maker. And my therapist, who is still an intern, told me that she would not be able to communicate with me if I was in London, or out of the state where I currently reside.  I have known this was a possibility for a while. It was part of the reason I deferred from LSE last year. I wanted more time to work with her. Anyway, she told me and I kind of just voided it. I guess it was just too much for my mind to handle so I put it in the emotional void of overwhelming news and went home.

I was cooking dinner, watching some tv, and all of a sudden, the depression just hit me. I mean, it came from nowhere. I wasn’t ruminating about anything at the time and then all of a sudden it was like I had just been punched in the gut. I couldn’t breath and found myself bent over in absolute mental pain. Everything imperfect, all of my doubts, it all came to the surface and slapped me. I felt nauseous. I tried to cry but when I opened my mouth nothing came out. And then the craving for self-harm felt no longer like an option but like a need.

So I did. And at the time, it felt amazing. I guess what it must feel like when you slip from your recovery and go back – that first sip or hit in a year, it’s intense and satisfying and feels fucking amazing and you wonder why you ever stopped. But I quickly realized it was escalating not calming me. I wanted to do it better and I was worried I wouldn’t be able to stop. I went through the tiny rolodex in my mind of people I could reach. This person wouldn’t be available, this person couldn’t handle it, this person shouldn’t have to. I truly didn’t want to call anyone but I guess I knew I had to do it. I was at my threshold and I just didn’t want to tip over because I think there was still a part of me that knew it wasn’t real – that it had just happened too fast to be right or rational and I just had to stop it before I did something I couldn’t come back from.

I didn’t want to bother him, but I called my brother. I’ve called him before. I hate doing it because he has so much on his plate and he’s just such an amazing person and I don’t want to hurt him, but I also know he’s a police officer, so out of everyone I know, he has seen it with others and can understand it without freaking out. When I called him sputtering and hyperventilating, he went into police mode – asking questions to ensure I was safe, if I needed to go to the hospital, or call 911. I was yelling out everything I thought meant I couldn’t do this anymore but he somehow got my breathing to slow, to pull me back or out of wherever I was. He was at work, helping on dispatch – the irony of others calling 911 while he talked me through my emergency was not missed.

And he just stayed on the phone with me. He told me some funny stories about ridiculous debacles of the day, he talked about the chaos of his life, mundane and big. He kept me listening, asking questions, laughing. I patched myself up while we were on the phone. He stayed on the phone with me as he finished up work, got in the car, drove home, fed the dogs and started eating his dinner. And when I knew I was okay for the night, when the exhaustion of it all hit me and I knew I was too tired to think or move, we got off the phone. Thank goodness people like him exist in the world and I am beyond lucky to have one in my life.

The next day is always the worst. Not only do you feel the ramifications of your actions, you feel stupid and ashamed. It all felt so silly – and worst of all, I had broken my streak that had become a badge of honor. But I made it through that day. And I made it through the next and got to my psychiatrist. It was easier to tell her. She has known me for a long time, since the ECT stopped working. And she’s known me when this was a regular thing. I guess that felt better because I didn’t feel like she was judging me, because both of us at that moment, knew it was clear that it wasn’t me.

I had spent the week overanalyzing if I was making things worse, fighting to not feel better, trying to exacerbate the depression. But saying it out loud, it just made no sense. It also made sense why I felt overwhelmed – I was questioning my next big move, and my therapist and I were going to have to end our relationship. I was also turning 35 in a few months and even if I wasn’t clinically depressed it was still a heavy date to approach as I had declared it, when I was 33, as the last day I would live in the pain I was in. Even if I wasn’t clinically depressed this would have overwhelmed me.

So I’ve been recovering this past week. The med change seems to be working, and I can handle the side effects, which in the past with this medication, seem to dissipate over time. The cravings aren’t gone, but the temptation is low,  especially every time I see the evidence of last Friday and realize how ridiculous it looks and the amount of work that will go into hiding and healing.

Funny enough, we are doing distress tolerance in DBT, which is meant for situations just like those. It started four days after the incident. I’m still unsure if I’ll make it to the gym today. And I’m unsure if I’ll be effective or what choices I will make. I still know deep down that the problems that arose when I was depressed are real. The way I handled it wasn’t me, but it doesn’t mean the issues don’t still exist. And I do have to deal with them. Maybe not today, but I have to apply for my visa in two weeks, so soon.

