Given that I’m an introvert, and I know several introverts, I know how tough it can be to relate to people, and feel pushed away or forced too close or just have relationships go sour when I feel uncomfortable. And I know that even as an introvert, I can make other introverts feel uncomfortable sometimes. So, I thought that this might be helpful to post:
Yesterday was not a good day on the anger scale for me. To be clear, when I say anger scale, I really mean on this scale:
0 – Totally at peace
1 – Mild annoyance
2 – Frustration
3 – Full annoyance
4 – Hostile
5 – Angry
6 – Seething
7 – Furious
8 – Red Rage
9 – Hulk
10 – Murdertron 9000
I imagine most people have a scale like this; they may use different words, but the result is the same. I spend a lot of the time hovering between 0 and 1, but yesterday I spent a good 8-10 hours between 7 and 8, and it was not pleasant.
Some of it was anger as a secondary emotion – that is, anger that people often use as an immediate reaction when they are in fact feeling something else. Like if someone were to say something hurtful to me, my primary feeling would probably be sadness – but I would instinctively react in anger, maybe saying something just as hurtful in response. I was feeling very sad and hurt by some events happening with a friend of mine, and while I didn’t respond to my friend in anger, I definitely felt it.
Then I had to fight with my insurance company – and everyone who has ever done that knows how much anger that can bring up. It seems that even though I don’t have a thyroid gland anymore, and so have to be on a thyroid replacement medication to mimic the production of thyroid chemicals, my insurance company thinks that it is an expense that is more than they want to cover. So, in order to convince them that it is a necessary medication, I need to get in to see my doctor – who doesn’t have an opening for a couple weeks, leaving me at the very end of my current prescription. I suspect they want me to change to a medication that is less costly, but frankly, I don’t care.
Third, Houston traffic. This is generally anger-producing even at the best of times, because Houston drivers seem to have never mastered the fine art of, well, driving. That left lane on a highway? The one for passing and going fast? They feel free to just sit there going the bare minimum, regardless of what you do. That line you’re in waiting for a light, because the lane next to you is closed – but the cones don’t start until the light? They will pull out from behind you, go around you, and then swerve back into the open lane just before the other lane is closed. And right now there is a lot of roadway construction in Houston – especially, of course, on my way to work. A drive that normally takes me 15-20 minutes took me an hour yesterday.
And finally, customers. I work in retail, and I imagine anyone who has worked in retail knows how annoying indifferent or careless customers can be. At the bookstore I work at, many people feel free to grab stacks of books or magazines, flip through them for five minutes, then leave them at their seat – or worse, they try to conceal the stack somewhere. Or people show up, sit in a chair – either in our cafe area or in the store – and proceed to work on their laptop for 6-8+ hours, never buying anything, never even browsing. As I spend most of my shifts closing the store, the messes inconsiderate customers leave behind are something I have to clean up before I can go home. And then there are always the joyous customers who come in, demand a book – sometimes a big new release (that is sold out because they waited too long to get it), but more often something more specialized or small-press that we either don’t get or have to special order – and get insanely angry when you don’t have it. Or customers who assume you’re an illiterate idiot because you don’t happen to know anything about their favorite author.
So I was pretty amped up yesterday when I got to work; my co-workers could tell, and some said they could hear me grinding my teeth. They were very understanding, when I explained what was going on, so there wasn’t any trouble there, at least. Oddly, the anger seemed to keep me very focused, and I think I went through my assigned tasks much faster than the managers were prepared for; they had to find more for me to do, which eventually ended up in just trying to keep the store tidy. And that kept up for much of the shift – thankfully, I wasn’t working at the cash register or the customer service desk for much of that time. But when the anger finally began to fade, I felt myself just become totally exhausted. The anger burned through what energy I had and left me with nothing when it dissipated. And now, a day later, I don’t feel any of it. I can look back and see why I was angry, but there’s none left right now. Of course, I’m now stuck having to deal with the pain and sadness that are the results of my difficulties with my friend, but I was going to have to deal with that anyway; the anger was just a way to hide from it for a while.
