Poems of Further Neglect

Well, I still can’t write.  Because reasons.  Lots of stuff stuck in my head.  But apathy.

Also, the upcoming move is kicking my ass.  Even though I’m not actually doing anything.  I kind of suspect that’s why I’m stuck in anhedonia-land.  It’s like some evil plot that mental illness likes to play: Need to get something done?  Tough!  Time to put on the brakes and completely paralyze and defeat you!  Whee!!!

Or rather: meh.

I feel like if I don’t post anything at all, I’ll completely lose momentum and also NO ONE WILL EVER READ ANYTHING I WRITE AGAIN.  Because melodrama.

So you get more poetry.  My poetry (sorry if you were hoping for something more clever).  These are from my book I Am Not These Things.  Which you can totally buy and I will be pennies richer.

~~

THE ACTRESS

There are times outside of the proscenium
When you, your tongue loosened by wine, and fire reflected in your eyes,
Become especially beautiful

Your laughter mirthful,
Alternating between throaty guffaws and the giddy giggles of guilty indulgence

You close space
And stop time

Spilling compliments and golden droplets of affection
To coat my palms And tuck into my heart’s back pocket

The waves of your hair, platinum mixed with straw
More often punished from view
Now resist constraint, twisted carelessly in a loose braid
Ready to swing away, unpartnered
Or perhaps only waiting for my fingers to cut in
And begin the dance

~~

BEAUTY

When you holler
Hey baby Hey baby
Looking good baby
Look over here, beautiful
Uh huh
Hey gorgeous

I get angry because
How do you know I’m beautiful
Just by looking at me

When you don’t even know me

~~

MOTHERS

I distinctly remember being much more mature for my age
When I was your age
And more respectful of my mother

Don’t believe your grandmother, though
Because she wasn’t nearly as understanding as I am
When she was my age
Back then

/rk

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Riding the Anhedony Pony

It would be great if I was prepared for days like this by getting everything done that I needed to ahead of time.  That’s not quite how it works, unfortunately.  I took it pretty easy this weekend because physically I was in the middle of a bad flare-up of my arthritis and figured that somehow that would prepare me for being super productive today.

Unfortunately my body and brain never seem to have their shit together, cooperation-wise.

So here I am today, over the worst of my arthritis flare (and therefore technically capable of getting things done), but I am stuck.  Can’t do anything.  Don’t want to, don’t care, and didn’t even want to crawl out of bed this morning.

Can’t think.  Can’t write.  Can’t get up and move things to the new house, which I was really excited to do yesterday but was physically unable to do.

Anhedonia has got to be the most pathetic and useless state of being.

If someone tells you they’re too depressed to do something, you might have sympathy for them.  I’m not depressed.  I just don’t feel anything or feel attached to anything or feel motivated to do anything.  I mostly want to just stop doing anything.  Even watching a video feels like too much work, because I’d have to make a choice about what to watch.

When I’m suffering from depression, I spend a lot of time sleeping.  But I can’t nap.  Everything seems unachievable – even nothingness.  I can’t even do that right.

I feel uncomfortable in my own skin.  Textures bother me.  Lights are too bright.  I don’t feel like eating, but if I don’t, I’ll feel worse (thanks diabetes!), so I eat anything that’s easy and doesn’t require decisions.  But it doesn’t taste like anything and it’s more about function.  Eat something and my body won’t bother me for another few hours.

It’s taking me a ridiculous amount of time to even complete this post, because no reasons.

Actually?  I don’t think I will.

/rk

Urbanitey Nite

We take possession of our new house tomorrow.  It will be a few weeks until our actual moving day, but it’s still pretty significant mentally as the shift from here to there.

The last 10 months have been really tough for me.  I made a decision to move out of downtown to the suburbs; which was sound financially and good for my partner, but unfortunately rather disastrous for me.  I can’t honestly say I didn’t see it coming — I just didn’t want to see it coming.  Sometimes my inner mental and emotional needs (and outer physical needs) aren’t practical.  But I’m finally getting the message that they can’t be ignored.

