Mental Illness in Entertainment: Six Feet Under

I recently binge-watched “Six Feet Under” for the first time (Michael C. Hall and Frances Conroy being the main draw, though my backup plan for life since I was 15 has been mortuary school) and was overall impressed with the show’s treatment of Billy, who has severe bipolar disorder with psychosis. However, though Jeremy Sisto’s* performance was excellent, I had a hard time fully enjoying it because of the painful memories it dredged up—not because of his behavior, but because of other characters’ reactions to it.

As I’ve mentioned several times on this blog, I wasn’t properly diagnosed until I was 24 years old, a full sixteen years after the initial onset of my symptoms. (The disorder is notoriously difficult to diagnose in children and teens because teens are stereotypically “moody” and, in my case, mixed episodes in children can look a lot like run-of-the-mill temper tantrums.)

The result is that in both of my long-term relationships, I’ve been accused of being manipulative and even emotionally abusive simply for expressing my needs. Most of you can probably relate to how difficult it is to reach out for help when you’re struggling, and I’m not sure how telling a loved one that I was worried about hurting myself and didn’t trust myself to be alone counts as either. Each time, I felt guilty beyond belief for making the person in question cancel plans to sit at home with me when I couldn’t stop crying and generally was not much fun to be around. But at the same time, I doubt many people would begrudge, say, a cancer patient for needing company on a bad day.

It’s true that at times, my behavior was what most people would refer to as “a little off,” and I am horrendously embarrassed by it. I try not to look back at the things I said and did back then because I know that my illness was the culprit and that I was not at all myself.

I take comfort in knowing that I’m stable now and haven’t had a major episode in over a year. I am in a relationship again, and though it’s in the fledgling stages, it’s actually functional and healthy and I can handle prolonged absences (my fella travels for work quite a bit) without panicking and worrying and feeling intolerably lonely. For the first time in my life, I’m experiencing true emotional independence. I’m able to take care of my own needs and create my own happiness. For the first time in my life, I am not hinging my happiness and emotional well-being on a man. I actually have object permanence and can trust that he’s going to return and not suddenly decide he no longer cares about me. I have accepted that if that ever does happen, it’s not my fault. And while I appreciate his presence and that he augments my life and has affected it in a very positive way, he is not my entire world.

This is a huge step. I’m pretty much the last person I ever expected to see in a healthy relationship, but amazingly, I’m managing to pull it off. The entire experience thus far has been incredibly healing, and with each good experience, each good day, I am learning to forgive myself for the past.

Since it’s official now, here’s a super-cute picture of us. :3

* On a lighter note, does anyone else think he totally looks like Kevin Rowland? (Check out the video for “Come On Eileen” by Dexy’s Midnight Runners, then tell me I’m wrong.)

Return of the Dark Core

About ten minutes ago, I was standing in the kitchen trying to eat a bowl of strawberry ice cream. My hands were shaking so badly, I could barely even hold the spoon, and then the dark core started its shit again. I’ve been feeling anxious, guilty, and extremely depressed lately—I shouldn’t have to add this qualifier, but I feel sad for no reason. Or rather, no reason that others can see; my brain chemistry has decided to take a dive again and I think I’m in the beginning stages of a major depressive episode.

We’re struggling financially right now and I’m still feeling a lot of guilt and self-loathing for not being able to work; I know those things don’t help. My meds aren’t quite right but I can’t go see my psychiatrist until I get my lithium checked. He fucked up the lab sheet again and the clinic I go to won’t take it without a time written on it along with the date, so I’m not sure when I can have those levels done. I’ve stopped going to therapy for the forseeable future because our deductible just reset and we can’t afford it.

In short, things are not going that well these days.

My cycles have been getting longer, which I was told is a sign that I’m getting better. But while it’s okay to have a two-week-long hypomanic, or even manic, episode, the major depressive ones frighten me, not because I don’t know what I might do but because I know exactly the sort of things I’m capable of doing.

I’ve been feeling out-of-sorts for several days, but things started their usual downward slide this afternoon. I put myself to bed for a few hours in hopes that I could sleep it off, and I did feel a little better when I woke up…but it’s back. The worst part is feeling helpless to stop it. Oh, I know some ableist scum would argue that I could do all sorts of things to “cure” it, but the fact is, it’s a simple matter of brain chemistry that’s not quite right. And unfortunately, type I bipolar tends to be very tricky to treat even if it’s not rapid-cycle (mine is).

