I Aced the Test! Part 4: Know thy enemy

I promised we’d take a look at the consequences of long-term stress (and, by association, trauma) on the body, didn’t I? That’s today’s topic so buckle up, Class.

Before I jump in, I want to define a few terms so we’re all speaking the same language.

The amygdala is a little almond-shaped cluster that controls your emotions–namely, fear and the fight/flight/freeze response. Memory and decision-making are also controlled by the amygdala.

The autonomic nervous system controls all unconscious processes, like breathing, blood pressure, and heart rate. Think of it like a car with automatic transmission, or being on autopilot.

Adrenal glands produce adrenaline and cortisol when the body reacts to a stressor. The inner medulla is the part that produces the hormones epinephrine and norepinephrine, which help kick off the whole fight-or-flight response.

In a nutshell:

Stressors trigger the sympathetic nervous system and hormones come rushing in full-bore. The amygdala enters the chat, which sets off a chain reaction with the adrenal glands and other endocrine systems. Your blood pressure goes up, your heart rate increases, you sweat. Without you even noticing it, your body is preparing to take one of three paths: fight, flight, or freeze.

When in crisis, our bodies and minds work in tandem to respond to the situation. The good old autonomic nervous system kicks into gear, triggering an immune response (which is designed to protect the body and fight off “intruders,” so to speak)¹. This immune response releases histamines, which are also the cause of hay fever symptoms like itchy eyes and hives. It may sound counterintuitive, but all of these unpleasant symptoms are part of your body’s fight to keep you alive. The second the stress hit that tiny little amygdala, you were no longer in the driver’s seat. Ever since that moment, you’ve been on autopilot–think of your body as a kind of gundam suit designed to protect you by any means necessary. This response is as effortless and natural as breathing. 

When most people hear the word “adrenaline,” they often imagine a scene such as a mother lifting a car off her baby. Our entire autonomic nervous system is wired to keep us alive, and the body can do incredible things when under acute stress. 

However, you can’t sustain that level of intensity forever. Think of a rubber band. You can only stretch it so much before it begins to lose some of its elasticity, and the same principle applies to stress and the body. Our bodies are not built to sprint at 84,000 miles per hour 24 hours a day, 8 days a week, and that’s precisely what long-term stress demands of you. 

Miller, Chen, and Parker (2010) describe stress as something that “accumulates” in the body’s cells. What this means for you, dear Reader, is that your body is in a constant state of inflammation because those hormones are poppin’. Even if it’s more of a wallflower than the life of the party, that inflammation is still there. 

This leads us to our next point: vulnerability for chronic illness. When your body is constantly on high-alert, it reacts to stimuli that may not bother the average bear. Many trauma survivors have at least one, if not multiple, chronic health conditions. Autoimmune disorders such as lupus are more common in adult cis female trauma survivors². Additionally, the odds of an autoimmune disorder causing an individual’s first hospitalization were higher among adults who reported two or three different types of childhood adversity, such as physical, sexual, and/or verbal abuse; parental neglect; or having a parent or caregiver who struggles with substance abuse or mental illness³. 

There is a strong behavioral component to this complex issue as well. Early trauma leads to hypervigilance and mistrust, meaning there are cognitive and emotional factors layered on top of the biological aspect. (It’s like the world’s worst sandwich, basically.)

Let’s pause for a visual aid. I wonder how many of you are familiar with our good friend Ouroboros. 

Picture the biological factors as the head of the snake, and the cognitive/emotional factors as the tail. Or reverse it. Either way, they are simultaneously feeding and devouring each other. Much like our old pal Anxiety, stress feeds itself. 

So, that probably sounds terrifying, right? It doesn’t have to be. Here are some platitudes to explain why:

• Knowledge is power.
• Know thy enemy.
• If it bleeds, we can kill it.

