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.

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New Scientific Possibilities for Help, But Not Hope

Sometimes I question whether I just wasn’t made for this world. That perhaps I was born defective and unable to survive. Many people are born with parts of their body that didn’t fully form or formed differently; some without the necessary components to function or function fully. And lots of people, who may have these differences, adapt and manage, and do not let their difference stop them from enjoying all life has to offer.

But my “defect” is in my brain, and I can’t seem to find a way to adapt or manage on my own. Often times, there are devices and tools to support and help in this process. I have tried the “devices” for my impairment: medications, ECT, exercise, diet, sleep, and a variety of therapies, to try to work with what I have been given. But for some reason, my brain remains resistant to change, unable to manage and function at a level that is personally acceptable.

It’s been exhausting – the entire process. And since I was in my late teens/early 20’s, I never thought I could make it to 35. I assumed my body would simply get too tired of the pain and stop working, or I would have to help do it myself. But even with these dark thoughts, every so often, there were flashes of hope; moments of a belief that things could get better. And so here I am – three weeks into 35, with a new possibility for change at my chemically-enhanced door.

I have had a good year and a half where I seemed to have found a concoction that made me feel more stable. Not perfect – I still dealt with mood swings, depressive dilemmas, and uncomfortable side effects – but enough to make me hopeful that I could work to form a functional and fulfilling life. Then we changed a medication, and the past three months have been a clusterfuck of mood swings, depression, and a melange of side effects. We hit a road block in terms of options and so a few weeks ago, my doctor conferred with her colleagues to see what ideas they may have for bipolar II medication-resistant treatment.

When I saw her last week she told me about two new scientific advancements that could drastically help me get better. (Please forgive my explanations, as I am still learning.)

The first suggestion is a test for genetic markers that show what medications work best in an individual’s brain. There are five markers and they are able to indicate drugs that will work; some that might work; and others that won’t. I found a website of a company that does it called Genesight. I don’t know if this is the company my doctor is referring to – but the hope is that with this test, we will stop having to do so much guesswork with my meds, and may find out if some are actually decreasing the positive effect of other drugs in my system.

The other suggestion is the use of folate. We all know about folic acid. (Okay I didn’t, but everyone else seems to refer to it like I should.) Doctors encourage women who are pregnant to use it to help with a fetus’ growth and have noted that it could help with growth and rehabilitation of other cells. If I were to just ingest folic acid, it would go through my blood stream and I would pee it out. However, this new folate supplement called Deplin specifically goes into the brain blood stream. Evidently, by delivering the folate directly to the brain, it helps with your body’s ability to absorb medications. So for me, while I have slightly benefited, my medication is still not being fully absorbed, and therefore, I’m not actually getting the full impact of the medications.

After explaining these ideas to me, my psychiatrist asked me if I felt hopeful.

The genetic markers sound interesting, though I feel like it isn’t going to be that helpful. I suppose it would provide me with the peace of understanding that there are genetic reasons why I am resistant to so many medications. And perhaps provide new ideas for medication usage. The Deplin definitely sounds too easy. The idea that a supplement is going to help engage my medications and that would help me feel better – I suppose it just sounds too good to be true. Then again, I know people who take incredibly small amounts of anti-depressants, and it changes their life. I find myself skeptical, but willing to give it a try. However, I would not say I am hopeful.

Hope is a complicated emotion for me. I don’t always have control over my hope – sometimes I can feel it behind my cynicism, trying to push through, small bursts getting by, evoking images of peace and contentment. But through the years, it has become an enemy of my depression – spreading fallacies of possible happiness into my brain, only to be devastatingly wrong.

I remember when I started to feel better after a few weeks of ECT. I was ecstatic because I had finally found something that would allow me the chance to have a life worth living. The short term memory loss was a bit annoying, but at the time, it was a small price to pay to have the heavy pressure of depression lifted. I’d found the “piece” that I was born without, that would make me whole – the component that would provide an adaptation to survive. And then it stopped working. And then I found out it wouldn’t work anymore, no matter how many times I tried. And then I was expected to go back to the medication drawing board and start again.

I would say that’s when my trust of hope died. That’s when I started to wonder if I was just too broken, the deficit irreparable and too impairing for me to ever be able to have dreams again. Hope had hurt me one too many times. So am I hopeful? All I can give right now is that I’m not NOT hopeful. I’m open to being pleasantly surprised, but I’m not running around telling the world to watch out because I’ll be out there soon! I have a feeling even if the Deplin works, I will still need to make changes to my meds, there will still be quite a bit of side effects, as well as possible withdrawal and mood swings. I am not naive enough to think that this is “my piece” anymore. But if my doctor is telling me that my what I was feeling this past year was only a fraction of the medication working and that I could feel better than that, I’ll swallow the pill faithfully, I’ll change the dosages, I’ll try medications again, I’ll do whatever it takes. At this point, what do I have to lose?

While some people believe that hope takes less energy than despair, I think there is a key component to that theory that often gets overlooked. Because when you are in the despair, you have to work to get to that hope, and you have so many factors against you. To reach a place of hope you must push through the exhaustion, find a way to ignore all past failures, and find the strength to block out the despair that radiates throughout your body and mind, draining you, beating you down, offering the temptation of rest.

I imagine myself on the side of a sea cliff, trying to pull myself up to get to safety, knowing that if my muscles get too tired; if I miscalculate one move; or a piece of the cliff simply loosens and drops, I could fall quickly into the dark, depressive water below, possibly being killed on impact. I wait, terrified, for a surge of strength or an outreached hand.

I want to have hope that I can feel better and find a new normal that doesn’t include dire mood swings and hypomanic bursts. I want to believe that help is on its’ way. But hoping for help doesn’t save me. And frankly, I’m getting really tired of holding on to this “sea cliff,” waiting for the moment when I can stand on firm ground.

Accepting the Ignorance of Others

[Disclaimer: I do not suffer from addiction to illegal or recreational drugs or alcohol. I do not portend to know the struggle to recover and manage this specific addiction. I wrote this post to highlight the idea of understanding and respecting different perspectives when it comes to mental health, healing, and recovery in general. I apologize if I offend anyone. Please let me know if there is something incorrect so I may learn from it, and change the post if need be.]