I’m counting the time until D. gets home so we can talk about a safety plan. It’s important to discuss that before things get really bad up in my head. For now, I think I’ll indulge in my usual anti-self-harm strategy of hugging a cat and listening to music. If I fall asleep again, so much the better. Anything to get away from these thoughts.

Informational post: panic attacks versus mixed episodes.

In May, I woke up feeling rather odd—jittery, teary, completely unable to calm down. I’d felt this way before, but it had never been that bad. After about an hour of trying (and failing) to steady myself, I asked my husband to take me to the emergency room because I was afraid for my safety.

I thought I was having a severe panic attack and spent four and a half hours confined to a bed in the ER on suicide watch; after demonstrating that I really was okay and didn’t need to be committed to the psych ward upstairs, I was released with a prescription for lorazepam. At the time, we thought panic attacks were a reasonable explanation, given that I have C-PTSD and a couple of dissociative disorders as a result.

I continued taking lorazepam whenever I felt that way, even after I’d learned I was having mixed episodes and not panic attacks. I needed a couple of milligrams before I started feeling okay again, but that much knocked me out for a couple of hours…not really the most productive way to handle the situation. I talked to my psychiatrist and learned that benzos are pretty much the worst thing to take during a mixed episode because they heighten the feeling of detachment, which can lead to more anxiety and make things worse. He prescribed quetiapine (Seroquel) and so far, it’s worked; I usually don’t need a very high dose, about 50 mg, whenever I feel a severe mixed episode coming on.

Having learned more about panic attacks, it seems strange to me that the ER staff didn’t recognize my mixed episode for what it was. While panic attacks tend to produce more physical symptoms (racing heartbeat, shortness of breath, chills, hot flashes, nausea, trembling, sweating), mixed episodes (also called mixed mania) tend to produce more mental symptoms, such as the highs of mania with the lows and despair of major depression, urge to self-harm or attempt suicide, and uncontrollable swings between moods and thoughts.

I think the reason the two were confused that day was because of the mental symptoms present during a panic attack—fear of loss of control and a sense of impending doom, which is how my fear of self-injuring or attempting suicide was interpreted. I was having cold sweats and my heart was racing, but as I’ve started paying closer attention to my moods and symptoms, I’ve found that those, along with an overall feeling of panic or being out of control, generally accompany my mixed states.

There are many great resources online about how to help and what not to do when someone is having a panic disorder, so I won’t touch on those. Below are a list of things that I find particularly helpful when I’m going through a mixed episode (and what to avoid doing). Feel free to chime in with your suggestions in the comment section!

• I really dislike being touched in general, so touching me is likely to make things worse. However, I’ve found that if my husband holds me in a particularly tight embrace, the compression is soothing and helps me calm down and feel safe and loved. During a mixed episode, I tend to feel very guilty and my self-worth plummets, so the physical contact from a loved one helps reassure me that I am worthy and do not need to harm myself as “penance” (the main reason I used to self-injure) or “eliminate my own map” to relieve loved ones of the burden.
• Obviously, confiscating my sharps prevents me from hurting myself and is very helpful.
• If I’m too far gone to realize I have medication that will help me calm down, being brought a Seroquel (which is an antipsychotic) and a glass of water with tons of ice cubes in it (which I love) is very helpful. It takes a few minutes for it to kick in, but when it does, the noise in my head quiets down, the psychomotor agitation goes away, and I’m able to focus again. The worst case scenario is that it knocks me out for a few hours if I’m given too much, but at least I’m not in danger of harming myself.
• Saying comforting things that are not in the form of absolutes is very helpful. For example, saying specific things such as “You are worth something because you’re spreading the word about mental illness” is much more helpful than saying “Stop it, you’re not a bad person.” If you reference specific things, my brain can recognize those as true—I am writing about mental illness in the interest of raising awareness and fighting the stigma—I will not be able to argue with it, whereas I could go in circles all day long with all the reasons I think I’m a bad person.
• Playing music or doing something over-the-top to make me laugh has been a good way to “break” the episode in the past. It’s important to note that not everything works as a distraction, but if you can get me laughing (which is not difficult because I have an entire folder of gifs/images/text posts that have made me laugh hard enough to cry in the past; also, my sense of humor runs extremely dark, so saying something really fucked-up is likely to make me lose it), there’s a good chance it’ll shorten the duration of the episode by giving me something else to think about.
• I cannot stress enough how important it is to avoid saying the things I mentioned above: “It’s going to be okay,” “You’re not a bad person,” “Stop getting down on yourself,” “Just try to calm down,” etc. They’re not helpful, they just make me feel worse, and they usually cause the situation to escalate.

