Those Old-World Blues

a cure for what ails you, anxiety, major depression, memories, personal experiences, ptsd, therapy

I won’t lie, readers; I’ve been down quite a bit lately. Most of it stems from deep-seated guilt that’s been playing the long con on me for most of my 28 years–it likes to pop its ugly head up and hit me so hard that sometimes it feels like I can’t breathe.

I’ve been carrying around a back-breaking load of guilt since I was a child. Some of it was inflicted by others, some of it by myself. There were so many little things–messages, perhaps–that sneaked in and grabbed me when I was at my most vulnerable.

When my mother went to prison, one of my maternal aunts abandoned her life in Chicago–what I perceived to be a vibrant life of friends and work and independent living–to return to her hometown to help my grandmother raise me. She never tried to make me feel guilty, but the damage had been done long before her arrival. I felt that there was something “wrong” inside me, that I didn’t deserve to be treated well, that I had done something to deserve the early childhood abuse and neglect that made me into a cautious, anxious, hypervigilant kid.

It all began to snowball from there. Anytime someone would do something nice for me–even something as simple as buying me an ice cream cone–I would immediately feel terribly sad for reasons that my child’s mind couldn’t comprehend. (Fun fact: To this day, the music from an ice cream truck makes me want to cry. Brains are weird.)

As many of you know, I’m studying clinical mental health counseling at Hopkins. I never expected to get in, but I was ecstatic! (I still am, though thankfully, the disbelief has faded a bit.)

My fiance has generously offered to support me financially through this time, as it’ll be probably another year until I can land a paying gig in my field. He’s told me time and time again that he doesn’t mind doing this because he’s financially secure enough to do so and because he loves me (and I suspect it also helps that I’m incredibly low-maintenance–see above paragraphs on guilt). I trust him and try to take him at his word.

But more and more frequently, the old guilt starts to creep in, which leads to devastating lows. Lately, I’ve found myself wanting to cry but not quite knowing why. I think it’s because I’ve suppressed so many emotions. I deal with everything by not dealing with it, which I recognize as alarmingly unhealthy behavior. Once I’m added to his insurance plan, my first order of business is to find a really good trauma therapist (that isn’t based out of one of the sites I’m looking at for practicum/internship).

Today, my fella told me that he thinks I have things “more together” than I think. And he’s probably right–I feel very good most days, although there are little nagging low points on even the best days. I can usually brush them aside using a couple of methods I’ve learned, which I’ll describe below.

Tonight is a rough night. He’s at dance practice, which is awesome–I’m glad we each have interests of our own, and it gives me time to practice the piano without being embarrassed about how rusty I’ve become. It also means I have time alone to cry everything out without worrying about making him worry.

Earlier, I went out on our balcony and looked up at the sky. It wasn’t quite dark but the moon was out in full force. It reminded me of my Great-Aunt Mare and how she’d come to the house twice a day when I was young–once in the morning for coffee with Grandma (her sister) and once in the evening to watch Wheel of Fortune with us. (Side note: I was awesome at Wheel of Fortune.)

I decided that a good cry would be the best medicine, since I’ve been feeling kind of weird all day, emotionally speaking. Shortly after her death, I made a small album on Facebook of the best photos of me and my great-aunt–Halloween at a pumpkin patch, hugging me close for a photo at my eighth birthday party, holding me when I was a baby. I looked at them and I let myself cry. I let myself howl my sadness into the void. And then I sat up and said, “That’s enough; let’s go write a blog post about it.”

I find that if I don’t come up with ways to distract myself, the sadness will become endless waves of grief and shame and all of the emotions I’ve been hiding away all these years. Once it’s out of the box, it’s so hard, so exhausting, to put it all back in.

I apologize for the downer post, readers. I haven’t had a personal post in quite a while but I feel as though being open and honest about my emotions, good or bad, can make others feel less alone. There have been so many times when I’ve been endlessly Googling about a specific worry or fear and bam, there’s a blog post about it. Though it may not help right away or offer solutions, it does make me feel less alone.