When I was younger, I mistook the knowledge of my idealism as fact and created definitive standards of right and wrong. Maybe my mind was too young to understand the complexities of human experience, or maybe I simply hadn’t lived long enough to see the dynamics of life. But thankfully over time, I have come to see the nuance in all human interaction, and our struggle to find peace and acceptance, especially within ourselves.

I have spent so many years on my quest to manage my mental illness. I have tried a smorgasbord of drugs, therapies, and alternative remedies. Some have worked for a time, and others simply did not fit. A simple example: while I have found DBT an effective form of therapy, group therapy has never worked for me. And while I am still searching, I have witnessed so many find the concoction of tools that help them survive. As long as it does not hurt themselves or others I support them without judgment. In fact, I envy them. I also understand that sometimes, in order to maintain their health, they might proselytize. I think it is common when you have found something that has changed your life. You want others to benefit from your experience and you want to believe in what you are doing, (something I believe plays a large part in what makes it work.)

All of that being said, I was part of a conversation recently where two people were discussing options to help someone who is currently suffering from drug addiction. At the end of the day, we all understand that she will have to want to change, and will have to most likely try a variety of mechanisms to help her battle her addiction. It’s going to be a long road, and I suppose those that love her are trying to find ways they can support and provide her with options for the journey to come.

One of those people is a recovering alcoholic who found his form of AA as key to his recovery. From what I know from others who participate in AA, there are varied forms of AA – it isn’t practiced or used in one way only. I also think it’s important to mention that this person is not educated or familiar with other forms of addiction therapy and tools. I believe he has lived a rather narrow life in terms of interactions and experiences with others. (This is not a criticism, just something to note.) And while I do not think he understands the situation fully, I do appreciate his passion for the techniques that worked for him and that have allowed him to remain sober for so long. I accept that I am not in his shoes and that in his perspective of the world, he has found the right answer – not just for him, but for so many addicts he has helped along the way.

While I held back my frustrations at his simplistic and contradictory ideas of “help,” at some point, I became incredibly frustrated. I told him that this matter was not just about drugs; it was about traumatic experiences, environment, social norms within their network, and a chemical imbalance that makes her have an addictive personality. I noted that while I appreciated that his version of AA had helped him, that for others, therapy, medication, and other forms of help might be better for her and we had to keep our minds open to what might fit her best.

This is when he began his tirade about “pharmaceutical money-scheming” and “bullshit therapy.” He noted that if doctors were to actually “cure” their patients, they would be out of a job. This isn’t the first time I have encountered someone with this opinion, and I know it will not be my last. But it stung. I am currently battling my bipolar II, and given my treatment-resistant depression (TRD,) I am in a frustrating and scary place.

Also, as someone who does take medication, I do not judge those that do not take medications – I know for some, the side effects are too much for them or they simply do not like the idea. Others have had unfortunately negative experiences in therapy, (who hasn’t,) and are weary of trying it again. And that’s okay. But this man has never tried therapy or medication (there are medications that can help with weaning people off addictive medication.) While I do not have a typical addiction, though I tend to see my self-harming personally as an addiction of sorts, I have spoken to those who have, I have read articles, and I have watched those around me get better. And so while I have heard ignorant comments that insult the mechanisms I choose to use, he added injury to insult by assuming I did not know what it might be like to be in a situation where you are not in control of your thoughts, feelings, and actions.

I had so much to say. But like many women, I have been trained to cry instead of show anger. The other person in the conversation, who knows my story, attempted to turn the conversation, and I stepped outside. I was crying because I was angry at his ignorance. I was crying because while I do not know his whole story, I do not belittle his belief in G-d, even though it is an idea I do not believe in. I actually see commonalities in the various techniques used, including in AA, like radical acceptance or letting go of past resentments. But he has developed an idea about medication and therapy, and without knowing what it really is, has decided it is worthless. And in doing so, he is negating the years of trial and error, and my struggle, because to him, it’s not just about proselytizing, it’s about “the right way.”

In the past few days, I have spent time thinking this through, and most likely giving him more time than he deserves. I know he is coming from a place of ignorance, and while some people are open to listening and learning, there are others who simply can not/will not. They say they are, but they already have decided their right and wrong. I have found this to be true when I tell people about ECT. Sometimes they don’t know what it is, and if do know or find out, their reactions are insulting. Often times, they look afraid and aghast, I have had people literally take steps back. You can see their idea of you shifting in their head. I have even had doctors look at me with horror and what feels like judgment. I always imagine they are thinking, “how can someone who seems so normal, be so fucked up? Who knew she was actually crazy – I mean she let herself be electrocuted.” Some are willing to listen and learn; others aren’t. And like this man, I allow them to make me feel ashamed of my choices.

I also think his comments hurt more than usual because I am currently struggling with my faith in the process. I am frustrated, scared, tired, and my hope is dwindling. Having someone exacerbate my fear is unsettling. Both of these reasons have more to do with me and my issues, and not him. I accept that.

I suppose in my own way, I want to proselytize my reasoning for being open-minded to all voices. I have found that if I allow myself to listen to the other side, I see how much we have in common, am able to analyze and understand some of what they dislike in my choice, and while I still may maintain my belief, find value in the challenge of learning to see it from different perspectives. I walk away with the understanding that nothing in life is as simple as we might want it to be. But not everyone works that way and it is not my place to tell them to do so.

I am trying to see this experience as a lesson. An opportunity for the radical acceptance that the nuance of humans includes those that are unwilling to open their minds. Understanding that he is a complex person, that this is one part of him that I do not like, but there are reasons why he is the way he is, he is not hurting anyone, and at the end of the day, he is more than just that one opinion. And he is entitled to that opinion, even if I do not agree.

Well, that is the ideal anyway.

The Unfortunate Reality of an “Eternal Sunshine of a Spotless Mind”

“Blessed Are the forgetful for they get the better even of their blunders.”  – Nietzsche

I’m not a detail-oriented person. And by “oriented,” I mean, I can’t remember shit – from the past and sadly, often from the present. It is starting to become a problem.

