Finding safety without armour

woman wearing suit of armour

I’ve had a pretty shitty last couple of years.  There have been multiple people in a variety of different contexts who have treated me like crap, including people whose role (in theory) was to help me.  While I don’t have PTSD, I do feel traumatized by the things that have happened to me, and that (in combination with my depression) has made me really withdraw into myself.  I don’t trust people, and I don’t feel safe with people.  I feel like anyone could harm me or turn on me at any time.  I expect to  be thrown under the bus because I have learned that this is how people treat me.  So for the purpose of self-preservation, I opt to hide beneath a heavy suit of armour, hoping that people won’t be able to get through it to hurt me.

There is one exception to this psychological mess-fest of mine.  He’s someone I work with, and right from the beginning I felt safe with him.  To some people “safe” may sounds like an odd choice of words, but for those of us living with mental illness psychological safety is huge.  And I trusted him.  I’m not sure why, but it just felt right.  I told him about my illness very early on, and he was totally ok with it.   As time has passed I’ve shared with him some of the really messy bits, but it’s almost as though the more I show my imperfections the more perfect he thinks I am.  It seems like he’s able to look past the illness and see the real me, which helps me feel a little more connected to the real me that’s lying buried beneath the depression.  In a lot of small ways he takes care of me.  While I am fiercely independent, it feels nice to be taken care of once in a while, and it had been quite a while since I last felt that way.

holding_handsLately we’ve started communicating quite a bit outside of work, which has been really nice.  I’m not sure where exactly this will end up taking us, but I’m enjoying the ride.  It’s interesting to reflect on how easily I felt safe with this person despite my internal scars and deep-seated mistrust of others.  Is it possible to “just know” that someone is not going to hurt you?  Probably not, but I guess it’s reassuring that I am still able to trust, albeit highly selectively.  I’m not so completed disconnected from the world that trust is impossible, which on some level kind of surprises me.

I think we all put on armour as needed to protect our vulnerable inner selves from the world around us.  The challenge is finding some sort of balance so that we’re not completely closed off, and establishing a dividing line between self-protection and avoidance.  I have a lot more work to do on relaxing my own armour, but at least I’m making a start.

What sort of armour do you wear to keep yourself safe?

 

Image credits:

bstad on Pixabay

Elvis Ma on Unsplash

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Feeling like a stranger in my own family

woman standing alone in a crowd

I spent Christmas with my family this year.  It was a small gathering – just my parents, my brother, his fiancee, and me.  Except it didn’t feel small; it seemed like there were far too many people around.  I haven’t had a lot of contact with my family for some time now because of my depression-related self-imposed isolation.  In the last year and a half I had only seen my brother twice, and hadn’t seen my soon-to-be sister-in-law at all.  I was reluctant to head “home for the holidays”, but decided I should push myself and just go for it.

Everyone gave me a fairly wide berth.  Not in a mean way, but in recognition of my need for space when I’m not feeling well.  Despite the cozy little gathering, I felt like an outsider, a stranger.  Not because anyone excluded me, but because their little family circle just seemed so foreign to me.

Since I wasn’t engaging much in the conversation, I felt kind of like a fly on the wall, observing from a detached position.  Or maybe not so detached; regardless, I found that things grated on me.  My sister-in-law is a lovely girl, but it seemed like my parents were putting on a performance of sorts because of her presence, and it looked so contrived from my odd perspective.  Things that would normally be minor irritants, like my dad’s poor table manners, stirred up a feeling that was closer to disgust.  Much of the general conversation focused on meaningless minutiae (kind of like Jerry’s parents in the show Seinfeld but without the humorous element), and it struck me as such a waste of time.  I was mostly able to keep a lid on my irritability in term of external expression, but it maintained a slow simmer on the inside.

I’m back home now, and it feels like a relief to be alone with just my guinea pigs for company.  I’m left wondering, though, if this feeling of being a stranger in my own family will ever really go away.  Maybe if (when?) my illness goes into remission things will go back to normal, but that seems hard to imagine at this point.  It’ not their behaviour that would need to change, it’s my perspective, and it feels like the connections that well me used to value have been washed away in the storm of my depression.  Maybe I’ll find them again, or maybe I’ll forge new connections in the future, but at this point I don’t see that happening any time soon.

 

Photo credit: Mike Wilson on Unsplash

Sometime the wheels just fall off

Partly shadowed woman crying

It’s been kind of a tough week.  I’ve been working night shifts the last couple of weeks, so my sleep pattern has been wonky and that certainly makes me more vulnerable.  December has brought on a lot of conflicted feelings related to Christmas.  I had originally planned to spend Christmas in Cuba with my best friend, but then something happened that made it abundantly clear that she really knew nothing about me, and we haven’t spoken since.  I have had a difficult relationship with my parents over the last year and a half; when I’m depressed, I push them away, and I think that’s been very hard for them.  They didn’t invite me to come for Christmas this year, and when I let them know I was thinking about coming, the response was lukewarm.  They’re probably just struggling in their own way to cope with my illness, but it felt really shitty.

I spent most of my hour-long drive home from work yesterday morning crying.  Being sleep-deprived tends to break down the walls I try to build to help me keep a lid on things.  To try and cheer myself up a bit I went out and bought some silly little toys for me and the colleague I’ve been working with the last couple weeks, a lovely man who is actually the only person I feel safe with these days.  Anyway, instead of acting cheerful about it he gave me a bit of a lecture on how I shouldn’t be spending money on stuff for him.  I know he was well-intentioned and not in any way trying to be hurtful, but it unleashed the stuff I had been barely holding in.  I spent about 2 hours crying at work last night (luckily the clients were asleep so none of them saw me), and then cried some more on my drive home this morning.