I’m hoping in another week or so, I can look at that moment with some understanding and compassion. To see it not as a failure, but as a reality check of both how far I’ve come and that it really is a disease and not the true me. So many of my scars are memories of a time and place. I used to think of them as tattoos of where I was was and what I’ve been through – and maybe these too will come to serve as mere place markers in my life. But for today, I just have to decide that no matter what I do, or how effective I am, it’s ok. Because it is what it is, and for now, that will have to do.

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Fighting Depression: A Sword Duel With a Wooden Spoon

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Wooden, Silver…You get the idea.

Well, it’s been a few weeks since the tapering debacle. Since about Thursday, I was feeling like I was coming back to “normal.” I will say this past episode really did a number on me…

and it reminded me of a few things:

  • medications are not cures.
  • in terms of mental illness, healthy sustainability, consistency, or complete “repair” are never viable realities.
  • patience is necessary for managing mental illness. and i am shit at it. too bad they don’t have a drug for that.
  • medication is a delicate dance with brain chemistry, and you can only take one step at a time. each time we try to change a med by lowering or upping, i can only do one, and have to wait weeks to see if it works, or if side effects pass or stay. if the med is not working, that means i have two to four weeks of feeling like shit, hoping that maybe it will work. and if it doesn’t, i try a different one and wait.
  • memories may fade, but the feelings of pain you feel from depression never leave you and you never really feel safe.
  • bad habits never truly die, and they feel so comfortable, right, and easy. even when you know it’s wrong, it still seems, at some place in your brain, so very right.
  • and so, every minute of every hour of every day is a fucking testament to will power, resistance, and opposite action, and it’s exhausting.

the scariest part about this past month was how low i got. the thoughts i had. the close calls. being ripped from my path of self-healing was brutal.

i wonder if it’s because my brain has gone to a very deep, dark place in the past. and so when i get depressed, it goes back there. like, if i had never gone that low, then my brain wouldn’t get there right away. but i think of it like a neuro “path” has been burned to that area of thinking in my brain, and so now, when i get sad, instead of just going to point A like a typical sad person reaction, my brain goes all the way past to point B.

and point B is a volatile, dangerous place.

i will say the fact that i know it’s my brain and not “me” really shows the progress i have made and what a lifesaver having this past year has made. because i now know what normal is, and so i know when my brain isn’t at its’ right chemistry. i think it’s what allowed me to reach out and ask for help when in the past i would have spiraled alone.

still, it didn’t matter because as we all know, when your brain tells you stuff it feels real and right and makes sense so it’s really difficult to fight it. it also makes the bad decisions even worse since you know you can do better. it’s a fucking temptress. (what is the male version of that word – tempter?)

i’m just a jumble. i feel great for 12 hours and then i panic and want to drop everything and disconnect. i use my dbt skills and get myself to do something i’m afraid of, and then 5 hours later, i’m sitting there and i just can’t use them. they seem moronic, useless, and dumb.

yesterday, i sat across from my psychiatrist and i talked. i gabbed, really. it might have been the caffeine, but at the end i said to her, “so it sounds like i’m back.” she agreed. and then i got in the car and started to drive. five minutes later i was crying. i got home and didn’t leave the apartment, answer any phone calls, clean, or doing anything positive for myself.

i’m either having mood swings right now as i recover, or i get excited that i’m doing better and am self-sabotaging to protect myself. or both.

either way, i don’t know what to do. or maybe i do, but i can’t. or maybe i can, but i don’t want to.

Melancholy Days

Melancholy:

  1. a gloomy state of mind, especially when habitual or prolonged; depression.
  1. sober thoughtfulness; pensiveness.

I’ve always appreciated the word melancholy. While it’s not used regularly, it is such a perfect way to describe the staid state of depression. I suppose it doesn’t cover suicidal ideation, self-hate, anger, losing your shit, etc., but I like that it touches on the idea of sober thoughtfulness and pensiveness. I guess it hits the mark on my day thus far.

Between the chaos of worry, anxiety, stress, and overthinking, there is a quiet to depression. For all the pain that rages inside, that racks our bodies till we are writhing in bed, crying, screaming, trying to push the pain out or down, there is an almost comatose component to it as well.

