JANE'S MHSP ARCHIVES: 1998

Where Do I Begin?

Finding out you have a mental illness is very frightening even when you probably have been living with it long enough to know something is wrong. You have talked to your friends and family members and nothing seems to be getting better. You suspect this may be more than just “psychological” or an occasional case of the blues. What do you do? Based on personal experience, here are important steps I’ve found that helped:

Write down a list

Write a list of what has been going on with you that puts you at the current point you are in. The reason why you’ll want to write this down (ex. “losing productivity at work, not eating, trouble sleeping”) is because you will have to recount them on the spot when you call a doctor. Answering questions can put you in an uncomfortable spot, so it will be easier to have things written down. When I first made the phone calls, I was embarrassed and nervous. I almost changed my mind and hung up the phone!

Here’s a short list to get you started; the list is actually based on a few of the criteria for diagnosis of major depression. For bipolar disorder, you may want to also include any extremes in behavior such as sexual indiscretion, spending sprees, incomprehensible and racing thoughts, or extreme euphoria.

You’ll probably need only a few items here for the initial phone call to make an appointment. Bring the entire list with any new information you can think of with you to the actual doctor’s appointment:

• How long have I felt this way?

• Have I lost sleep or slept more than usual?

• Have I gained weight or lost a weight in the past few weeks?

• Have I felt like doing nothing, including things I used to enjoy doing?

• Do I feel like if I were to disappear from the world no one would notice or care?

• Have I begun to try alcohol or painkillers (or any other drugs or substances) to try to “dull” the pain?

• Have I felt constantly irritated or aggravated for the past several weeks?

Call your insurance company

Find out who may be participating providers under your insurance. This is so you know what will be covered and what the policies are. The insurance companies will ask you for the symptoms and this is where your list comes in. When you are speaking with an insurance representative, remember to ask about coverage on medications and numbers of visits. Most health plans only cover a number of therapy sessions – after that you may have to pay a large percentage of the doctor’s fees. Medications may also have a copay.

Call the doctor

The receptionist will ask you why you believe you need help. Tell them what’s on the list.

Now you have a doctor’s appointment. Unless you got lucky (I didn’t!) and could see the doctor THAT AFTERNOON, you have to wait a few days – maybe even a week. What do you do till then?

Take control by learning

Educate yourself on what you may be facing. Chances are, you have a clue to what may be wrong (for example, “I feel more than just blue” or “My mood swings seem to be getting out of hand”). Even if you aren’t sure, there are places where you can browse to start homing in on what might be going on with your moods.

There are many shades of depression or bipolar disorder or traumatic disorder – you may learn which category you may fit in. Don’t be tempted to look at all the disorders and think that you have all of them! I want to emphasize that it is important NOT to make a self diagnosis. Many disorders have overlapping symptoms. If you make up your mind before speaking with a professional, you may cloud the presentation of the clinical symptoms by emphasizing what you believe should be emphasized.

Try to remain objective about the severity of the symptoms. Losing a few nights of sleep because you’re blue is not the same as losing 2 months of sleep because your mind is racing constantly.

Get support

The fastest means of support may come from a newsgroup. Newsgroups are also a wonderful resource for support. Why would you want to do that? Because one of the best things you can do for yourself right now is to seek support and know that you are NOT alone. Ask for email support if that is what you need. People posting there are likely to be going through what you may be going through and will be very glad to communicate because they have been where you are.

Getting support from news groups has been a tremendous help for me. One of the “common” characteristics of people who are depressed is a feeling of isolation and loneliness: “I’m the only weird nut feeling this way and no one else is as crazy as I am.” Getting in touch with people who understood how I was feeling was a big relief.

Remind yourself that it’s all right to “feel bad” then go through the motions of daily life. Sometimes people invalidate their feelings by telling themselves that they shouldn’t be feeling bad. They end up being angry with themselves, which makes them feel worse. Allow yourself to feel bad, but keep doing the boring everyday stuff. Even if you only get one thing done today, you did it, and it wasn’t easy.

