In reality, being unwell may not be hard, but it can be incredibly painful. It can be isolating. It can be complicated. Juggling the day to day tasks of living can be an effort. There is too much or not enough of everything. Things are too bright or too dim. Things are too big or too small.
Through a 12-step program, I tried coping with my new, clean life. But I was still consumed with self-loathing, insecurities, imaginary judgments, and panic attacks. At the same time, I had lofty thoughts and philosophies, grand plans and delusions. I was right back in the kind of spiraling bipolar episode I’d been bandaging for more than seven years.
There are times when, if it’s brought to my attention, I can notice that the natural exuberance is missing, that the interconnectedness of everything is minimized by the meds. The talent is still there, but I’m delivering it through reduced affect, an emotional blunting that appears regardless of whether emotion is actually reduced or not. This is rock and roll and I’m leaving it all on the stage, except that it’s only noticeable if you close your eyes.
I arrived at the state hospital not as a novice any longer, but with approximately five years of direct clinical work under my belt as a psychiatric social worker. I had worked with families with issues involving mental illness and / or substance abuse related problems in a variety of contexts. However, I also realized very quickly that I was far from an expert in my field, and that there was much to learn in order to better assist my patients.
When I say I like to be prepared, it is an immense understatement. I take pride in being prepared for the known, and the unknown. I obsessively play the tape through every possible scenario knowing that being fully equipped for each one will boost my mood up a notch. But in all actuality, I obsess over having to know what to expect at every turn, from hour to hour and day to day. My routine and planning consumes my thoughts. So while I feel I cannot rest until I am prepared for every task, every day, every adventure…I never really feel prepared. Never at rest. There is always something tugging at my nerves.
So what does it feel like to be included? It’s a rich, rewarding connection. Inclusion feels like the kind of acceptance that I dream about, where I can just be the best version of me and have that be all right.
The hard part is remembering that I’m included. I can’t always do that and I don’t always trust it. Negative symptoms tend to scrunch all that insider- ness into a ball and toss it in the wastebasket.
I kept up my pattern of not admitting when I was feeling depressed, of hiding my illness, of not disclosing my symptoms even when asked directly. I kept saying, “I’m okay,” even when I was not okay because I did not trust that doctors would respond to my mental health concerns with empathy. I felt ashamed of admitting when I was not coping with stress and emotions effectively and I was afraid they would judge me or push me to try another medication. In church I did not trust that my pastors would respond with belief in the validity of my illness. I was afraid they would blame me.
After years with my previous therapist, it is strange navigating a new therapeutic relationship. Firstly, it stings a little, breaking up with an old therapist. My internalized shame told me that I hadn’t tried hard enough. My shame told me I was unfixable. My shame told me my trauma was too ugly to be examined. I know, intellectually, that these things aren’t true, but trauma loves shame. Secondly, working with someone new comes with its own set of baggage. It is always a little bit unnerving, unzipping yourself and showing a relative stranger all your complicated clockwork parts: your past, your broken pieces, your hurts and bruises.
I had been comfortable living my life in the fringe of psychosis. I worried that my art would suffer. But I’ve managed to surprise myself as a medicated man in that my creativity has not faltered. Quite the contrary—my artistic focus has increased, and I feel like I am doing some of my best work to date. Medicine was key in discovering newfound stability.