it needs to hit you with a thud, lani
my therapist’s body was taught, and her eyes were serious.
you have a chronic, progressive disorder. progressive, meaning that without medication, it will almost definitely get worse
recently, a friend asked what i would consider my biggest non-relational accomplishment. i answered,
finally getting to a point where i can accomplish things
“you seem exhausted.”
“why are you so tired?”
i had to come off a stimulant medication that i had become dependant on
“a stimulant! why are you on a stimulant – do you mind me asking?”
um, i haven’t talked about it much, but
i’m actually on a number of medications, because
i mean, i struggle with
i have mental health diagnoses.
post-robin williams, it seems almost passé to come out of the mental illness closet. many of us are inoculated against the shock of learning that someone we look up to, someone we know, someone we love has a broken brain. there are so many of us. despite this cultural trend toward acceptance, though, the closet looms large and inescapable for the many who are still incarcerated in secrecy.
and the worst part? many sufferers can’t muster the strength to leave the closet of secrets until their mental illness is in remission.
i have always been afraid.
when i was born, the first words out of the doctor’s mouth were not, “it’s a girl.” no, that doctor in a little city in eastern washington remarked, “my, that child can scream.” after a few months or years, the outer scream turned inward. as a child i was terrified, intense, either up or down. there was no middle ground for my moods, thoughts, or energy.
i finished high school at 13, was working full time at 15, started college at 16, got married at 17, and at 18, i crashed. years of a secret, deep depression followed as i floundered, trying to make sense of a life that grew less precocious every year.
i worked as an office manager. i taught piano lessons. i music directed children’s theater. i started a photography business.
i cried almost every day. i struggled to accomplish even the smallest task. i hid. i faked. i begged god to fix me, to reach me, to change me. i engaged in depressive behaviors that led to a downward cycle of worthlessness. my life, like the lives of so many who suffer in the dark, was a paradox. i simultaneously loved and hated life, and my greatest hope was that i could someday escape the hopelessness.
i could write a book right here, a book of the things i did in the dark, the things i said in the dark, my fight with the dark, the ways i gave in to the dark. it would be a long, repetitive, depressing book. if you have ever suffered in the dark, substitute your book here, and we’ll just skip that part.
this went on for almost ten years.
i follow my 7-month-pregnant belly into anna’s* office and huddle on the couch. my fingers, pale and shaking from anemia, twist into nervous pretzels.
tell me why you’re here.
i hand her a note from my husband, a note that explains how my struggle with depression has hit rock bottom. i’m not functioning, barely making an effort to care for myself, my fetus, and my 9 month old son. my photography business has crashed and burned, my pregnancy is rife with complications, and my friends are unaware because i cannot reach out. his note explains that he is worried that i will hurt myself. “hurt myself” is what he says instead of what he really means, because he is afraid.
anna’s eyes are the color of warm, her hair loose and wavy. her face, unmarred by any trace of makeup, glows with an inner light.
she is softness.
she is peace.
she is hope.
i remember nothing else from this first session with my therapist. i was numb.
that was the beginning of a journey i had given up, a journey of hope.
this journey of hope began with a step forward, a tiny, incremental step that i don’t even remember taking.
and then another. and then another. i take 3 steps forward and 2 steps back, but i can survive the steps back because that 3rd step is lifechanging. new levels of stability, of mental acuity and emotional regulation open up; suddenly i can fly …
i make plans and execute them. i care for children and get housework done. at the same time! i remember the story i heard on the radio this morning. i am able to track with a spoken conversation and express myself verbally without losing my train of thought. i read whole books!
perhaps even more significant are the emotional changes. i can be alone with my thoughts without having dissociative episodes and panic attacks. i no longer cry every day. and that voice, that awful voice with its abusive script on constant repeat, that voice no longer has free reign in my mind. it is not gone, but it is shackled, contextualized, bound within a dark corner of my mind that no medication will ever touch … but i don’t visit very often.
why did this change happen?
