The Blame Game With Mental Illness

[Trigger warning: Mention of self-harm]

I met with my psychiatrist last week and told her that I have been feeling worse but I was worried that maybe it was my fault and I was somehow doing it to myself. Well actually, I started to say that and she cut me off right at “maybe I” with a sharp “No.” After apologizing, she told me that I have to stop blaming myself for my depression.

People can undoubtedly lie to themselves. For example, someone with an addiction tells him/herself they don’t have a problem and they stay in denial that their actions are negatively impacting their life. I get that. But can you be lying to yourself if you are asking yourself if you are lying? If the idea of denial in the example above is to convince yourself you do not have a problem, what is it if you convince yourself you are trying to convince yourself that you DO have a problem? Can you accuse yourself of having a derivative form of Munchausen Syndrome?

It’s an odd thing: the idea that I am purposefully making something worse; that I am sabotaging myself from recovery by somehow forcing myself into depression or not fighting as hard as I can. I interrogate myself: Is it really just fear and weakness and not a “disease” at all? Could I try harder, do more, stop whining? Do I just need to have the will and gumption and am too meek to face my reality? Am I somehow lying to myself?

But there is a part of me that knows that this is real. That leaving a job I was proud of, friends that I loved, and a life I had built wasn’t just for attention. Lying in bed in for weeks, crying for hours, choosing to have ECT, well that would be one hell of a con. Perhaps at the core of this questioning is an insecurity, hate, and long-developed distrust of my thoughts and feelings.

This doubt of my own feelings was developed over time and starts in my younger years. I was constantly told I was too sensitive. It wasn’t intended to be an insult, but it also wasn’t always used in a positive context. Rather, it was often noted as the cause of my intense feelings of sadness over anything that was bad. In defense, I was incredibly empathetic as a young child. When I was five, my mom had my dad change the mailing address of the newspaper from our house to his office, because I would read the paper and cry about all the horrible things happening in the world.

I hoped to find something physically wrong with me that would provide tangible symptoms to explain why I was like this. I remember feeling relief when I became sick – whether it was a cold or ear infection. Because when I was “sick,” I knew those around me believed my pain. And it wasn’t my fault or something I was failing to fix. 

There was always a rational reasoning for my behavior: in grade school, it was that I was being bullied; in high school, it was hormones. The darker melancholy that was growing inside me was overlooked because I didn’t believe it was legitimate and therefore never mentioned it. I assumed my constant complaining was indicative of a selfish, childish, and  weak personality defect. When bad things happened, I began to question if the amount of pain I felt was fair. Was it really that bad, or was I making it worse? Maybe my feelings were being manipulated by my selfishness?   Did I have the power to stop it?

When I got to college, I still blamed myself for my thoughts and feelings. And that’s also when I discovered self-harm. While there are many reasons why I self-harmed, I think one of them was having something to show for my pain, and it helped me feel better about my sadness. Still, I continued to chide myself for feeling sad all the time – I needed to get over myself. Other people didn’t have ideal lives and they were managing, so why couldn’t I? I still find myself asking that question.

The real problem is that even if I could convince everyone around me that this isn’t my fault, I can’t fully convince myself. In my mind, every time I cancel an appointment; take a pill for my anxiety; cry hysterically for no reason; not feel any different when starting a medication; or start to feel bad on a medication that seemed to be working for a few weeks, I worry it’s something I’m doing wrong, not the depressionMaybe it’s my fault that I am a burden, and maybe it was somehow a choice I made – though why – I cannot figure out.

And yet, I also know that this isn’t me is because I have experienced what it is like to have clinical depression lifted. When I found the medical concoction that stifled my depression about two years ago I felt so different. While I was tempted to sometimes cancel because I was scared or maybe just out of habit, I didn’t. When I was feeling anxious, I went to the gym because I knew it would help. Sometimes I would have weeks where I was exhausted from trying to change my habits and face my fears, but it all still felt possible and I wanted to try. The difference in how my mind worked was so clear. I had been functioning within this cloud of depression and it was the cause of my actions and reactions.

