It’s late. I can’t sleep. I need to empty my mind and rejuvenate my body. I have objectives to meet that I can’t because of my mental illness. Despite being medicated, I’m in no shape to achieve those goals. I’m just not. Even if I wanted to. There’s stigma to contend with, and images from previous experiences to try to overcome. If that past is any indicator, I will fail.
I’m aware of my symptoms, the racing thoughts, the voices, the poor working memory, the anxiety caused by OCD and schizophrenia, reinforced by depression and trauma. I hold onto longterm memories of happier days when distress caused by psychosis didn’t inform my emotional responses, and the accompanying PTSD didn’t overshadow my reactions to life.
I can’t meet expectations today because of my vulnerability. I’m hyper aware of this. During the day, I skulk around like the vampires that I’m so afraid of. At night, I’m like a tiger with a bad dream, unable to respond to my nocturnal imperative. My very nature is at odds with itself. So I lie awake, unable to unwind and invite sleep. My whole being is in tumult. Coupled with my injectable reaching its monthly cycle of waning efficacy, the anxiety and depression are compounded. It feels at once both familiar and foreboding, disarming and nightmarish.
I could possibly find relief if I took my PRN—the smallest, effective, single dose of the main component in my injectable—but I have concerns about that. What if the effect is too much? What if I have trouble functioning? I’m riddled with worry, my anxiety increased exponentially. For the sake of a 1.5 mg increase to my regular 234 mg dose of a medication I’ve been taking for the better part of three years, the equivalent of inhaling the aroma of the espresso compared to drinking the entire venti. I can feel the itch of my old med noncompliance rising up, paranoia dogging my otherwise stable sense of calm. All because I needed a letter from my therapist detailing my diagnosis.
I’m reminded of the first time I was given a psych eval and how challenging that was on so many levels. I remember thinking at the time, “These are easy questions,” yet I was unable to answer them correctly. I thought the then current president was Abraham Lincoln, and the days of the week were all Monday. I couldn’t spell my own name or remember the year we were in. I was time-traveling at high speed, courtesy of psychosis. I’ve had other psych evals since. The results are always the same. There is always a hospitalization on the other side.
I worried about the content of the letter for the remainder of the day after I’d had it read to me. I trust my therapist implicitly, and the letter was a total necessity; knowing its content helped ground me in the common reality, but not after first feeling somewhat ill at ease.
I felt exposed. I knew that this would be the case, but hearing my diagnoses read in an official letter for legal purposes was almost more than I could accept. Because of my regimen of medication and therapy I feel stable enough on a daily basis to think that I’m a card carrying First Class citizen, a person living with a mental illness who has beat the odds and can pass for normal. Then something like this comes up and I’m forced to accept the truth, however reluctantly.
It’s been a life lived with mental illness. I started out as a child with traumatic beginnings and continued living through one impactful event after another, leading me here. To a place where I can accept my illnesses and their roles in my life. That doesn’t mean that it doesn’t bring up the stigma attached to the various terms. I can say their names, and, while saying them or researching them, or describing them in print doesn’t phase me in the least, knowing that they’re on file as descriptors of my life, definitions by which others may know me on a level better than superficial, keys the anxiousness in my system and raises the lived trauma experience.
I don’t assume that I am the only mentally ill person with multiple diagnoses. I’ve known about mine for some time. It was the shock of hearing them all at once that kickstarted my smoldering anxiety into the next highest gear.
I appreciate that my therapist would take the time to write the letter, let alone read it to me. Her professionalism and trust combined to help me see that I have meaning and purpose beyond the descriptors attributed to my varied illnesses. I’m more than those words used to define me.