Mutual Support

This can be a difficult subject, yet a common concern visitors to my site have is relationships. For example, a loved one has mental illness symptoms, but would not seek help or admit it. The relationship is strained. Or, communication between a mental illness sufferer and spouse is crippled from the pressures of dealing with an emotional disorder. Then there is the issue of “how do I know which is You and which is the Illness?”

“Support” Means Mutual Support

When we think of support, we default to the person managing a mental disorder as the one needing support. However, a relationship is a dynamic state. There are two persons involved, and both need support in a situation where emotional pain is prevalent. Supporting the patient encourages him or her to seek help and to stay on medication. Supporting the “caregiver” or significant other is especially important during the phasic manifestations of the highs (bipolar disorder) and the lows (depression or bipolar disorder) that are emotionally draining to the caregiver.

Seeking support is a way of validating our feelings

We accept that we can feel how we feel without being judged. Separating the person from the disorder helps the caregiver maintain perspective during trying times. Gaining this recognition involves actively educating yourself in how the illness manifests, then choosing coping methods for the particular situation.

For example, you may want to have a signal that you both understand to mean “onset of a symptom”, and agree on what you both can do when this happens. When a person is in midst of a crisis, it helps to have a gentle reminder that something needs to be done.

Establishing boundaries is healthy

When a patient encounters depression, the significant other may try to “cheer him/her up” and end up feeling helpless and frustrated if it did not work. This only makes the patient feel even worse. Rather than turning your back or cutting communication, allow the person to “be”. Let him or her know that you’ll be there if he or she needs to talk.

When you set boundaries and understand that it’s not your fault for “failing to cheer up” someone who is depressed, you will be less emotionally drained. Boundaries also prevent the person who is experiencing mania from feeling “intruded upon”, since senses are often heightened during this phase of bipolar disorder. There is nothing wrong or unusual in feeling angry, hurt, helpless, frustrated, grief, drained, sad, or scared. However, you can make choices with how you want to help yourself deal with those feelings.

Unfinished

Another Friday evening comes
Tuning down the midi hums
Here I sit at my desk and stare
Somewhat jaded and aware
I still wonder through scores passed
At how life oft times feels harassed
Many who knows me don’t believe
Of despairing thoughts I can conceive
Perhaps because I know too much
I long evaded a healer’s touch
So my head churns out bits of rhyme
To work through this confusing time

When I was just five years old
I decided that the world was cold
Then I lived with life for ten
Children became the pawn of men
Young girls run to sweet sixteen
I wait for heaven I’ve yet not seen
Soon life began to up its stake
Pain to sleep and pain to wake
The prime of being twenty-five
Became a thorn for being alive
Spirit cajoled me, “Stay one more
Year to see what life has in store.”

So I stayed to wait a while
I had forgotten how to smile
For me the beauty of love’s rose
Only happened on TV shows
Words became a panicked rant
Peace assumed a dying slant
Death’s still-forbidden cocoon
Allured my senses all too soon

Struggling through my torturous plight
Love calls to me, “Child of Light!”
I look up and said “You’re nuts.
I’m only full of ‘if’s and but’s’.”
Love explains, “I’ll give you a ride
Just until you get back your stride.”
Suspiciously, I looked ahead
Life still seems but dark and dread
I crossed my arms and narrowed my eyes
I tried to decipher the graying skies

Love says, “Keep your feet on the ground,
Forget about that thundering sound
Thank the raindrops that may come
For the rain is the spirit’s rum
You will not need a place to hide
When you’re protected from the inside
Falling down does not make you meek
Strength means naught without the weak
Your spirit’s compassion through your pain
Weaves golden lining after the rain
Your self becomes the healing coals
In the fireplace of other shivering souls.”