I’m not sure if there’s a point here, really – maybe it’s that feeling my anger, instead of suppressing it, allowed me to let it go, or it to let me go, instead of having to deal with it for days or weeks on end. Maybe it’s that anger can be productive int he short term, but long-term it just sucks you dry. I’m not sure. It could be any number of things. But I felt it was worth talking about.
So today is the one-year anniversary of my last day at the step-down I went to after Menninger. It’s weird, looking back on it; I had only a few weeks earlier decided that I wanted to stay in Texas, and just a week after that found an apartment; I had spent several days prior to my last day preparing my new apartment so that it would be ready for habitation after I left the step-down. I think that, honestly, my biggest worries at that point weren’t what I was going to be doing with my life after leaving the step-down, but whether or not the new bed I had bought at Ikea would hold up. I had no job, I had really only vague ideas of what I wanted to do, and everything was still very confusing.
Now, I have a job – not a great-paying job, but one that keeps me busy, and has good people to work with. I volunteer at a local chapter of NAMI (National Alliance on Mental Illness), I am applying for training as a Certified Peer Specialist, and when admissions open up, I’m going to apply for the MSW program next year for the University of Houston. I have lived on my own for an entire year, something that worried me at first (and I think may still worry my parents) because I need social contact, and living alone can make it easy to avoid that – but I see several of my friends regularly, and I talk with several more by text, e-mail, phone, or internet chat. I learned how to cook, and I keep my apartment clean – sometimes eerily so. I found some cool decorations, and a new direction I want my life to go in. I’ve gotten closer to some friends, farther from others, and sadly have even lost one.
But a year has made a lot of difference in my life, and while some of it has been hard to get through, I think that a lot of what I learned at Menninger and the step-down – and what I continue to learn from my own reading and education – has made it much easier to cope with things that, before coming to Houston, I thought were completely unmanageable. I’m not saying I’m a huge success story – even though I feel like it, a year isn’t all that long – but I think what I have made is a pretty promising start, and is proof that there ware ways that things can get better. It’s very hope-inducing for me, especially since, two years ago, I wouldn’t have thought that hope was ever something I could aspire to.
Here’s to hoping I have many more anniversaries like this.
For the last several days I’ve been thinking about what to say in regards to Robin Williams and his recent suicide. I’ve seen a lot of really good things written – things like this article on Cracked, or a piece of writing about how depressed people often don’t know they’re depressed, linked here. I’ve seen some really despicable things said, too, like what Rush Limbaugh said about Robin Williams, which shows a shocking lack of tact or caring for the life of another human being – which is all too often par for the course for Mr. Limbaugh.
As a survivor of two suicide attempts, I know the lengths that depression can drive you to. Depression gets inside your head, and like a computer virus, it starts taking bits and pieces over, but in such a way that the rest of your mind is convinced that everything is just fine. Then, once it’s taken over enough, it tries to destroy the whole system – or, rather, make the depressed person commit suicide. It’s not something we have any control over; as far as I’m aware, there’s no real evidence for reasons why some people have depression and others don’t. And, biologically, it makes no sense – it’s a mental illness that, for the most part, tends to drive those who have it to thoughts of suicide, eventually. It can’t spread or be transferred to another person, so the depression dies with whoever has it.
But it can make your life a living hell, no matter who you are, how much money you make, or what you do. A homeless person living under a bridge is in the same kind of mental hell with depression as someone like Robin Williams, though sadly with fewer treatment options. Being depressed means you feel worthless, useless, hopeless. Nothing you do has any lasting effect to cheer you up or make you happy. It saps the energy from your body, but doesn’t always make people sleepy – just feel like they don’t have enough energy to do much beside sit around. It makes some people overeat, to try to fill a void that can’t be filled by physical sustenance; it makes others just stop eating, because it’s just not worth the effort. It can’t be a battle just to shower in the morning, never mind do something like an actual job. And, once it’s set in, you believe that this is normal – that life is always like this, that there is no other way to be.