I hope you’re all staying safe and doing at least okay tonight. We all need to support each other, at our best moments as well as (and especially) our worst. We’re a community. We survived horrific things, and we continue to survive. Never forget that.


A Few Coping Techniques

  • I saw this one on Reddit last week and loved it. In a nutshell, the poster’s therapist advised them to think of someone they really dislike and imagine that all of the negative thoughts and worries are being spoken aloud by [whatever person]. The person this poster chose to use is Trump.
    • The way it works: Whenever worries or negative self-talk pop up, you go, “Shut up, Trump! [or whatever person you’ve chosen].” It actually does work, and it’s great for shutting down those thoughts at the drop of a hat. Of course, it’s always good to revisit those thoughts at a calmer, more appropriate time, but it’s nice to have a method to use when you’re in a situation where you can’t fully emote.

 

  • Another method I love (and promote to others quite frequently) is Ellis’ A-B-C-D-E method of challenging distressing thoughts. It comes from Rational Emotive Behavior Therapy (or REBT). Here’s the breakdown.
    • Step A: Identify the activating event–this is the event that triggers anxiety, depression, etc.
    • Step B: Look at the emotion you’re feeling and combine it with the activating event. Then, try to identify the beliefs that go along with that event and examine how they cause anxiety/etc.
      • For example, someone buying me something makes me feel guilty. This feeling of guilt and sadness comes from early childhood experiences. The end result is that I feel as though I don’t deserve kindness.
    • Step C: Look at the consequences of your irrational beliefs and realize that they can become a self-fulfilling prophecy. Because my response to kindness has been guilt and sadness for so long, I expect to feel that way every time someone is kind to me.
    • Step D: This is where you start to challenge those irrational beliefs and replace them with other, more positive ones. In my case, I need to work on building up my self-worth (long term) and thinking about the symbolism behind gifts and acts of kindness–“This person loves me and cares for me, and this act of kindness is coming from that place of love, not from a sense of obligation.”
    • Step E: This is basically the end goal and is usually called “cognitive restructuring.” At this point, you put all of the steps together and take special care to notice how the process has affected you and whether or not it has helped you to combat all the pieces that bring on the negative emotions (in Steps A and B).
      • You’re essentially re-conditioning your brain to replace negative associations with positive ones. It’s definitely a long road, but I’ve found it to be extremely helpful. However, it’s less useful to me when I’m in a crisis moment.
  • The last one is very calming to me, because a lifetime of CPTSD has led me to an incessant and sometimes self-destructive need for control. I worry endlessly about bad things happening to loved ones (because abandonment issues are fun!), so this little mantra really helps me chill out and remember that I can’t control every variable in my life.
    • Essentially, the saying goes, “If you can change something, do not worry, because you will find a way to change it. If you cannot change something, also do not worry, because there’s nothing you can do about the situation.”
      • This takes some getting used to if you’re like me and overanalyze and catastrophize everything, but once you’re there, it can be a very powerful tool for derailing anxiety before it hits its boiling point.

News Day Tuesday: Ohio State Mental Health Triage

a cure for what ails you, anxiety, News Day Tuesday, therapy

Good afternoon, readers! Today, we’re tackling the concept of mental health triage for university students. Ohio State University has reported a 43% jump in the last five years in the number of students seeking mental health care. Needless to say, that’s huge.

The question of how much academic demands contribute to anxiety levels among the student body is a complicated one. Parenting styles have definitely changed over the last decade or so–I’m 27 and when I was young, “helicopter parenting” really wasn’t a thing. My peers and I were allowed to walk alone to and from school and play outside unsupervised, often late into the after-dark hours. My family placed relatively few restrictions on how I spent my free time; reading and viewing choices were left up to my own discretion, with the assumption that I would make good choices for myself. As a result, I didn’t have much trouble adapting to the freedom that comes with college life, though I did live at home for the first two years of my undergraduate program.