I know that while depression feeds off itself, it’s not me feeding it. I’m not giving in because I want to, because honestly, I really do want to be able to get up in the morning and be an independent person who can make it to work, handle responsibility, and rebuild my life. Perhaps the fact that it terrifies me to think that I could be doing this is enough to know that I’m not. But that’s the thing about depression. It wants you to blame yourself. It convinces you that you are the cause of everything bad in your life, even if it’s irrational. It tells you that you are the way you are because you did this to yourself. It tells you to stop blaming some “idea,” and take some control over your life. Then it laughs at you when you try and fail.

I just have to keep telling myself that this is the illness. This is the lack of chemical reactions and electrical signals in my brain. This is not something I can control. And this is not on me. There is a serious problem, but it’s nobody’s fault…or at least nobody’s choice.

The Dilemma of Accountability and Mental Illness

There are a lot of shitty components to being mentally ill. But one of the hardest, at least for me, is identifying accountability.

Growing up, I was told I was too sensitive and empathetic. I didn’t know why, but I was lazy, a whiner, indecisive, a drama queen. I got sick a lot.

I hated myself. I mean every part of me – inside and out. What I looked like, things I said , things I wanted, both physical and emotional. I could not stand my personal evolution and I knew no matter what I did, I never would. So when things didn’t go my way, I understood my culpability.

And I blamed myself for all of it. Somehow the fact that there was nothing good in me, nothing worthy of life, was a weakness, a failure…and my choice.

Once I got diagnosed with my repertoire of mental disorders, I was told that so much of my life was not in my control. That my choices weren’t really mine because I wasn’t really myself. The way I felt was not my fault, but rather a consequence of my disease. Okay, that’s an oddly chilling concept, but I get it.

But I still made choices that affected others. Maybe my brain was not able to think “correctly,” but I still hurt people and my life by the decisions I made. When they say “it’s not your fault” is that entirely correct? I was thinking under a depressive hypomanic state, but I was still functioning. I have lost so many friends because I never returned phone calls, text messages, and emails. My reasons weren’t rational or healthy, but I still made those choices, and in doing so, I hurt them. (Sometimes to a point where I have found them unwilling to forgive.)

So where does the buck stop? Because unlike a cold, this isn’t going away. All I can do is temper and manage my brain chemistry, try and develop and practice techniques to help guide me, and hope I have the moxie to push through the torrential shit of life.

It may not be my fault that I thought that way, but I still feel I am accountable for my actions. I didn’t care at the time because I figured I’d be dead soon, but I am still responsible for the pain I may have caused others and the outcomes that now lay before me.

So where is this line between the disease and the person? Does it even exist? At what point is it me and not my illness? Or when is it not me, but my illness? How do I know with every decision and choice I make, if it’s truly “me” making it? Is it possible to not be responsible but still accountable? Who is to blame and who must handle the fallout?

Consider me befuddled.

I’m Mad as Hell and I Don’t Want to Take It Anymore: My Latest Hissy Fit


This past week I have been angry. Pissed off. “Mad as hell.” The little girl inside my head is lying face down on her bed, arms flailing, kicking her legs and screaming into her pillow: “No! I don’t wanna!”

I’ve found over time there is such a thin line between sadness and anger – at least for me. I’m lying in bed, feeling a profound weight of sadness, and after two days of wallowing in both my depression and pajamas, I realize I’m no longer sad – I’m fucking angry.

I suppose I could be angry at my psychiatrist for still not getting my “concoction” of meds correct. Maybe I could be angry that my friends didn’t sense my depression from 3,000 miles away and call me constantly to see if I was okay. Hell, I could even be angry at my parents for creating me to begin with or for someone in my family tree for passing this disease along into my genetic code.

A) I know none of these people are to blame nor should feel my “wrath”
B) I have no “wrath”
and C) I don’t really “get” angry.

I mean, sometimes people anger me and I mutter something under my breath but I don’t/can’t actually yell at someone. Even in the car, if I flick someone off, I do it under the window so they can’t see it. But maybe that’s why my anger and “wrath” is directed to the easiest, most convenient, and easily found target: me.

Since I was bullied in second grade, I have always found a way to turn the anger I felt onto myself. I am angry at myself for letting others abuse me, angry that I allow myself to feel so sad, angry that the medications aren’t working because maybe I’m just not doing something right or trying hard enough. And I do think I am responsible for some of my pain, and I suppose I am angry with myself for that.