I’ll put together a post like this on C-PTSD and what my specific triggers are, what people can do to avoid triggering me, etc. I’d really like to hear from my readers, though—I want to hear about your coping techniques and how people can avoid triggering you.

Love and antipsychotics,

J.

Manic Depression: A Brief Explanation

I finally got around to editing the explanation video on bipolar disorder/manic depression (I prefer the latter term as I feel it’s more descriptive).

In the video, I talk about the different categories of bipolar disorder, what each phase (from depression to mania and mixed states) is and what it feels like, and tips for dealing with a mixed episode.

Self-Objectification, Part Two

I recently found this gifset on Tumblr, taken from The Sexy Lie, Caroline Heldman at TEDxYouth@SanDiego, and it stirred up a lot of memories and emotions for me.

The best way for me to describe its effect is to copypasta my reaction from my personal Tumblr, written moments after viewing this gifset.

I have been doing this ever since my ex-boyfriend started coercively raping me and abusing me in every other conceivable way when I was seventeen.

I’m almost 25 and I am just now starting to break out of this. I met my now-husband at 19 in the middle of a promiscuous streak (in what I thought was an attempt to reassert control over my body but was actually just another way of validating myself after all the abuse), and it has taken me six years to even begin addressing this. Before my husband and I got into a serious relationship, I didn’t even care about my own pleasure because I was so focused on my (incorrect) belief that if I could make another person feel good, then I was worth something; I wasn’t as scary and damaged as I thought, a belief that my ex instilled in me pretty much after the first week of our relationship.

I had extreme PTSD and undiagnosed (and therefore untreated) ultra-rapid-cycle bipolar I (I was cycling 10+ times a day, every day) when I met my ex. He was the first person I ever (thought) I loved, and I quickly became codependent and terrified of being alone. I thought all the pain was worth keeping him around, so I was complacent and took the abuse.

It took me a very long time to realize that none of it was my fault.

My current therapist told me that even without all that abuse, it’s no wonder that I’m suffering and carrying around so much baggage. I didn’t even realize I was objectifying myself until this summer, and even then I joked that “no one has to objectify me—I’ll do it myself.” I masked the pain with my characteristic dark humor to avoid having to deal with the real problem.

This post made me cry because it made me finally understand what’s been going on in my head for the last eight years.

I think it’s really important for all of us, regardless of gender orientation, to periodically “check in” and make sure we’re being kind to ourselves, mentally/emotionally and physically. It’s something I’ve really been struggling with lately, but as usual, I’m fighting like hell to make things okay inside my head.

I don’t really have the energy to write a proper, full-fledged blog post today and I apologize, but I thought this was important enough to share on DP as a thought to leave all of you with for a while. I’m going to be working pretty ferociously on the memoir outline for a few days; if it were an outline for any other project, I could breeze through it in less than a day, but these memories and observations are incredibly triggering, so I have to be very careful.

In the meantime, I have a homework assignment for my readers. Over the next couple of days, I want you to make a habit of “checking in” a few times a day. I don’t mean checking to make sure you’re still attractive and desirable—I mean making sure you’re treating yourself well: eating properly, being kind to yourself, taking care of your body, getting enough sleep. It’s important, and it’s something I often neglect. If you have the means and motivation to start a mood diary, I’d strongly recommend that, too…it has already proved invaluable over the relatively short course of my treatment.

Please stay safe if you can’t stay happy, everyone (and that’s okay, too!). I hope to have a new post up within the next couple of days.

For once, I know exactly why I am crying.

A Sylvia Plath tattoo blog on Tumblr reblogged my thigh piece with the entire poem (“Elm”) attached…and reading it actually made me cry.