As a non-parent, I can’t speak personally to what parenting styles are in vogue these days. However, it seems that (for very valid reasons) parents have become much more cautious and protective. This naturally leads to students feeling anxiety over the unprecedented freedom that comes with college and living away from home for the first time. Tuition and student loans are also enormously stressful–I know I’m not the only one who had a bit of a freak-out upon receiving that first scary bill after the post-graduation grace period ended. The overall “climate” of university life, combined with the myriad of complicated developmental changes adolescents and young adults have to navigate, creates a perfect storm for the emergence of mental health issues.

This brings us back to the subject at hand: mental health triage. It’s an intriguing concept and one that’s particularly timely; with so many patients in need being turned away from psychiatric wards due to lack of beds, it’s clear that we need to figure out a way to prioritize who needs what kind of help, and how urgently they need it.

Ohio State’s triage consists of determining whether students require more intensive one-on-one therapy or more general group-based therapy and seminars. The university offers a workshop called “Beating Anxiety,” which is something that I’d love to see implemented at more schools, particularly as part of the standard first-year curriculum. During my first year of undergrad, I saw many of my peers struggle with taking full responsibility for every aspect of their lives. It can be overwhelming to navigate roommates and coursework as well as meeting daily needs for the first time. Add to that a work-study job or two to supplement financial aid, and it’s not hard to see why so many students are stressed.

Another aspect of Ohio State’s program that I love is the “Recess” event:

On a grassy lawn, there are tents where students can make balloon animals, blow bubbles and play with therapy dogs and a large colorful parachute. The event is designed to help students relieve stress and to introduce students to counseling center services and staff in a fun way.

– Students Flood College Mental Health Centers, The Wall Street Journal

You can read more about the impressive range of resources offered to students at Ohio State here.

Readers who have a college background, what kinds of programs do you think are most valuable? What was/is available to you?


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News Day Tuesday: Bipolar Awareness Day!

a cure for what ails you, explanations, major depression, medication, mood diary, News Day Tuesday, ptsd, rapid-cycle bipolar disorder, stigma, therapy

Happy Tuesday, readers! Today (October 4th) is Bipolar Awareness Day, so I wanted to share an article with you that outlines the basic symptoms (for the uninitiated, as I know there are some new readers here) as well as what’s on the horizon in terms of treatment.

First of all, let’s hear about what bipolar disorder actually is. I’m referencing bt.com for the purposes of this tidbit, as the article I found gives a really great Reader’s Digest condensed version of the illness.

National charity Bipolar UK characterise the condition as “a severe mental health illness characterised by significant mood swings, including manic highs and depressive lows”, and note that, “the majority of individuals with bipolar experience alternating episodes of mania and depression”.

According to this article, it takes 10.5 years on average (in the UK) for people with bipolar disorder to be properly diagnosed. The National Depressive and Manic Depressive Association (NDMD) paints a similarly grim picture: it can take ten years or more for a diagnosis to be reached, and 69% of cases are misdiagnosed.

What are the symptoms?

There are two sides to bipolar: mania and depression.

During a bout of depression, it is possible to feel: grumpy, without hope, guilty, self-doubting, suicidal, pessimistic, worthless, lacking curiosity and concentration.

And with mania: elation, full of energy, ideas and plans, easily distracted, feeling invincible, risky behaviour including spending huge amounts of money.

Both can feature: lack of appetite, insomnia and delusions.

-bt.com

My experience began very early. I remember fits of agitation and depression as early as eight years old, which at the time was chalked up to the incredibly rough hand I was dealt–a broken home, a mother who struggled with bipolar disorder herself as well as alcoholism, extreme bullying, and persistent nightmares (which were later diagnosed as a feature of PTSD). NAMI states that rapid-cycling bipolar disorder, the most severe form of the illness, seems to be more common in individuals who begin exhibiting symptoms early in life.

From NAMI.org:

Early Warning Signs of Bipolar Disorder In Children and Teens

Children may experience severe temper tantrums when told “no.” Tantrums can last for hours while the child continues to become more violent. They may also show odd displays of happy or silly moods and behaviors. A new diagnosis, Disruptive Mood Dysregulation Disorder (DMDD), was added to the DSM-5 in 2014.

