TW: mental illness, suicide.

TW: mental illness, self-harm, suicide

I haven’t written here for a while now, but I will get onto the general update posts after this one, as I just feel I need to get this all out. (It ends up quite long, and me somewhat rambling about mental illness in general.)

Most of you have possibly already heard the awful news about Robin Williams, who has apparently committed suicide. As I’ve been feeling on the brink of a self-harming relapse for a while recently, this has really hit home to me that some of us really are “lifers” in depression. We get over episodes and feel good, but down the line we don’t know how bad it might get again. I’m somewhat come to terms with this in general, but it’s still hard, of course. So, I just want to use this space to get out everything I need to, and I hope that people don’t see this as me trying in anyway to hijack and derail this tragedy. I hope Robin has finally found peace and he and his family are in my thoughts. I hope to find strength from the loss of a fellow warrior, and I hope that the rest of you in this fight can too. I just want to write this mostly as catharsis for me, but also to educate people some more on what it’s like to fight this, to suffer from mental illness, because, while I haven’t seen any horrible comments relating to Robin, I know that they’re most likely out there and I probably will come across ignorant comments, some intentionally vile, but some from ignorance. I’m trying to fill that void of ignorance for those who are willing to listen.

I’ve suffered from depression and self-harm since about age 10, and I’m what I call a “lifer”. While therapy, medication, and simply time can help in a specific episode, I inevitably will relapse later down the line. I’m aware of this, it’s been happening for more than half my life, and in some ways I accept it. It’s been easier to deal with knowing that a relapse is inevitable; I feel more prepared and feel I can be more open about it than if I and my family pretend that I’m “cured” after an episode wanes. Right now, I am recognizing the signs, and it may or may not turn out to be an actual relapse with harming; sometimes it passes, sometimes I pass an invisible line without having actually harmed again yet where I know I can’t stop it. Maybe it sounds defeatist, but knowing you’re relapsing with a physical illness doesn’t stop it happening, rather it makes you more prepared to deal with it. And as I often say, I’m a proponent of the fact that mental illnesses are physical illnesses that affect mental processes (and often physical ones too actually).

In psychology, I didn’t find therapy helpful for a long time because we were pretending, basically, that I could end the cycle through changing the way I think alone. Well, part of my therapy was to accept that negative things happen in life, and so by a certain point, I told the therapist that this was also something I needed to accept to be able to cope with it: my mental illness, just like my physical, is incurable. I will have good days and bad days, good months and bad months, but I must always be prepared somewhere in my mind for a relapse. Same with the lupus: I spent a lot of time deluding myself that it wasn’t going to get worse, that somehow someday I’d have my old life back. Well, all that did was cause me more upset and disappointment, waking up to find that I wasn’t better, that I was sometimes worse. Coming to terms with the lupus being permanent helped my mindset a lot, and so did the acknowledgment that I was never going to be completely “cured” of my mental illness either.

If you don’t suffer from any form of mental illness, or not so chronically, it can be hard to imagine being in a state of mind where self-harm or suicide seems tempting. Believe it or not, in my good phases, I also can’t imagine wanting to cut, enjoying that pain. I think of some of my worst wounds and cringe hard. I think “How could someone do that to themselves and be able to bear the pain and the gore?” Because to do these things, it needs a certain mindset to do it. It’s not the case that when you’re feeling absolutely amazing that you just think one day “Hmm, I think I’ll cut or kill myself”, even if it seems that way to outsiders, although episodes can come on so suddenly during what you thought was a good phase: my worst wounds, where I was hospitalized, were inflicted the very day I graduated from uni. But even from the graduation to the harming, a swift change of mindset took place. Darkness had settled in.

