depression

How to ask for help? If mental illness was treated like physical illness…

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Photo credit Hyperbole and A Half Blog

I’ve been struggling recently with trying to figure out how exactly to ask for help.  How do you even tell people around you that you are not okay when you are struggling with an invisible mental health disability?  How do you tell people that the disability which you live with daily and generally “manage” is currently in a crisis state?  How do you tell people that you are struggling with thoughts of harming yourself?  How do you tell people that you need help because you are suicidal?  How do you even bring up the topic of suicide?

It’s not easy.  Half the time I drop the topic casually into conversation the person I’m talking to thinks I’m joking.  They might even laugh, then awkwardly realize I’m not laughing and say “Oh wait, were you serious?” and when I say “Kinda” I hear…

<crickets>

That’s right…nothing.

A lot of the time when I disclose thoughts about harming myself I hear:

<crickets>

Or people keep talking.  Or they assume this is normal for me and say “that’s too bad” and move on with the conversation.

I’ve learned that most people don’t know how to handle disclosures of thoughts of suicide.

If I walked up to you right now with a serious physical medical emergency, for example signs of a heart attack and said “I need help, I think I’m having a heart attack”  I can pretty much guarantee the response would not be:

<crickets>

Someone would do first aid, they’d call 911.  They’d drive me to the hospital.  They’d stay with me.  I’d get flowers and cards, meals delivered.   I’d get time off work, more cards.  People would visit me at home as I recovered.  Friends and family would be so glad I survived the heart attack, they’d offer to help with child care and housework and cooking.

People KNOW how to help with a medical health emergency.  So why do they respond with

<crickets>

to disclosures of thoughts suicide, self harm or other signs of a mental health emergency?

Why is it so hard for me even to disclose the struggle?  Why is there SO much stigma?

I’m afraid to ask for help because of the risk of two things

  1. The person will overreact (call 911, police, hospital, panic, lock up dangerous items)
  2. The person will under react (see <crickets>)

What I really need when I ask for help is for someone to:

  1. Believe me that I’m actually suicidal and that things actually feel THAT BAD
  2. Trust me that I’m not actually going to do anything dangerous, but that I need some help in the moment to achieve that
  3. Listen to me.  Validate my feelings.   Let me know that they can hear I’m in pain.
  4. Remind me that I might be experiencing flashbacks, triggers or emotional flashbacks and that they are real, but I might not be seeing things completely clearly and I might need time to get safe and get grounded
  5. Keep me company (text, phone, go for coffee, take a walk, cuddles)
  6. Remind me that people care about me and that I’m not a bad person.
  7. After validating my feelings, offer some hope that things will improve one day and that I have the strength to carry on until then.  Remind me of some of my strengths (but be realistic, don’t go over the top with praise)

I really believe that you can help people around you who might be struggling with suicidal thoughts.  You can help them by listening to them, believing them and keeping them company.  You can also offer to do some of the same things you would for someone who is physically ill.   Offer to help with child care, meal preparation, cleaning, picking up groceries, running errands, drop by for a visit (ask first), call to check in, text to say hi, send a thinking of you card, send flowers etc.   In my own experience, the worst thing you can do is…

<crickets>

I wanted to share my favourite  blog Hyperbole and a Half and their post about depression:

http://hyperboleandahalf.blogspot.ca/2013/05/depression-part-two.html

How are you?

/ hopeforsanityblog / 3 Comments

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How are you?  How are you doing?

Fuck.   They feel like SUCH  loaded questions right now.

99% of the time people want to hear the standard answer:

“I’m fine thanks, how are you?”

But I can’t lie.  I’m not fine.  That being said, I know that 99% of people don’t have the time or energy to listen to how I’m really feeling.  Maybe they don’t care, maybe they are busy, maybe they don’t have spoons, maybe they are at work, maybe they were just asking to be polite.

I’ve started answering this question with:

“The same.  It’s always the same.  I’m always the same.”

Until I get the verdict, I’m not going to be fine.  I’m probably not going to be feeling better, and I don’t have the energy to lie about it.

I’m feeling grumpy today.  I’m feeling grumpy because I just want to cry when people ask me how I am.  I want there to be space for me to not be okay.  I want there to be space to just not function for a while.

I came home after a long day.  It’s cold outside, unseasonably cold for May.  I was shivering.  It was time to eat.  I decided to make myself grilled cheese. Comfort food.  What could be simpler?

I burnt the shit out of that sandwich.  So burnt it wasn’t even possible to scrap the black bits off the edges.  Throw it in the garbage burnt.   I wanted to burst into tears.  “You can’t even make a simple sandwich!” screamed the self critical voice in my head.  Somehow this burnt sandwich became a symbol for everything I feel isn’t going right today.

It’s difficult feeling lonely.  It’s difficult feeling like the one who is never “fine.”  I feel like I’ve been losing friends or driving people away from me because my life is complicated and I’m not always easy to be around.  I feel like I’m whining, complaining, self-absorbed, wallowing, not being grateful…lots of self criticism.  I know I’m doing the best I can.  It just never seems like enough.

In all likelihood, there are only a few more weeks of waiting left.  Things are going to shift in my life soon.  Potentially in major ways.  I’m so close to the end of this chapter of the journey.  I’m so close I can almost see the finish line.  I can almost reach out and touch my new life.

But it’s just out of reach.  It’s blurry and uncertain.  After 3.5 years in court and almost 14 months of waiting…a 16 month long total (and counting) trial process…it’s actually no longer possible for me to clearly visualize or imagine it being over.  I used to fantasize about getting the verdict.  Where will I be when I get the call?  Who will I tell first?  How will I feel?  What will happen from there?  So many unknowns.  In a way, waiting has become normal for me.  In another way, it has never felt normal.  I’ve never adjusted to having so little control over my own life.