– See more at: http://www.nami.org/Learn-More/Mental-Health-Conditions/Bipolar-Disorder/Overview#sthash.l0XKtkSy.dpuf

When I was eighteen, I decided to see a therapist and psychiatrist for the intense mood swings that had plagued me for most of my life. I was initially told that my deep depressions were the result of PTSD. I was prescribed fluoxetine (brand name Prozac), which only made the agitation worse. And I was still depressed.

At 22, I relocated to Wisconsin and began the search for something, anything, that would finally help me feel “normal.” The misdiagnoses continued: major depressive disorder, for which I was prescribed Abilify and trazodone. I felt amazing on Abilify for about two weeks, and then I crashed. Trazodone made me a zombie. (Note: It is not atypical for antipsychotics to be prescribed to treat both MDD and bipolar disorder.)

Bipolar disorder is most often misdiagnosed in its early stages, which is frequently during the teenage years. When it is diagnosed as something else, symptoms of bipolar disorder can get worse. This usually occurs because the wrong treatment is provided. Other factors of a misdiagnosis are inconsistency in the timeline of episodes and behavior.

-healthline.com

When I was 24 and in my first “adult job” with health insurance, I found a wonderful psychiatrist who, over the course of several sessions, examined my family history and asked very specific questions to find the root of my illness. At first, I didn’t even think to mention my “up” periods, because even with the agitation and sleeplessness, I actually felt good–and no one goes to the doctor when they’re feeling well. But upon deeper probing, he came to a conclusion: first bipolar II, then, after further investigation and a few weeks of mood tracking in a journal, rapid-cycling bipolar I.

That first year was rough. I cycled so frequently that the days were exhausting. One day, I bounced between depression and mixed episodes several times in a single 24-hour period. Slowly but surely, the medications my doctor had prescribed (venlafaxine/Effexor, lamotrigine, and lithium) began to take effect. I began to stabilize. There were no more florid creative periods, but I was also able to sleep for more than an hour a night for the first time in weeks. My misery began to ebb, and though it didn’t disappear completely (a dysfunctional marriage contributed, among other things), I began to feel like a person again instead of a defective thing that needed to be turned off and fixed.

Aside from pharmaceuticals, NAMI’s website mentions cognitive-behavioral therapy, psychotherapy that focuses on self-care and stress management, and, in rare cases, electro-convulsive therapy (ECT). Learning to recognize the triggers for each type of episode is key; one suggestion offered by the numerous therapists I’ve seen over the years is mood tracking/journaling.

However, I had to stop at one point because, in the heyday of my illness, I began to obsess over the cycles, sometimes tracking up to ten or eleven times a day. Instead of the journaling soothing my mind, I began to worry that I was untreatable. I found my mood journal during a recent move and it was difficult reading, to say the least. But it was also a reminder of how far I’ve come and how much my quality of life has improved since receiving a proper diagnosis.

These days, I’m doing much better. My medications have been adjusted slightly to accommodate the deep depressive episodes I’m prone to during the fall and winter months, but I am proud of myself for being able to recognize that the winter storm was a-comin’. Three years ago, I would not have been able to see the symptoms for what they are: a warning sign and a signal that I need to not only keep up with my medications, but to practice good self-care. In the past, I saw fall and winter as something awful that I had to endure. Now, I realize that I can still enjoy life even when the days begin to get longer and darker. The seasons are no longer a metaphor for the overall “climate” in my head.

How long did it take for you to receive a proper diagnosis, readers? Are you taking care of yourselves as winter approaches? I hope you’re all doing well and staying healthy and safe. And spread the word–this illness is massively misunderstood, even by mental health professionals, so it’s our job to reach out and counter-strike against the misinformation and discrimination.


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News Day Tuesday: Local Mental Health Resources

a cure for what ails you, abuse, anxiety, medication, News Day Tuesday, ptsd, therapy, three hopeful thoughts

Good afternoon, readers! This time, let’s talk local resources for mental health care.