I grew up in the suburbs, and it always felt like a prison.  It’s difficult to explain.  All I know is that when I was there, I felt oppressed and constricted and trapped.  I started to get a glimpse of urban life in my teens when I got into an accelerated program at a high school downtown.  I ended up becoming best friends with a girl who lived not far from the school and spent most weekends at her house.  But I still had to go home eventually.  In my 20s I moved downtown for a year or two, but that changed when I started dating (and ultimately married) my first husband.  I was back in the suburbs.  Trapped again.

During my second (common-law) marriage we nearly went into financial ruin because of my push to move back to downtown.  It was an obsession, definitely, but I knew I wouldn’t feel right again until I was there.  And I did feel right once I was there.  Unfortunately I also felt trapped because of the relationship, so I left the husband, moved out of the house but stayed downtown.

Again, we were briefly pushed out of downtown when I became disabled and couldn’t afford the rent there while we waited the three months for the disability payments to come through.  But as soon as they did, I cut out of my lease after only six months and we moved back to our old neighbourhood downtown.

So what, exactly, made me think I could survive another move out-of-town.  Not just to the suburbs either, but the far suburbs.

I guess the simple answer is that I didn’t want to make it a money issue between my husband and I.  He’s a very practical person.  I wanted to be practical.  It was hard for me to justify the additional expense because of a feeling I had.

A feeling.

It’s interesting how, as someone with mental illness, I get angry when others diminish the impact of the effect of emotions on me as a sufferer of bipolar disorder, and then turn around and do the same thing to myself.  I guess when it comes to me, I can be a bit of a hypocrite.

So we moved to the suburbs and everyone adjusted quite well.  Except me.

I mean, I put on a good front for what seemed like a long while.  I tidied the house, I made dinners, I took the dog for long walks.  I tried to adjust.  But the bad feelings started to creep in, anyway.

I stopped doing much around the house.  I stopped showering.  I spent most of the day sleeping.

That went on a long time before I finally spoke up to my husband to tell him that I wasn’t happy.  It’s a really hard thing to tell someone you love, at a time when you’re supposed to be happy for finally being together, that you’re not.  Especially if they can’t change the thing that is making you unhappy.

So that’s where we were stuck for a while.  Me feeling unhappy and trapped but trying to fake my way out of it, and him being unhappy that I was unhappy and feeling stuck with no way to fix it, until finally thanks to some unexpected financial changes, we found a way to fix it.

At no small cost to them, mind you.  My son has to change schools again.  My husband now will have a long commute to and from work everyday.  All because I couldn’t hack it.

That’s a huge responsibility.

On the one hand, I’m relieved.  I’ll be back in the hustle and bustle of downtown.  Close to people walking and moving and being.  I don’t know what it is that is so important to me about that.  Something about knowing I can walk to everything.  I’m not trapped by needing a car.  Things are laid out in a grid and I can find my way around.  I guess there’s something about being downtown that makes me feel very self-sufficient.  Very un-trapped.

But there is also a certain amount of pressure, because I worry about everyone else adjusting.  If they hate it, I will be to blame.  Which I guess is why it was so difficult for me to speak up in the first place.  I don’t like always being the squeaky wheel.  Except unfortunately, I am always the squeaky wheel — or at least the wheel that squeaks the loudest.  When I’m miserable, everyone is miserable, because my misery tends to get amplified by my mental illness.  I hate that about myself, but I also can’t deny it.

The next two weeks will be the hardest as we dismantle our current house and set up the new one, and I have to deal with mixed feelings of exhilaration and guilt.  I want to jump ahead to when we’re settled in and know that it hasn’t been a huge mistake to put my needs first.

/rk

 

What’s Up Pdoc?

