I want to talk about mental illness – but really, I also want to tell you a few things. Many of these things you may already know. Still, I think some of them are worth repeating. To begin with, mental illness is born, manifests and is treated in a myriad of ways; but often, it isn’t treated as other medical conditions are. No one would be ridiculous enough to suggest to a cancer patient that she should take a walk and get more sunshine. Instead, doctors would isolate the type of cancer and introduce a targeted treatment. You’d never tell a diabetic that meditating might be a better alternative than giving in to “big pharma.” That’s because, when it comes to actual illnesses, “big pharma” produces lifesaving medicine.
If you look closely at that line of thinking, you can begin to see the threads that bind misunderstanding to blame. Frequently, we treat mental illness as a kind of bad decision making which can be cured by trying harder and making different, better choices. Mental illness isn’t weakness or bad decision making; it is a misfiring of neurons, an imbalance of chemicals, a physical response to trauma. It is any of those things, or all of them. For a very long time I didn’t understand this so I looked outside myself for ways to sooth my hurts; those hurts I caused myself, but also those hurts I caused others. After years of self-medicating in every way imaginable- holistic medicine, eastern philosophy, chanting and gonging and ecstatic dancing (but honestly, also a recreational drugs, booze, sex and self-destructive behavior) – I finally had to admit to myself that the coping skills I had developed to survive were no longer serving me. The only way to affect real change wasn’t going to happen without help. For me, that came as a combination of both pharmaceuticals and psychotherapy.
Now, maybe you’re one of the lucky few who finds just the right medicine, or cocktail of medicines, on the first try. Maybe you find a good diagnostician and a clever therapist right away. Maybe, but I’m here to testify, it almost never happens on the first go’round. Finding the right psychiatric medical team is like a series of bad blind dates. He’s too quiet, she’s too clinical, they’re both too something, or not something enough. Chemistry is hard to force. You click or you don’t. It’s a crap shoot.
Finding the right medication can also be a real shitshow. One pill makes you larger, one pill makes you small – dry mouth, tremors, fatigue, emotional numbness, loss of sex drive, loss of hair, weight gain, weight loss, diarrhea, constipation – the possibilities are limitless and none of them are sexy. Still, if you can hang in there, you’ll find the right doctor; one who will listen to your concerns and treat your whole self, not just the part that exists above the neck. You’ll find the right medications, although that sometimes takes a bit of trial and error. Finally, you’ll find the right kind of therapy. This, my darlings, is how you begin to build your support system.
Once I had a diagnosis and a treatment plan, there was an adjustment period that I wasn’t fully prepared for. Now that my illness had a name, it belonged to me. For a while, I let it define my actions, my feelings, my movements and my silences. Eventually, I learned to co-habitate with it. I learned its patterns. I watched for its sneaky little tracks in the dust on my side table. I babied it and put it to bed. I enjoyed my life when it slept. With the help of the support system I was building, when it woke, I learned to cope. In some funny kind of way, I felt safer after my diagnosis than I did before I knew – because, really, it was there all along, hiding behind my sorrow, feeding my fear and anxiety, fueling my racing thoughts, pushing me in and out of love and solitude and hunger and famine. The only thing that changed was that I knew. Now I knew its name.
Everyone knows about medication. Television and print ads are everywhere. To some degree, they have even begun to normalize treatment. Swallowing a pill was the easy part. The work that came after I swallowed the pill(s) was where the healing really began. You have to willingly lay down the things you thought you knew about yourself, the things you thought defined you, the tools you carved from bone and hair to survive in the wild. You have to let go of those things so that your hands are free to hold new things. To pick up and put down things that may or may not fit. To hold and examine new tools, shiny still-in-the-package tools. Your sick coping skills will not serve you any longer.
This is the way I muddled through the beginning of my diagnosis. Asking for help and being willing to receive that help, humbly and with gratitude. I became vigilant about my own health, my triggers, my treatments and my medications. I learned to be my own advocate even when I felt like I was sinking in quicksand or clawing at my own flesh, desperate to get out of my body. You do these things because you are stronger than you think you are. You allow yourself to rest, retreat and then put your britches back on and saddle-up again. All this work moved me toward a new kind of wellness. The kind of wellness that coexists with un-wellness. I embraced the kind of healing that comes from understanding that there is treatment, but no cure, for the thing that lives inside my brain. I allowed myself to be well, so that I would be safe when I was unwell.
Lastly, I want to talk about the part that I experienced, and which I rarely hear discussed: the aftershock to your family and friends. No matter how loved or supported you are, there will always be people in your life who have experienced you at your worst. Everything after that will be seen and interpreted through that skewed lens. Your successes will be attributed to your new therapy and medication. It may feel like your personal growth goes unnoticed. Your failures will simply be a repeat of your bad choices. For some, you will become a singular condition. She’s mentally ill, she’s sick… we don’t expect much from her anymore. This is just the way it is. Some folks don’t get it. Some folks may never get it. But hang in there kids, you got this. Many people in your life will learn. You will be a living, breathing lesson about mental illness, coping, healing and determination. You will be a lesson in forgiveness. The people who love you will gain understanding, and forgive what happened during the low points in your illness. There will be days, though I hope not many, when it will be enough if you are the only person able to forgive YOU. In fact, it will be exactly enough.