People have called those who attempt or have committed suicide cowards. They say things like “man up”, that everyone goes through shit and that people should just hoist themselves by the bootstraps and cope. I’m a believer in optimism, and a good attitude can take you far, but it is not miraculous: optimism isn’t going to magically sort out the biochemical imbalance of my brain or indeed cure my lupus by altering my immune system so it stops attacking my own body. If you’ve thought something along those lines, that suicides or harmers are attention-seekers, cowards, that you think they’re beyond help, try this: imagine a bad day you’ve had, a day where for no pinpointable reason you felt inexplicably sad, angry at life, apathetic, perhaps, where nothing seemed to go right, or even though everything was going right you still felt this way, when it should have been an easy case of you saying to yourself “just cheer up, have a positive attitude”. It didn’t help? Sometimes it doesn’t. Sometimes there’s absolutely nothing you can do on a day like that except let it pass. Now imagine that bad day stretched out over weeks, months, years, with no end in sight, and no matter what you do, that darkness, that cloud just doesn’t let up. Would you be a coward for wanting that to end?

I do have days where kicking myself up the bum helps. I have days where I’m moping about and changing my attitude changes everything. But that’s not what I’m talking about, and that’s not what depression is.

Now, it’s not always so explicably constant for people. Many people with depression have amazing days, have weeks or even months where they are, to all outward experience, just fine. I’m not talking people putting on a mask, although that’s a whole other problem. I mean that even while depressed, people can actually have good days. Take grief for example, which is a kind of depression in a way; people grieving have days even in the midst of their grief where they genuinely enjoyed themselves and generally forgot about the loss. Because people with depression can have those intermittent days, or indeed long gaps between episodes, people often thinking we’re not as ill as we make out. Often when people commit suicide, friends and family will say “But they’d gotten much better”: sometimes this apparent improvement is a result of the decision of suicide, which often takes the weight off someone’s shoulders, removes their burden, but also sometimes someone did genuinely get better from an episode and then relapse, which the family doesn’t recognize because if you’re better, then you’re better, surely?

A friend of mine has recently been feeling generally down and dissatisfied with life. When I suggested to her that she was depressed, she said she had considered it, but she had decided she wasn’t, not because things didn’t point to that, but because she had been made to think that being depressed meant constantly crying, not being satisfied with any part of your life. I told her that personally I never cry for myself–mind you, I think part of that is due to having hidden my true feelings, mental and physical, for so long–and that doesn’t mean much in terms of whether you’re depressed or not. I explained to her that many people go through it for a relatively short time; if she’s depressed now, it doesn’t mean she has always been or always will be. But some of us are lifers, and it’s certainly not due to a lack of strength.

This has gotten very long at this stage, and I’m not positive exactly what I wanted to say with it. I just feel that people who are most dismissive of disease, whether mental or physical, are people who complain most about the little things in their own lives. I’m not saying that people can’t complain, but when you act like the world is over because you had one shitty day and then dismiss people who go through worse every single day, it’s kind of crap. Some people make ableist and ignorant comments based on just that, ignorance, but I’ll know the difference when someone make the effort to listen to me and try to understand and makes an effort to change their thinking about mental illness, their ignorance. So often with disability and ableism in general–in fact, in any social oppression issue, really–I’ve had people who think they are “allies”, they try to support the disabled community, but when one of us comes along and says that they’ve said something ableism or that we find an issue with, they often walk out of the conversation, acting like a rebuked child, thinking it’s unfair because they show support for us and we “pick holes in it” or something. Those people are not true allies. On the other hand, I’ve had people, including my twin sister, who’s been there for all my life through my struggles with physical and mental illness, who say ableist things, and then when they’re called out on it, they apologize sincerely and take it on board to try to adapt the way they think about disability and mental illness, which they have no first-hand experience of.

Basically, I’m just asking people, if you haven’t experienced this first-hand, don’t jump to making ignorant or mean comments about Robin Williams or any other sufferer of mental illness. Read and listen to our words to try to understand what it is we’re going through and how you can help. I understand, it’s awkward for you. I can think personally where I’ve been comforting friends who are going through tough times, and I know that sometimes you don’t know what to say. You’re afraid of saying the wrong thing. Listen to your loved one and try to engage with others’ experiences, particularly online, and if you do say the wrong thing and are called out on it, apologize, take it on board, and don’t make the mistake again. You don’t have to have a degree in psychology or psychiatry to support people with mental illness: mostly we just want to know that people are there for us if we need them. Don’t get offended if people then don’t vent to you or confide in you; don’t get offended if your partner or friend or family member is still struggling no matter how much you help, don’t get offended if you get called out for saying the wrong thing or something ignorant or ableist, no matter your intentions, because out of being told you said something insensitive and being dismissed or hearing a cruel comment when you’re trying to fight this, I think we know what’s worse.