If we know what our own vulnerability factors are, we can find ways to counter them. If you have a chronic illness, make sure you’re keeping in touch with your doctor and taking any medications you’re prescribed. Try to eat well, stay hydrated, get enough sleep. Take at least a minutes throughout the day to do something you enjoy and celebrate being alive. A client once very astutely described living (versus surviving) as “nurturing the being as well as the human.” We exist on many levels–physical, emotional, cognitive, spiritual. Please be kind to yourselves and send love into the darkness.

One final note:

Take care of yourselves, Readers. Go take a safe, socially distant rainbow walk. Get some vitamin D–it’s good for you! Read a book. Plant a tree. Take a hot shower with a frozen orange. Meditate. And for the love of god, wear a mask and stop touching your face.

---

1 Quas, J. A., Bauer, A., & Boyce, W. T. (2004). Physiological reactivity, social support, and memory in early childhood. Child Development, 75(3), 797-814.

2. Roberts AL, Malspeis S, Kubzansky LD, et al. Association of trauma and post-traumatic stress disorder with incident systemic lupus erythematosus in a longitudinal cohort of women. Arthritis Rheumatol. 2017 Nov;69(11):2162–2169.

3. Miller, G. E., Chen, E, & Parker, K.J. (2011). Physiological stress in childhood and susceptibility to the chronic diseases of aging: Moving toward a mdoel of behavioral and biological mechanisms. Psychological Bulletin,137(6), 959-997.

On Vulnerability

There are so many words in the English language relating to innocence and vulnerability, and most of them can bring me way down if I’m not careful. They provoke some ancient anxiety that I’ve come to realize, with the help of my excellent therapist, are linked to what she calls my “wounded younger self.” (I was incredibly skeptical of inner child work at first, but it is incredibly effective and incredibly healing.)

“Little” is an adjective that, when paired with certain words that also remind me of innocence, usually messes me up emotionally. That’s the word that got under my skin tonight.

I’ve been feeling kind of “off” the last few days. I recently blocked my mother completely on my phone–including the second number I thought she’d deleted until she used it to contact me after I blocked the first number–and was treated to some really unsettling dreams on Monday and Tuesday night.

Monday’s main feature involved me skipping my grandmother’s birthday party because my mother was going to be there and I knew she’d be drunk. Tuesday’s late-night horror show involved a healthy helping of guilt because I was hiding from her (in a Target, of all places) while she wailed and lamented that she “couldn’t believe [I] didn’t want to talk to her.”

Naturally, this put me in a pretty weird headspace today. Wednesdays are my big clinical days and I do group as well as individual client work. As such, I generally store my feelings away to deal with later and do a pretty good job of not thinking about them at all during the day because I’m 100% focused on my clients. (Side note: I adore them, and I’m bummed that I’m leaving my practicum site in a few weeks!)

On the drive home from class this evening, though, those neglected feelings reared their ugly collective heads and roared.

The anxiety and guilt were so powerful that I considered just going to bed early and sleeping it off.

Instead, I took a shower.

I focused hard on those thoughts and attempted to get a good, cathartic cry in. Nothing happened.

I turned the focus to that wounded younger self I mentioned and took the opportunity to literally hug myself while I waited for the conditioner to work its magic on my decidedly unruly hair. I decided to speak aloud because I’m home alone most days during the week and hey, I knew the cat wouldn’t judge me. (Audibly, anyway.)

I told my younger self that it’s okay. I told her I love her and that I’m sorry she felt like no one could keep her safe. I told her that I’m going to do it. This changed into me speaking to whatever hypothetical future child I’ll end up having. I promised that child to take the best care of it I can and to make sure it never feels afraid or lonely.

And I cried. Instead of stifling it or trying to be tough, I gave myself over to it completely–ugly, wracking sobs. After a while, those sobs turned into relieved laughter that I’m sure sounded like I’d finally gone completely ’round the bend.

I think there’s something to be said for having a good cry.

