Trapped

truck stuck in mud

I feel trapped in several areas of my life.  Trapped in a few different ways, and really not sure how to get myself out.

The most obvious is that I feel trapped in my depression.  I’m feeling at a loss as to what to do.  I’m managing ok for the most part, but I want to be able to do more than just managing.  Yet I have a reluctance to mess with the treatment regimen that’s keeping me reasonably contained a fair bit of the time, so I’m coasting along and getting knocked off the rails whenever anything mildly distressing comes up.

I feel trapped in my career.  I’ve kvetched about this before, but there are factors outside of my control that seriously limit my options (mostly related to a former bully‘s somewhat successful attempts to destroy my career).  Plus I worry that trying and failing to push back against those external factors could further destabilize my mental health.  So I look for the path of least resistance, which is typically to stay bogged down in the status quo.

Then there’s interpersonal relationships.  I shut people out of my life.  I’ve pushed my family away, yet at the same time the maintenance of this distant but still kind of there relationship doesn’t feel very good.  Yet I have no idea how to let myself open up and move in closer, because it just doesn’t feel safe.

In a sense I feel trapped in my city.  I like where I live, and I’m very comfortable in the condo where I’ve lived for the past 13 years.  But I’m so settled in that even if moving seemed like a good thing to do for my career or other purposes, the very idea is terrifying.  The thought of having to go through the process of selling my place and trying to find a new home is completely overwhelming, to the point that I don’t even think of it as a feasible option, at least for the time being.

While some of this trapped-ness is related to external factors, a large part of it is firmly rooted in my thinking.  Yet recognizing it doesn’t necessarily make it easier to move out of my rut.  When even my rut feels scary and unsafe a lot of the time, and when past experience has clearly shown that the world often in unsafe, it’s hard to contemplate what positive change could actually look like.

 

Are there areas of your life where you feel trapped?

 

Image credit: MikeMyCoach on Pixabay

Advertisements

How not to be supportive

hand statue supporting tree branch

I think most of us probably have a few of them in our lives: the people that want to be supportive, but they’re just way off the mark.

The fixer:  This is the person who wants to figure out how to solve your problems because then you’ll no longer have anything to be mentally ill about, right?

Have you tried… ?  My aunt’s neighbour’s dog’s best friend said that going out for a walk every day made them feel much better.  You should try it!

Other people are worse off:  This is the “children are starving in Africa” argument.  As if by reminding you how bad some people have it they’ll magically convince you that you’re not actually mentally ill after all.

It’s not so bad…  Oh, you’ve been bullied, that’s really sad, but look on the bright side, you didn’t get physically assaulted.  Cheer up!

It’s normal to feel that way:  Anyone would feel badly if they had to deal with [shitty situation x], it’s normal!  No need to worry about it!

Are you taking your medication?  I get this a lot from my family, because they don’t seem to understand that I can be unwell and still be taking my meds as prescribed.

You look really good:  This is the good old assumption that if you look good, then you can’t be sick.  Maybe if you’re reminded of this often enough you’ll realize that you were just confused and you must not be sick after all.

Try to focus more on the positive:  Thank you.  Perhaps I will need to remove my pink unicorn horn from where it is shoved up my ass and use it to stab you in the eye – now that would be positive.

 

In many ways I find it easier to ignore the people who are saying stupid things out of stigma, because I can write them off as being dumb-asses.  I’m less sure how to handle the people who are well-intentioned but clueless.  It’s not exactly polite to ask people who hit them with a stupid stick.  Sometimes I think it’s easiest to just let things slide and try to focus on the good intentions rather than the crap that comes out of the mouth.

What are some of the well-meaning but ignorant comments you’ve gotten?

 

I’ve done a follow-up to this post on how to be supportive.

Photo by Neil Thomas on Unsplash

Cave-dwelling

cave

I live in a figurative cave that is of my own making (although I suppose of my depression’s making would be more accurate).  I have pushed nearly everyone out of my life, and while that is occasionally lonely, it feels much easier.

My oldest friend keeps trying to remain in my life, even though I don’t allow her in.  It’s been over a year since I last saw her, and almost as long since I last responded to any of her messages.  Yet she stubbornly continues texting me every few months.