Just remember your own bad days and consider how that must be to cope with, day in, day out. Don’t blame us; be there for us. You wouldn’t blame or dismiss a relative with cancer; you’d probably do whatever you could to support them and make sure they’re comfortable. Well, it’s not all that different, really. The main thing is try, and if you’re wrong, adapt.

I hope that Robin Williams is at peace, and I hope that those of us still here in this fight can find strength. I’m hoping I don’t continue down this slope to a relapse, but I know I might. And I know that even if I don’t fall down it this time, there will most likely be a next time. Yes, I am a “lifer”, and it’s scary to think that at any point in the future, I could go back to my worst place, I could find myself in Robin’s position. And so I believe in being as open as I can about my struggles–that doesn’t mean during my episodes, I can talk to family for example about my thoughts and worries, because I most often can’t, but I won’t be ashamed to stand up and say that, yes, I suffer from depression. Yes, I take medication for it. Because if we’re going to help those with mental illnesses and prevent people from taking the final step in removing themselves from their pain, I believe we need openness and understanding; many of us have hidden our struggles because we don’t want to hurt loved ones or make them angry, and suffering in silence is one way to worsen it, to let it progress, sometimes to a point where it’s too late. Please support your loved ones in this fight, even if you can’t understand it fully. I personally have found the panicking about being caught harming worse or just as bad as the feeling that drove me to it, and being able to say to my sister, yes, I did it, and make sure the wounds are cleaned and uninfected, has helped me beyond words. It doesn’t mean she “lets” me do it, it doesn’t mean it doesn’t upset both of us, but bear in mind that guilt is often the strongest emotion in mental illnesses, and is often the one that leads to suicide, so please try not to produce even more guilt in us by blaming us or getting angry with us.

RIP Robin, and all the other warriors we’ve lost.

Vent (TW: self-harm)

TRIGGER WARNING: self-harm, mental health

I’m having a very strange time right now, and I thought what is this blog for if not for me to get these things out? The people from my life who know who I am and perhaps read this blog are people who are closer and know more detail about my issues, and so it’s not loads of acquaintances reading detail I “shouldn’t” be sharing.

A few weeks ago I relapsed relatively minorly with cutting. It was just a few, and it came after I was really down about my life, and was talking to my mum and sister. I haven’t been out of the house for ages for myself, my room was an absolute dump, I’m not organized, I have no further ideas with career, I put off booking a trip with my sister… Generally, I’m just tired and annoyed at myself. This talk wasn’t so serious, but I was lying down saying how pissed I was and that I hate my life right now. I thought I was going to cry, which is big: I’m so used to keeping emotions inside that I pretty much never cry for myself now. I often have incidents where I know I’m sobbing inside, but outwardly I’m rather stoic. I’ll cry at movies, news stories, and things like that, but even I’m desperately unhappy, it’s hard for me to actually shed a tear for myself. The last time I got very close was after I was cracking up in the hospital; I was in for a few days for surgery but then had to go back in for a week or so after the wound got infected and reopened. I’d only gotten home for two days or so, and it was in a different city so my sister couldn’t be there all the time; I usually cope fine alone, and last year I was in hospital 100 miles away for a few days and coped fine with no visitors, but after it was approaching two weeks this time I was just cracking up; I had no internet, and I wanted to learn things. I found I could only read so many books and write so much of my novel before I needed other things that I usually do.