Sometimes, when the pain was too great, when my mind was so overfilled with thoughts it ran blank – I would find myself looking at a chair, a squirrel in a tree, the weeping sweat on a cold glass of water – and the thoughts that had been racing would slowly come to a halt and arrange themselves as if on lined paper.

How can I eradicate this pain?

What would it feel like if the pain could go away?

Am I dying inside?

Is this who I am and what my life is and will be?

Am I strong enough to withstand this ravaging, cruel, deep, crushing agony for another hour? Day? Month? Year?

Do I want to? Do I have to?

I have had so many days and years sitting, silently crying, my stomach clenched, my body in a fetal position. I felt like I couldn’t breathe but my heart was racing and my head throbbed.

I wanted to scream and yell.

I wanted to slam my clenched hand into the wall.

Tear at my skin and hair.

Run. Sleep. Vomit. Cry. Cut. Burn. Fast. Binge.

Quash the pain.

That specific pain has been lifted now though I feel the scars and soreness it left behind. It’s not a memory because it’s never gone. I don’t choose to think about it. It drifts behind me, beside me, in front of me. Sometimes I have to push through it like a cobweb or a thick, wet black fog. My stomach, my eyes, my chest are still sore, still tight. I suppose they are afraid to atrophy, they need to be on guard.

My mind is still a bully, I guess that wasn’t the chemical imbalance. It tells me:

I’m worthless.

I’m going to fail.

It’ll never last.

I’m still not good enough.

I’m too weak, the power of my hope too worn, emaciated, and thin to protect me from my true self.

It begs me to come back.

To accept the “real” me it sees.

I do my best to ignore it. I know it’s lonely and like all bad relationships, is addictive and seems comforting from afar. I want to see a future. I want to be the person others claim I can be – insist that they see. I want to strengthen, tone, and mold my esteem and faith in myself. I wonder if I just have to seem to be whole, and in doing so, trick my body and mind into believing and becoming so.

I don’t know anymore. Good days. Bad days. Hope and distrust. Tears of joy and pain.

I still find myself looking at a chair, a squirrel in a tree, the sweat of a cold glass and asking myself what I am possible of and if I have the energy to make it. I want to say yes. I want to laugh at the pathetic ripple of depression that taunts me like a pathetic, weak child. To have dreams, beliefs, and hopes that build resolve and break the bad habits of weakness. I want to want to live a life worth living.

I really do.

Food: A Necessity and Nemesis

foodThe ups and downs of my mental illness have added additional complexity to my relationships with family, friends, work, and…food – my constant nutritional foe.

Recently, a close friend and I were discussing our travails with food and he pointed out the key problem with food addiction. So dig: to break free of addictions to drugs and alcohol, you rid your life of the drugs completely. You might have to change the people you hang out with, the places you go, and any other tempting habits you have formed that may lead you astray. (I in no way am presuming this to be a simple or easy task). The point is to never go back, not even for one sip or hit – you must learn to exist without it. The problem with food addiction is that you can never truly “rid” yourself of the temptations – be it situational, psychological, or physical – because you need food to survive. A true catch-22.

For me, around the age of eight, I became overweight and my relationship with food was soon tarnished with guilt, shame, and anger. Every time I ate something, I blamed myself for perpetuating my looks, even though in retrospect, I’m pretty sure it was just the pre-puberty baby cheeks that had yet to disappear. Every time I ate, I disappointed myself because I was convinced I didn’t earn it. At the same time, I would punish myself for my failure by then purposefully over-eating. I never understood why the majority of my classmates were thin and were able to ate more than me or eat candy without gaining weight. I never understood what I was doing wrong, but nevertheless, blamed myself for it.

We had a family crisis when I was in fourth grade, and I think that’s when I started using food to somehow push down my pain. If I could eat enough, I would feel physically sick – something I could capture, unlike my emotional pain. During high school, when both my family and school life felt amiss, I craved not only the attention of boys, but also a way of feeling in control. I would try to gain this control by not eating. And then when I would eventually fail, I would binge, perpetuating the cycle of my unhealthy relationship with food.