Now, part of my memory loss is the depression. It blurred life and sometimes even erased it. Blocks of times, details of events, all on the tip of my brain, but unable to reach.

Naturally, ECT for almost two years most likely played a part. ECT is only supposed to effect your short-term memory and I can assure you it does. I have only a few vague memories but most are situations that reoccured often rather than a specific time. Also, when I began ECT, my sense of smell became incredibly strong. And it still is: I’m like a police dog. I mention this because it is an effect that didn’t go away, so maybe there are longer term effects of the ECT that have impacted my cognitive skills. (Note: I still would do it again, even if it has played a role.)

And then there’s the medication that my old, shitty doctor got my body hooked on, whose main side effect is memory loss. (She never mentioned that.) I’ve been on it for over a decade but last time I tried to get off of it, the reaction was so bad, I fell into a frightening depressive episode that I am still recovering from. Still, I need to get off of it soon, especially if it’s impacting my mind.

I used to like the fact that I had a bad memory…or at least I convinced myself I did. I told myself that most of the past decade was full of depression and the bad habits that go with it. Besides, I would tell myself, I am a different person now, starting life new and fresh, so who I was shouldn’t matter.

But in truth, it didn’t make my mind “spotless” and provide me with the “eternal sunshine” Alexander Pope raves about. I might not remember, but the effect of the experiences does not allow me to be set free from my past. There is no reverie to be had.

Now I realize that while I may have lost the bad memories, I also lost the good. And for me, I lost more good than bad. It’s amazing how those bad experiences burrow into your mind, refusing to let you forget. The internal scars, the essence of the memories, they stay within you. You may not remember what happened, but you remember how it felt and in some cases, how it impacts you now. When tired or weak, your mind pulls them out, tempting you to follow the pattern of your past. (Fucking depression.)

But I’ve learned to get by. I have my friends and family to tell me stories (albeit subjective stories,) of things that have happened. (I haven’t quite figured out what to do when I’m on a date, but texting in the bathroom might come to be.) Sometimes I see a photo and I can feel the emotion of the memory even if I don’t remember it. (Does that make sense?) And I try to focus on those feelings; I argue that indeed, that is the most important piece of the memory itself. Not what we ate or the embarrassing thing I did. But rather, it’s the flutter of excitement, the lightness of that moment I can feel even though I couldn’t tell you the year or where it was taken. I remind myself that that is what’s important: when I find myself smiling or laughing at a smorgasbord of tiny, faint memories.

It’s only recently that I’ve come to resent it. After all, it’s not just a night of drinking that I don’t remember; it’s a wedding, a baby shower, helping someone in a crisis. I’m ashamed because I love my friends dearly and I hate that I can’t share memories with them. I hate having to ask who this is or what’s this restaurant even though we have been there more than once. I’ll be talking to someone and say “well I’ve never done that,” and my friend will interrupt with, “yeah you have.” Luckily, I have years of experience playing a dolt, so I can usually save the situation.

And I’m angry. Because now that I want to live, (on most days.) I want to go back to loving people, having experiences, and being someone people can rely on for whatever they need. And friendships are built on the past; the moments we share form together to create the inner heart of the friendship itself.

I always hated pictures. I thought I was so fat and ugly that I avoided them. Often, I would agree and then sneak out just before someone took the shot. And now I regret that. Because even though I know I might look at the photo and think I look disgusting, it would have helped as a marker in my “emotional memory” bank. I was so busy hating myself, I missed a captured moment of love and laughter. Luckily my “regret” bank is open and operational.

I’m getting a neuropsychological test done next month. It just feels like things are getting worse. Mainly, my cognitive skills have slowed. I can’t find words; if I take a breath in a sentence, I forget what I was talking about; I find I can only do one thing at a time in terms of information absorption; the more I try to focus on someone speaking, the less I actually absorb. If I’m driving and you try to give me dates of when you’re visiting, it’s a waste of your time. I’m also slower and my concentration is for shit. That’s probably my meds. It’s annoying, but I can make it work.

Maybe I’m just an airhead – I believe that was one of my “titles” as a child. You take that natural trait and add medication and perfectionism, and maybe you get my situation. But whether I go to school or get a job, life requires memory – both the past and the present. I’m scared that I will go to work, and I won’t be able to remember things. My wit and humor, which I have relied on, can only get me so far before my dumb-founded stare avails my ignorance. If I go to school, I will be with some of the brightest minds in the world. It’s going to be fast and it’s going to be intense. I don’t know if I will have the brain capacity to keep up.

Memories would help.

I feel like I am missing parts of myself. Pieces of me literally blurred out like in the movie Eternal Sunshine of the Spotless Mind. Looking into the past can’t fix the present. But as I am becoming a “new” self without clinical depression, I find myself often asking “Who am I?” And I can’t seem to remember who I was, to help in the formation of who I am.

I miss my memories. I miss my life. Warts and all.

 

The Disadvantages of Being a Blank Canvas

I used to write poetry, as I suppose many emotionally-wrought young adults do. I remember how intense the words felt, how little I had to try – the release of my pain, my frustrations, my truth just spewed out of me.

I decided to read my poetry today. I think most of it was from college. I remember how soothing it felt to put my emotions on the page. But my goodness, it is truly awful shit. My metaphors are painfully melodramatic. I wrote about things I only understood from movies. I was tangential – though that hasn’t changed.

Since I’ve been on medication, at least when it works, my creativity seems to evaporate. When creative opportunities arise, my mind is blank.

Those with bipolar I often say that medications drain them of their creativity. And many of them refuse to take medication because they fear losing that integral component of themselves. The mania, for many, has helped define their selves, their passions, their art. I have bipolar II so it’s not the same thing in terms of hypomania. However, I do believe my medications dull my mind.

I kinda miss it: the intensity of it all. I think it was indicative of my resolve to find a way to still get what I wanted. I was yelling then – in my behavior and actions: “Someone listen. I am in pain and it is killing me. I want things like love and laughter and all I feel is rot. And I fucking deserve those things. My gentle, loving soul is slowly vanishing and I don’t know how to stop it. This is bullshit and it’s not fair!” I was angry at this disease and how it punished and controlled me. I just wanted it to go away. I’m still angry I suppose. Frustrated by the damage, the uncertainty, the lack of control.