For the first time in my life, I am weeping for everything that’s happened to me over the last 24 years, all the pain and heaviness and self-doubt from the horrifying amount of unimaginably cruel things that have been done to me (and that I’ve done to myself as a result). I am finally allowing myself to feel everything that I’ve repressed over the years because I was scared to let it out, terrified to lose my tightly-wound control even for a second.

For once, the tears aren’t the product of a chemical fluctuation in my brain. They’re cathartic and even though I can’t seem to stop, I’m not all that freaked out. I know this crying jag is of the good, healing variety. Experience isn’t the source of this knowledge—it’s a sign that I am finally beginning to trust my therapist, my husband, my friends who have told me all along that it’s better to let it out than to hold it inside.

I’ve been turning that pain inward for over two decades and somehow have not destroyed myself yet.

I am crying for Sylvia Plath. I am crying for my mother. I am crying for myself. I am crying for every person who has ever been a victim. I am crying for every person who is trying not to be a victim.

I am trying not to die.

“Its snaky acids kiss.
It petrifies the will. These are the isolate, slow faults 
That kill, that kill, that kill.”

I am completely baffled by the fact that I’m still alive, still breathing even though there are days when every single breath hurts and every thought, every second of every minute of every hour is occupied by a battle of wills—resisting the urge to run a bath and grab a knife or stop casually poisoning myself and finally get the job done.

For the first time, I know I’m going to live and that thought doesn’t scare me.

Some days, my need for acceptance and praise is really disturbing.

I say this because of the things I know beyond a doubt: I am attractive, there is nothing wrong with my body. But I need reassurance about the physical things because of the most important parts I can’t accept—the thought that I am worthy and lovable and worthwhile and that I don’t ruin everything I touch.

*

I had a particularly disturbing dream last night that D. suddenly decided he didn’t love me, never had. I told him I was feeling suicidal and his response was something along the lines of, “Actually, that’s the best thing that could happen to me right now.” I woke up in a panic, convinced that it had been real. I had some terrible dream-within-a-dream-within-a-dream experience last night, and it’s left me a little rattled. I know the dream is just my subconscious vomiting out the particularly horrible bits of all the abuse I’ve taken—the dream situation is ripped almost verbatim from something that happened countless times in a past relationship—but it’s still upsetting.

It’s upsetting because after all these years and how far I’ve come, I still feel like a victim. It’s upsetting because my childhood would have fucked me up enough without the awful part in my teens where I realized that even if someone tells you they love you, they can still hurt you terribly. In some cases, they can hurt you more after they’ve said it.

*

A stranger once complimented me on my eyes and followed it with, “But there’s something unquiet about them.” It took me a long time to realize that everything I’ve gone through has turned me into a haunted house. If the eyes are windows to the soul, then the restlessness in mine is because of all the horrible memories, all the ghosts.

*

D. and I were discussing “Inception” the other day. “I wonder what my subconscious would look like,” I said. He replied, “I’m pretty sure it would be full of monsters.”

*

I’ve been reading a lot about self-harm and how it relates to prior abuse (the book I’m currently reading focuses on the theory that childhood abuse is completely to blame, but for me, it’s been more of a cumulative effect). I have to go slow because it’s very triggering for me, but it’s also hauling some useful anecdotes up from the depths and forcing me to confront a lot of hard truths about myself—about what happened to me during the first twenty years of my life and how those experiences have shaped almost everything about me.

*

I’m heading back to therapy on Thursday, and I’m feeling particularly anxious about it. I’m not sure what to expect; I already know my prognosis for ever coming out of the dissociative state is pretty grim, and that it’s likely I’ll be in therapy for the rest of my life. We have to move so maddeningly slow—working through the trauma without awakening my defense mechanisms is like trying to sneak past a sleeping dragon in a cave. If it shifts in its sleep or makes a sound, we have to go back and find a safe hiding place until it passes.

My therapist is wonderful. She’ll start off by prompting me to share what’s been going on in my life, and then she’s somehow able to zero in on what I need to talk about during that session. She reassures me that it’s okay if I can only handle remembering things for a minute or two—she says it’s a lot healthier than going at it too hard and making the dissociation even worse.