---

On Monday, I spoke to my clients in group about the concept of “ghosts”–they had all shared some intense and profound stories about their deepest wounds, their secret shames, their most painful memories. I told them that while they can haunt you, they can’t physically hurt you. You can start to let go of them.

I led them in one of my new favorite exercises, which is “HA!” breathing. Basically, you take a deep breath and push that breath out while making a “HA!” sound. I opened the group with the exercise and invited them to imagine themselves yelling at someone or letting frustration out. I demonstrated (because I am not afraid to look silly anymore), and they loved it. After the big, intense sharing session, I led them in the exercise again, this time instructing them to imagine the “HA!” on the exhale as them blowing out part of their ghosts.

I’m glad it was a hit, and I encourage you all to try it, readers. Howling into the void or, as I called it, “therapeutic yelling,” is incredibly cathartic.

 

A Wild Blogger Recognition Award Appears!

Jeanette at My Life with PTSD & Bipolar: Mental Health Matters kindly nominated me for
Write a brief story about how your blog began. I’ve been running The Dissociated Press for five years now (holy cats, time flies!) and have been documenting my journey to mental health–or at least, relative stability and improved daily functioning. When I started this blog in 2013, my life was a total mess. I was in an unhappy marriage and missing a lot of work because I was freshly diagnosed with bipolar 1 and adjusting to my new medications. I ended up losing that job, which was a major low point.

There have been a lot of low points throughout my blog-writing history, but things have dramatically improved in the last couple of years. I escaped from that unhappy, unsupportive marriage, enrolled in graduate school for clinical mental health counseling at a great school, and got engaged to a lovely, wonderful man.

I still hit depressive episodes from time to time, but unlike my pre-medication, bad relationship days, I take comfort in the knowledge that my life is so much better than I ever could have imagined. I have a wonderfully supportive partner, and his family is incredibly encouraging of me sharing my journey. My classmates have expressed appreciation for my candor, and I’ve been able to help a lot of people through my disclosures.

Advice for new bloggers is something I haven’t really thought about, but my main piece of advice is to write for yourself first and foremost. TDP has evolved over time–at first, it was a place for me to get my thoughts and experiences out into the ether in hopes of finding others who were also struggling.

Also, I like to focus on and directly address my readers as a group in my posts and always try to end a post with a positive thought or insight. It prevents the blog from feeling dreary and helps promote the overall message: recovery is possible, and recovery never looks the same for everyone. Your journey matters. Your message matters. Your experiences matter.

As I’ve gotten healthier and stopped focusing so much on my illnesses (which are still a main focal point of the blog, albeit in a different way), I realized that my relatively small following was a great audience for information about the stigma surrounding mental illness.

I realized that everyone, but especially others living with my specific conditions (PTSD with depersonalization/derealization and rapid-cycling type 1 bipolar disorder) could benefit from learning about the latest news and treatment options. I’m building up quite the library of scholarly articles and studies, and if there’s enough interest, I plan to post a few quick-and-dirty rundowns of them.

Again, I can’t thank Jeanette for this nomination–it came out of nowhere and I feel very honored about the whole thing and appreciate being recognized for my work. Validation and recognition for what I’m doing always feels nice! Also, the badge image is really cute.

My Picks for Nomination:

The Global PTSD Survivor Blog

Bloomin’ Uterus (a blog about endometriosis, which I also have)

Ruth at PTSD – Accepting, Coping, Thriving

 

 

An Audio Post!? 4-7-8 Breathing Exercise

Hey readers! I haven’t posted any sort of “There’s a real person in here!” content in a really long time, so here’s a quick clip of me walking you through an even quicker breathing exercise. Click below for the transcript and let me know what you think!

(Side note: I love transcribing stuff because it makes me uncomfortably aware of my verbal tics. Sorry ’bout that.)

---

News Day Tuesday: BLOOM by Anna Schuleit

Hey readers! This week, we’re doing something a little different for News Day Tuesday.