Treatment can be tricky, too – there are many antidepressants on the market, and they work differently on everyone. I, for example, am SSRI-resistant, which means I get virtually no effect from most of the big-name medications. And once you find a selection of medications that work, you have to watch to make sure your body doesn’t become used to them, and stop making the medication effective. And medication is only part of it. People with depression often withdraw from social contact, when it can be one of the things most necessary to helping them – we feel like we’re a burden on others, and so we pull away. But having others around to talk to, even about things that aren’t terribly serious, can be a great help. Therapy is important, as well, because most friends probably won’t be able to understand what you talk about with regards to depression like a therapist will, and won’t be able to suggest things to do – or just listen t what you’re really saying. Therapy isn’t limited to just a therapist; there are a number of therapy skill sets, like DBT (Dialectical Behavior Therapy) or CBT (Cognitive Behavioral Therapy) that can help to redirect your mind from its depressed state. Even taking care of yourself physically – keeping a schedule, exercising, eating well – can help to manage depression.
But sometimes, everything that can be done just isn’t enough. Maybe the medications don’t work. Maybe you can’t connect with others. Maybe you can’t find a therapy that speaks to your needs, and maybe you just can’t find the energy to take care of yourself. At that point, everything becomes a losing battle, each action a desperate attempt to hold on for a little longer – to maybe find that one thing that works – until you just have no more ability to cope. Then, sadly, many people attempt suicide – like I did, twice – and even more sadly, some succeed.
It’s like having the Battle of the Bulge in your head, and you’re the Allied forces – only there are no reinforcements, the Nazis are endless, and you have limited supplies. You can only hold on for so long, and even if you fight tooth and nail until the bitter end, without help, you lose. And this all takes place inside your head, where nobody else can see it – and where all too many people assume that you can just decide to be happy, to not think about it, to focus on something, to will yourself to be better like you have some sort of Green Lantern ring in your brain. It’s these people who don’t understand what depression is like who can be the worst to be around, because if the scars from your wounds were physical, they’d be amazed at your survival – but since they can’t see them, they assume it’s nothing serious, and that you’re just being lazy.
Everyone with mental illness has to deal with these people, and it’s sad, because they can take a toll on you. How many times can you listen to someone saying that your illness is just made up and if you were a better person you’d just think your way out of it before you believe that somehow, you are just too weak to fix yourself – when, in fact, there is no way to do so? Even all the treatments I noted above are just ways to manage depression, or really any mental illness – they can never be cured, never fixed. Even someone with Robin Williams’ resources can only do so much, because it can take a long time to find a treatment that works for you – and some people never do.
I mourn for Robin Williams. He made some amazing movies and touched the lives of many people. And he did it all while suffering from something that was telling him to kill himself every day. I wish he had been able to find the treatment that worked for him, but sometimes that never comes. Sometimes the battlements of the mind are simply overrun. I can only hope that his death, and the public nature of it, along with his celebrity status, can call serious attention to this. Mental health care needs to be better. Nobody needs to die like this, hopeless, alone, and feeling like there is no value to their life. Much like we can stop the spread of cancer, we need a way to stop mental illness in its tracks. A cure, if there ever is one, is a long way off, but ways to manage mental illness should be something that children being born today can rely on.
I’ve had a lot of time recently to think about things, and while I’m muddling through a book or two, I don’t think I’ll be writing about those. Relationships have been on my mind recently – both damaged and lost ones, to be exact. As someone with depression, I’ve never been very good at dealing with loss; negative feelings like sadness tend to hit me pretty hard, and relatively easily. So the last few months have been both a trial for me – and an exercise in seeing how far I’ve come since coming to Houston.
I think first, and most permanent, is the loss of Alice in June. We really formed a connection in Menninger, and getting to see her again afterwards when she eventually wound up at the same step-down program as me was nice. As I’ve mentioned before, I don’t tend to form friendships easily or quickly; that’s why making so many friends at Menninger was surprising to me. Even though, after the step-down, Alice and I grew apart, I still considered her a good friend, someone who I would do just about anything for. And so, when she died, it hit me pretty hard. I still think about her; I wonder if maybe talking to people who knew her from Menninger might have helped. And she’s one of the reasons I want to go into social work; maybe my first-hand experience with mental illness, combined with training in therapy, might be able to help someone in a situation similar to hers. But she’ll never be back; there will always be an Alice-shaped hole in my life.