But there is a sad acceptance nowadays. Maybe after medications, ECT, countless attempts at different therapies, efforts in life changes (in diet, exercise, sleep,) I’ve come to a melancholy understanding of the possibilities in my life and the restraints that come with the mental illness that will always be a part of me. Funnily enough, I think I know less about myself now than I did then. Back then, even with all the self-hate and self-harm, I still felt like I knew who I was underneath the depression. But maybe, living so long with the depression, it had come to define me, mold me, make me. But now the depression has lifted and I am, much like my brains’ creative canvas: blank.

 

Who Am I: A Life With Fleeting Memories

I hate filling out medical history forms. I don’t remember family history, or what year I saw a doctor, what medications I have taken, surgeries I have had.  In the past few years, now that doctors have online patient portals, I can look stuff up online, but otherwise, it’s a call to my mother for a history of all things about me, my body, and my mental health. As I was filling one out yesterday, I became incredibly agitated and sad. Then this morning, I had to go over dates for my upcoming move to London. I had prepped this stuff when I thought I was going last year, and while everything felt familiar, it was annoyingly still new. The dates were on the tip of the tongue, I just couldn’t pull them out.

When I was prepping for ECT a few years ago, one of the possible side effects was short-term memory loss. For a lot of my friends, this seemed like a scary prospect: to not remember what happened the day before or even a few hours ago. For me, I was at a point where I didn’t feel like I was creating memories anyway, except for maybe sad ones that involved me lying in bed, angry at every breath that continued to push its’ way in and out of my diaphragm. I went three times a week for about a year. A few months in, we noticed some changes. I might ask a question and then half an hour later, ask it again. This was usually on the days of the treatment itself so we would laugh it off. As for the blur of memories of that year, it wasn’t like much was happening. Monday, Wednesday, and Friday, my mom got me up early, I changed my pajamas into other sweat pants, and got in the car. I had the procedure, slept in the car, got back home, usually slept some more, and then watched tv until I fell asleep. I’m not sure what I did on the days when I didn’t have the procedure. I might have walked the dog, or driven in the passenger seat while my mom ran errands. I realized that the tv I was watching, the books I read, probably would blur. Conversations with my friends probably drifted off after a day or two. I probably should have kept a diary so I could reflect on it later.

After about a year of treatment, I was feeling better and I decided I wanted to go back to the world, happy and healthy. I took a job a few hours from home. It wasn’t what I wanted to do, but it was something I was familiar with and good at doing. I continued to receive treatments every couple of weeks, though I’m not sure how I did that, since they didn’t offer them on weekends. Evidently, my memory got worse. My mom told me I would call in a panic forgetting where I placed a file on the computer. I don’t remember this but that’s what she said. And I was starting to get depressed again. It could have been because I didn’t really like the people, the town, or the stress of the job. I knew I was doing well and that people liked me, but I could feel the depression coming back in. I started missing more and more days, until it became weeks. I finished the project and quit. I came home to continue doing treatments full-time. It was at this point, the treatments stopped working and I was re-diagnosed with bipolar II.

But in all honesty, the memories I miss most are not from ECT. Most of my childhood through college, and then my seven years in DC, a year in Berkeley, and the two years after the year of ECT. So yeah, pretty much my life. Sometimes I think I have a memory when I look at a picture, though I’m not sure if I’m just looking at the picture and envisioning a memory from it. Sometimes I tell a story about my childhood and a family member tells me that it was actually them that did that or it wasn’t like that or that never happened. I remember specifically horrible times. When I was bullied as a kid, the times I have been sexually assaulted, some of my self-harming episodes. Mostly, I remember feelings. Like when I think about someone, I get a feeling inside. Or when I think about a time in my life, I have a sense of how moments made me feel. My friends might describe a night in college when I did something particularly ridiculous – I usually don’t remember the moment itself, but I can remember that feeling of doing something ridiculous – the high of making people laugh and feeling free to be myself.

I don’t remember a few weddings – just what others have told me. I barely remember my best friend’s wedding and I was the maid of honor. I recently caught up with someone I haven’t seen for five years and evidently, I did some amazing things to help her while I was in DC.

I also don’t remember things people have told me. Stories of my grandparents, family history, names of people I have met, people I have had coffee with, conversations I have had with people, things I have said or done.

I joke that my best friend and my mom are memory banks for me. I call them sometimes to ask if I went to something or if I liked something. If I had a feud with a certain person or why we no longer kept in touch. Sometimes I will complain about something from my childhood and my mom will tell me that they did actually do something or it wasn’t how I remember it to be.

I laugh it off, but the frustration and irritation lingers and grows. I not only feel I have lost something precious, I feel bad for my friends. They had me in their life-changing moments, and I can’t even remember the speech I gave, or what conversations were had. I know I was there, but can you really share a moment if you can’t remember it? For the most part, I have tried to take this all in stride. I believe the depression blurred a lot of my past – making my memories lose focus, and become distant until they faded. I don’t know if the ECT has anything to do with any long-term memory – they say it’s only short term. For most of my life, we all blamed it on me being an airhead – and that is true. Sometimes I really am listening but almost too hard and I don’t actually absorb the information. I avoided pictures most of my life because I hated looking at myself so I have few pictures to help me store my memories. I rarely kept journals, only when I was really depressed, and in college, I evidently expressed myself through poetry which I can no longer access because Microsoft has some shitty software problems. Most of my time in DC, I complained that I didn’t want to remember – but now there are documents I created, bills I helped fight for, and I can’t even remember unless I look at the date and know I was working at the organization at that point.

I tell people it was all worth it. That maybe that was the sacrifice I had to pay. Maybe it was my brain’s way of protecting me. Or maybe it was depression’s way of punishing me. Maybe my brain is picky, and only maintains what I need to know when I need to know it. Or maybe I’m a free spirit and I live in the moment or some bullshit like that. But the truth is, I miss my memories – good and bad. I feel so empty sometimes, just a body of emotions. It’s embarrassing to look through my contacts and not remember why I know someone, or worse for someone to contact me and I have no idea who they are. I hate having to rely on others for my memories. It’s not that I don’t trust them, but memories are subjective. I take what they say as truth, but deep down I still wonder if maybe I do remember it correctly – and they just remember it their way.