It’s a unique situation.  Very few people in my life can relate.  It’s gone on for so long, very few people still have time to listen to me talk about it as much as I feel I would like to or need to.  Everyone around me is tired and frustrated too.  Nobody knows quite what to say. I understand.  It’s been a long journey.

I’m so close to the end.  But I’m not fine.  I’m burn out and I’m afraid.

Blue Monday.

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Some pseudo-scientific research has shown that the 3rd Monday in January is the most depressing day of the year.  It was even given a name: Blue Monday.

There isn’t any actual research behind this, and of course depression isn’t just caused en masse by a specific date on the calendar.  But, evidence aside, I’m tempted to agree; mid-January is an extremely depressing time of year!  Especially for folks who already live with depression, and even more so for those of us whose depression is seasonally affected (made worse by the darker winter days).

It was a stressful week, the holidays ended too soon and I’m tempted to curl up in bed and stay there until the snow melts in April.

It’s so hard to be cheerful when there isn’t any hope of seeing any green living plants for another 3 months!  It’s hard to be cheerful when it’s – 1 000 000 degrees outside every day and the roads and sidewalks are covered in ice.

I took two weeks off over Christmas.  I was burnt out and exhausted.  I was grateful to have the time off, but it wasn’t enough.  It’s very difficult to relax on demand.  During the second week of the holiday break I took a vacation on my own.  While I was away I walked for hours every day, as much as 20 km per day.  I took photographs of all the beautiful green plants and I stood by the ocean.  I walked and walked and walked to clear my head.  It seemed amazing that plants, flowers and trees were growing and blooming in January and that the air was warm instead of freezing my face.

Since I came back I’ve been struggling.  Work has been stressful and I don’t have any more certainty or answers in my personal life.  I’ve been having a lot of memories, flashbacks and PTSD symptoms.  A year ago this week my family law trial started and my PTSD has always been very sensitive to anniversaries of traumatic events.

Since I stepped out of the airport last weekend, into the -25 C air, whenever I’ve felt overwhelmed I’ve been thinking of the images from my vacation.  Specifically, the lemon trees.  Inside my head I’ve been saying to myself, “lemon tree, lemon tree, lemon tree”  like a mantra.  Visualizing the yellow fruit and the succulent plants surrounding it.  Trying to bring back the warmth into this frozen, cold, blue world.

I’ve never been particularly good at positive imagery.  My mind is exceptionally skilled at recreating negative, scary or traumatic imagery!  But something about this lemon tree seems to be working for me.

It’s a grounding technique I’ve taught to my service users at work, but one I’m not good at using myself.

So if you are feeling blue this week, dark and hopeless about the world.  Maybe try imagining a time or a place in your life when you felt safe.  An image from a vacation, a childhood memory, your favourite place to relax.  Breathe deeply and slowly and visualize that safe, happy place.  Try to imagine yourself there.  Escape, just for a moment.

Because I have a feeling this is going to be a difficult week for a lot of us.

Sending out much love and support to you all.

 

Not really accommodating.

/ hopeforsanityblog / 2 Comments

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It’s frustrating trying to explain invisible disabilities to people who don’t understand disability.

It’s even more frustrating when people, places or organizations which claim to specifically accommodate or treat folks living with a specific disability or illness, don’t even remotely accommodate the symptoms of that condition.

I live with chronic, complex PTSD which has remained somewhat unresponsive to treatment.  I consider it a disability because for me, at this time, it appears to be permanent and it impacts my life on a daily basis.  It changes the way I think, act and complete tasks of daily living.  It also changes on a daily basis, which means some days I am quite simply more “able” than other days.

I recently sought alternative treatment at a clinic which claims to specifically treat people with PTSD.   This is their main focus is on helping clients with PTSD that has not responded to psychiatric medicine.

Logically, I thought that this clinic would be expert at accommodating the disability of PTSD.  Makes sense right?

I had a pretty good first experience there.  The doctor and the counselor I met with were helpful.   But the receptionist…not so much.

I had some issues with the treatment that was prescribed.  This was nobody’s fault.  But I needed to make another appointment to change the plan, shortly after the first appointment and sooner than planned.

To someone without PTSD and extreme anxiety this wouldn’t have been a big deal.  Just call, re-book the appointment and move forward.

But for me, it was a nightmare.

I felt like it was my fault.  I’d chosen the wrong plan to begin with.  They were going to think I was crazy for changing my mind.  They weren’t going to believe me about the side effects.  They were going to question me.  I felt embarrassed.  I felt ashamed.  I avoided making the call.  I invented stories in my head about how bad it would be going back. I felt angry that the plan hadn’t worked out.

I avoided calling the secretary and emailed the counselor.   He had told me I could contact him if I  had any issues and had seemed approachable.

Person with PTSD is going to choose to approach the least threatening person.  Person with PTSD (me) is going to choose email rather than speak to a person on the phone if they feel embarrassed.  The phone sometimes seems extremely intimidating to me.  What if I get nervous and say the wrong thing?  What if they say something that upsets me?  With email I can plan what I’m going to say and the response.  There is time to react calmly and clearly.

The secretary called me back.  I missed the call.

Then I avoided calling her back.  Anxiety was making the decision.

She called me again.  I missed the call.

I avoided calling her back.  Anxiety was making the decision.

My kids got sick, I had a stressful week at work, I procrastinated calling her back. I was busy with other things.  But I was also working through the anxiety, getting myself to a place where I felt I could make the call.

She left me three messages and probably about 3 weeks went by.

Today I called her back, expecting to apologize for not returning the call sooner, make an excuse about my kids being sick and then re-book my appointment.

But receptionist was cold and very abrupt.

“You waited too long to call me back.  There are no more appointments.”

I was confused.  I asked her until when.