Emotional Abuse: A healing letter

“My dearest daughter,

“I don’t know whether I am writing this letter for you, or for me. Maybe it is for us both. There is much I have wanted to say to you over the years but have been unable to do so. It is very hard for me to explain my actions, and maybe it is because I am ashamed to admit the reasons. It is not easy for an elder to admit one’s mistakes to a junior, especially when that person is your daughter. You see, I was supposed to set the example for you, to educate you, to be your role model. That’s a lot of pressure, you know. Humans are imperfect, and mothers are human.

“Being brought up in a different era created part of the wall between us. Back then, a woman’s identity depended on the man she married. She was supposed to bear his children and take care of his home. It’s different now, though. A woman makes her own identity through her career and independence. I think that one of the reasons why I have not been supportive of your career choices is that I am jealous. It’s too late for me. I realized too late how important self-identity is to the soul. Without it, your sense of self awareness dies, and you live through others. It is not easy to renounce the way you have been brought up. It is also not easy to fail to notice things changing around you.

“A person without career or identity has no control and is dependent on others. That what made me resent you. You chose the path which I would have wanted for myself, but could not choose. I could not go against my upbringing, even though I knew it was not in my best interests. As you grew up, you grew more independent, and I was jealous. I felt that I was losing control. So I tried to control you even more. To keep you on a leash. And everytime you broke free it would make me resent you even more.

“Some things I did to you were out of resentment. That was the only control I could have over you. Sometimes I felt that you were taking attention away from me. Attention means a lot to those who have little to make them feel important. When your independence got the better of you, I felt the sting of people’s eyes, the knowledge that I had no control over my daughter. I lost face, and blamed you for it. If you wouldn’t do it my way, then I hoped that you would fail. The past years have been marked with failures of my own, which further increased my frustration. The failed motel business and losses in the stock market. There was nothing I could tell my friends that would save my face.

“In the old days, and even presently in this culture, a woman likes to think of herself of a success if she has married well, and has children that have married well, and she can tell her friends how much her children love her and the things they buy and do for her, and how they take care of her. I want to do that. I feel that somehow, I am owed that. I want to have my friends look up to me and say how succesful I am. ‘Look at her loving children! Look what they do for her.’ It is very hard for me to accept that my success will have to depend on myself. That my sense of self-identity comes from within. They were lies that the old culture told us women. But society still tells them. And even though I know the truth, it is hard to let go of the old ideas. It is too late.

“I regret many of the things I did to you as a child. The only explanation I can offer is like the child that torments a small defenseless animal. It gives him a sense of power and control. But it is control by fear, not understanding. It was the only way I could get a sense of control. I did not have much control over my own life, so maybe I could control another’s. And it happened to be you. And it was wrong. It was out of my insecurity that I did those things. When we were sick and your father paid you more attention, I felt jealous. I felt less important than you. I resented you for taking that love and affection away from me, even though it was not your doing.

“My pride and selfishness is a prison that I do not know if I’ll ever be free from. It is so hard to fight. Deep down inside, there is a voice that tells me what I should say to you, but somehow, a much louder, angry voice drowns that one out and says things I know are wrong. My failures loom so large that I cannot see the successes of my daughter, or be happy for her. I am who I am, and I cannot change that. There have been so many times that I have tried to bite my tongue and refrain from saying the wrong things to you, but my fragile sense of self worth overpowers it, and I still cling to the idea that if I get you to do what I want, then maybe I can save some of the face I have lost. I know it’s selfish, but I can’t seem to control myself and do what’s right.

“I’m sorry that our family environment was not the best for a little girl to grow up in. Ever since you were young, you displayed a sense of self-identity, intelligence and direction that most girls of your age did not have. I felt proud, but for the wrong reasons. I felt proud because it made me look good. It made me glow when people commented on how well behaved you were. It made me furious when you misbehaved, because it was a reflection on myself. That is what happens when you sense of self-identity comes from without, not within. Do not make the same mistakes I did, dear daughter. Your life is just beginning. And you are in control. My angry voice is still loud, and prevents me saying to you what I should have a long time ago. And I do not know when it will quieten down.