I’m about to embark on a few intense adventures and while self-doubt is a learned trait, I think that my memory loss scares me as well. What if I don’t remember how to write as well? What if I don’t remember what I have learned, or worse, what I am going to learn? I have to write a dissertation, read tons of books. I will be living in a fast-paced environment. It will be an intense, fast year of my life and what if I don’t remember it? What if all the medications, the depression, the ECT – what if it has changed my brain chemistry and I have limitations now that haven’t been tested but I will soon find out through my failure – either at a job or in school?

Not everyone has a rock solid memory bank. While a lot of people I know do remember quite a bit, I was talking to my sister the other day about our childhood. I mentioned that I can’t remember us spending time together growing up. That maybe I was wrong, but I just remember her being gone, and by the time my memories do start, she was already disconnected from the family, out of the house. She told me she doesn’t remember much of childhood at all, so she can’t really tell me if we did spend time together or not. She might remember a memory here or there, but not much. She didn’t seem upset about it – I suppose she knows the main components and remembers what she needs to, and I know she remembers other aspects of her life. So maybe we all just blur parts of our childhood.

But it makes me feel like a liar. I tell a story and I wonder if it’s the truth. I try to express a relationship to someone or to explain a person’s personality and I wonder if I should be trusted. I know at some point, I knew the time and circumstance for each of my self-made scars. Now, I only remember a few, and I don’t even know if I’m right. I’m not planning on having children, and I suppose maybe I will need to get over my self-hate and start taking more pictures of my life. I don’t know if I will never be able to really store information long-term. I don’t know the implications in the long-term, devices I may have to employ, the radical acceptance I may have to have.

I hear people talk about the time when they were five, and I crave to tell a story as well. I keep a general diary card for DBT and my coach will ask what happened that day to make me feel a certain way or give in to a certain urge and I can’t remember. I suppose I could keep copious notes, that’s probably the solution, but I’m bitching now, so no need for thinking rationally.

What I do know is that for the first time, I am angry about it. I suppose that is a good thing – wanting to be in a place in life where I care about remembering. But while I believe we are who we want to be, I still think our past plays a large role in who we are. And if I can’t remember my past, then how can I know who I am, what I have become, what I don’t want to become, and who I strive to be? I feel like an outline, a resume of facts and vague overtures of experiences. But at my core, I feel empty and for some reason, a liar within my own body. People see me but I feel paper thin, merely an echo, an imprint of the experiences that have formed me, but which I cannot remember.

Shock it to Me: Me and My ECT

Disclaimer: So clearly I’m not an expert on ECT. I’m just one person who did it, and have some opinions on it. Take it or leave it. Also, this is a long-ass post. Feel free to skim or ignore.

Ok, I know it’s not a well-known procedure but wow, you’d think with all the mental illness coverage in the news, people would fucking … nevermind. why actually know what you’re talking about before you judge it? where’s the fun in that? it’s almost become “unamerican” now to not judge a book by its’ cover. ECT gets such a bad rap – and it’s so uncommon. If people were dying left and right, I could see why people are so terrified, but the disgust people show when I mention it, it’s just so unfounded, uneducated and rude.

There’s a long, not always glowing, history behind electroconvulsive therapy. It started basically as a way to completely erase people’s minds, and was used as torture starting in the 50’s. (I’m not a historian and too lazy to look up dates, so consider this a generalization.) However, like most cutting edge science, it takes time to figure out the best way to administer a treatment. How many vaccines killed people before they figured out the right antidote? How many procedures of the heart, lungs, pancreas failed miserably before they could do transplants, remove polyps? How many people still die today due to unforeseen complications? Any time you have a procedure, there’s risk. ECT is not terribly higher than other procedures – I think that’s just a misconception.

And as we mentally ill know, scientists are still way behind when it comes to the brain. They study the shit out of it, and come to a lot of theories, but it’s still such a complicated piece of machinery and no one quite knows how it works. After all, what makes me bipolar II and someone not? Why do some medications work on some people and others with the same illness have no relief? Just like each one us, the study and research behind medical advancements in mental health take time, missteps, trials, and perseverance. Ok, I’ll step off the soap box now.

So why did I choose to get ECT? Let me tell you, it wasn’t at the top of the list. I had been on medication since I graduated college. I went through the alphabet of drugs – since there’s no real “test” to know what illness you have, doctors generally give you meds until one works and then treat the other symptoms and side effects with other meds. For a while there, I couldn’t even keep track of the drugs I had taken. At this point, most drugs sound familiar. I hated my psychiatrist in DC, but I was too depressed to change. Besides, nothing was working and it gave me someone to blame besides the illness which felt like a part of me, which I already blamed enough. Needless to say, I’m shocked I lasted as long as I did before my breakdown.

By the time I moved back home to California, I was a mess. I didn’t have good weeks – I barely had good days. And I was going to be turning 30, only I decided that I wouldn’t. At the time, I had found a psychiatrist who was amazing – even though the medications weren’t working, she was thoughtful, and went above and beyond to think of ways to help. But I think at a certain point, we felt like we were out of options. I had tried medications and DBT and therapy, and nothing seemed to work. I was getting worse and my birthday was approaching. She had actually done her residency with a doctor who studies and performs ECT and brought it up.

I didn’t really know very much about it, besides “One Flew Over the Cuckoo’s Nest.” I read “Shock” by Kitty Dukakis and I sat down and thought about it:

  • There is a tiny chance of death, like most surgeries anesthetic complications, etc. But I was planning on killing myself so if this was the worst case scenario, what me worry?
  • It could effect my short-term memory. I had completely destroyed my life – why would I worry about forgetting if I had gone to the store or not? Besides, I’ve been an airhead since I was born.
  • I could have headaches after the procedure and possible body aches. Well, my depression was giving me severe migraines, and at the time, any pain felt deserved.
  • ECT is still viewed as “freakish” and “horrific” in society. Yeah, well so was my life.