“Until the new year”

I said that was no problem, could she book me in for January.

“I don’t have the schedule for January”

Um….okay…I was getting really anxious by this point.  I asked her to call me back in January and ended the call.

When I got off the call I was frustrated and angry.  I’d been anxious to return the call because I was afraid of being judged for needing to re-book the appointment in the first place.  I waited because of anxiety.  I waited because I felt stupid and I was judging myself.  The anxiety was related to my PTSD and anxiety is a common symptom of PTSD.  PTSD is the reason I was seeking the treatment in the first place.

I told myself the fear of being judged was irrational and that the clinic staff would understand and assist me in booking an appointment because they were there to help me.  I told myself that they would understand that someone with PTSD might be anxious about making a call and thus might procrastinate.  They might understand that someone could have a few rough weeks and not return a call.  I reassured myself.

I made the call.

But it turns out my anxiety wasn’t misplaced.  I wasn’t able to re-book my appointment.  They were annoyed that I didn’t call back right away.  And I’m now seriously questioning how well that receptionist knows how to accommodate someone living with the disability of PTSD.

It’s not about the fact that there was no appointment until January.  I’m fine with that.  I procrastinated, I wasn’t expecting to see the doctor tomorrow.  But the phone call could have been handled differently:

“I’m sorry to hear your kids have been sick and you weren’t able to return my call.  I’m glad I have you on the phone now.  Unfortunately our appointment slots are booked up until after the holiday break, but can I fit you in for the New Year?”

Another option might be

“It sounds like getting phone messages and returning calls is difficult for you, and email is easier.  Sometimes people with PTSD find calls difficult.  Don’t worry, we can book your appointments over email as an accommodation.  Let me book you in for January.”

This post isn’t about that one receptionist and this one situation.  This post is about not making assumptions about why people behave the way they do. Especially if you work in an organization providing health care services!

It’s also about realizing that accommodation for people with disabilities means more than just building a ramp (though ramps are needed too, I’m not knocking ramps!).  It means realizing that disabilities impact different people in different ways.   Accommodation isn’t always something complicated or expensive.  Sometimes it could be as simple as using email as a way of communicating, or offering choices for methods of booking appointments or receiving information.  Accommodation starts with realizing that not everyone lives life the same way you do.  We all have different abilities and that’s okay.

Seeing things.

/ hopeforsanityblog / 4 Comments

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It’s been a difficult week for so many of us, including women and gender non-conforming survivors of sexual violence.  I’m struggling with my PTSD symptoms.

Marian was the only one I could ever talk to about some of my more intense PTSD symptoms.  She was the only person I’ve ever met who I really felt completely understood what I was going through.  I never felt “crazy” when I talked to her.  I could call her, say what happened and every time she would know exactly what I was talking about because she’d experienced it too.

I’ve learned with symptoms of mental illness that there are some things that are more acceptable to talk about, and some things which are more highly stigmatized.  There are some symptoms which almost nobody ever talks about, for fear of being judged or experiencing discrimination or persecution.

In 2016, almost everyone knows someone who has struggled with depression, anxiety or who has issues related to food.  These are things we talk about.

People very rarely talk about suicidal thoughts, self harm, paranoia, delusions and seeing and hearing things that aren’t real.

It’s almost like there is a divide between the mental illness that society accepts and the mental illness that is forced to exist in the closet.

When PTSD is really acting up for me, I see things that aren’t there.

I’ve rarely told anyone about this because I know that most people won’t understand.  Marian understood.  I felt so accepted, like there was at least one other person in the world who experienced seeing things as a symptom of PTSD.

This week, there have been three separate occasions where I’ve “seen” my ex in public places.  It’s so hard to explain how this feels.   The first person was in the food court at the mall.  He had a coat, scarf and haircut similar to my ex, and even though I looked at him and my intellectual mind recognized it wasn’t him, I kept looking back over and over, convinced it was somehow him.  My heart was racing and I felt panicky.   It isn’t just the feeling of mistaking someone else for him.  I actually SEE him, in someone else.  Someone else is replaced by him for that moment and I’m afraid.

This happened again today when I was buying my coffee.  The person didn’t even look like my ex, but he became him for a moment.   My intellectual mind tries to reassure me that what I’m seeing isn’t real, but it feels real.  It happens with cars that look like his too.  Sometimes, I have to check and check again, sure that the car is his, even though intellectually I know it is not.

I’ve had this experience before, in the past, in the years leading up to me leaving my ex.  I would see X sometimes, when I was triggered.  I remember talking to Marian about it.

It’s an unsettling feeling.  Sometimes when I’m very stressed and have been sleeping poorly, I also see tricks of the light which aren’t there.   These experiences are all more illusions than actual hallucinations, but they are still disturbing and they signal to me that my brain is over-stressed, overtired and in need of relief.  My doctor assures me that none of these are psychotic symptoms, but they are symptoms of PTSD.

These experiences of “seeing things” are different that what happens during flashbacks.  They seem to happen just out of the blue when my brain is stressed.

During flashbacks, it also happens that my brain sees something from the past rather than what is in the present.  The person I’m with, “becomes” my abuser, I can’t trust what I’m seeing, my brain is mixing the past and the present into a mash up of confusion.

Nobody really talks about these things.  As a survivor it can be very isolating and it can make me afraid to speak out about the symptoms.  Sometimes I don’t know what is more terrifying: feeling crazy or worrying that people will perceive me as crazy.   I know, intellectually, somewhere deep inside, that I’m not actually crazy.  My brain is coping with trauma and it is doing what it needs to do to survive.  Sometimes this coping mimics, looks like, and produces symptoms of mental illness.  But often the symptoms are my brain letting me know that I need to reduce my stress.  If I don’t listen to the early warning signals, my brain escalates to more dramatic signals like suicidal thoughts and seeing things.