“But deep down inside, my quiet voice whispers, and I hope you can hear what it says. “My dearest daughter, I have always loved you. I regret that the ways in which I expressed myself were so confused and convoluted. The ways in which I sought to control you by fear. You are a beautiful, intelligent and loving child. Our roles have reversed; you are now an example for me. My heart is filled with warmth to see you as the woman you are, determined and strong. Your fierce sense of independence and direction in your career is one I wish I had myself. My heart is filled with sorrow when I recall the efforts you have made over the years to be a good daughter to me and your father. We were immersed in our own problems, and could not fully show our appreciation for your loyalty and filial piety.

“It pains me to think about how our problems became yours, when they should not have. It is a parent’s role to protect her child, not expose her to harm. But through it all you handled it with grace and an inner strength which made me proud. When you had your own problems, I wished I could have reached out to you and told you how much I loved and cared for you, but the ‘scolding mother’ in me could only find harsh words instead of words of comfort. I wish I could be as good a mother as you are a daughter, but we are different people.

“All I can say is that anyone would be proud to have a daughter like you. You are entitled to your own happiness, and you do not owe it to me to ensure that I have mine. You have a loving soul and take an exuberant joy in letting those you love know of how you feel. You have a husband who recognizes how worthy you are of love and sees you as the wonderful person that you are. Jane, I wish you all the happiness and success in the world, and I see you now as a strong-willed individual, that can think for herself and knows what is best for herself. I see the efforts you make in life, and want you to know that I am behind you in every step that you take. I am proud to be your mother.”

In pieces

I feel like I am disintegrating. Like my soul has split into many broken pieces and I cannot place them back together because I don’t know where many of the pieces are, and the few that I’ve found, I don’t know how to “put them back right” because I don’t know what I’m trying to re-create.

Earlier tonight I was online and saw someone whom I put on my buddy-list because this person was only recently diagnosed as bipolar and wasn’t taking the diagnosis very well. I am familiar with the initial shock and confusion and fear. Tonight I’m glad he talked a bit, because he was suicidal and had attempted suicide twice in the past couple of weeks.

As I was frantically trying to keep him talking and not give up, my fingers shook terribly as I typed. I hardly ate anything the whole day. I didn’t want to eat because I was in a severe depression slump. When I become depressed, I go against biology even as my stomach was growling at me. I thought it funny to be terribly depressed myself while trying to convince this person not to give up and that this will pass.

I asked him to look up a crisis and suicide hotline in the phonebook – and I went to look for where it might be located on a phone book so he could find it quickly. I found that the crisis line for my city was located just on the inside front cover of the phone book, under the rabies hotline. I joked that it would be really embarrassing if I dialed the wrong number and got the rabies hotline instead. I DID get a kick out of that, even though I wasn’t sure he smiled.

If I were in his position, and I had been, I probably wouldn’t have called. But at least now I know where the number is. I asked him to have that number handy, without necessarily a commitment to call it. Have it handy, just in case. This was something I learned from my husband – doing something “just in case”. That was a good thing I learned.

Disintegration is happening to my cells. I feel the spaces between the electrons and protons and neutrons of my atoms grow, to the point where I cannot tell the beginning of one atom from the end of another. Everything seemed to be a floating mess, an oily pool, a puddle of pain. Tonight I’m trying the 3-depakote-at-nighttime dosage, but I am not sure if I will let myself sleep. When disintegration happens, even the most tired body cripple against a defiant mind. Then they both collapse.

Chatting with this suicidal man gave me a close look at what my husband saw when I experienced the darkest despair from depression. Granted, I was the sick one, but it doesn’t take away the burden that loved ones endure. Chatting with this person helped I understand what my husband meant when he told me that talking with me when I was depressed was mentally taxing for him. This experience made me appreciate that mental taxation.

You cannot walk away because you care. Then you wear yourself out caring.