Now maybe I got lucky, and maybe my memory is fuzzy, but when I think back to my time doing ECT, I have great memories of a calm, positive time in my life. My doctor was a genius. Plus, he had this amazing combination of being serious and then cracking a dry joke out of nowhere. The nurses never looked at me like I was a beaten puppy. They asked difficult questions but there was no judgement in their eyes. I have shitty veins, so I do think when they saw me, they probably played rock, paper, scissors to find my vein, but they knew my name, smiled, and I developed a pattern that they all knew. My anesthesiologist – I wanted to adopt him as my uncle. Turns out my family actually knew him, but I didn’t remember him. He was this sweet, cuddly man who was light-hearted, but confident. I just trusted him completely.

So every Monday, Wednesday, and Friday, my mother would wake me quite early in the morning and drive all the way into the city. (Yes, she received her 8th sainthood medal at this time.) She would sit in the waiting room but she loved it (unless she lied to me to make me feel less guilty but I choose not to dwell on that) – she got to drink coffee and read her library books which she generally never got around to when she was at home. Meanwhile, I changed into my robe and the doctor came by and put my tres fashionable stickers on my head, chest and foot.

They’d wheel me to a room and I would see the post-op nurses and we’d exchange jokes and pleasantries. Everyone on the medical team had this ongoing joke with me. Well, they thought it was hilarious – I smiled because hey, these people had my life in their hands so whatever they want, they get. So when I first saw my doctor, he asked for my allergies. I was nervous and when I get nervous I tell the truth – but like way too much truth. So I mentioned that I was allergic to eggplant. Clearly this is not a problem in a surgery situation but every time I wheeled into the room, there it was – Allergies: latex, codeine, eggplant.

They gave my fentanyl, which honestly, is the best drug I have ever had. If you could have a crush on a drug, it would be fentanyl. Anyway, they check all your vitals, and stick all the cords into your head and chest, etc. I can’t imagine how awesome I looked. In the past with ECT, one of the problems was that they gave the seizure and people’s bodies would obviously seize as well. Hence, biting their tongue or hurting themselves accidentally and having major muscle aches afterwards. I don’t know how they do it, because doctors are magical beings, but they have now figured out how to temporarily paralyze the body except for the right big toe. When they are attempting to find the right level to engage the seizure, the big toe moves and they know from that and the screen that the seizure is occurring.

Now I’m one of those people who overcompensate my fear when in front of others so I was always making jokes and teasing. But I was always scared that they would start the procedure before I was fully asleep. Totally irrational but scared every time. I told the nurse the first week I was there to promise not to start until I was out. She promised me and took my hand. From then on, every time I went in, she held my hand as I counted backwards. Evidently, the procedure only takes 15 minutes. Pre-op and post-op are what take so frickin’ long.

I was friends with the post-op crew – they knew what I liked after and how to help when I had the occasional headache. They would let my mom come in and visit me, which was actually the hardest part just because – I can’t really describe her face. I imagine it’s frightening to have your daughter have “surgery” three days a week for months on end. And while I was feeling better, she also saw my memory slip a bit, my headaches, and I’m her baby – I just felt like I saw all that on her face, all tied up in an attempt to look brave and happy.

I’d usually go home and take a nap until the meds wore off. I couldn’t drive, but as I started to feel better, I would sit in the car while my mom ran errands. I started to have dinner with my family, until I remembered that meant eating with my father. I started taking the dog on walks. I called my friends.

I had found my cure and I didn’t care about the side effects. I didn’t want to die anymore, and the deep pain had passed. I was high on hope and it was awesome. The more I did it, the more I did notice my cognitive skills slipping a bit. I would ask my mom a question and then ask again five minutes later. We assumed it was ECT and made tons of jokes, but honestly, I still do that sometimes now – like I said, born airhead. I guess I started to feel cured. I was ready to get my life back. I wasn’t in therapy or on meds but I started to look for jobs. I had to stay in California – if I could have had a leash, I think my mother would have bought one. I had scared the shit out of them, and I think they had more trepidation than I did. I don’t think I was numb, but I definitely wasn’t how I am now.

I thought it was my new normal, I felt lighter, calmer. I got the job, and it was two hours away. Once I got there, I started to feel like shit again. So I started trying to go home every other week for a treatment. That was when I noticed I would come back to my job and I didn’t feel better. I just started to feel worse. I also couldn’t remember where I had saved documents.

I called my doctor in a panic – I was slipping again. We tried more treatments and then he and my psychiatrist gave me the news. See, ECT is really good for schizophrenia, major depression, and bipolar I. And I had always been diagnosed as having major depression. But bipolar II, which I had never heard of, had a caveat with ECT. It would work the first time, but once you stopped, if you went back, it wouldn’t work. In fact, it wasn’t until then that we knew I had bipolar II, which in the end was a blessing because it explained why my meds weren’t working and I probably wouldn’t have found the cocktail I have today.

But at the time, I was devastated. My safety net was gone. I couldn’t remember shit. I hated my job. I was back to my self-harming ways. I kicked ass at my job but I went home and just laid in bed under my covers. I avoided all my friends and left really vague texts with my mom. I finished the event I had been planning and then started to miss work. It was Washington, DC all over again. I quit my job, came home, and then spent another two years in bed, trying to find the right medication mix before I decided to stop trying.

The rest is history and irrelevant.When I speak to people about ECT, I talk about it with joy and hope. While it wasn’t the right fit for me, I saw it change people’s lives, and for a bit there, it saved me from myself. ECT is not a cure-all. It will not fix you completely. You will still need to supplement it with medication, therapy, exercise, the whole song and dance for mental health quality. But for those of you who have tried and just can’t get up anymore. For those of you who are just hurting everywhere and it feels like it pulsates from every pore of your body, I think it should be something to seriously look into.

They are constantly improving, understanding the brain more and more and making the treatment faster, more effective, and with less side effects. They are researching the shit out of it and kicking ass and taking names.