I stumbled across Anna Schuleit’s beautiful BLOOM project from 2003 (yes, I know I’m super late to the party). Today, I want to celebrate that project.

In 2003, artist Anna Schuleit installed 28,000 (28,000! Yow!) potted flowers throughout the psychiatric ward of the Massachusetts Mental Health Center (MMHC).

Anna Schuleit’s installation project was created within the entire building of MMHC, on all floors, inviting former patients and employees, staff, students, and the general public, to re-visit the historic site once more before its closing. There was also a symposium at a nearby venue, and an open forum on the front steps of MMHC, during which the patients were invited to tell their stories. The events were dedicated to the memory of the thousands of patients of MMHC, and included as many of them as we were able to contact, as well as the doctors, nurses, support staff, researchers, students, and the general public. The project was a non-profit effort run entirely by volunteers and all of the events were free and open to all.

Source

As people living with mental illness, some of us with more than one, we know the therapeutic power of telling our stories, of having a voice when we’re so often voiceless. Mindy Schwartz Brown wrote some beautiful poetry about her experiences at MMHC, which you can read here. One poem in particular, “Asylum,” touched me deeply.

ASYLUM
(for Anna)

How did this edifice become “home” to its inhabitants-
the renowned multiply degreed,
the haplessly homeless dually diagnosed,
the walking wounded,
the worried well,
the happy go lucky who cleaned floors,
cooked lunches,
took blood pressures.

How could it contain all of the
the egos,
the disintegrated, the inflated,
occupying one space in parallel play?
MD, SPMI
Ph.D, BPD
MSW, DBT
Tell me in this soup, where does one find one’s ME?

DSM IV, Anybody going for V?
What’s the code for those who close hospitals
then open prisons for the sick?

We all feel so much better now,
knowing our brains are
faulty and we are not.
Structural errors ,
neurotransmittor deficits,
viral origins,
genomic misconfigurations.

So now can we all be friends?
Can we do lunch?
Just as we would with a diabetic?

October 3, 2003

Mindy Schwartz-Brown © 2003

The pain of not being recognized is one we know all too well. The lines “We all feel so much better now, / knowing our brains are / faulty and we are not” struck a chord with me that resonated all the way through my body and down into what some people call the soul.

We are the ones who are forgotten. We are the ones who are hiding in plain sight, not out of our own desire to be invisible, but of the desire of others to make us invisible. We make others uncomfortable, particularly when we don’t outwardly fit the mold of the “mentally ill person.” Whenever I reveal that I have bipolar I and CPTSD to someone, I am typical met with one of two reactions. The person either recoils–the discomfort in their eyes is stark and harrowing–or they tell me how “brave” I am.

I am not brave. I simply live. What choice do I have? I do not want to die, though there are plenty of people who view living with a mental illness as a fate worse than death–and I find that more disturbing than anything going on in my attic. There have been countless times when the hauntings have gotten so noisy that I feel as though my mind may literally split in two. Still, I live. Our lives have worth. We have worth.

I’d like to end by including a few photos of Schuleit’s installation. I spent a great deal of time yesterday perusing the photos and reflecting–not on my own experiences, as I have never been inpatient, but on what others’ experiences might have been like as they lived out their day-to-day at MMHC.

All images above copyright Anna Schuleit.

Tell me your stories, readers. It’s important.

News Day Tuesday: New treatment for PTSD?

Good morning, readers!

This week, I rustled up an article about some exciting developments in PTSD research.

Basically, scientists are looking at glutamate (one type of those fun little things in your brain that sends signals) and how alterations in glutamate levels affect PTSD. What this means for us is that PTSD is now being studied on a molecular level, which means that new treatments could be on the horizon!