She texted again a few days ago to ask how I’m doing.  I thought about whether I should respond or not, but then realized I wasn’t there yet.  Even if I wanted to respond, what on earth would I say?  This is someone who has a normal life and does normal things, and I just feel so far removed from that.  I feel like we live in totally different worlds.  It’s not that I don’t think she cares; I know she does.  Maybe what scares me is that I would be reminded of what I’ve lost, and what I can’t do any more.  There’s probably more to it than that, but I feel a strong sense of revulsion at the thought of interacting with her.  And it’s not anything about her; she knows about my illness and has always been supportive and nonjudgmental.  It’s 100% about me.

I got an email from my brother yesterday.  He said this friend had contacted him to ask if he’d talked to me recently.  The idea of them talking about me was disturbing.  It’s not that they would say anything “bad” about me, but it just doesn’t sit well with me.  Part of me feels annoyed with my brother, although logically I know there’s nothing to be legitimately annoyed about.

I thought writing this post might help me figure out in my own head why I’m feeling a messy jumble of emotions about this, but I’m still feeling just as jumbled.  I hate what I’ve become, and I know that’s not fair and I don’t hate the self that’s at the core, but this has caused a bit of a stumble.  I’ve stumbled before, though, and like before I will pick myself back up and carry on.

 

Image credit: Glavo on Pixabay

Book review: Strong at the Broken Places

StrongAtTheBrokenPlaces

Strong at the Broken Places: Voices of Illness, a Chorus of Hope is an intimate look at living with chronic illness.  Author Richard M. Cohen, who himself has multiple sclerosis, works with five participants who have various chronic illnesses to capture their stories and help others understand the overwhelming toll that chronic illness can take.  The participants are Denise, who has has ALS (often known as Lou Gherig’s disease), Buzz, who has has non-Hodgkins lymphoma, Ben, who has muscular dystrophy, Sarah, who has has Crohn’s disease, and Larry, who has bipolar disorder.  The author engages with those featured in the book over a span of not just months but years, getting to know them on a far deeper level than simply the words they chose to use.

This is not a sanitized, at-face-value look at chronic illness.  Rather, it probes the depths of it, encompassing the myriad ways in which chronic illness affects the lives of those it touches both directly and indirectly.  The author skillfully ties the stories to one another, illustrating the many commonalities among the experiences of disparate chronic illnesses.  The book gives voice to those who society tends to silence: “Too often the sick are seen and not heard.  Listen.  Their songs are soft but steady.  Hear the sound of steel, the quiet toughness at the core.”

There were a few things that surprised me and at times somewhat disturbed me about Cohen’s approach.  He openly brings in his own opinions and expectations of how the participants should behave, including questioning Buzz’s decision to accept his oncologist’s recommendations rather than seeking additional information or other opinions.  Initially this struck me as inappropriate, but as the book progresses, as a reader I become more comfortable with it, as the purpose seemed to be a deeper exploration of the participant’s ideas and behaviours.

The author’s interviews with people who knew the ill participant initially felt awkward to me as a reader, seeming almost a betrayal.  In particular, his attempt to interview Buzz’s 9-year-old son accomplished little besides making the child uncomfortable.  However, in checking my own reaction I recognize that at least to some degree I’m projecting because of of my own illness.

A  mildly irritating quirk was that the dialogue didn’t contain the contractions that would typically be used in casual speech.  This made the dialogue feel a bit stilted at times, which is unfortunate, as it seems unlikely that this accurately reflected the quality of speech.

Cohen describes the “daily brushes with public ignorance and indifference and the stigma of being sick in a society that worships health, brand and define us.”  The weight and pain of the burden this imposed were difficult for the participants to carry.  Larry likened chronic illness to a battle with two fronts: the disease itself and public ignorance.  Denise’s slurred speech led people to ignorantly jump to conclusions, such as assuming she’d had a stroke or was drunk.  Sarah was quickly identified as abnormal because of the side effects of long term steroids, which significantly reshaped her face and body, and this took a heavy toll on her self-image.