I saw a wonderful counselor through the Johns Hopkins Student Assistance Program (which I’m eligible for because my significant other is currently a student). I’ll share more of the personal details in a post later this week, but the counselor I met with gave me some information about local resources I had no idea existed, and I’d like to pass those on to you. I feel they’ll be particularly useful to anyone in the Baltimore area, but I’m sure there are similar programs throughout the country.

First is Sheppard Pratt. Being new to the area, I was unfamiliar with this hospital, but they have a program specifically designed to help people dealing with all sorts of trauma.

The Trauma Disorders program at Sheppard Pratt specializes in dissociative disorders and CPTSD, which is exciting because I had no idea these types of programs existed anywhere. They certainly weren’t a thing in the Midwest, where I’m from. It’s an inpatient program, which isn’t a good fit for me for a number of reasons, but I plan to reach out to see if they know of any good outpatient therapists who are well-versed in these issues.

It’s comforting to know that there are facilities that offer support specifically tailored to complex post-traumatic stress disorder, which can present challenges to many therapists. I found one therapist during my time in Madison who seemed to know quite a bit about PTSD, including my dissociative symptoms, but she went on maternity leave shortly after I began seeing her. My subsequent searches for therapists was largely unsuccessful, which is not a negative reflection on any particular counselor–as I said, it can be a tricky affliction to effectively treat. I’ve been told that because of the depth of my dissociative symptoms, I’m not a great candidate for EMDR, which eliminates one of the most widely-used techniques for treating PTSD.

The second resource I learned about last Friday is the Baltimore County Crisis Response, which offers not only crisis intervention (as the name suggests), but also a 24-hour hotline and–this is the most exciting part–one-time psychologist and psychiatrist consults, which are particularly useful for people who are in a transitional period and looking for providers in the area but need refills of medication or therapy. That’s right, readers; there’s actually a place you can go for those all-important refills you can’t get anywhere else, which means no more rationing of medication to make it through.

The counselor at JHSAP was also kind enough to email me a long list of references for therapists in the area. Admittedly, I’ve been procrastinating a bit and haven’t gotten around to checking them out, but it’s on the list for this week.

Are you aware of resources and programs in your area, readers? Are they easy to locate, or do they require a bit of digging?


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News Day Tuesday: Digital mental health care

a cure for what ails you, News Day Tuesday, stigma, therapy

This week, I’d like to touch briefly on digital mental health care, which has become increasingly popular. I recently applied to work as a volunteer with Crisis Text Line, which is an awesome resource that allows people in crisis to communicate with trained volunteers via text message.

I’m still waiting for one more letter of recommendation, but if I’m approved, I’ll get to counsel others via text–how cool is that? It’s a four-hour-a-week commitment that lasts for one year, and I’d definitely encourage anyone with an interest or background in mental health to consider applying.

From Crisis Text Line’s website:

  1. We fight for the texter. Our first priority is helping people move from a hot moment to a cool calm, guiding you to create a plan to stay safe and healthy. YOU = our priority.
  2. We believe data science and technology make us faster and more accurate. See our Founder’s TED talk for more scoop on how we’re using this stuff. While we love data science and technology, we don’t think robots make great Crisis Counselors. Instead, we use this stuff to make us faster and more accurate–but every text is viewed by a human.
  3. We believe in open collaboration. We share our learnings in newsletters, at conferences and on social media. And, we’ve opened our data to help fuel other people’s work.

This article from Scientific American examines digital mental health care and its pros and cons. I’m a huge fan of anything that allows people to get the help they need, and many people simply don’t have the means to physically attend therapy due to income, transportation, disability/illness, or other factors.

The article also raises very valid concerns about “impression management,” or the tendency clients have to only share information that is likely to make the therapist think positively of them. On the one hand, many people find it easier to express themselves through writing; because there are barriers between the writer and the reader, people may share more freely than they would in person.

On the other, it’s hard to overstate the importance of face-to-face interaction, particularly in a therapeutic environment. Being able to see the client allows the therapist to assess the client’s nonverbal cues, such as body language and facial expressions. This, in turn, can help the therapist direct the session in ways that make the experience as comfortable and productive as possible.