Learning to listen to my own inner voice is part of the healing journey.

Essentially,  I think society needs to talk about these stigmatized symptoms of PTSD and mental illness.  I think we need to break down the misconceptions and the misinformation and realize that for the most part, folks are just doing the best they can to cope.   When you are living it, all mental illness is terrifying.  It’s just a matter of degrees.  Sometimes the fear of stigma is what keeps people silent and stops them from reaching out for help.   Talking openly and without judgment heals.

I sometimes see things, but if Marian could understand, maybe you can to.

Depression.

/ hopeforsanityblog / 8 Comments

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Depression doesn’t always look the same.  Sometimes it is most clearly described by how I feel when it lifts.  When I’m depressed I’m not actually myself and when the depression lifts I wake up and I’m me again.

When I’m depressed, I am physically exhausted by social contact and social situations, but at the same time I don’t always want to be alone.  One of the reasons social situations are so difficult is because social anxiety is a symptom of my depression, and depression is fueled by my social anxiety.

Over the past few weeks, interactions with others leave me drained. Probably because half the time I’m spending with people I’m hyper aware of whether or not I’m behaving appropriately.  Because depression blunts and numbs some feelings and amplifies others, I’m constantly monitoring myself and thinking:

“Am I acting normally?  Can this person tell I’m acting?  Am I smiling enough?  Am I smiling too much?  What should I do with my hands?  Stop picking at your skin! Remember to make eye contact!  Not too much eye contact!  Stop fidgeting!  Is my facial expression appropriate for what they just said?  Make sure your face is responding like a normal person! That was a joke, laugh.  But don’t laugh too much.  Did that sound stupid?  Do they hate me?  Did I make a mistake?  Is my facial expression appropriate?  Oh my god, did I even hear what she just said? Smile.  Act normal“

After a short interaction I’m exhausted and I want to flee to a place where I can just be.   This usually means being alone.  I’m completely relieved to be alone.  I often hibernate under quilts and blankets where I feel safe.

But then the loneliness hits.  I text.  Texting is much easier than phone calls or in person hang outs.  When I’m texting I just have to think about the words and not all the other complex social dance behaviours that I’m sure I’m completely mangling.  Texting is safe.  Texting breaks isolation, without crowding me or making me self conscious.

When I’m lonely and depressed, I start to believe I’m literally the only person on the planet who doesn’t have plans at that moment.  All logical reasoning to the contrary is dismissed by my social anxiety brain.   I start to think that nobody likes me, that I’m boring or annoying, that I’ve said terrible things to offend everyone I know.  I feel jealous about the plans and social gatherings of others.  And yet, ironically, I often cancel plans or say no to things I am invited to.   The contradiction of depression is frustrating and impossible.

Depression is panic attacks in crowded places.  Panic attacks about choosing food, or anxiety about eating around other people.   Depression is feeling “fat” when my body hasn’t changed. Depression is anxiety that everything I say or do might get me into trouble or make my situation worse.  Depression is reading my emails over and over and over and over, obsessively, worried that I made a mistake, said the wrong thing or was oppressive.   Depression is paranoia that the email was accidentally sent to the wrong person, somehow ruining my life.  Depression is knowing I have to do something at work, but feeling incapable, afraid and ashamed to ask for help, thus procrastinating and avoiding.

Depression zaps energy.  I’m literally exhausted almost every minute of the day.  It’s not something that can be fixed by more sleep.  Though less sleep makes it much worse.  My body feels heavy and I struggle to get out of bed in the morning.  My bed feels warm and safe in the mornings, but physical pain and stiffness in my body prevents me from lying down for too long. Sometimes I’m drained and have to lie down after taking a shower in the morning.  But somehow I push through it.

I feel like robot, automatically going through the motions of my day.  I check each task off against a mental list.  Breakfast, check, kids to school, check, commute to work, check.  Each day moves through a series of tasks to be completed.  I’m always counting time until the next time I can be alone and rest.  I’m often watching the clock, but I’m never comforted by it. Then after about one day of a weekend alone, I’m lonely and waiting for my kids to return.  It’s a terrible feeling, like you have nothing to look forward to, but are always looking forward to something unimportant.  Maybe the next day will be brighter, maybe the next _____ will break the cycle, maybe I’ll wake up tomorrow and feel better.

Depression is being unreasonably and intensely irritated by innocuous things.  Like the sound of someone chewing near me.  I could scream.  My whole body is tense, I can hear every sound.  Depression is losing patience in a split second, in situations I would normally be able to cope with.  Depression is feeling frustrated when people repeat themselves or take a long time to get to the point of their stories.  Depression is hating myself because I know I’m not being as kind as I should be.  Depression is losing my temper at my children, when they are barely doing anything wrong and my rage is uncontrollable like a volcano, then dissolves into guilty desperate tears.  Depression is intense compassion fatigue.  Not having enough energy to have empathy for others and then beating myself up with self judgment afterwards.

Depression means rarely living in the moment.  Depression is being caught in a tangle of awful memories from the past, or absorbed in worries or thoughts about the future.  Or more often, ping ponging back and forth between memories and worries.  In the moment, there is often zoning out, disassociation, numbing and that floating feeling of being something less than human, unable to connect with anyone.  Feeling like my essence of humanness is just beyond reach.

Depression is either crying too much, or (this time) not being able to cry at all.  Depression is either all the feelings right at the surface every single minute, or all the feelings pushed down and boxed up into controlled spaces inside me.

Depression is the darkness in the Fall and Winter months.  Depression is waking in the dark, coming home from work in the dark and forgetting what the warmth of the sun feels like.  Depression is like sitting at a dirty window, watching the normal world proceed just outside my grasp.