I had to smile when Cohen identified “How are you?” as the most insincere question that people ask.  I share the experience that “people really do not want to know and inquire under the assumption that no one will be rude enough to actually answer the question honestly.”  Another point that strongly resonated with me was Larry’s experience that others tended to place him into a diagnostic box, attributing much of his behaviour to his illness.  “When does the diagnosis stop and the human being regain a sense of control of a life?” he asks.

Social support varied amongst the participants, and maintaining relationships could be challenging.  Denise was divorced and had limited family support.  She pointed out that she was alone before she was diagnosed, and there was no reason for that to change after her diagnosis.  She observed that a benefit of this was not having to experience guilt over being a burden on a spouse.  The author repeatedly challenged Denise on her choice to be alone, which initially struck me as imposing his own preconceptions.  His attempts to intercede in Denise’s family situations seemed like inappropriate interference, even meddling, or a misguided attempt to apply his own agenda.  Yet again, I must check myself, since like Denise I have chosen to isolate myself because of my illness.

Roles and identities are a recurring theme across the participants’ stories.   Buzz, unable to work, fell deeply into debt and feared ending up homeless, which compromised important role identities he held as a husband and father.  Ben’s parents, especially his father, struggled with the idea that their son would die before they did.  Sarah’s illness “constantly makes me second-guess myself and question who I am”.

Buzz drew heavily on his faith in God to maintain a positive outlook.  The stoicism that resulted was challenging for those around him to face.  Larry identified himself as a very spiritual person, and found it frustrating when doctors dismissed his spiritual experiences as psychotic, attempting to “force patients into non-psychotic behaviour with such zealotry that they dismiss too many possibly positive and healthy dimensions of the patient’s mind, body, and soul.”

Hope was a theme that arose often.  Larry struggled with doctors who would try to take away hope, saying he would never get his life back.  He felt they had no right to do this, and he saw hope as being as necessary for the soul as oxygen for the body.  The book concludes on a very hopeful note, with all of the participants presenting their stories to Harvard Medical School faculty and students.  Meeting one another and speaking together was a way to come together as a community and connect in finding hope, voice, and inspiration.  Through the advocacy work they engaged in, they were able to take ownership, find a sense of purpose, and establish identity.  As Larry observed, “We are connected, and were strong at the broken places.”

This book is a fascinating journey into the depths of chronic illness, and while there are some elements I wish were done differently, the message of being strong together at the broken places is certainly a powerful one.

 

You can find a list of my previous book reviews in my blog index.

Reining in the thought gremlins

gargoyle.jpg

One of the (many) things I’m working on is checking myself on my depression-related misinterpretations of things happening around me.  Not stopping the misinterpretations (I’m nowhere close to being ready for that yet), but noticing them for what they are.

This past weekend I was exchanging emails with someone in my life who I consider “safe“, and helping him out with a course he’s taking.  At a couple of different points during those exchanges, I felt really hurt.  Thoughts started running through my head: he’s just using me, he’s taking advantage of me, he doesn’t care about me at all, he’s judging me, I can’t trust people, I can’t deal with people, etc, etc.  The reasonable part of my brain knows none of those things are true, but the thoughts kept going full steam ahead.

So I tried to sit with them.  I did a guided meditation on emotions in mindful communication.  I cried for a while.  I thought about how hard it’s been to find any hope for the future.  After a good chunk of time wallowing in miserableness, I thought about whether he would have wanted me to feel this way, or how he would react if he knew how I was feeling.  Whether my thoughts were consistent with the gratitude he frequently expressed and the regular check-ins to see if I felt pressured into helping him.  Whether he did anything “wrong”, or if this was all me.

The only conclusion I could come to was that yes, it was all me.  He did nothing wrong; I misinterpreted based on what’s going on inside of me.  I needed to take ownership of my own thoughts and feelings, and not project blame onto him.  It didn’t make the gremlins go away, but it meant I saw them for what they were.  I’m proud of myself for that.  There’s still a lot of work to be done, but I deserve to give myself credit along the way.  And maybe the next time I misinterpret, the wallowing period will be ever so slightly shorter before I’m able to start to rein in those thought gremlins.

 

Image credit: desertrose7 on Pixabay

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

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 all the other 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

 

Follow my blog with Bloglovin

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