What do you think, readers? Would you be more likely to “talk” to a counselor via text, or do you prefer old school face-to-face therapy? Personally, I’m all for attacking issues from every possible angle, though I haven’t tried digital counseling myself (yet). If anyone has personal experience with digital mental health care and would like to share their story, please do! I’d love to hear from you.


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My very first column – “Depression: Cancer of the Mind,” published October 15, 2008.

major depression, memories, stigma, therapy, three hopeful thoughts, Throwback Thursday

This marks the beginning of a new mini-feature on the blog: Throwback Thursdays. See below for more!

When I was nineteen (and probably manic), I submitted a column proposal to my hometown’s newspaper. Shockingly, they decided to pick it up. It wasn’t a huge reader base—my hometown’s population is somewhre in the 60,000 range—but I was surprised and elated to have the opportunity to share my experiences and put a face to mental illness, which was a big deal in a small city in Iowa.

I had to abandon the project seven months later, when taking a full course load and working two part-time jobs plus an internship became too much; however, I was approached the following summer by two women in my hometown to write a series of articles regarding the transition from high school or college to the “real world.” The series caught the attention of Mental Health America (the Iowa branch) and I was honored with an award and some cash (which, as a poor twenty-year-old college student, was greatly appreciated). 

I’ve kept all of the articles and letters in a box for years. I still pull them out sometimes when I start to feel like a hack or minimize the impact of the things I’ve done. Ultimately, it’s not about recognition or awards (although I must admit that my writerly ego really enjoys being stroked from time to time). It’s about having tangible proof that I was here, that I was able to accomplish something despite having been dealt what most would agree is a fairly difficult hand in life. 

As an existential nihilist, it’s difficult for me to see any inherent meaning in the universe, which I view as absurd and often confusing. But it’s actually a very hopeful philosophy/worldview to have, because it means that each of us has the opportunity to create meaning for ourselves and share it with others. I am slowly beginning to learn that “hope” is a four-letter word, but it’s not necessarily a bad one.

Over the next few weeks, I’d like to share my articles, some memorable stories about my time as a columnist, and perhaps a few of the more poignant letters and emails I received in response to my columns. I’m somewhat mortified by how young my voice is, but I’m reminding myself that it’s an interesting and valuable snapshot of who I was at 19: a girl who wasn’t afraid to put herself out there, who believed she could make a difference in her own small way and was maybe a bit idealistic.

In some ways, I think I am still that girl.

“Depression, cancer of the mind” was originally published on October 15, 2008. My editor had titled the first article, which I’m assuming was because I was too disorganized/cycling too hard to do it myself. I can’t remember who came up with the titles after that; it was probably a mixture. The column appeared every other Wednesday.

Note 1: The features editor decided to give my series a title—Depression: Cancer of the Mind—and a little banner at the bottom, which I thought was the coolest thing ever.

Note 2: At this point in time, I was still diagnosed with and being treated for mild-to-moderate PTSD and general depression. It wasn’t until September 2012 that I was re-evaluated and diagnosed with major depressive disorder, and it was an even longer wait (July 2013) until my correct diagnosis—rapid-cycling bipolar disorder, type I, and C-PTSD with dissociative features—was confirmed and I was able to begin treatment.

Depression, cancer of the mind   Published October 15, 2008

Sometimes people ask me, “How did you do it? How did you make it through 11 years of severe depression without ever once asking for help?”

I guess I can understand their disbelief: I have been through the mental equivalent of hell and come out the other side. I have climbed over Satan’s frozen back, much like Dante traveling through Hell in The Inferno. The only difference is that in this case, “Satan” is the despair trapped inside my mind, causing it to decay slowly from the inside out.

Some say that schizophrenia is the cancer of mental illness, but to an extent, I disagree. It’s true that schizophrenia does kill the mind and allow the sufferer to descend into madness. But just as there are many types of cancer, there are infinite varieties of mental illness that could be considered cancerous.