More recently, I’ve had some relationship troubles with Calla. She told me that she doesn’t feel like she is ready for a relationship, and might not be for a long while, and I wanted to try to understand why. My misguided attempts to understand what she felt was holding her back may have pushed her too far, though, and now we’re not speaking. She’s an important part of my life, and so every day that I don’t hear from her just makes it clear to me how much her absence can cause me grief. I want to talk to her, to try to explain what I was trying to say, to apologize, to do something, anything, to get her back in my life. But for right now, the only thing I think I can do is wait for her to decide to talk to me again. Hopefully, she’ll do that soon, and we can work on repairing the damage.
It’s weird; the closer I feel to someone, the more frightened I am that I will do something to drive them away. And now, in some way, that fear has been realized with Calla. I guess it’s just a fear of being abandoned or rejected – well, I say ‘just’ when it’s clearly pretty serious for me, but I guess it’s not all that unusual. It means I kind of need to be in contact, and meeting up with, the people I care about in order to live a healthy life. I can’t do that with Alice, but there’s still hope for me to do that with Calla.
As an aside, as a loyal Marvel fan (both the comics and the movies, as well as the sadly defunct Marvel Heroic Roleplaying game), I feel that I have no choice but to provide a link to this blog post:
After hearing a story recently from a friend about how her encounter with a prospective new therapist went (hint: badly), I thought it might be interesting to look at that kind of situation and see what could be made of it. From there, I decided to make a list of things that perhaps therapists should consider when taking on new patients; it is by no means comprehensive, and is not meant to be insulting or an affront to the ethical portion of a therapist’s job – these are just things I would think might be useful for a therapist to consider, coming from someone who has both been a patient for quite some time and who knows many others.
1. Your patient is not just a patient – they are also a husband, wife, father, mother, brother, sister, son, daughter, or friend. They have a life outside of your practice, and while they may have issues that drive them to come to you, that is not all that they are. Don’t treat us as broken just because we have damage.
2. Don’t start the therapist/client relationship with an agenda. It’s cool to form one along with the client, but having one before you go in means that you are already working towards goals that the client might not know about. Work with your client, not through them.
3. We understand that a lot of therapists might do research, and some of their clients might become part of that. But don’t treat us just as research subjects; that’s not why most of us came to you. We want to find help for ourselves, not just help you research something.
4. Listen to what we are saying. You can look at our records and find some things out there, but the best way to help us is to listen to what we say and work from there. Some of us may lie or evade, and if that’s the case then either end the relationship or be more persistent, but listening is important – it’s the best way to find out what’s going on (well, unless you’re like me and write all your issues out in a blog, but still, the advice stands).
5. Try not to judge us. Once you start judging a client, then the relationship changes, and you start to treat them differently. We may have done bad things – stolen, cheated, hurt others, hurt ourselves. But we are coming to you for help because we want to change, and it’s much harder for us to do that if we feel like you are weighing our sins to find us wanting.
6. Our illness can make us feel isolated; don’t add to that by treating us like people who need to be hid away from society. It’s hard for us to ask for help, and we hope that the people we go to for help – especially the professionals like you – will see that asking for help as the courageous effort it is.
7. Some of us with mental illness might not want help. I’ve known people who had mental illnesses, but clearly weren’t ready to accept that fact and try to work to make themselves better. You can’t help everyone; do your best to help them, but be ready for the fact that they might not want to be helped.
8. We may pay for your time, but please try not to treat us as just another paycheck. We came to you because you were a professional who could help us, and if you aren’t doing anything but collecting a paycheck after each session, then it’s a waste of our money and your time.
9. We might have difficulty establishing boundaries, because our illnesses can make it hard for us to know where that starts. So set your own and stick to them, because otherwise some people will try to monopolize your time with a multitude of issues.
10. Often, treatment for mental illness involves a combination of things – lifestyle factors, medication, therapy, and a support network. We understand that you can’t be all of these, or provide them all, but work with us to help make sure that we can eventually manage things on our own.
I’m sure there are more things that could be listed, but I think ten is a pretty good number. I might also have to write a similar post for people who are suffering from mental illness, because I know that we can often – even without meaning to be – be very hard, mentally, emotionally, and sometimes even physically – on those who are trying to help us.