Anyway, the wounds weren’t too bad, they gave me a bit of release. I felt better and hopeful again about life and was proud of myself that I hadn’t gone further with the cutting. I did it again a few days later in the shower; this was worse, but still relatively minor, and I soon had the courage to tell my sister I’d done it, which greatly lifts the burden of having to make sure no one in the house sees it. So far, so good. I talked things through with a friend who’s recently been to Hell and back, and we were both feeling hopeful. I still had the urges (each episode is very rarely only one “session” for me), but I still felt pretty good again about life, and although I haven’t been out for non-medical reasons, I did write about 1000 words for my novel which ashamedly is the most I’ve done in a long time! (I usually freak out when I’m getting to the end of them, and then it takes me ages to get through it!)

Then yesterday was very odd. I swear I got up at something to 6pm, and I even Tweeted not long after that saying how I was annoyed at the fact. My sister was working, and I am positive she called me when I was already up and online, and she too says I was very alert and she thought I was up. But she swears she called me at something to 4, before her shift, and her phone confirms it. I was absolutely positive I had not taken a phone call while in bed – but my online activity shows I was up about 6 as I thought, not before. So apparently there is about a two-hour period where I can’t account for myself. What the Hell was I doing? There’s a chance I did take the call in bed, but my sister can often tell by my voice whether I’m up or not (even if I’m still in bed but awake), and I’m sure I was up, because I was going to ask Mum about something just after it, but my parents weren’t in.

The brain fog I suffer with lupus can mean that I forget things that happened the same day, but this is just weird. And I’ve just gone downstairs and harmed again. My main method is cutting (or picking skin and nails); sometimes I do burn, but very minor ones, e.g. dripping hot oil on my hands when I’m cooking fries. Today I threw a small cup of boiling water over my arm, which is an escalation for me; I’ve never done that before. I did cut too, and they’re not too bad, but I have a considerably wide gash in my elbow that I have put a dressing on; I’m also not one for treating my wounds much, I usually just mop up, let them dry out, and leave them, which is what I’ve done with the rest of my arm that isn’t the elbow gash.

I don’t know. I just feel like I’m cracking up. The thing is, though, I feel fine now! I’m sitting here quite fine, writing this post, but I know it’s probably that detachment I get with harming, and also the release. Self-harm is such an enigma. I wonder if I should pursue psychotherapy again; my psychologist and I were going round in circles, but I wonder if another therapist’s input would help. Not that I can even think what they can do for me. I was doing acceptance and commitment therapy (ACT), and in the sessions, everything made perfect sense to me. I agreed with the steps I should take, and identified my values. Yet when the urge takes me, I dissociate; logic goes out of the window. More often than not, my harming is unrelated to what’s going on in my life, so it’s not as though I can combat the issue that’s causing it. I often think it would be easier for me if I did have an identifiable trigger – that way, both I and my family could be more watchful. I mentioned psychiatry to the psychologist, because of this dissociation and the fact that behavioral changes didn’t help; on fluoxetine, I find that I can postpone the episodes of harming more, deal with the urges more logically, but there is a threshold beyond which I know it’s inevitable and nothing can talk me out of it. We couldn’t identify what that threshold was. I also think I held back a bit with her. I don’t know. I don’t necessarily think I have a psychiatric disorder; I’m diagnosed with chronic depression, but my harming also doesn’t necessarily coincide with the episodes of depression. Usually in an episode of depression, I will harm, but I often harm outwith them too.

Uggh, I’m just rambling here, which was actually the point, I guess. I’ll tell my sister what I did when she comes home. I just wonder about going to the doctor again with this AND the autism worries; they’re definitely going to think I’m a hypochondriac in spite of my diagnoses. I don’t really have people I can talk to face-to-face about any of this stuff except my sister, who does her best but of course doesn’t quite get it. I have no friends in my city, really, more acquaintances I volunteer with; although I’m really close to one of the managers in a store I volunteer in, I have no way to contact her except in the store, and I’m not really leaving my house for non-medical reasons. Anyway, I can hardly walk in, and just lay that on her. I don’t know. I’m hoping things level out soon. It’s just scary not knowing what’s going on in this head of mine!

My struggle with chronic depression

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.