But obviously that’s what is so perplexing and futile about this disease, and particularly with my new diagnosis of bilpolar II. It encourages you to get a running start and then out of nowhere puts a wall down in front of you, which you then charge into like a clown, sans hilarity. It’s like your life is like the fucking Hunger Games – a gamekeeper constantly changing the course, hoping for you to fail, give up, and die. And I assure you: I’m no Katniss.

I see all these stories in the news about people who overcame the odds, changing the outcome of their lives. A man who is paraplegic fighting to get feeling back in his arms; a woman who lost her legs in the Boston Marathon bombing but ran in the marathon this year; someone who found themselves homeless and started an organization to help their community and now has a place to live and food to eat. Whatever spark of determination and drive those amazing people have, I lack completely.

I idolize those people but I am so jealous of them, it just makes me angrier with myself for not being more like them. After all, who am I to wallow when others are pushing through their disabilities and misfortunes? Even writing this, I can see the cycle of depression alive and well inside my brain: somehow all of this is my fault and fuck me for being weak; for not deserving the air I still get to breathe.

I was speaking with a friend the other day and I told her that I feel like I have spent the past two and a half years fighting to get better for everyone around me. I have pushed past suicidal ideations and wishes, undergone procedures that have pretty much eradicated the past two years of memories, and taken a variety of pills to help me wake up, get out of bed, leave the house, and then help put me to sleep. Drug after drug – and for what? I am still living at home, unable to keep a job, my creativity all but vanished, weight gained, no boys in sight, let alone to cuddle with. Where a good day is leaving the house or not having a crying fit.

And this pisses me off…again: why am I trying so hard to stay alive to get better so I can have a life “worth living” even though in truth, I never actually get to that worthy life? I spend each day just trying to get somewhere that I may never be? Am I really going to spend my life fighting, agonizing and painfully trying to just be okay but never actually move forward? Am I doing this for myself or for others? What kind of life is worth living when you live it more for others than yourself? When you stop seeing a future and only see time passing, you struggling, feet stuck in the quicksand of depression?

I believe that life, even without this mental illness, is an uphill battle; a series of events that push you to live and thus write the pages of your life. Life isn’t meant to be easy – after all, how can you enjoy pleasure without understanding pain? How can you fully rejoice in happiness if you have never felt true loss? But I feel like I keep aging, days and weeks and months pass by, and I am still on the same chapter. It’s something like:

“Chapter 30; Age 30: Ava struggles with depression and anxiety. Tries new medications. Tries to start working but must quit because she is unable to get out of bed. Tries new drugs. They give her horrible side effects. She feels suicidal. Her family and friends surround her with love but her depression impedes their efficacy. She gets up, hates herself and every imperfection she sees with each breath she takes but doesn’t want to hurt the people she loves. She takes a bunch of pills and finally falls asleep.”

“Chapter 31; Age 31: Ava struggles with depression – see Chapter 30.”

On a more positive note, a few days ago I started a new medication and I’ve felt better the last few days. I’m still anxious and having a hard time sleeping, but I wake up and while I still feel like my actions are pointless, I do them anyway. I’m not going to say I have hope because that’s a bit premature but I can’t help my brain from starting its’ bout of lofty ideas of my “future” self. I’m reticent and sad because I wish I could just enjoy not feeling like shit today. But I can’t help but wonder if tomorrow I will wake up and it will stop working. Oh…hello anger.

And yes, while I am a cynical pessimist it’s more than that – it’s the scars of experience telling me to watch where I’m looking because I don’t want to look up to the beauty of the sky where my hope lives and hit that wall again with the same ignorance I have done so many times before. (See metaphor above of running into walls.) And I’m angry because the truth is it might last and it might not, but if it’s only going to last for a little, I should forget the wall and enjoy the sky but I’m just not built to do that.

The last few days, I can feel my anger slowly turning to sadness – a good sign really. There is a peace that comes with sadness when your anger melts away – maybe that’s the medication working. And I might just have to accept this is where I stand right now. Not blind to the reality of my possible futures that include this same monotonous cycle, but also willing to look up now and again at my “sky of hope” and maybe let myself dream without the fears of walls…at least for just a little bit.