My PTSD is generally well-controlled, as far as “controlling” it goes. I’m still mad-jumpy and don’t have a good time in crowds (the dissociation spikes, and sounds that hit my left ear first seem to make it worse, though my previous psychiatrist had no idea why). I still feel depersonalized/derealized every single day, though the level of detachment varies widely. I haven’t been able to pinpoint exactly what it is that makes it better or worse, but admittedly, I’ve been super lazy about charting it.

However, I’m sleeping soundly for the first time I can remember. I think a lot of us can relate to the hypervigilance and, by extension, light sleeping. Loud noises still startle me awake and my fiance sometime scares the bejeezus out of me by touching me–gently–to wake me up. But! and this is good news–the sounds of the cats wheezing or vomiting or fighting don’t wake me in a panic. It’s more of a “God, this again?” reaction, which, while not fun, is better than waking up with a racing pulse and momentary confusion about where I am.

As far as journaling about symptoms goes, I’m still trying to figure out a system. How many times in a day should I note what’s going on upstairs? I don’t want to become obsessive about it, as I did with my mood journal when I was first beginning treatment for bipolar disorder. At the same time, I want to make sure I have an accurate log of my symptoms and the events that may have caused an increase/decrease in the weird floaty feelings of unreality.

That being said, it’s sometimes hard to notice the changes because they’re subtle. Because this has been chronic for six years now, it often takes an absolutely massive spike before I notice anything is off. On a related note, I often don’t notice the symptoms decreasing because hey, it’s my “normal” now.

Any ideas or tips, readers? Should I follow the standard day/time/preceding events/level (on a scale of 1-10) format I’ve used in the past for mood tracking? What system(s) do you use?

I look forward to hearing from you! I’ll see you next week and as always, stay safe and remember to say one nice thing to yourself every day. Today I have two: “My new DIY manicure is bangin'” and “I am surviving my fiance’s work trip with zero negative emotions!”

It’s important to focus on the positive, especially when our emotional weather is often stormy.

News Day Tuesday: BiAffect App Links Keystrokes with Bipolar Episodes

Greetings, readers!

It was a bit of a challenge to find an article for this week, but I finally stumbled upon something that could make a huge difference in how we track our moods. There’s a new app called BiAffect that uses your keystrokes, frequency of texting, and social media app patterns to track manic and depressive episodes.

To find out whether a user might be experiencing a manic or depressive episode, the app tracks typing speed, how hard keys are pressed and the frequency of the use of backspace and spellcheck.

–chicagotribune.com

I know there are a lot of people who dislike the idea of being tracked in any sense, which is totally fine. However, I feel a bit more comfortable with it knowing that it comes directly from a research group. It’s only available for iPhone, which is kind of a bummer because I’m a die-hard Android user.

I wish something like this had been around in 2013, when I was deep in the throes of exhausting rapid-cycling episodes. I was newly diagnosed, but the challenge of finding the right combination and doses of medication, the loss of my job (probably due to my cycling), and the overall disintegration of my marriage had more or less temporarily erased any benefits or relief I found from my diagnosis.

One of my long-time friends mentioned that he noticed I was posting a lot more on Facebook when I was manic than when I was depressed. Like, a lot. Even now that I’m stable and successfully medicated, I still pay close attention to what and how often I post. When I’m more energetic and feel like interacting with others, I find myself wondering if it’s because I’m manic, hypomanic, or just…not depressed.

When you’re living with bipolar disorder, it’s a constant question of Column A, Column B, Column C, or a bit of each. You learn to analyze your moods and energy levels, and this tracking can quickly become obsessional.

I see this app as a double-edged sword. On the one hand, it would save those of us who pay attention to our moods a ton of work. On the other, those of us who are prone to preoccupation and overall obsessional thinking could end up checking in a lot more often than usual.

If BiAffect is released for Android, I’m for sure going to jump on it, at least for a trial run. It seems like it could be a useful tool for mental health care providers and patients alike–rather than having to drag in pages and pages of mood diaries, we could pop open an app and have the data right there at our fingertips (literally). And, at least in theory, it seems like any sort of self-report bias would be removed, or at least mitigated. I know I’ve been guilty of fibbing a bit in my mood diaries due to the shame that comes from realizing just how sick I am.

