Last summer, I posted about some of the mental health-related challenges that I’d been facing in the previous year. It’s been about six months since I wrote that post, and I thought it would be interesting to write about some of the things that have happened since then.
I saw my psychiatrist a few days ago. He’s new, and we’re still getting to know each other. We agreed that I’m doing pretty well and there’s no need to tinker with my meds right now. I said, as I always do, that I’m still not convinced that I need to take them, and that I want to have another “me” who’s not on meds to be a control group, so that we can determine whether or not they are actually doing anything. He said we could do a double-blind study in which neither of us knew whether the meds were placebos, and see what happened. Except that he doubted we would get approval from the Human Subjects Research Board. I had to laugh. It’s always nice when mental health professionals have a sense of humor, and actually talk to you instead of lecturing.
Last summer, I was up to three hospitalizations in the previous year, and pretty much treading water as far as my mental health was concerned. Not drowning exactly, but wondering how close I was to drowning. And then last November, the week before Thanksgiving, came hospitalization number four. This one didn’t come as too much of a surprise. It was actually partly due to the meds working—we’d increased one of them, and I was starting to feel a bit more alive. For a person with bipolar or depression, this can be a particularly dangerous time, because you have the energy to act on whatever self-destructive thoughts may have been simmering. I reluctantly admitted to my therapist that I couldn’t contract for safety, and away I went.
Well, I actually didn’t go away quite that fast. I spent a good 12 hours in the ER, getting medical clearance and waiting for a placement. The person in the room across from me, a middle-aged man, was there because of chest pain. He talked to himself quite loudly about the FBI and J. Edgar Hoover and other such exciting topics. When the nurse came in, he said that he was going to sue the hospital for medical malpractice because he knew that his doctor wasn’t a real doctor but an FBI agent, and he wanted to know had happened to the real doctor. Since I was on a psych hold, there had to be someone watching me at all times, and the security people observing me were joking that they were maybe assigned to the wrong room.
It was a really rough night. They told me they were going to send me to the place I’d been for hospitalization number three, which had been a horrible experience: a bleak environment, a clueless ex-Marine who ran mental health classes (really!), and just a general lack of any sense of community. I’d worked very hard to get back out as quickly as possible, and I couldn’t imagine going back. I told the doctor that it was only going to make me worse, but he wasn’t terribly sympathetic. I lay in my room in the ER and sobbed and wondered how I was going to get through this, given that my emotional state was already so unstable. And then—it turned out that that hospital wouldn’t take me. I don’t know if I’ve ever been so happy to be rejected. I know I wasn’t the only one praying for things to work out, and while I can be plenty skeptical about stories of divine intervention in the world, in this case I’m not about to rule out the possibility that that’s exactly what happened.
I finally got a placement somewhere else around 2:00 am, and I endured 45 minutes lying in the back of an ambulance and feeling more than a little queasy as we headed to large, private hospital, where I would spend the next week. And remarkably, something really shifted for me. This hospital was a much better place than the previous one, thankfully, but that wasn’t all of what made this such a different experience. Due to something I can only describe as a gift of grace, I was surprisingly at peace—especially for someone who was in a psych ward due to internal turbulence. I felt okay about being there, and willing to accept that it might be what I needed right then, rather than construing it as some kind of failure to have landed in the hospital yet again. Instead, I could see it as a place where I could take a break, figure out how to breathe again, and maybe think a little more constructively about some of the challenges in my life.
So all things considered, it was not a bad week. They did a good job with keeping us busy. There were five units, I think, and I was on the highest-functioning one, which from what I heard, was much tamer than the others. I found that I connected with some of the people there, which really made a difference, and we spent a lot of time hanging out and coloring—a surprisingly soothing activity. The classes and groups were for the most part helpful, and I didn’t feel resentful about having to attend them. (You don’t have to attend such things, exactly, but the more you hide in your room, the less likely you are to get released.) And they had long visiting hours, which was great.
The usual things were still frustrating. No electronic devices, or access to the internet. Just one phone for the whole unit, which was locked during groups. A ban on any kind of normal pencils or pens. Since writing is probably my number one coping strategy, I found that one particularly crazy-making. We could use those little golf pencils, but that was it (and of course, we couldn’t sharpen them ourselves; we had to get staff to do it). And as in every place I’ve been, there were some staff who were great, and some who weren’t.