It’s difficult for me to speak positively about the psychiatric profession.  In spite of my own negative experiences, I see therapists on television who seem wonderful, dynamic and caring.  Gabriel Byrne’s Dr. Weston on “In Treatment” was fascinating.  Even when he made ethically questionable decisions and recommendations to his patients, there’s a man I’d enjoy talking to.  And Vanessa Redgrave on “Black Box” has already demonstrated in one episode that she is able to unflinchingly tackle her patient’s flawed thought processes head-on, while still managing to remain kind and compassionate.

But those aren’t real people.  Real psychiatrists generally aren’t like what you see on television.  I’d like to believe that those types of practitioners exist — because it’s hard to remain hopeful if you believe an entire field of medicine is a sham — but I have yet to meet any of them.

I know I’m probably being somewhat unfair in my expectations.  One of the reasons television pdocs have the right answers is because they’re written by the same people who ask the questions.  It’s not real life.  In real life you have to think on your toes and answer off-the-cuff.

Except… not really.  Psychiatrists are supposed to be trained for this sort of thing.  It’s their job.  They have scripts and scenarios.  They are supposed to know the warning signs.  They are supposed to know what to say and what not to say.

And yet in my experience, most of them say almost nothing at all.

Getting a referral to a psychiatrist is no small feat.  If you’re lucky, you might see one within a year of a referral from your family doctor.*  At the time when I first asked my doctor for help with my mood, her only option while awaiting referral was to diagnose me with suspected depression and anxiety and to prescribe me antidepressants.  They only made me more anxious, so she increased the dose.  This induced mania and psychosis.  I still had no referral.

In a moment of clarity between psychosis and the ensuing crash, I returned to the doctor’s office and told them I thought I might do something bad.  They insisted I go to the ER, whether by ambulance or they could call my mother.  I opted for my mother.

pay attentionThey left me alone to wait for her in one of the examining rooms.

Alone.

I went through the (unlocked) drawers and cupboards.  I found a box of razor blades.

Razor blades.

I took one out.  I stared at it for a long time.  I put it in my purse.

We waited for several hours in the ER.  Eventually a doctor from psych came to talk to me.  We discussed how I was feeling and the fact that I had been suffering from insomnia for several months and that I had lost more than 20 lbs.  She confirmed that I had a referral to a psychiatrist.  She told me it would be best to wait for the referral.

I told her again that I was feeling suicidal and I asked to be admitted.

She said that wouldn’t be possible as the psych ward had no beds.  She said it would be best to wait for the referral and she could give me an emergency hotline number and a bottle of sleeping pills to help me sleep.

A bottle of sleeping pills.

I asked her if she thought giving a bottle of sleeping pills to someone who says they are suicidal was good medicine.

She said she would only give me 3 or 4 instead.

I removed the razor from my purse and put it on the table.

I was admitted to the hospital.  Because there was no room in the psych ward, I was admitted to one of the regular floors with a security guard posted to sit in the room with me for the first 24 hours.  The next morning I saw a psychiatrist.  He offered to prescribe antipsychotics and change the antidepressant I was on.  But only on the condition that they would give me one-third the dose of the narcotics I was on for pain.

Their strategy to turf me was bitterly transparent.  They would give me what I needed — the drugs for my as-yet undiagnosed bipolar — but I’d have to be willing to go through narcotic withdrawal.  The fact that I had been legally and justifiably prescribed those narcotics by my doctor didn’t make any difference.  Ultimately they knew I’d either refuse and sign myself out of my voluntary committal or I’d accept and bail after a few days of withdrawal.  I lasted about 3 days.  But at least I now had the medications I needed to bring me out of mania.

happy cartoonWhen my referral appointment finally came, I met with the psychiatrist at the Royal Ottawa Hospital.  She reviewed my history.  She reviewed my medications and asked me if I felt they were working.  (No.)  She upped the dosage.  I saw her several more times.  Every time, she asked if I felt there was an improvement.  There was no counselling.  (Unless you count “try to think positive thoughts” and “try to focus on what makes you happy”)  She just continued to make changes to the medication and say “these things take time.”  Then I got transferred to a different psychiatrist.  Same thing.  Then a third.