What do you think, readers? Would you give something like this a spin, or do you find it intrusive? Let me know! I’ll be keeping an eye on this one.

Until next time, stay safe and remember to be excellent to yourself.

News Day Tuesday: Sick Days

Hey readers! I’ve gotten really bad about posting regularly and as we all know, structure is crucial when you’re living with a mental illness (particularly bipolar disorder). I made myself a super-nifty planner before I started school in January and am actually going to start using it to keep myself on track. What this means for you is that hopefully, I won’t disappear for weeks at a time!

Anyway, today’s article addresses the stigma against physicians taking sick days for mental health. While it focuses on doctors in Australia, the topic is extremely relevant to anyone who has ever taken or needed a “mental health” day. According to the article, doctors (unsurprisingly) feel uncomfortable taking sick days for self-care, even when they begin to feel burned out and can’t deliver their usual level of care to patients.

“I’m completely supportive, but I’ll admit I’ve never been brave enough to take a mental health day,” one doctor said, adding, “How can you dump your workload on a colleague who is going through much the same things as you are?”

– abc.net.au

I find this extremely relatable because I’ve always felt awkward calling into work or needing to leave early because my brain has decided that doing anything other than crying in bed is just not going to happen. It doesn’t happen often, but I’ve always felt the need to claim another reason–usually migraines, which I used to get several times a week–because we’re conditioned to believe that depression, anxiety, and other disorders of the mind are not a valid reason for absences. We’re taught to believe that we need to suck it up and get on with our lives, even if that means hiding in the bathroom to cry or have a panic attack.

Naturally, this poses a huge problem for anyone in the workforce, but it’s especially problematic for health care providers. It’s something I’ve often thought about as my clinical practicum draws closer. How can I best serve my clients if I’m experiencing the same symptoms as they are?

I also fear that even in a mental health facility, where one would expect supervisors to be a bit more sympathetic, I’ll come across as weak or unsuitable for the job because of what’s going on in my brain. There’s an indescribable level of self-loathing and shame that comes with mental illnesses, and I’m sure all of you can relate. It’s the feeling of being less-than, the feeling that you don’t deserve to have a job because some days, you just can’t handle the world. You begin to question everything about yourself–am I being weak or overly sensitive? Am I doing this whole “adult” thing wrong? The fear of losing your job is a constant presence, which only makes things worse.

So what can we do about it? Unfortunately, there’s no easy answer to that question. One would hope that with increased media exposure, employers will become more understanding, although every boss is different and there are zero guarantees.

When I was first diagnosed with bipolar disorder, I loved my job. I was working as an editor at a translation company, but my symptoms were so severe that I actually had what I called my “Oh shit, I cried at work!” kit, which I kept in my desk so I could patch myself up after crying jags. Some of the items included eye makeup, because it’s embarrassing to have streaked makeup after crying (even though I became very good at crying without messing up my face). Although my employer was aware of my struggles, I still lost that job due to absences, which sent me into a horrific downward spiral that took over a year to break.

Since then, I’ve become quite anxious about divulging any information related to my mental health to anyone at any job…and that’s problematic by itself. Why should we feel ashamed of something that’s beyond our control? The answer lies in the stigma.

It’s going to be a long, uphill battle, though the fact that today’s article even exists gives me hope. Exposure and time are the only things that are going to remedy this issue. It’s an unhappy thought, but I sometimes find myself wondering if mental health issues will ever be considered as legitimate as something as simple as food poisoning when it comes to work absences.

I’d like to end on an up note with another quote from the article: “If we can’t help ourselves, how can we help others?”

Self-care is so important, readers. The Compassion Project offers a list of self-care activities that you can check out to build a plan for yourself. Here are some of my favorites.