Depression is feeling suicidal, obsessing about death and dying.  Sometimes it is destructive impulses, or sometimes, wishing I hadn’t been born at all.  Sometimes it is a passive thought of just not wanting to be alive.  And then the torturous, trapped feeling of knowing that suicide is no longer an option.

Depression is boring.  Like this blog post feels boring.

It’s a world without light.  Depression is obsessive, recurring thoughts.  Depression is feeling like a bore to others, feeling self-obsessed, immature and uninteresting.  Depression is feeling unlovable and like you will always be alone.

Depression lies.

Even if I know that depression lies, it’s not so easy as just snapping out of it.

When I’m depressed I’ve learned that the best I can do is to stay as safe as possible, sleep regularly, eat and drink regularly, self care, be patient with myself, lower my expectations of myself and just do my best.

Because depression always lifts.  It’s not forever.   But it feels awfully bleak.

Talking to kids about mental illness

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At dinner tonight my  kids were joking about various things and my younger child started joking about being in the “mental health room” and the “mental health unit” and basically laughing about people being crazy.

I felt frozen.  I’m a social justice warrior parent and I’ve been quick to call in, correct, and stop my kids around issues like racism and oppression.  But I was tired today and I wasn’t sure how to broach the subject that I’ve been a patient in mental health hospitals.   My older daughter knows about some things from my past.  They both have seen my scars and know that I used to self harm.  My older daughter knows a bit more, she was more aware of my depression before I left her father.  But they don’t know even a fraction of the story.   I wondered today about what they will think of me when I tell them.

I wanted to jump into the conversation with “it’s not polite to joke about people with mental health problems.”  But that didn’t seem like enough and I was so tempted just to honestly say: “I’ve been in mental health hospitals and it’s not something funny to joke and tease about.”  I wasn’t ready for the conversation and they were happy and I didn’t want to add stress to the evening.

But now, hours later, I’m thinking about it.  What will I tell my kids about my past?  When will I tell them?  Will it be planned, or will it spill out one day in a situation like this one?   I don’t want to talk too much about things that might upset them, but I also don’t want them to feel like mental illness is a taboo or a stigma that people should be ashamed of.

How do we talk to children about mental illness?   Before my first child was born I downloaded a fact sheet from CAMH called “talking to children about mental illness.”  I told myself that I had a few years, until she was 2 at least, to fully recover.  I told myself that she would never know and that I’d be 100% better by the time she was old enough to be aware.

I was optimistic.  But even when I downloaded the fact sheet, I think a part of me realized that it wouldn’t be that simple.  Anorexia, depression, anxiety and PTSD weren’t going to disappear the moment my new baby was born.  It made me (and makes me) so sad to think about talking to my children about my mental health struggles.

The fact sheet suggested reassuring the child that they were not responsible for my health.  Reassuring the child that I was seeking my own help and talking to other adults about my issues.  In this way, she would not feel responsible for me or worry about my health.

I struggled with postpartum depression after both my kids were born.  My older child was impacted more severely because she lived through both episodes.  I struggled to cope with taking care of my toddler after my second baby was born.   I hated myself for it and I still struggle to forgive myself for how I felt during the postpartum depression after my second baby.  By the time my older one was 5-7 years old, I was again coping with depression due to the abuse in my marriage.

My child was bright and extremely emotionally aware and emotionally intelligent.  I knew she worried about me and it broke my heart.  I knew she was aware that I was not happy.  When she was about 6, I read her some books from the public library which explained depression to children.  I told her the words from the fact sheet: “I love you,  I talk to my doctor and my friends when I am sad, you aren’t responsible and it’s not your fault.”  But it was difficult and I felt like a horrible mother.

My eldest was 18 months old when she first noticed my scars.  She was sitting on the potty and she looked at my arms and said “draw, draw?”  She thought they were marker marks on my arms.  I told her they were just marks and not to worry.  I knew I was only buying time until she would ask again.

When my eldest was 7, I separated from her father.  My mood improved and we no longer talked about depression. But over the next year she started to ask me incessantly about my scars.   For a year I told her that I would “explain when you are older,” but after a time it wasn’t enough.  She began to cry at night, get angry at me and say that I didn’t trust her enough to tell her.  She started refusing to talk to me about her problems because I wouldn’t explain the scars.  I spoke to my doctor and together we came up with a plan of how I could talk to my daughter.   He said that the fighting was likely more damaging to our relationship than just telling her an age appropriate version of the truth.

So I told her.  I told my 8 year old child about my past self harm.  I told her that all the scars were due to me injuring myself.  It was very difficult for me and I had a lot of guilt.  I told her a version of the truth.  I told her that when I was younger someone was mean to me and not respecting me and that I never told anyone.  I told her that sometimes when you keep secrets like that inside you start to cope in bad ways like hurting yourself.  I explained to her that this is why I always encourage her to talk to an adult about her problems.   My daughter was sad.  She told me that self harming was a very bad decision and that I should have talked to someone.  She asked me such a wise question: “If someone was hurting you, why did you hurt yourself?”

Since I told her, the questions stopped.  Once in a while I notice her looking at my scars with a sad expression, sometimes when I read to her at night she touches them and looks wistful.  I hope that my honesty will allow her to make choices to help herself in her own life and not turn to such negative coping.   My younger child still thinks the scars are cool, like battle wounds that make me funky and unique and a warrior of sorts.  She knows on some level that they are from self harm, but I’m not sure she is ready to accept that and she doesn’t ask questions.

I don’t think that talking to an 8 year old child about self harm is ideal.  But what options do I have?  My scars are obviously visible and it’s impossible to deny them or hide them.  If I had another type of physical disability I would have to explain that to my children.

Why is it so difficult to have open and honest conversations about mental health and mental illness?