I’ve gotten pretty good about just accepting the way things are, the numbness and the detachment. But there are times when it makes me want to scream, when I just want to feel something other than all the pain and numbness. I want to be in the moment all the time instead of faking it. I want hearing “I love you” during sex to feel good instead of scaring the shit out of me and causing me to shut down.

I want someone to turn me off and fix me. I wish I had a factory default switch, that I could go back to being an infant and be born into a situation that wouldn’t cause so much damage. People say I’m lucky; the abuse has given me an endless source of inspiration for writing, and most people with “normal”/stable home lives have to work harder.

To that, I say: Fuck you so very, very much. If any one of those people had to live like this even for a day, they’d probably end up putting a gun to their head before sundown. No one wants to live like this. No one.

*

I know this post has jumped all over the damn place; please bear with me, as I’ve been dealing with some pretty brutal cycling as of late. I want to close this on a positive note, so let’s just appreciate that I made it through two suicide attempts, nine months of self-harm, and a lot of substance abuse—and that’s just this year.

I want to live the rest of my life without ending up in a hospital. I want to make it through this without dying by my own hand. I want to be happy, if I can’t be completely well ever again.

Capturing moods.

My psychiatrist is teaching me how to handle my episodes. Lamictal twice a day, 200 in the morning and 250 at night. Seroquel for mixed episodes; never, never take lorazepam for a mixed, because it’ll do nothing but heighten the sense of detachment. The only problem is, I find it difficult, if not impossible, to differentiate between anxiety and a mixed episode. Both make me feel jittery, anxious, prone to sobbing uncontrollably and fighting so hard to hold back the urge to self-injure or finally do myself in that it takes all of my energy. I guess the solution is to take a benzo when I feel it coming on, and if that doesn’t work, the antipsychotics might. He’s instructed me to take the Seroquel 50 mg at a time, and I can take up to 200 mg a day if necessary.

I am trying very hard to stay off the Seroquel. I’ve read terrible things about antipsychotics—uncontrollable weight gain, tardive dyskinesia—and I am terrified of having them happen to me. I know it’s just my hypochondria kicking into overdrive, but I’m so unlucky, so prone to having bad things happen to me, that my fears about the worst coming to fruition actually don’t seem that silly or off-base.

And my memory is getting worse. I’ll tell the same story three times and not remember any of it. We went to Teslacon this weekend and had a lovely time, but by the time we left on Friday night I was unable to remember any of the panels we’d gone to that morning. I can’t focus on anything for longer than perhaps 20 minutes, which is disturbing because I used to be able to read or write or play the piano for hours on end. My psychiatrist thinks it’s ADD brought on by the concussion I suffered in July, but he can’t prescribe anything to help until my cycling stops and my moods are finally under control. Considering 450 is a higher than usual dose of lamotrigine (so high that I now have to undergo blood tests periodically), it seems like the manic depression is fighting hard to keep its grip on me, just as hard as I’m fighting to get rid of it.

Relief is always just within reach, but miles away.

*

I feel guilty and hate myself every single day. My husband works 40 hours a week as the shift lead at a drug store and is taking six credits at a local community college. He hopes to transfer to a large state university within five years. My inability to work full-time so he can go to school full-time upsets me so much that sometimes I wonder if he wouldn’t be better off without me. I feel as if I’m holding him back from his dreams—having to care for an invalid wife surely isn’t what he set out to do with his life.

Meanwhile, I stay home every day, reading books and watching movies and trying not to give in to the nasty little voices that whisper to me: I’m useless, I’m a drain on everyone’s energy and resources, I’ll never amount to anything because I am so sick and seemingly unable to recover.

I’m afraid to go back to work until this is under control because I’ve lost two jobs this year; I can’t handle getting fired again. D. agrees that a break from it all, time off so I can rest and work on my memoir, is the best plan. I made a budget; we can easily afford it if we cut out all luxuries. But I want to spoil him, want to give him everything he wants because I feel so awful and guilty, and then I feel bad because the money’s gone faster than we expected, and the whole cycle starts all over again.