Weakling

Earlier today I slept more. I can not believe how exhausted I am no matter how much I slept.

I slept at 4 a.m. this morning and woke up at 6… then at 7… then at 7:30 because I just was so exhausted. Turns out the lab training is tomorrow. So I went to see Dr. M instead. Dr. M said that when I keep hearing I’m weak, I might just start acting that way in a rebellious, “fine then I’ll show you how weak I can be” mentality. I haven’t thought about that.

Perhaps I grew angry at being called weak because this is what I am. I know I am physically weak but I can accept that. I cannot accept mental weakness. Perhaps I want to clutch onto the little bit of mental strength I believe I have left. This illness has left me feeling lost and defeated but I want to believe I still hold a compass that will guide me through my journey.

I feel ashamed that I deemed myself intelligent and articulate, yet I cannot argue against suggestions of my mental weakness. I didn’t have a track record of consistency and perseverance to counter this argument. Even if I am in a doctorate program in one of the more difficult majors one may pursue, I feel my work is questionable.

I suppose if I have admitted that I am indeed physically weak, were I to lift my blinders, I will only have to also admit that my physical weakness saps my mental strength. Then I will have to admit that in some ways, I have given up control.

Every time when I admit to a flaw that I fear admitting to, a strange thing happens: my flaw takes a lesser grip on me. It’s almost as if I were exorcised, that by admitting I AM flawed, I garner more strength, the strength that I had been draining towards maintaining a facade.

I suppose life is a constant display of the paradoxical and the absurd.

It’s an amazing show.

Unsightly

I wonder if this is another one of those projects I’d start but don’t finish. I’m even capitalizing correctly, I must be taking this rather seriously, ha-ha.

This Monday I went to the doctor’s, and an hour-and-a-half later, emerged from the office clutching in my hand a photocopied sheet of the diagnosis: “Bipolar Disorder-II”. Great, I grimaced. All this time, I thought I was ‘clinically depressed.’ Now I’ve got a whole different ball game to deal with, one that I’ve not dealt with past skimming a Psych-101 text book from college. And what does ‘manic’ really mean? Bipolar Disorder is the current preferred term over ‘manic depression’. I’m not manic! I’m not hyper… am I? Maybe it’s the strange and silent whirring in my brain that seems to keep going on most of the time and preventing my tired body from slumber. Maybe the strange bursts of energy that comes from nowhere, and translates into nothing particularly productive. The energy drones on and on….

The evaluating nurse told me she did a little survey a while ago on how readily people would admit they have bipolar depression and asked whether people would rather admit they have bipolar disorder or an STD. I jumped to the answer in my head.

“Why would anyone choose STD over bipolar?”

“That’s what one would think!” said the nurse.

It’s been about 3 days since I’ve found out that I have, in the psychiatrist’s words, “a touch of bipolar disorder” and I begin to understand why people would choose to feel unsightly from STD rather than unsightly from bipolar disorder… or any other mental illness for that matter.

Brains are frightening things simply because even amidst our biotechnological revolution, we still have little clue to how it works. Something happens inside the soft spongy grayish white mass and we have no idea what exactly. Unless the brain experiences gross anatomical misformations or atrophy, we would have to use complicated machinery just to get some kind of a pattern of its activity, but not exactly a roadmap to what’s happening. We naturally fear what we don’t understand, that was why the ancient people sacrifice virgins and boil potatoes (or do they boil something else? I just made up the latter part since I have no evidence of any potato boiling by any aboriginal tribes,) we are afraid of the unknown.

Mental illness belongs to dysfunction in the brain, which largely remains a mystery even to modern science. With STD… well… just check under the ‘scope or take a look and there you see it. At least you can see where you are applying your salve on! Where do I find the problem in my head, and once found, a salve for it?