I would like to tell my children that joking about the “mental hospital” isn’t funny.  I would like to tell them that it is triggering for me and could be upsetting for other people as well.  I want them to know that there is no shame in asking for help and getting treatment for a mental illness.  I do want them to know some aspects of my story when they are a bit older.  I want them to know because I made a lot of mistakes, and I hope that the knowledge I’ve gained on this journey could help them avoid the same mistakes.  I also want them to be the kind of people who help others rather than judging them or putting them down.

I want to shatter the stigma.  But today I was tired, my kids were happy and I didn’t want to put a shadow over a good day.   The conversation that started at 18 months old with an innocent “draw, draw” is likely one that will be taking place in stages as they grow up.  My psychiatric survivorship story IS my life, it is a part of me, and because of my scars I can’t hide it, even if I did want to.

And maybe one day I won’t feel ashamed and embarrassed to talk about it.

September 10 -World Suicide Prevention Day

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On this day I remember the friends I have lost to suicide.  I think of the friends I know who are suicide survivors.  I think about the service users I work with who struggle with suicidal thoughts.  I think about what it means to be a suicide survivor.

I am a suicide survivor.

I can’t speak to the experiences of other people who have survived suicide attempts, but I would like to share my own thoughts.  I think there are a lot of myths out there related to surviving suicide, how to help people who are suicidal and why people attempt or complete suicide.   It’s a taboo subject, one that people skirt around.  Sometimes the mere mention of suicide can silence a room, create uncomfortable looks and make those around you ill at ease.  I think this is mainly due fear.  It’s almost like people think that suicide is contagious.

I rarely talk about my experiences as a suicide survivor.  There seems to be a tacit agreement that it is not a suitable conversation topic.  Even in therapy there is the worry that talking about suicide will lead to unwanted consequences, trips to the hospital, worrying others, making others think that you are “crazy” or “unstable.”

Here are some of the myths surrounding suicide that I’d like to dispel.  These are my own thoughts and I don’t claim to speak for everyone who has these experiences.

  1. Suicidal thoughts and suicide attempts are impulsive reactions and pass quickly.
  2. Talking about suicide means that someone is not serious and is not really at risk
  3. Suicide attempts are always a “cry for help” and the person doesn’t want to die
  4. People who survive suicide attempts are grateful to be alive and recover quickly
  5. Talking about suicide will just “give someone ideas” and it will increase their risk
  6. The best way to help someone who is suicidal is to call 911 or take them to hospital
  7. If someone is habitualy suicidal, the experience is normal for them and they don’t feel afraid or need support.

Realities

  1. I’ve struggled with suicidal thoughts on an ongoing basis since I was 17 years old.  That’s almost 20 years.  My suicidal thoughts can sometimes be impulsive, but in my experience they are usually long lasting, persistent and even obsessive in nature.  I wouldn’t even like to hazard a guess as to the number of hours I’ve spent planning ways to die and thinking about ending my life.  In my experience, the impulsive thoughts are the most dangerous and the scariest, but the chronic obsessing about suicide is more exhausting and creates  a sense of hopelessness.   Many people struggle with suicidal thoughts over a long period of time, just because they don’t act on it or don’t talk about it, does not mean they are not at risk.
  2. I hear this a lot.  “If she is willing to talk about her suicide plan it means she isn’t serious and she really wants help.”  This is a dangerous assumption.  Every person is different, every situation is different.  Some of the times I tried to kill myself I didn’t tell anyone, I didn’t talk about it before hand, there wasn’t an opportunity to intervene.  Other times I spoke about it to many people, I asked for help, I went to the hospital without harming myself, and I often found that I was not believed or taken seriously.   It was incredibly frustrating because when I went to the hospital AFTER harming myself the doctors were angry that I didn’t “ask for help.”  When I went without harming myself, they assumed I was safe and rational and did not need help.  It was a vicious unhealthy cycle.  In my opinion, if someone is talking about suicide you should listen and you should take it seriously.  Many people who complete suicide have talked about their thoughts prior to taking the final step.  On the other hand, if someone never talks about suicide we can’t assume they are not at risk.
  3. Suicide attempts are not always a cry for help.  Sometimes the suicide survivor really did want to die and their attempt failed.  Suicide attempts are not a way to seek attention.  They are not a way to control or manipulate people.
  4. When I attempted suicide and survived, I was not grateful.  I felt like a failure.  I felt worthless and ashamed.  I felt like I couldn’t do anything right.  I felt ill and I had physical effects from harming myself.  I felt alone and I felt stigma. Even today, years later I regularly wish I had died years ago when I attempted.   Not all suicide survivors are happy to be alive.  We don’t all wake up the next day, thankful for a second chance.  It’s also common to be happy to be alive sometimes and wish you had died at other times.  The recovery process can take a long time and will last far longer than the short time someone might spend in the hospital or away from work/school.
  5. Talking to someone who you think may be suicidal will not increase their risk.  It’s far more risky to stay silent, not ask the questions, not check in with someone.  If you are concerned about someone you care about, I recommend asking them directly if they have thoughts of harming themselves, ending their lives, or wishing they were not alive.  Ask them if they feel like a burden, ask them about what connections they have in their lives, ask them if they feel hopeless.  It’s better to know the answers, then to assume someone is not suicidal.  Sometimes a suicidal person feels like nobody cares about them, and staying silent could reinforce that belief.  I can’t even remember the number of times that I was stopped from harming myself by receiving a phone call from a friend, or a connection with someone around me.  Connection is the opposite of depression.  Asking someone about suicidal thoughts is not easy, but losing them to suicide will be harder.
  6. Calling 911 or taking someone to the hospital is not always the best way to help a suicidal person.  Sometimes involving the police, ambulance or hospital can escalate a situation.  Sometimes it can destroy the trust you have with that person.  In many situations it can be helpful to give the suicidal person choices and options.  Thank them for opening up to you.  Ask them what they feel would be most helpful.  In my experience, suicidal feelings are often linked to feeling out of control and overwhelmed.  Taking away choices from someone or punishing them for suicidal thoughts can add to feelings of powerlessness.  Offering choices can be an antidote.  Maybe the person wants company, maybe they don’t.  Maybe they just want a chance to talk about their suicidal feelings without being judged.  Maybe they do need medical intervention, maybe you can take them to the hospital and stay with them.  If someone is suicidal and impaired by drugs and alcohol, or has access to lethal methods such as a gun, you may have fewer options.   But calling 911 without somoene’s permission should be a last resort.  Hospitals don’t even always admit someone who is suicidal.   I’ve been in the ER, highly suicidal and at huge risk, and just sent home.  I’ve been told “she isn’t psychotic so  she can go home, she isn’t at risk.”  I’ve often felt WORSE after unpleasant and unhelpful interactions in the ER.  It’s a myth that hospitals always help suicidal people.  Consider all your options and include the suicidal person in decision making as much as possible.  Also make sure you take care of yourself.  You are not responsible for saving anyone.
  7.  People like me, who struggle with suicidal thoughts on a chronic basis, still get scared.  Feeling suicidal is a scary thing.  It doesn’t matter that I’ve felt this way hundreds of times before.  I’m afraid.  I always worry that I will become impulsive and make bad choices.  I always feel afraid of telling someone, afraid of their reaction, afraid of the stigma.  Afraid people will think I shouldn’t be working, parenting, left alone etc.  If you know someone who chronically talks about suicide or habitually harms themselves, don’t give up on them.  Don’t assume they don’t want to get better.   Suicidal thoughts and self harm behaviours can be a coping mechanism for many survivors of violence.  Sometimes thinking about harming myself feels like the only way I can have control in an out of control and scary world.  Suicidal people need and deserve compassion.  Never underestimate how much good you can do by just non-judgmentally acknowledging someone’s struggle:  “Those thoughts sound very scary, you must feel pretty overwhelmed right now, I’m sorry you are struggling, what can I do to help?”