II know this sounds weird, but I miss those days. Between the depression and the ECT, I really don’t remember most of the last decade – but most of the memories were shitty, and the good ones my friends and family tell me about. I am happy with my current set-up of medication, therapy, and besides this insomnia, keeping my body healthy. I have bad days and I go to the gym when I don’t want to, and I deal with the side effects of my meds, and I push past my anxiety as much as I can to take steps towards finding myself. And it doesn’t feel quite as good, but it feels real. Not having clinical depression, it’s like redefining a life I never knew I could have. It certainly isn’t perfect, but there is some hope, some laughter, and hopefully a future.

I see so many people in pain, who could be freed from their agony. i see people taking medications with such severe side effects and I just think – if only they would try. While ECT stopped working for me, it was a blessing, not only while I was doing it, but because it helped us see that I actually was bipolar II, change my medications, and now I feel so much better.

I truly believe I would not be where I am today without the ECT. I would not have survived to be able to fight today, tomorrow, and hopefully into the future. So yeah, I’m e.c.teed_off and proud of it.

Finding My New & True Voice

 

So remember how last year I got into that school in London but decided not to go because I didn’t think I was ready? Well I reapplied again, and they let me in again. I wasn’t supposed to find out for a few weeks and have been trying to prepare myself. Needless to say I wasn’t ready for it today. Best laid plans, I suppose…

I get in the shower to get ready to go see my psychiatrist. And I just start sobbing. You know that sobbing when you aren’t breathing and no noise is coming out, but your mouth is just wide open, as if the pain is just this black smoke slowly creeping from your mouth. Do we call that sobbing? It feels like an aching echo of pain.

I find myself in a fugue state. I’m getting dressed, getting in the car, but I’m out of my body. I can’t even remember if I put underwear on. I can’t think because I can’t seem to slow my brain down long enough to pick a topic to think about.

And then my mind stops and I begin to think. See, technically, since I have pulled out from the depression, I have moved “forward” from my depression. I finally got out of bed, started keeping appointments, analyzing past experiences, trying new things, losing weight. I have been taking positive steps to a healthy life. But I have no job, no friends, no hobbies. There’s no one to call to share my news, giggle about boys, drag to a museum exhibit. I know that when I had that life I was fucked up. I was self-harming, and drinking, and fucking with my diet and my body. I would hole up in my room for days, not showering, not responding, unable to move. But I had a life.

In fact, I’ve never even know a “life” without depression. I can’t dream of my “perfect” world because my only reference of having things I want is from when I was clinically depressed. All I have to show for it is the life I have built so far – and that is really not a life, but a daily process of trying to stay healthy – physically, emotionally, mentally.

In 2012, I decided I was going to die. And so, from 2012-2014, I received ECT treatments. I voluntarily allowed someone to give me seizures three times a week for over a year. It’s only been 4 years since then. It’s only been two years since I told my mother than when I turned 35, if we hadn’t “resolved” my depression, I was leaving and she needed to prepare. And now, I am 7 months from turning 35 and I am debating whether to move to London? I’m just totally boggled at where I am right now.

I mean – what the fuck? I’m better but I’m not whole. I don’t know how to be whole without my disease. I don’t know if I can be better and be whole. I can’t tell if I might finally get both and then my medication will crap out on me, and I will fall too far, and this time, just refuse to get back up.

Man, I hate hope. It’s such a manipulative monster. Then again, so is depression. Hope makes you want – desire, happiness, passion, joy. It fills your mind with possibilities and “what-ifs” that don’t end in tears. I’m so fucking scared right now, my fingers are shaking.

I feel so selfish to even feel this way. I mean, this is what we all want, right – to be better? I wonder how many people actually get “better” and go to their psychiatrist just to “check-in” but they actually are living functional, content lives. I mean, I didn’t actually think that would ever happen. Not in reality. I don’t know whether I can handle another breakdown, but I also will never know if I can find a life worth living if I don’t try.

And the weirdest part of this whole thing, is that with all of these achievements, my urges to self-harm have increased. I keep trying to protect myself from letting go and believing good things can happen. I don’t trust my own voice because for so long, it wasn’t mine. It sounded like me, it came from within me, but it was my depression. Do I have a voice? What does it sound like? Can I trust it? How do I know it’s my true voice?

 

Memories Erased: A Life Forgotten

My best friend of 16 years, came to visit me this past week from the East Coast. As we spent time together, we “reminisced” about college, our time in DC, and our lives since then. As we spoke, we both realized I can’t remember shit. And it’s not just because I have a bad memory, drank a lot in college, or had ECT two years ago – though those all have played a role I’m sure. But I think the depression blurred all my memories into just this swirl of images and deep, painful feelings. And I miss those memories. I miss hilarious debauchery from college; embarrassing nights in DC; weddings; deaths; adventures abroad and stateside. I also don’t remember a lot of my life since I’ve been home. I don’t remember how to get places from my childhood, or people that visited while I was suicidal, or even how to get to where I lived when I first arrived three years ago.

It’s hard listening to other people tell you about your life. Not because I don’t trust them – even if they lie, as long as it’s funny, I don’t care. It’s that I can’t remember a hysterical incident or watching my best friend marry the man she loves. I can’t remember how I set a friend up with her now-husband, or a gym I went to two years ago. Sometimes I get images, or I look at pictures and I feel emotions about the events, but I think a lot of times, I’m manipulating what people have told me into an imaginary memory.

I mean, I remember that we laughed hysterically. I know for a fact that I made an ass out of myself repeatedly. I know that I was so happy for all my friends who found their loves and that my toasts killed. I am so thankful for their love, devotion, and support which I can feel even if I can’t remember exactly what they said, or when, or where.

But I feel so empty without my memories. They are a testament to a life lived. For me, depression is not living, it’s just being. And every time I can’t remember something, I feel like it’s a part of me that was taken away; stolen violently from me to be replaced with images of searing pain and endless crying.