• Reading
• Baking (I’m a huge stress baker, though I haven’t done it in a while)
• Knitting or embroidery
• Crafting
• Cuddling with a pet
• Going for a walk (which you can even do at work–take a five-minute break to stretch your legs)
• Doing a crossword puzzle

What are some of your favorite self-care activities? Let me know–I’m always looking to add to my list!

As always, readers, stay safe and I’ll see you next week.

Andrea Gibson – The Nutritionist

Hello, readers!

Today, I want to share with you a poem/spoken word piece that has always deeply resonated with me. The first (and second, and third…) time I heard it, I was reduced to helpless tears. I had the privilege of meeting Andrea Gibson and seeing her perform about six years ago, when she was doing a show in my hometown of Dubuque, Iowa. I ended up getting a comforting hug and crying on her shoulder when I told her how much this poem means to me, and I will never forget that moment.

“The trauma said, don’t write this poem. No one wants to hear you cry about the grief inside your bones.” This, and the final lines: “Live. Live. Live.” will always make me cry–not from sadness, but from relief. This is the single most reassuring thing I have ever read (and heard) in my life.

When I discovered Andrea Gibson I felt, for the first time in my life, that I was not alone and that everything was going to be all right in the end. It was the first step in my long journey that eventually culminated in the ability to just sit with the pain and accept it for what it is. I have learned that no matter how low I feel, how dark the dark nights of the soul get, not every day will be like today.

The Nutritionist

The nutritionist said I should eat root vegetables
Said if I could get down 13 turnips a day
I would be grounded,
rooted.
Said my head would not keep flying away to where the darkness is.

The psychic told me my heart carries too much weight
Said for 20 dollars she’d tell me what to do
I handed her the twenty,
she said “stop worrying darling, you will find a good man soon.”

The first psychotherapist said I should spend 3 hours a day sitting in a dark closet with my eyes closed, with my ears plugged
I tried once but couldn’t stop thinking about how gay it was to be sitting in the closet

The yogi told me to stretch everything but truth,
said focus on the outbreaths,
everyone finds happiness when they can care more about what they can give than what they get

The pharmacist said klonopin, lamictil, lithium, Xanax
The doctor said an antipsychotic might help me forget what the trauma said
The trauma said don’t write this poem
Nobody wants to hear you cry about the grief inside your bones

My bones said “Tyler Clementi dove into the Hudson River convinced he was entirely alone.”
My bones said “write the poem.”

The lamplight.
Considering the river bed.
To the chandelier of your fate hanging by a thread.
To everyday you could not get out of bed.
To the bulls eye on your wrist
To anyone who has ever wanted to die.
I have been told, sometimes, the most healing thing to do-
Is remind ourselves over and over and over
Other people feel this too

The tomorrow that has come and gone
And it has not gotten better
When you are half finished writing that letter to your mother that says “I swear to God I tried”
But when I thought I hit bottom, it started hitting back
There is no bruise like the bruise of loneliness kicks into your spine

So let me tell you I know there are days it looks like the whole world is dancing in the streets when you break down like the doors of the looted buildings
You are not alone and wondering who will be convicted of the crime of insisting you keep loading your grief into the chamber of your shame
You are not weak just because your heart feels so heavy

I have never met a heavy heart that wasn’t a phone booth with a red cape inside
Some people will never understand the kind of superpower it takes for some people to just walk outside
Some days I know my smile looks like the gutter of a falling house
But my hands are always holding tight to the ripchord of believing
A life can be rich like the soil
Can make food of decay
Can turn wound into highway
Pick me up in a truck with that bumper sticker that says
“it is no measure of good health to be well adjusted to a sick society”

I have never trusted anyone with the pulled back bow of my spine the way I trusted ones who come undone at the throat
Screaming for their pulses to find the fight to pound
Four nights before Tyler Clementi jumped from the George Washington bridge I was sitting in a hotel room in my own town
Calculating exactly what I had to swallow to keep a bottle of sleeping pills down

What I know about living is the pain is never just ours
Every time I hurt I know the wound is an echo
So I keep a listening to the moment the grief becomes a window
When I can see what I couldn’t see before,
through the glass of my most battered dream, I watched a dandelion lose its mind in the wind
and when it did, it scattered a thousand seeds.