 

I miss my friends who completed suicide, but they are not cowards.  They are some of the bravest, most beautiful people I have ever known.  Suicide survivors are all around us.  We are regular people, living regular lives.  Suicide isn’t just something that happens to “crazy” people.  It can happen to anyone.  Breaking down the stigma helps everyone.  I think about suicide on a regular basis, but I still have an ordinary, productive life.  If you struggle with suicidal thoughts, or have lost someone to suicide, you are not alone and you should not be ashamed.  Be good to yourself, I’m happy you are alive.

Depression meets PTSD. Crash.

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raw-chicken

I’ve realized over the past three years that depression is often more of a secondary problem for me.  It’s very situational and very linked to PTSD.  By the time depression flares up, it generally means that I’ve been coping with PTSD triggers for too long and I’ve started to crash into exhaustion.  Depression sometimes means feeling literally nothing, while PTSD can mean feeling everything and things that are from the past vaulted into the present, clear as day.   This can be a confusing progression.

Lately it’s hard to tease out whether I have a whole host of mental health diagnosis or just one (PTSD) causing a host of symptoms.

Abuse triggers can lead to negative feelings about my body which can then trigger my good friend Ana…yes, PTSD comes first and anorexia is a symptom.   For me anorexia is mainly a series of obsessive compulsive thoughts and behaviours which are linked to extreme anxiety around changing my food rituals.   So anorexia comes first, and OCD traits follow.

When I have a lot of PTSD symptoms and flashbacks, I start to have trouble sleeping and I have vivid nightmares.  Sometimes I wake in the middle of the night to a full panic attack.  Flashbacks can lead to panic attacks during the day as well, and also to anxiety in crowds and enclosed spaces.  So PTSD comes first, and anxiety and panic symptoms follow.

At the end of the line comes depression.  DEPRESSION.  It feels so heavy.  Depression to me leads from coping to constant suicidal and self harm ideation in what seems like mere seconds.  For me, suicidal thoughts are often the first real indicator that I’ve slipped into depression again.  This may seem backwards, but for me the most severe symptom tends to come right at the start, even if I’m depressed for only a few days.

When I’m depressed I feel like I’m walking through a thick soup of fog.  Every fibre of my being hurts and feels heavy and leaden.  Sometimes I have to lie down after just showering and getting dressed in the morning because I feel too exhausted to continue with the day.  When I’m depressed I have no energy.  I want to crawl into bed and hide.  Unfortunately, I’m a single parent and I have a full time job.   It’s not an option just to crash.

So I keep going, but the time crawls by.  I feel unsure if I can get through the day.  I feel unsure if I can stay safe, and resist the negative thoughts.  My self esteem crashes.  I start to feel a lot of feelings from the past.  Or maybe that is backwards, maybe I feel the feelings from the past and it triggers depression.

When I feel out of control of important aspects of my life, I am triggered and I think about suicide.  This is the way my life is.  It’s been this way since I was 17 years old.   It’s both normal to me, and completely terrifying every time it happens.

The depression always lifts and these days it lifts more quickly than it ever did in the past.  The lights come on again, I see the world clearly and not through a haze.  I feel connected and I feel like I am competent at some things.  When I’m depressed I feel alone and I feel utterly worthless.  I feel like a burden and a problem and someone that people I know put up with, rather than care about.  I have trouble making small talk.  I spend a lot of time silent.  I feel an immense amount of social anxiety and discomfort in social situations, especially those involving food.  Depression, anxiety, anorexia, PTSD….it’s a perfect storm of misery.  I’m caught in the middle of a storm of symptoms and I don’t know when they will abate.