There was no therapy.  There were only drugs.  Antipsychotics, sleeping pills, antidepressants, anti-anxiety pills, lithium.  I stopped going.

When it comes to mental illness in Canada* there is a certain pattern of triage that consistently occurs.  If you suffer from depression, maybe you stand a chance.  You’ll see either a psychiatrist or a psychologist and the chances are good that eventually you’ll get talk therapy or behavioural therapy to change any faulty thought patterns that you need to go along with any drug cocktail they deem necessary to change your brain chemistry.  Someone will ask you about your trauma.  Someone will help you deal with your abuse.

But if you have bipolar disorder or schizophrenia, you become a medical patient.  Drug therapy is the only perceived solution.

And that is incredibly short-sighted.  The human mind is complex.  In the same way that my bipolar has shaped my experiences, my experiences have shaped my bipolar.  Why wouldn’t I benefit from therapy?  When the voices in my head haunt me and taunt me, why shouldn’t I be prepared with the tools to fight them?  With all the studies that show links between trauma and mental illness, it is completely irresponsible how the mental health industry fails certain categories of patients.

I acknowledge that it’s a complicated issue.  First and foremost are the restrictions placed on mental health treatment by the government.  Under OHIP, there are limits to coverage for mental healthcare as well as limits to the number of visits that are covered (which might make sense for things like situational depression or seasonal affective disorder, but not for a great majority of permanent and lifelong mental illnesses).  Compounding the problem is the unhappy marriage of the fields of Psychology and Psychiatry.  They are unwilling bedfellows at best.  Disagreement (and occasional outright disdain) between the two professions stands in the way of patients receiving possibly more effective combined therapies.

I try not to be pessimistic.  I don’t always succeed.  At a time when mental health organizations are pushing social media campaigns to remove stigma and encourage an open dialogue about mental health with things like Bell Canada’s “Let’s Talk” and ROH’s “You Know Who I Am” (and weirdly named “Friends with Benefits”), there is still a more important area of dialogue that I feel is missing.

And that is the one between mental health professionals and their patients.

You have a responsibility that extends beyond your prescription pad.

/rk

*For reference, I am in Ontario, Canada in a fairly large city.  Referral times for other locations certainly vary, but it seems to be a common theme in most places that referral times are one of the things that pose the greatest risk for patients with mental illness, especially those at risk of suicide.

Beware The Undertoad

There are a lot of things we hear as little kids and never question.  Or maybe I was just one of those kids who only questioned things I didn’t understand, and if a thing made sense to me – even a weird, convoluted, twisted kind of sense – I just kept my mouth shut.

Some of those things were fairly benign.  For instance, I believed for years that the train on Mr. Rogers’ Neighbourhood carried its passengers through the wall to the ‘Land of Maple Leaf’.  Yes, I acknowledge that make-believe seems far more logical now, but at the time it would have seemed completely plausible if it had been the Land of Purple Potatoes or the Land of… well anything, really.  It was a kid’s show and my mind was open to possibility.  Upon reflection, the Land of Make Believe is pretty lazy story-writing, really.

Beware the Under-Toad

Beware the Under-Toad

Which brings us to the under-toad.  As a child I spent a lot of time at our family cottage; which provided a beach with relatively easy swimming, since the current didn’t pick up until much further out than I was generally wont to swim.  I was about 4 or 5 when one day we hopped  in the boat and motored out to the sandbar down-river.  It had a great stretch of yellow-white sand perfect for beach-combing.  We were allowed to wade in the water, but always with the caveat not to go too far out and to “be careful of the under-toad!”  My mother would say this sternly, so I could tell she was serious… but it also confused me that she didn’t seem a bit more panicked.  The notion of some creature waiting in the depths to pull me under initially kept me out of the water.  I sure as hell wasn’t going to take any chances.  I think she sensed my hesitation, and she gently admonished me and ushered me in.  “You can go in, just be careful not to go out too far.  No further than your waist.”  I was beginning to wonder if my mother had my best interests at heart.  This was starting to seem more than a little reckless.  How the hell was I supposed to know what was too far?!