So the next time I tell you how easily I come out of my skin, don’t try to put me back in
just say here we are together at the window aching for it to all get better
but knowing as bad as it hurts our hearts may have only just skinned their knees knowing there is a chance the worst day might still be coming
let me say right now for the record, I’m still gonna be here
asking this world to dance, even if it keeps stepping on my holy feet

you- you stay here with me, okay?
You stay here with me.
Raising your bite against the bitter dark
Your bright longing
Your brilliant fists of loss
Friend

if the only thing we have to gain in staying is each other,

my god that’s plenty

my god that’s enough
my god that is so so much for the light to give
each of us at each other’s backs whispering over and over and over
“Live”
“Live”
“Live”

You can watch one of the many versions of Andrea performing here, and I encourage you to check it out! It’s a great reminder that no matter how lonely we get, none of us exist in a vacuum.

Continue to raise your bite against the bitter dark, friends. Fight as hard as you can, because the world sees us as broken. Refuse to give up. Fight to show everyone that you matter, that you are more than the sum of your parts or the chemicals inside your brain. You are more than a diagnosis, a code on a medical chart, the endless insurance claims and the bills and the medications you swallow every day just to feel okay.

You are a human being, first and foremost. I hope none of you ever forget that. You matter. Your life matters. You are worth something to the universe not because of who you are or what you’ve done, but because you’re here. And you’re going to be okay.

News Day Tuesday: More Progress on Mental Health Care Parity?

Good afternoon, readers!

It’s no secret to most of us that securing quality mental health care can be frustrating, if not seemingly impossible. In 2008, the Mental Health Parity and Addiction Equity Act was passed, which basically ensured that insurance companies were not allowed to discriminate against mental health care when offering coverage–benefits for these services had to be more or less equal to the benefits offered for standard medical and surgical care. (You can read more about the act here!)

I was nineteen years old when the act was passed, and it was a huge moment in my life. But things are still not great; many insurance plans have extremely strict limits on the number of counseling visits allowed per year (the insurance plans I’ve had in the last ten years have placed a limit of twelve appointments per calendar year), and there is still much to be done before we can honestly say that mental health care is equal, in the eyes of insurers, to other types of medical care.

For one thing, enforcement of the parity law tends to leave much to be desired. The task force, which formed in March of this year, has identified the following objectives in reforming mental health care parity:

• The Centers for Medicare & Medicaid Services is awarding $9.3 million to states to help enforce parity protections. California, New York, Massachusetts, Oregon and Rhode Island were cited as models of promising enforcement efforts.
• A new government website will help consumers identify the right agency to assist with their parity complaints and appeals.
• A newly released consumer guide will help patients, families and providers understand their rights and look into whether they have experienced a parity violation.
• The Department of Labor will report each year on its investigations into parity violations

-npr.org, “Federal Panel Calls For Stricter Enforecement of Mental Health Care Parity Law”

Though I am a bit skeptical that any great strides will be made in the immediate future, I am trying to remain cautiously optimistic that within the next few years, we’ll be able to enjoy equal benefits for mental health care.

My current insurance plan offers a very limited selection of counselors and psychiatrists, and wait lists are often several months long. I had an intake appointment a few weeks ago and am still waiting to hear back on whether or not the counselor in question will even accept me as a patient. I know my experience is not unique and, even more disturbingly, there is the continued dearth of hospital beds for people struggling with severe mental illness who need immediate hospitalization to survive.

---

Like what you see on Dissociated Press? Check out and “like” the Dissociated Press Facebook page for even more posts, links, and news articles!