Right now I’m triggered because I’m worried about my children.  I’m triggered because of the way my ex-husband treats my children and me.  I’m triggered because this is the time of year, 3 years ago, leading up to my physical separation from him, when things were at their most tense and scary.

I’m triggered today because my daughter told me that her father’s avatar/icon for me on his phone is a piece of raw meat.  Raw chicken.   The father of my two children sees me as nothing more than a piece of meat.

Fuck.

 

Inpatient bonds.

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20160727_214408[1]One of the bright sides of spending so much time in hospitals during my teens and early twenties is the people I met there.  Some of them became lasting friends and the bonds between us defied understanding by outsiders.

If you’ve never spent a significant amount of time as an inpatient in psychiatric wards and mental health treatment facilities you probably won’t understand.

I’ve had people close to me tell me that I “shouldn’t have so many friends with problems” or that I should “try to make healthier friends” or that I “shouldn’t talk to people who depress me.”

These comments miss the point for a number of reasons.

First of all, if my “friends with problems” aren’t worthy and I shouldn’t be friends with them, does that mean nobody should be friends with me either?  In case you hadn’t realized from reading this blog, the secret is out.  I identify as living with mental illness! I’m not exactly 100% well myself, otherwise I wouldn’t have been in the hospital in the first place!  Does this make me less of a good friend?  Does this make me a person who should be shunned and avoided?  I certainly hope not.  I would like to afford my other hospital friends the same courtesy.

Two, it’s hard for people who are mentally well, neurotypical, never struggled with severe mental illness to understand me.  Sure, I have well friends who empathize and who don’t judge me.  But the bonds and mutual understanding I’ve shared with other people who struggle with PTSD, eating disorders, depression and suicide are very strong.   It’s like I can breathe again, when I talk to a friend who I know “just gets it.”

Three, when you are living in a hospital ward, you naturally form friendships and alliances with the people you are living with.  Some of them become friends.  It happens and it helps us survive.

So please, don’t judge these special friendships.  Even when I’ve lost friends to suicide, even when I’ve been triggered by friends and had to set boundaries, even when it feels like listening to their struggles is too much to bear, I never regret them.

My dear friends who are gone.  I desperately miss that feeling of belonging I had when I talked to you, laughed with you.  MJ, there was never anything I shared about PTSD that you hadn’t breathed and experienced yourself.  I never had to explain myself, you just knew.  This blog entry’s photograph is a picture of all the cards you wrote to me during our friendship.

Who else could I share my strange experiences with?  When I told her one day, crying in the bathroom in my ex-husband’s house, that I was scared because I thought I was seeing X everywhere.  I literally thought I could see him all around the city.  Intellectually, I knew he wasn’t there, but it felt real and my heart skipped a beat each time.   She almost laughed and said, “It happens to me all the time.  I see everywhere too”  We breathed out together, suddenly this PTSD symptom was normal and okay.  We understood each other, we weren’t crazy.  I loved her for this and I know she loved me for it too.

When I was in treatment for anorexia when I was 17, I met another young woman named M.  She and I were stuck on the eating disorder for 5 weeks together, while other patients attended groups.  We were on “modified activity phase” until we gained a certain percentage of our goal weight and it took forever.  During this time we talked, bonded and sometimes sneaked around doing things we should not have.   She was painting rocks when I got there.  I asked her what I was doing and if I could help.  She told me she wanted to paint 1000 rocks so her wish would be granted.  Soon, we had an assembly line going.  We would fill our pockets with rocks on our 15 minute outside break, sometimes walking further than we should have away from the break area.   Once inside, I would paint the rocks a solid colour, then when they dried she would write “Expect a Miracle” in careful lettering on each one.  The final step was applying a clear glaze once all the paint was dry.   We painted so many rocks, I don’t remember how many we had finished when I discharged myself 3 months later.  I still have some of them in my bedroom almost 20 years later.  I’m still waiting for a miracle.   I often wonder what happened to M.  We lost contact and I still think of her often.  I wonder if her miracle came true and I wonder if she recovered.

I met my friend Lexi at a support group in my city.  It was the first place I really talked at any length about leaving my ex-husband and what was going on in the marriage.  Lexi loved to crochet and knit.  She loved her family.  I used to go to her apartment sometimes and we would chat about all sorts of things.  Sometimes we shared stories of our trauma and sometimes we joked and laughed about our future.  I was inspired to try online dating because of Lexi.   I lost her suddenly last summer, about  a year ago now.  I still miss her.

Darlene, whose story I recounted in another blog post, her anniversary was this week.  14 years ago I lost her.   I wish I’d had the chance to know her better, but I won’t ever forget her.

Some friends like my dear sister LJ, I have kept in contact with for over 12 years, through email, fb, text and phone.  She lives in a different country, but she calls me sister.  I miss her and I hope to see her again one day.  I have ever letter and card she has ever sent me. She has inspired me in many ways and her commitment to recovery and to survival is tremendous.

My friend John, he is also gone now.  But his music lives on and I have his CD which I listen to from time to time and remember his gentle courage.

I will never forget the stories of survival I heard and witnessed during my hospital stays.  I met so many survivors.  I met war veterans who were kind and brave enough to share small details of their own private hells with me.  I met residential school survivors who shared with me the abuse they endured.  I met childhood abuse survivors who overcame.  I met women who were admitted to the hospital in full psychosis, speaking in delusions and making little sense.  I saw those same women, mere days later, completely calm and rational again after taking their medication.  I met people who had lost family members in tragic circumstances.  I met people who had nearly died from multiple heart attacks due to anorexia and bulimia and some of those women have children and are well and healthy today.

These friends give me hope.  They remind me that I’m not alone.  They remind me that recovery is possible.  And the ones that have died, I will hold in a special place in my heart forever.

Inpatient bonds are something to be celebrated.