Depression is one of them.

When you are depressed, most people assume that you will “snap out of it,” even though the stereotypical person living with depression does not leave his or her bed for days, sometimes weeks, at a time. It is every bit as destructive as cancer or diabetes, though even now few people realize it.

I suppose this is because people traditionally fear the unknown, and mental illness, aside from death, is one of the biggest unknowns of all. It can strike anyone at any time. Even those of us living with depression who have found ways to cope and make it through the ending and exhausting days look just like everyone else. Unless you are having a particularly bad bout of depression and feel the urge to run from the room crying (which society views as unacceptable), depression usually goes unnoticed.

It is my hope that by sharing my struggles against the silent suffering associated with depression, others will know that they will be OK, that mental illness is nothing to be ashamed of, and will share this knowledge with others. The more that people know about mental illness, the better; educating the public is the first and most effective step in fighting to tear down the stereotypes.

Something that I would like anyone who has lost hope to know is that you are not crazy, only extremely sensitive to the world around you. You are very brave, but you do not need to suffer alone. There is always help available, and accepting it is not admitting defeat.

Some thoughts.

abuse, ptsd, rapid-cycle bipolar disorder, suicidal ideation, therapy

It is physically painful for me when people thank me for writing, or helping them, or tell me I’m brave or a role model. I’m not a role model. I wake up most days hoping to die. I don’t know how or why I’m still alive. D.’s theory is “sheer dumb luck,” and I think he’s right.

I am a junkie. I cold-turkeyed it over a year ago, but not for noble reasons. I stopped because it was no longer taking away the physical and emotional pain in one fell swoop. It simply stopped working, so I quit. That’s all. I still think about it every day and I think I always will. This is one thing I’m proud of, however—that I was able to stop and stay clean despite all the awful things that have happened in the last year.

My therapist told me last night that I’m the toughest woman she’s ever met. She’s in her 60s, so I’m guessing she’s met quite a few people. I’m not tough because I want to be or try to be. I’m tough because of my animalistic survival instinct–in other words, I’m tough because I’ve had to be, not because I want to be.

I vacillate between strong feelings of self-loathing and guilt and equally strong moments of self-esteem where I actually feel good. But those feelings are always tempered by the fear that my meds have stopped working, that I am manic again, that I am going to ruin things and use people up like I have countless times in the past.

Right now, my pride is wounded and I feel terribly alone. I know I have good people in my life who care about me, but none of them can relate to being raped innumerable times and having people blame you for it because you were too afraid to actually say “no,” to trusting someone completely for the first time in your life and having it unravel all at once, to visiting your mother in prison as a child.

On top of it, I’ve been having horrible nightmares again and the partial memory that strongly suggests I was molested by one of my mother’s boyfriends when I was five is beginning to come into focus at a time in my life when rehashing sexual abuse is the last thing I need.

My therapist referred me to a clinic that specializes in sexual abuse and PTSD. I didn’t take it personally—as an aspiring counselor myself, I understood where she was coming from when she said that she didn’t want to risk making things worse because she doesn’t have much experience in sexual abuse or trauma. I’ve been through enough therapists to know that I wasn’t being “fired” as a patient. Therapists, it seems, are the easiest group of people for me to trust. Their motives always seem to be pure, and the confidentiality helps, I think.

I’m thankful for all the support I’ve been getting, both for the blog and in my personal life. Words cannot express how much I appreciate each message and each person who reaches out, whether it’s to reassure me or tell me how I’ve helped them. That’s what keeps me going—fighting the good fight. I want to feel strong. I want to beat this thing. I want to help people. If I can make things even a little lbetter for everyone living with a mental, I’ve accomplished more than I could have ever hoped for or imagined. If you’d told me what I’d be doing now when I was a motherless, lonely child being bullied and dealing with the prodromal phase of bipolar, I wouldn’t have believed you for a second.