I’ve also never been comfortable eating around people. I have always had an overwhelming fear that people look at me, no matter what I am eating, and think to themselves “Well no wonder she is overweight – she eats!” If anyone is trying to argue rationality for this issue, it’s never going to work. I still can’t eat in a restaurant by myself, and am uncomfortable eating around people I don’t know. But trust me, it pisses me off to be my 30’s and still be ashamed and disgusted to the point where I don’t believe I deserve to eat.

Throughout my twenties, I attempted to develop a positive relationship with food. I had been pescatarian, then vegetarian, which led me to veganism. I really liked being vegan because I felt like my ethics/values were finally matching up with my eating habits. I also tried a variety of exercise routines to try and balance the alcohol and food I ate. Still, I would be lying if I didn’t say they also served as a way to restrict my diet and lose weight.

The first year after I had quit my job and moved home, I was living alone and hardly left the apartment, i.e. barely moved for weeks at a time. Because I was alone it was easier to binge and I gained a lot of weight. After a year, when I decided to do ECT, I moved in with my parents, and started my weight loss through Weight Watchers. It was exciting to feel like I could have a sense of control without necessarily starving myself and it gave me realistic goals I could achieve that were small enough to not be too overwhelming.

Unfortunately, when ECT stopped working (thank you bipolar II,) I started trying new (and old) medications again. Within two months on one medication, the 30 lbs I had lost over the eight months on Weight Watchers was back without a change in diet or exercise. It was so sudden: one day, I wasn’t wearing gym clothes or pajamas, and none of my clothes fit. While weight gain is difficult for any woman, mental illness or not, I think because of my insanely deep self-hate, this hit me especially hard.

Lately, while I have been eating healthy and exercising, I have had a few nights of bingeing. I know this happens to all of us. But when it’s three or four nights in a row, that’s a red flag for me. I know it means I am super-anxious and feeling out of control. But I think it’s less the food (though it does not help the scale) and more the process of bingeing and the shaming that goes along with it that’s so frustrating and upsetting.

After all, I spend each day trying to keep my head up, maintain order, patience, and balance – keys to what I imagine keeping myself in a healthy place will require and therefore must be developed into rote habits. So when I binge at night, I’m falling into old traps of self-hate eating. Without alcohol, men, or cutting, food is the last resort of self-harm. And that is why bingeing is more than just knowing I need another 10 minutes on the treadmill. It means I am not as strong as I want to be. I am not as stable as I wish I could be to move forward in other parts of my life (developing a social life, hobbies, and perhaps a job.)

I have started back on the path to losing the weight I gained on that awful medication, but as usual, everything takes longer (thank you aging). I’ve read so many articles about weight loss and gain; loving your body and yourself; whether women can ever truly accept their body, etc. and have been trying to find a place where I fit. (Those articles can blow me.) I’ve known since I was quite young that having a healthy relationship with food would never happen nor would ever really be the goal. I know that when I look in the mirror I will always see the fat, no matter how thin I am.

Given that my relationship with food is more than just about what the scale says, and also knowing that I won’t ever be fully in control of my addiction because I will always need food in my life, makes it even more difficult. But I guess it’s true – it’s a process I have to deal with day by day, and frankly, for someone that is banking so much on her future, I guess it’s just hard to swallow.

Self Mutilation: An Ugly Tattoo of Hate & Shame

Disclaimer: Let me first say that cutting, or “self-mutilation” is a horrible thing and I do not condone it in any way. I do not think it’s helpful, actually works in the long-term, or is a worthy form of positive self-medication. I’m also not going to go into details about how I did it or where I did it, because I always found that when I read about it, it was like a how-to with tips, and that’s not my intention either. If you find yourself cutting, you should seek help – whether by telling a friend or family member; finding a support group; seeking out a therapist; or calling a hotline. And if you are someone who is told that someone you love is cutting, the best thing you can do is ask them how you can help.

That being said, for me, cutting was a self-medication I began my sophomore year in college (see post on self-medication for background.) I will say that when I started, I was at a point where I felt like I was going to explode inwards. My pain was so severe and nothing seemed to dull it. I physically felt like I was throbbing with pain and bloated with agony. I imagined myself like a balloon that had too much air in it and needed a release. And that’s what cutting did. It was like I was letting a little of the pain out psychologically by creating a hole physiologically. The release never lasted more than 2-5 minutes and then the shame of having hurt myself plus now having to hide it led to other negative self-medication like binge-drinking and eating. But sometimes, it just led to a good cry. Not even a cry – a good all-out sobbing. And now I realize, that’s what I really needed and what felt so good. It wasn’t the cutting. It was that I was feeling so much I felt nothing and the pain of the cut allowed me to feel and then brought all of my emotions to the surface.