I started to imagine that big toad out there, watching me inch forward, eagerly plotting my demise.  The damned river water didn’t make anything better, since the current made it hard to see what was going on down there and played tricks with my imagination.  Ultimately I made a speedy retreat for the shore and declared the water too cold.  I spent the rest of the day looking for beach treasure and checking uneasily over my shoulder to double-check if anything had snatched my little brother.

I don’t remember when I was set straight, but I felt a bit better about the whole thing after reading The World According to Garp, in which Walt suffers a similar confusion.  ‘Undertow’ is sort of meaningless word, and I guess it’s just easier for a young mind to imagine the concept of a malignant being dragging you to your doom than a confluence of water catching you randomly unaware.

~~~~~~~~~~~~~~~~~

When I met and fell in love with my husband, I experienced a confusing mixture of exhilaration and terror.  He was so level-headed and emotionally stable.  He was kind and loved life.  He was just so… normal.

No… that’s inaccurate.  Better than normal, which sounds so boring and vanilla.  He was engaged with life.  He actively enjoyed the world around him and was happy.  A lot.

And I became immediately convinced I would ruin him.

Even after I realized my emotional antics didn’t seem to be driving him away — that my bouts of irrational anger, paranoia, crying for no reason and separation anxiety were met with patience and an effort to talk and understand me rather than a withdrawal of affection or outright rejection — there were moments of deep depression that sunk in where I wanted to set him free from me.

Not because he couldn’t take it.  But because I didn’t want him to have to take it.  I would see him looking at me with pain in his eyes, caring for me and worrying for me as I sunk deeper and it would just add to my despair.

I was the under-toad.

horrible personHere was this sweet, kind man… and I was going to drag him under.  I didn’t want to, but I knew I wouldn’t be able to help myself.  I knew without question that the dark misery I was powerless to escape would transform me to the under-toad and drag him to his doom.  Because there was no way his sunshine-y heart could withstand my black, poisonous soul.

I finally tried to explain this to him one day and he simply said:  “That won’t happen.  You can’t drag me down.”  I tried to strenuously argue with him, but he simply stressed that he felt concern for me when he watched me suffering.  Concern and sadness.  And frustration.

I took this as confirmation of all my fears.

Once he calmed me down again, he stressed that he would not deny that he felt these emotions.  But he was not overwhelmed by them.

~~~~~~~~~~~~~~~~~~~~

That was a tricky one for me to wrap my mind around.  The problem with mental illness is that it distorts reality.  It amplifies emotion.  There is a huge difference between sadness and depression.  Depression is a whole-body experience.  Your body aches.  You sleep too much or too little.  The world is too bright.  Food tastes wrong.  Everything in the world that you could trust is no longer to be relied upon.

I forget sometimes that other people don’t experience emotion the way I do.  When you have bipolar disorder (or other mental illness), you start to assume that everyone is a slave to their emotions and anxieties the way you are.  I first toyed with suicidal ideation at the age of about 4 or 5.  I remember being a bit shocked to realize those sorts of thoughts never crossed other children’s minds.

Realizing that I wasn’t giving my partner (now husband) the credit he deserved for being his own judge of what he could and couldn’t handle was a revelation of sorts.  I stopped being afraid of sharing my dark thoughts.  As horrible as things were in my head, when I spoke them aloud and we talked about them, he became a welcome sounding board for helping me sort reality from delusion.

The experience has also helped me realize how much I have been drawn (in the past) to relationships with other people who suffer from mental illness.  And how much that fed into my inability to pull myself above water.  I felt like they would understand me.  And they did.  But when you are clinically depressed, another depressed person may be either too self-absorbed or emotionally incapable of saving you from drowning.  When you say “life isn’t worth living,” they might just agree with you.  We had a tendency to bring out the worst in each other.

Pessimistically, it never even occurred to me that a sane person might actually rub off on me.

There is no cure.  I can’t be fixed.  But having a positive influence in my life to help chase the demons away is something close to good.

/rk