I feel pathetic.  I usually try not to beat myself up too much about my depression unleashing itself on the world around me, but I hate crying at work.  It’s the one setting where I feel like I really should be able to hold it together.  Except realistically that’s not always going to be the case.  So I guess I need to let it go and accept that sometimes the wheels are just going to fall off, but tonight I will get some sleep and tomorrow will be a new day.

 

Photo credit: Pexels on Pixabay

Let’s talk about sex (and mental illness)

couple kissing

What do mental illness and sex have to do with each other?  Quite a bit, actually, both in terms of the illness itself and the medications to treat it.

Let’s start with meds.  Antidepressants that affect serotonin (such as the SSRI class) can do a real number on sex drive/function.  This tends to be mediated by a particular type of serotonin receptor known as 5HT2a, which means that some antidepressants that affect serotonin are less likely to cause this problem, such as mirtazapine and vilazodone.  Another option is something like bupropion, which doesn’t act on serotonin receptors.  I talk more about antidepressants in my psych meds 101 post.

Antipsychotics can also be problematic (more on this in psych meds 101).  Antipsychotics work by blocking dopamine receptors, but if there is too much dopamine blockade along a certain pathway in the brain (the tuberoinfundibular pathway to  get really geeky with it), you disrupt levels of the hormone prolactin, and boom, you get sexual dysfunction.  Different antipsychotics vary in their potential to affect prolactin, so having sexual side effects with one doesn’t mean you will necessarily have the same effect with another medication.

Some mood stabilizers such as valproic acid are quite teratogenic, meaning they’re likely to cause fetal malformations.  This means reliable birth control is something that has to be considered along with everything else that goes with a mood disorder.  This is easier said than done for a woman in the midst of a manic episode.

woman lying in bed

Then there is the illness itself.  As a nurse, I’ve spoken to clients who are deeply ashamed of reckless sexual behaviour they’ve engaged in while manic or psychotic, things that under normal circumstances they would never even consider doing.  At the other end of the spectrum, depression can shut down sex drive and sexual function.  These are issues that it’s not easy or comfortable to talk about, so they tend to hide in the shadows, but they can have a huge effect both on an individual level and on a relationship.  I don’t have any great insights or answers to share with you, but I do think it’s important to talk about it.  It’s also worth considering sex as a potential barometer of your mental health.  I remember at one point when my depression was starting to improve I met a man who actually made me feel turned on, and I thought wow, this is the most normal thing that I’ve felt in a very long time.

I’ll close with a quick word on autoerotic activity, to borrow a term from Seinfeld.  Orgasm releases happy hormones like oxytocin and dopamine, so it seems to me a little bit of self-love once in a while can’t hurt.  And really, we all deserve some self-love, whether it’s in an erotic sense or not.

 

Image credits:

efes on Pixabay

Berzin on Pixabay

 

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Lessons in love and mental illness

hands forming a heart shape framing a sunsetI met Ron 10 years ago, during my first psychiatric hospitalization.  He had schizophrenia and had been around the block many times before, but it was my first experience on the patient side of the desk (I’m a mental health nurse).  At a time when everyone else could only see my depressive illness, somehow Ron was able to see past the illness to my true self, the self that I thought I had lost.  He served as an anchor of sorts to help me reconnect with myself, which played a significant role in my recovery.  I would say that he was probably more instrumental in my recovery than any of my treatment providers.

In part because he had a good heart and in part because he struggled with mental illness himself, he accepted me completely and unconditionally.  He just got it.  It seemed like the more he saw my imperfections, the more perfect I became to him.  I can’t even begin to describe how comforting it was to have this kind of connection, and how much more whole it made me feel.

That’s not to say there weren’t challenges.  Besides schizophrenia, he struggled with addiction, and there were some problematic behaviours related to that.  His mental illness was only partially controlled, and it was hard to watch him wrestle with his inner demons.  At one point he attempted suicide by overdosing on my stash of psych meds that I’d been hoarding rather than taking.  I felt tremendous guilt over that, and spent as many hours a day at his bedside as the ICU staff would allow.  I tried to stay out of his psychiatric treatment, especially since I knew some of his treatment providers in a professional context, but it was heartbreaking to see him not getting the help I knew he deserved.

heart outline in rocks on beach

There was also stigma.  I’m a nurse and very high functioning when well, and people didn’t always approve of my relationship (first romantic and later just friendship) with someone they saw as a schizophrenic addict.  My parents didn’t approve, which caused a lot of tension.  During one of my later hospitalizations a psychiatry resident, who read something in my old chart about my relationship with Ron, asked “why would you get involved in a relationship with a schizophrenic?”

Ron passed away 2 years ago from an accidental overdose on fentanyl-laced drugs.  I miss him every day, but I always knew that the reality of being close to someone with serious mental illness was that I would quite possibly lose him prematurely.  I have learned from him that I deserve someone who truly sees me and truly accepts me, and I thank him from the bottom of my heart for that.  Maybe I will find another person like that and maybe I won’t, but I will not accept anything less.

 

Photo credits:

Jack Moreh on Freerange

AnnaER on Pixabay