Like most self-medications, I became addicted quickly and learned how to hide it. Now, in retrospect, I think a part of me always wanted someone to see it. It was like I was waving for someone to help me from a sinking ship by flashing a part of my skin that hadn’t healed or accidentally showing a band-aid with hopes someone would catch me in a lie.

I also was struggling with some family issues at the time and was frustrated that I thought no one in my family understood my pain. As a child, I was deemed the sensitive, empathetic one. (And to be fair – I really was and still am.) But I had tried to explain to my family that something just wasn’t right since I was little. They would check my forehead, tell me I was hormonal, or just tell me I was taking things too seriously. By high school, that’s when I stopped complaining as much and took matters into my own hands. From my perspective, my family was too busy living their lives to see my pain and I was in this alone – the odd one out that never belonged there anyway.

And so perhaps a part of me cut because I wanted to hurt them and I wanted them to see my hurt. I wanted to make them believe my pain was real and not hormonal. I was sick and I needed them to see it. And so, after a few years of cutting, with some therapy to boot, I told my family. I want to say I felt sick seeing how it hurt them, and given my love for my family, it did. But it also made me see in their pain, their love for me. I know they have always had it, but I never really saw it, and I guess the cutting opened up that opportunity for me.

I’ll never regret the process of self-medicating. It’s what made me realize I needed to accept support from others, to get on prescription medication, to change my lifestyle, and eventually to get ECT. I still have the random bender where I cut, but it’s different now. The high doesn’t last, and I know now I’ll need to tell my family and I’ll be ashamed because I know how much time and effort and faith they put into me. I know that they themselves deserve more from me, and so do I.

Self-Medicating: How Can Something So Right, Be So Wrong?

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Mental illness or not, we all do it. No, I’m not talking about masturbation – I’m talking about self-medicating.

Life is a stressful, complicated, big blob of fear, anxiety, and failure, wrapped in a bomb with an unknown time limit before explosion and death. It’s no wonder people need a way to relax.

For some, they go the way of meditation, aromatherapy, yoga, acupuncture, natural and prescribed medications, exercise, and healthy eating – and I am in no way knocking these things. In fact, I have tried, and am doing, the majority of them. But sometimes, it’s not enough. And especially if you working with the complexity of life and a mental illness, it can be too much to balance with breathing exercises and a downward dog. Besides, medications are expensive and as I mentioned in my last post, take time, are unreliable, and have major side effects.

So we try to self-medicate first. For me, it started with food. I could stuff myself with food and just before I thought I would throw up, stuff myself some more. Then, by the time I got to high school and was constantly trying to lose weight, it became anorexia – trying to see how little I could eat to see how much control I could gain. But there was also alcohol and drugs. And it’s not like someone was asking me if I was okay because everyone was doing it, it never impacted my grades, I never got busted, drank and drove, or made those mistakes that some Beliebers do.

In college, I would outdrink the guys next to me and then make out with a few – trying my best to convince myself I wasn’t the ugly, worthless piece of shit I knew I was. It never quite did the trick and since I was too much of a control freak to sleep around, I started to wonder how I was going to find my release.

Somewhere around sophomore year, I found cutting, or as some call it “self-mutilation.” It was the best of times; it was the worst of times. It was the point I realized I needed therapy but it was also when I finally found a self-medication that did what I needed. I’ve tried to explain cutting to many, and I’ve learned from others that like most things, it’s different depending on the person. But I can tell you what it gave me, and why to this day I still miss it. But more on that later.

I know people self-medicate in different ways that take them on much more intense addictive paths. These paths exacerbate their psychosis, and can lead to, for example, homelessness, violence, and abusive relationships. While I know that prescription medications are not a cure-all (I’ve been “unlucky in love” with most of mine,) I think the difference is that self-medication is a short-term fix while medication and therapy seek to find a long-term solution. And given how exhausting this process is, I think the latter is what we’re truly looking for on this journey.