But while nothing amazing happened while I was there, I came out of that hospital much less depressed, and in a better place than I’d been for a really long time. Still feeling lost, confused, uncertain about life generally—but somehow not as hopeless. I credit a lot of things for that: meds, friends, therapy, and spiritual support have all played a significant role. But I also keep thinking of the lines of a poem by Jane Kenyon, who was herself no stranger to depression:
“There’s just no accounting for happiness,
or the way it turns up like a prodigal
who comes back to the dust at your feet
having squandered a fortune far away.”1
When I’m really depressed, I find it difficult to label it as such. In other words, I don’t necessarily think oh, I’m depressed—instead I think, the world is a miserable place and life is hopeless, and that’s just the way things are. I forget any frame of reference that would challenge that. (I remember a psychiatrist telling me, after I’d scored in the “severely depressed” range on a standard screening questionnaire, “this really isn’t normal,” and me replying, “are you sure?” That was the beginning of a conversation that led to hospitalization number three.) Usually, it’s only when I’m less depressed that I can look back and say wow, I was really in a bad place then. In the past few months, things have come back that I hadn’t realized I’d lost, such as the ability to concentrate enough to read a book, or to genuinely enjoy things, or to think about the future without overwhelming dread.
Though while I am less depressed these days, I feel fragile, hesitant, tentative. Like things could easily shatter again, or whatever resilience I have built up may not hold up against the next storm. It’s good to be doing better, to have the darkness recede a bit. But it’s also scary. It’s unfamiliar. I’ve thought a lot about an observation made by patient-turned-psychologist Lauren Slater:
“I started to understand that, like Gretel, I might need a map, a scatter of something to mark my way, but when it comes to deciphering health there is surprisingly little help . . . After all, when you are sick, there are plenty of places (insurance willing) where you can go to get healed, but when you are healed are there any places you can go to learn not to be sick? The very idea of having to learn the landscape of health sounds vaguely ridiculous, so ensconced are so many of us in the notion that health is organic as grass, in the right conditions growing green and freely.”2
Like many who have the diagnosis of bipolar, I struggle to accept it. As I said at the beginning of this post, I’m not entirely convinced I need the meds—and it is always tempting, despite all of my experience, to go off of them, just to see what will happen. I tried out a support group for people with bipolar last fall, and it was actually reassuring to hear that everyone in the group had at some point gone off their meds, and that multiple hospitalizations were not uncommon. It made me feel less crazy. And I do think some acceptance of the reality of this illness helped me a lot in my last stay in a psych ward—I was able to say, okay, this is a real problem, and I need help for it. I drift in and out of that kind of acceptance. Maybe it’s so difficult because it means letting go of a certain amount of control, and realizing that there are challenges in my life that are not going to go away. It is unsettling to consider that if I don’t take this seriously, if I don’t engage in the kind of self-care required to stay on track, it can be lethal. It can be difficult to take my meds simply because every time I do it, I am implicitly accepting both that this is a real illness, and that it’s okay to treat it, to get help—that I don’t first have to earn that somehow (which is often a pressure I feel). And while every other time I got out of the hospital, I made a “never again” resolution, I’m coming to realize that part of learning to accept this is accepting that there are no guarantees.
My experience with meds is that they can make a significant difference, but they aren’t a magic bullet. Rather, they take the edge off of things, and get me up to a level where I can do the work of therapy: the work of learning to think differently and act less self-destructively. It’s hard, and it’s slow, and I don’t always believe that it’s worth it. I often find myself using something like Alma’s paradigm of experimenting on the word to make sense of what I’m doing. To have faith, I believe, is to adopt an attitude of openness to possibility. I try to come back to that when I’m not sure there’s much point to any of it. Sometimes you walk by faith not because you are particularly virtuous or committed, but simply because there is no other way to walk.
Two years ago, I was putting the finishing touches on my dissertation. I haven’t done a whole lot of academic-style theological work since then. But I’ve been dabbling again lately, and I feel shaky. Can I still write, and do the kind of critical thinking that I spent so many years training to do? As I mentioned in my previous post, I feel like my identity has taken a real beating. I feel disoriented, and yet in some ways, oddly liberated. I’ve been re-evaluating a lot of things. I’ve realized just how much pressure I’ve felt from both the church and the academy to live out particular narratives, and I’m not sure that the standard narrative for either of those is really a great fit for me. I might well end up going in a different direction altogether. That’s unsettling, to say the least, but sometimes, on good days, it’s also exciting.
And I do have good days. That’s something that’s still pretty amazing to me. As I said above, it can also be scary—it’s hard not to wonder how long this will last, and to worry that people will be disappointed in me if I crash again. It’s not easy to stay in the present. But I am working on it, grappling with the question of what it means to be okay, to be alive and not just surviving. I’ve been thinking of these lines from the poet Adrienne Rich: “but this life of continuing is for the sane mad / and the bravest monsters.”3 I like that way of putting it: a life of continuing.
- 16 February 2013