My family, for all their dysfunctions and refusal to discuss the dark side (the way bipolar disorder has spread like wildfire down through the generations), has been immensely supportive. While there was a rough period when I first started my column in my hometown’s newspaper at age 19, they quickly warmed to it and realized that I was doing something most nineteen-year-olds wouldn’t be capable of and that I was taking all the pain and trying to turn it into something positive.

Some of my earliest memories are of my grandmother and beloved great-aunt and other aunts telling me that I was talented, that I had something special that I needed to hold onto. It’s difficult to believe some days—as we all know, knowing something and believing it to be true are two entirely different things.

But I’m trying. I do what I need to do in order to get through the day. Some days are easier than others. Some feel impossible. I’m a big believer in the “fake it ’til you make it” mindset; while it doesn’t work for everyone, it’s served me well over the years. At the very least, it allows me to save face and present as “normal,” even if I’m completely falling apart on the inside.

It’s another bad weather day in my head, which I guess is my reason for writing this. I also wanted to reach out to all of you and say that I’m here for you, too. I’ll always listen if you need to talk—all you need to do is reach out and I’ll be there. It’s the least I can do.

I’m not afraid of anything, except feeling.

abuse, major depression, ptsd, therapy

This is something I think I’ve known for a long time, but I never fully realized it until my most recent re-reading of More, Now, Again (Elizabeth Wurtzel), where Wurtzel’s therapist tells her the exact same thing.

One of the ways I managed to survive, for better or worse, was by learning to numb myself to all the “big”/important events that would normally have provoked a lot of emotion. To this day, I can recite all the details of being abused and neglected as a child, or what it was like to visit my mother in prison, without shedding a tear or breaking out of a monotone. I can tell you exactly how it feels to be terrified by verbal abuse from a romantic partner, what it’s like to have them hit you for the first time, what it’s like to be coerced into sex (which is a form of rape), what it’s like to be sexually assaulted by someone who initially seemed like a nice guy. I can describe all of these things down to the very last, tiniest detail without feeling any of the emotions behind them because I’ve learned to store those emotions as far back as possible, but for some reason, my memories stay right up front, almost as fresh as the day they were formed.

It’s safer to feel sad about old people in general than to cry over the fact that I am terrified of losing my grandmother, who raised me and is like a mother to me. It’s safer to get upset about the minute details I remember about the days when the abuse (both as a child and as a teenager) was at its worst than to release all the emotions that pertain to the actual events.

This is why I’m so detached. I put all of my energy into feeling depressed and hopeless over seemingly insignificant things because once I open the floodgates about the really important things cluttering up the back of my mind, I can’t turn it off. Instead, they languish there, floating around like bits of shrapnel and inflicting more and more damage as time goes on.

I think this is why therapy doesn’t work for me. It’s like an ouroboros, really; we can’t get at the roots of what’s fucking me up because of my defense mechanisms, which are touchy and what’s keeping me so numb. But without working through the underlying issues, there’s no hope of ever relieving some of the numbness and the angst…it’s an ongoing process. Right now, I’m not seeing my therapist because money is an issue (but when isn’t it?).

In the meantime, I’m trying to keep myself occupied as well as I can, considering I’m unable to work. D. and I have been talking about me going back to school to finish up the last few credits for a B.S. in psychology, then on to grad school. I’m not sure if I want to go into counseling or go down the forensic/criminal psych path yet, but there’s plenty of time to figure that out.

Trying not to turn into my mother seems to be taking up most of my time these days, but I’m also trying to balance that with keeping myself alive. My coping methods really suck sometimes, but the general consensus (from friends, my husband, even my therapist) has been that even if something is problematic in the moment, if it can get me through a crisis alive, it’s okay. We can work on that bit later, but in order for any of the work to get done, I have to be alive.

I am alive. I left the house on a small errand today, and though the dissociation was a whole lot worse when I got home, I’m still relatively okay. That has to count for something.

Self-Objectification, Part Two

abuse, major depression, ptsd, self-harm, therapy, three hopeful thoughts

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.

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

abuse, major depression, ptsd, rapid-cycle bipolar disorder, self-harm, suicidal ideation, therapy

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.