Maybe the fear of unknowns have less to do with our stigma towards mental illness as… fear of loss of control. When you say you have STD, people would look at you like you’re stupid, and frequently, you were indeed – for not slapping on the glove before you go to love (and love doesn’t play a role in half the cases). Unless you were fooled by the partnering dickhead who didn’t tell you they’ve rolled in contaminated hay, this is something you CAN control.

When you say you have bipolar disorder or a mental illness, people start looking at you like you’re someone to be watched out for, to avoid, to be careful around because… heck you might be… crazy.

It’s the loss of control over one’s destiny that seems more frightening to others because it might mean they also have no control over their own.

Vomit

When my father went overseas to work for a year, it was an emotional struggle for my mother. I can understand it now, because I was in a long distance marriage myself as I finished school on one coast while my husband worked on the other. Even though my mother has friends and family close by, it just wasn’t the same. I don’t condone what she did even if out of ignorance – but I have learned compassion for her situation and her mental state of mind.

When I was five or six years old, I became rather sick with a fever. My mother took me to a clinic and the doctor prescribed some pills for me. I’d always gone to the apothecaries and the herbal powders, even though bitter, weren’t too bad to swallow. Western medicines were saccharine syrups in strange lime-green and black colors, and the pills were huge and intimidating.

That evening it was time for my medicine, and I was in my parents’ bedroom. There were five pills I had to take, one was particularly large – the size of a multi-vitamin pill or a big furry caterpillar. I had usually been rather good at taking medicine because I was taught to be an obedient child. However, that night I felt tired and feverish and uncooperative. I was also crying. I wanted to take the pills one by one. But my mother wouldn’t hear of it – I was to take all five pills at once. I looked at the pills in my palm, horrified and intimidated. I was afraid one of them would stick in my throat and I’d choke to death.

I didn’t argue. Crying, I popped the pills into my mouth and drank some water to push them down. I threw up – my mother had already prepared a tin basin just in case, and sure enough the contents flew into the basin. She was angry that I had wasted the pills. She counted out fresh pills and handed them to me.

She said, “If you don’t swallow these, I don’t want you anymore and I’m going to leave you.”

My life was dependent on swallowing these pills. I’d surely die. I was numb with horror and fever.

Another valiant attempt, but I couldn’t hold it down. Once again the pills came flying out of my mouth and into the basin. My mother took off, like she said she would. I – a normally quiet and docile child – began screaming after her.

“Mommy! Come back! Mommy!”

I grew more shocked as I heard the door slam, and I knew that my mother had left me. I was an evil child because my mother would not want me anymore. My uncle’s wife rushed into the bedroom when she heard me screaming and sent her brother out to chase my mother down. She comforted me and told me that my mom will come back.

My mother did come back, and I remembered her hard expression. I’m still scared of throwing up to this day.

Sick of Suffering

I’ve decided to make an appointment tomorrow.

I’ve tried to “best” myself – analyze myself to shreds – but I keep falling short and I don’t know how to climb over the fence.

I’m sick of wanting something, but feel this invisible wall placed over me; it’s like I can see it but I cannot get to it.

I’m sick of feeling like I’m worthless no matter what I am consciously aware of. Just feeling like a big nothing and that no one would really, in their clear minds, want me or cherish me.

I’m sick of being afraid all the time of thoughts in my head that I can analyze but cannot wave away.

I’m sick of feeling like I’m just not good enough for anybody else – and everybody else.

I’m sick of consciously knowing that I am a capable human being but feeling like I can never amount to anything.

I’m sick of this all, and I am really desperate.

I’m sick of feeling helpless and frustrated and defeated – by me.

I’m sick of being such a big mess for myself. I’m sick of neglecting and abandoning Me.

I’m so sick of this I am Hurt. I’m so sick of this I am Angry.

I am aware but I cannot seem to perceive. I want but I cannot seem to achieve. And I’m beginning to wonder if I should consider the possibility that I might need a good dose of serotonin to experience what life can be like without feeling sick of myself.

I’m scared of losing Me.

I’m sick of Suffering and I’ve had enough.