We’ve applied for food stamps. I’ve applied for disability. Each day, I commit myself to two hours of research (reading books on dissociation, manic depression, PTSD, and anything else I feel might be applicable), jotting down quotes on note cards with obsessive precision—a purple heading for dissociation, green for bipolar. Most of the time, these quotes help me remember anecdotes, pieces of the puzzle that I can use when I actually begin to write this thing. I am determined to be as organized as humanly possible, despite all the things that are going on inside my head, because I want to finish this book. I want to keep going on this project and not give up; I’ve tried to write a memoir three times before and got stuck after the first chapter. How can I not know what happened to me? I’ve realized the failures were probably because I didn’t have everything laid out just-so: and then, and then, and then.

I know the cycles will make things difficult. I need to make the most of the mania and hypomania and try not to hate myself too much when I crash and can’t do anything but lie in bed and sob.

Jesus Christ, I just want to be okay and make something of myself, be able to provide for our little family again. I want to be good and successful and not feel like I’m wasting my life, like I’m already useless and dead at 24.

I want to make it to 25, and then 30…

*

I feel like I need to give myself some credit for staying out of the hospital through all the years of misery. Two suicide attempts, eight months of intense cutting, and that’s just this year. 2013 has sucked, and I’m ready for it to be over. I want a fresh start. I want someone to turn me off and fix me.

I want to not be me. I want to feel like it’s okay to be me.

I want my husband to always see me as interesting and pretty, not as a sad, pathetic mess.

I want my family to stop seeing me as a disappointment (they probably don’t, but I worry that they do) : If only I tried harder, I could go back to work. Mind over matter, J.

I’m seeing my therapist on Thursday, and I feel like that’s a very good thing. What I need most right now is for a neutral third party to reassure me, to comfort me and tell me I’m doing exactly what I need to be doing, that I’m right where I’m supposed to be at this point in my life.

I hope I’m going to be okay.

It’s finally finished!

There’s really not much else to say about this tat, other than I’m really glad I had it done (and am finished with it now). I sat for 6 1/2 hours during my first session, 3 1/2 for the second, and two yesterday. I’ll have to go back for a touch-up, since I lost some color on the purple sections, but I’m quite pleased with the result. :3

If anyone’s in the market for a tattoo and lives in the Madison area, check out Ultimate Arts. Jim did this entire complicated, beautiful piece, and he’s an awesome person to chat with as well.

Sick, sick, sick.

As I write this, I am having a little bit of an episode. I got up at three in the afternoon, cleaned my tattoo, took my meds, took my morphine (to ward off the crippling pelvic pain I have every single day, will have for the foreseeable future), ate breakfast, read a book, couldn’t get dressed, dealt with racing thoughts for a few minutes, crippling anxiety because I am home alone until my husband returns from class at 4:00, cried, took an Ativan, stabbed myself in the arm with a fork because of the intense guilt I was feeling at the time.

This is my “normal.”

My sleep patterns are completely fucked at the moment because I’m working 7–2 (third shift) three days a week. I haven’t weighed myself in months, but the last time I was at the doctor (a week after I started dancing), I’d lost seven pounds. My appetite is, by turns, ravenous and nonexistent.

I’m seeing my psychiatrist on Wednesday morning, provided I can drag myself out of bed at that ungodly hour, and then I will tell him that my meds are not enough, never enough. I have one mg tablets of Ativan and am only supposed to take one to two per day, though I can handle much, much more. 150 of Effexor, which I am not even supposed to take because with bipolar (even type two), antidepressants can make you fucking crazy, and 200 of Lamictal. My moods have been more stable, but my default state is still numb and detached. I don’t often swing to hypomania (well, more than once or twice a day, and even then I don’t want to accept that it’s hypomania—I am just not depressed), though the crippling bouts of intense depression hit so many times each day, I can’t even keep track of them. They range from twenty minutes to several hours in duration, and then I’m back to flat.

I can’t get disability because I am technically still able to work, I am too young, I don’t think my doctors will sign off on it. I’m afraid to ask. I should probably ask at my next appointment, just to see, just to confirm that I’m not sick enough to actually get the help I need to take some time off and focus on recovering.

The thought is profoundly depressing.

Obviously, I’m not doing that well these days, though I’m keeping my shit together, as they say. What keeps me going is the knowledge that eventually this will break and I won’t have to deal with my rapid-cycle bullshit anymore, that I’ll have some reprieve from all this madness.