Either a mental health issue or a physical one is difficult enough to cope with at one time, but having both can add so many extra problems to life. Many people with lupus or a similarly chronic condition develop depression as part of their condition, or due to the constraints their disease puts upon their life. I’m one of the ones who struggled with a mental health condition before anything physical came along. I wanted to write about my recent relapse, but as the post has turned out more a history of my struggles with depression, I’ll write the more recent stuff in another post.
It’s difficult to say when my depression started, but I know I was self-harming at about ten years old, before life got tough for me in school with bullying, before any pinpointable reason came along to suggest I was unhappy. That’s the thing with depression; it can be purely chemical, and so unrelated to anything that’s going on in your life at the time. My parents were naturally aghast, sure I was being bullied, or that there was another reason beyond “I don’t know”. I think my twin sister and I started quite curiously, and then she stopped, while I found it a reliable coping mechanism. I remember being very young, and I struggled even then with severe insomnia, and would find myself awake at night, hiding under the covers and just crying for no reason I could find. When I think about it now, I also used to have strange paranoid thoughts that “they” were always watching; I had to keep my ears under the covers at all times, and my teddies always had to be under the covers too, because if “they” saw the teddy, they would take it away when I was at school. Every morning I would make sure the teddy was under the cover, and I had some anxious days at school because I couldn’t remember whether the teddy was safely hidden or not.
When I got to high school, suddenly there were enough reasons to fuel my depression. While my twin and I were admired in primary school for our “eccentricity” – we were very creative, wrote and performed our own songs, and that sort of thing – in high school, all of our “friends” from primary school suddenly dumped us. I went through high school being very unpopular and picked on, and unfortunately I think for a long time my sister was caught up in it just through her association with me. I continued to be “weird” – the Goth phase didn’t help the ostracization! – and people either avoided me or picked on me. (Various doctors now think I have a form of high-functioning autism, but I haven’t been formally diagnosed. It would certainly explain a lot about my struggle with social interaction and more.) I was picked on for being quite a loner, for being smart, for being bisexual.
Of course, when I was 14/15, the lupus hit, and suddenly I was absent from school for such long periods of time, and when I did appear, I was pale, gaunt, sick. God knows what people thought. This meant I fell even more out of touch with the few friends I had, and became more isolated. By my senior year, I even had the 11-year-old first year students calling me “f****t” every day! By this point, the bullying didn’t really bother me, partly because I’d grown such a thick skin, and partly because I had my health to worry about, so much that I attempted suicide at 16 in desperation.
Life has improved a lot since then, I loved uni, and I’m much more comfortable about my “odd” social preferences. Still, the episodes of depression and self-harm continue, because as I said before, they come out of nowhere much of the time for me. More recently, I was seeing a psychologist regularly and am on medication. I’m doing all I can do for my mental health, but more and more both my psychologist and I have accepted that self-harm is likely always going to be a part of my life. When the urge overcomes me, my mindset completely changes, and no logic pervades it. Everything that I’ve agreed with my psychologist goes out of the window. I know that if I manage to overcome the urge (before this mindset comes, as is this point of inevitability), it only happens so many times before it culminates in a severe, dramatic incident, such as what happened in November 2012 when I was taken to hospital with cut wrists, refusing to talk or look at even my twin sister. I still couldn’t say whether that was a suicide attempt or not, and more likely designate it “parasuicide”.
But I struggle with the concept of allowing myself to self-harm, and saying that it will always be part of my life on one hand feels like me giving myself an excuse. However, now, if I get an urge, I try not to say to myself, “You will never self-harm again”, because I know it’s unattainable, and I will just feel more guilty if I break this “promise”. Similarly, I don’t count how long I go without harming, because if I ruin a year free of harming, I’m going to feel like a failure. My main coping mechanism at the moment is to tell myself when I feel the urge, “Tomorrow”. When I relapse with harming, it’s usually precluded by fantasizing what I want to do, and then planning what I’ll do, until a point where I move onto action; this is the point I say “Tomorrow”, or even “Later”, or “Next time I’m in the bathroom”. Sometimes this can prevent me from a proper relapse into actual harming; sometimes it just prolongs the inevitable. Something else I did this last time was to tell my sister relatively soon after that I had cut. Sometimes she can tell from my mood, sometimes not. But telling her meant I didn’t have the extra pressure of panicking about it being seen by anyone. I think it helps to tell anyone, even an online friend who can’t be there in person, because I feel it lifts the burden a bit. And rather than guilting myself about it, I think every day is a new day. I don’t tally how long I’ve gone; I take it one day at a time. Cliché, perhaps, but it does work for me.
I think it’s important to give yourself attainable goals, without feeling that it merely gives you an excuse to continue destructive behavior. I know that it’s personally far too reaching for me to say “I’m never going to self-harm again”, so I say “I’m not going to self-harm today“. My occupational therapist keeps telling me I aim too high when I see her, I say “I need to sort out my whole life”. The point is to start with bite-size chunks, short goals that are attainable. This week’s goal is not “Sort out and catch up on the entire backload of laundry”, it’s maybe “Take one bag to the launderette”. I know from experience that saying “This week I’m going to tidy up the whole bedroom, take my unwanted things to charity, and reorganize all my spaces” is simply setting up such a big goal that, even ignoring my physical state, will make me shy away and think “I’m not up for doing so much, so why even start?” But if the goal is “Sort out the books I don’t want and lay them aside to take to charity”, or “Tidy up one drawer”, you can do the task and then stop without feeling like you had to hold up the whole world. After all, putting off a big goal for weeks might mean even less gets done than if you tidied or did domestic stuff for only 5-10 minutes a day.
Anyway, this is my general experience with depression and self-harm. Separately I will write about the issues of the combination of a mental and physical health condition, and why this often still sets me back even when my mental state is clear and motivated.