When I mention my loss of memory, everyone always assumes it was during ECT. And yeah, it fucks with your short term memory. While I was getting ECT, I don’t really remember the other things I was doing. I do remember laughing because I would ask the same question twice within a ten minute period. I know I relied heavily on my mom to keep track of the days. But nothing was happening during ECT that really needed to be noted and stored away. In fact, it wasn’t until I got a job and tried to keep doing ECT that I realized I couldn’t actually live a productive or meaningful life while I was doing it. But those aren’t the memories I miss. It’s the ones stolen by this wretched, unforgiving disease. The good ones. The ones you pull when you need to laugh or remember why you forgive someone after they’ve done something mean.

Every year my dad ages, his stories become more and more embellished. Instead of being a faculty member in a story, that person is now the dean. Instead of him watching an event, he was actually there doing it. At times, I can’t decide whether I’m angry at him for lying, or sad that I think he actually believes what he’s saying.

I’m not one to embellish. In fact, I tend to downplay stories rather than pull out narcissistic exaggerations like him. However, I worry that my memories will be manipulated. Like myths and bedtime stories, my life will be put together through the tellings of others. And now, that the cloud of depression has lifted, I haven’t many things that I want to store in my memory bank. A few lovely occasions, one or two kooky nights, maybe a phone conversation that made me feel loved.

I hope to add to that memory bank – to start living a life and have stories to tell from my perspective. But if we are the sum of the experiences that have made us who we are, then no wonder every day I struggle with the terrifying feeling that I still don’t know who I am or who I want to be.

I guess I should have kept a journal.

Finding Your “Path” With the Baggage of Mental Illness

“Purpose, it’s that little flame, that lights a fire under your ass.

Purpose, it keeps you going strong, like a car with a full tank of gas.

Everyone has a purpose, so what’s mine?”  -Avenue Q

I’m not sure when they start or who exactly embeds them within us, but at some point, we start to think about the possibilities of our future. As young as grade school, we dream of what our lives might look like one day. I always wanted to be one of the classics: a doctor, a lawyer, an actress or a journalist. And as a child, I was lucky enough to think that all of these paths were possible. But slowly, as your mental illness kicks in, you begin to grasp who you are and what your expectations for life can be.

For me, by high school, I realized that my self-image issues were always going to get in the way. I stopped believing people who told me I was good at things, because I started questioning whether I’d ever be good enough anyway.  I told myself that if I couldn’t be good at something, I would at least do something I loved, but I never really believed that. I always knew that I would never be good enough even if I didn’t know what that “enough” was. I had opportunity all around me, but I was petrified of picking a path, should it be the wrong one, and avoided it at all costs. I knew that expectations were simply set-ups for failure: I would set them too high, and if I could reach them, then clearly they weren’t high enough.

After I left my life in DC and started receiving ECT treatments, I wondered how I would ever be able to get back to the life I had built in the seven years after college. It always seemed so mediocre in my depressive spirals, but after having to give everything up, I realized I was working in a field I was passionate about, I was excelling according to my superiors, and doing it all with amazing friends to boot. Could I ever get that back?

A few months into treatment, someone suggested that maybe I needed to change my expectations for my future. And while they didn’t say it, I believe they meant, in the best way possible, to lower them. That maybe I would never have a job at an organization like before, maybe I’d never be able to work 60 hours, or walk the path I had started to develop for myself. That even though I had never fully reached the expectations I had currently set, they were too high for someone like me. This illness would never let me reach certain expectations ever again.

About 6 months ago, when I had to leave another job, I was told a metaphor that I believe in, though I still fight to accept. After having a debilitating breakdown, it’s like you are in kindergarten again. Your goal is to paint pictures and play at recess. And doing that, is considered a good day. But if you’re in kindergarten and you start wondering why you aren’t doing the math problems the fourth graders are doing, you are of course going to feel stupid. And, if you try to do that work, you will feel like a failure simply because you aren’t ready yet. I was comparing myself to my peers who lived on their own, had jobs, boyfriends or husbands, who seemed to have their life and their expectations met. I couldn’t compare myself to them because they were metaphorically in college, and starting anew, I was still in kindergarten. While I intellectually understand that, I worry about my future: how do you know when you should be ready to move up a grade? How do you know if it’s too soon or if you’re not challenging yourself and dwelling in a grade too long? What if I will never be able to get to college again? Do I have to accept this? Is this my destiny whether I want it or not? (Okay, enough of this metaphor.)

If I have to change the expectations for myself, what should they be? Will I never work again? Does it mean I have to work part-time? Stay close to home? Do something that isn’t too stimulating because even though that’s what drives me, it also is what can burn me out and lead to another breakdown? Do I have to accept less in order to maintain my mental health? Will I never be able to find my path because I can’t actually be on that path with a mental illness?

Expectations are dangerous, but they are also important. They are what give us purpose and drive. They are what dreams are made of. And that hope is the difference between living and dying. I worry that one day I’ll stop dreaming a possible content life. Maybe not a fairy tale ending but a life I can truly accept. And will I ever be able to accept what this looks like – or will I forever feel I have had to give up my real dreams and settle.

I’m not there yet but I will say that each time I fall, I feel like it’s harder to get up. Each time my meds fall out of whack, my faith in reliance of medication cracks a little bit more. Each time I can’t get out of bed or have a bad day, my hope for myself and my expectations deteriorate more and more.

What I can say is that coming out from a breakdown isn’t like a fresh start. All of the wounds from before are still with you, just like the scars I have from each burn and cut I have given myself over the years. I want to say that I will find the right medication, the right job, the right guy, and the right path. That one day I will be able to accept not only my “expectations,” but also my life for what it is. But I also fear never truly feeling safe enough to trust myself to develop and maintain these things that all lead to a fulfilling life. I’ve seen what losing a job you really like can do. I’ve watched myself be unable to care for myself in the most basic way because I have been unable to get out of bed. I’ve seen myself hurt those I love most by my actions, and worry I’m starting yet another cycle of eventual failure.

I know that human resilience is based on hope and I can only wonder if my young heart full of beauty and innocence is still there underneath the scars. I can only hope I find my path before it’s too late and that I can still follow it, mental illness and all. I want to find my purpose, my path, my life content – but as the song “For Now” in Avenue Q also says:

“Don’t Stress,

Relax,

Let life roll off your back,

Except for death and paying taxes,

Everything in life is only for now.”