it wasn’t a great effort of will. it wasn’t because i finally got my act together. it wasn’t because i finally lost those last ten pounds. it wasn’t because i abused my mind into compliance. it wasn’t a result of a great spiritual awakening, extra bible reading, or finding the right prayer.
no, at 27 years old my life was turned upside-down by hope because
i took a pill.
this journey of hope that i’m on is wondrous … but apparently hope can have unfortunate side effects. it has also been a journey of medication trials, therapy, and diagnoses.
what are my diagnoses?
i don’t mind sharing them; i am not ashamed. i have bipolar ii and adhd. people with bipolar ii are on the spectrum between bipolar i and major depressive disorder, and often spend a significant amount of time in major depression, cycling between that and agitation, anxiety, and hypomania. women with adhd often flounder through school and work, unable to sustain ideas, remember, organize, multitask, or plan. both are treatable with medication and lifestyle changes.
i have trialed more medications than i can count on my fingers. anna calls this “failing” medications. i’ve failed a lot of medications due to inefficacy and, mostly, side effects. the side effects have been awful: crawling skin and weight gain and whacked up blood levels and headaches and exhaustion and shaking and irritability and exacerbation of the very mental health symptoms we’re trying to treat. this is not an exhaustive list.
despite this, some have helped. that 3rd step forward comes infrequently but unmistakably. i am currently taking 5 different medications, and am about to start a new one. a big scary high-powered drug that requires frequent blood tests and meticulous lifestyle management.
which brings me to my most recent visit with anna.
it needs to hit you with a thud, lani. you have a chronic, progressive disorder. progressive, meaning that without medication, it will almost definitely get worse.
seconds earlier, i had asked for help with motivation to take care of myself. with two little kids and a house to run, it is often hard to muster the time and willpower for rest, exercise, and other forms of self care, not to mention the level of self-management required for my new medication. “help me change my mindset,” i asked, “i need a reminder of why i need to do these things.”
i’m not trying to shame you or make you feel bad. but we haven’t really talked about this part of your diagnosis. your life needs to change, to adapt around this. you have a serious condition that requires management.
and somehow, it did.
hit me with a thud, that is.
i did not feel shame. i did not feel defective. i did not feel worthless. but in that moment, i felt very, very sick.
you have a chronic, relapsing-remitting, progressive disorder.
i am sick. my brain is sick. my brain is broken. my brain is profoundly, incurably broken.
but i have never felt so free.
because, (and here is the secret that has allowed me to share my secret)
learning in my gut, not just my head, that i cannot overcome mental illness releases me from the from the constant struggle to overcome mental illness. i am released of culpability for this disorder, absolved of blame for my sickness. this is the grace in the diagnosis, the grace of the pills.
because we who suffer in the dark, we know that there is something deeply wrong. and we assume that it is our character. inside the closet, the script plays in stereo:
i am worthless.
i am stupid.
i am lazy.
i am fill-in-yours-here.
over and over and over. for 10 years. or 20 years, or a lifetime.
diagnosis and treatment turns this script on its head, because it acknowledges that something is wrong, but it unties the darkness from our value, our humanity.
i am broken, not worthless.
i am sick, not stupid.
i am stuck, not lazy.
there is a deep freedom in being broken. there is grace in being broken. there is hope for being broken. because no one, not even me, not even you, is broken beyond worth. as megan tietz writes in her post the depressed christian, “the dark night is no measure of your soul.”
my journey is unfinished. life has changed, but it could change back. i have good days and bad days, good seasons and bad seasons, good moments and bad moments. and really, it’s so much more complicated than just “good and bad.” i have hypomanic days and days i can’t focus and productive days and days when i cry and days of peace and days i feel afraid. i’m currently working through a phobia of flying. (don’t judge.)
but here, i just handed you my closet. i handed you my story of darkness, in the hope that it brings a little bit of light into your life.
may we all move toward the light. and may we do it together, one closet door at a time.
*not her real name.