Gravity Journal by Gail Sidonie Sobat

I picked up a book for teens by an author I had read before. It sounded interesting – its main plot line is the experiences of a girl with mental illness – so I thought I would give it a try. It was an enjoyable read, very accessible too. A quick synopsis from the book’s back cover:

Life is very grave for Anise. Hospitalized for anorexia, she wonders about the point of it all. Her frigid mother and ineffectual father seem oblivious to her struggle. Her beloved brother is too busy screwing up his own life to take note of hers. Living on the loony ward seems not to be making any difference at all, and Anise feels like a prisoner. Her only free choice is to turn to her journal – the place where she can make scathing observations about her family, other people, the world; the place where she can dream, and where she can decide whether to live or die.

Like I said, it was an easy and enjoyable read. I think Gail Sidonie Sobat, the author of this book, has a way of making any topic interesting. She talks about very important issues in this book. Not only about anorexia but also suicide, cutting, hospitalization, and the treatment options for of mental illness. It was surprising to see such bold discussion of these topics – I know that I expect only allusions to suicide or cutting, but in the book there is outright discussion. I give credit to the publishers, Great Plains Publications, for printing the book so raw. I think this fact cannot be over emphasized as I think it is very important for youth to have resources for thinking about these issues.

These facts aside, the book was a bit disappointing. I think there was so much potential for greatness that was not realized. The characters were simplified and predictable. I think Anise’s life was oversimplified as well. While I don’t want to dismiss the experiences of those similar to Anise’s I really thought the book portrayed a very simple and, honestly, easy experience with anorexia. Mental illness, especially illness requiring hospitalization, is devastating. Women, girls and men who are hospitalized and force fed are often at the edge of death. All aspects of your life are affected and relationships are often ruined. I wanted to see a book that really recognizes the depth of suffering people with mental illness endure.

Sobat secured a hopeful ending which is a positive thing… but is it realistic? The reoccurrence of anorexia is something like 90% but Sobat left the reader thinking that as long as Anise works hard, she will be successful. Maybe that is true, or maybe mental illness can be so strong that it can rip through people like nobodys business. I kept wondering if this was because the author was writing from an outsider perspective. Perhaps she has experienced hospitalizing anorexia or had only known someone who had (or perhaps neither). Her bio mentions that she is a teacher at the Alberta Hospital (a mental institution) so perhaps the book is a reflection of her experience there. I recognize that the publishers probably wanted a happy ending for such a heavy topic. Also, I think it is good to give a message of hope to the teens who read the book (or twenty-somethings like me). I do think there is a way to be hopeful while also recognizing the long, and often grueling, times ahead. I have recently read a book that was successful at doing this which I will be reviewing in the future, so more on this later.

So, in summary, the book was interesting and I was thankful for it but didnt quite meet the heights it could have reached. Check it out!

The Shame of Suicide

I am lucky to say that I have never attempted suicide. I am lucky to have never been in that place. I have been suicidal on a number of occasions but never passed the planning phase. During my last episode I approached the attempt phase dangerously. I am lucky to have had someone in my life who I decided I did not want to have to deal with my death. He saved me because I was there, it was over, he was the only reason why I didnt attempt my death.
Having been so close has required a certain level of healing. When people talk about suicide I feel very uncomfortable. I dont think many people know what it is like to be there in that space when there is only one option. When people talk about it it reminds me of what it was like being there and the sadness is unbearable. I also feel ashamed that I was so close to doing that to my partner. I know that ultimately I made the right choice but the shame of suicide has stayed with me.
Some people say that suicide is the most selfish act one can make. I dont know how I feel about this. I think that is something that people who have never been there would say. Something that people say when they find out that a friend or loved one was suicidal. I would agree it is selfish if we take selfish to mean only doing something for one's self. But I do think that some choices need to be made selfishly. This is not to say that I think suicide is the right option. Suicide is a permanent solution. I know that I choose temporary solutions to my pain, long term or short. If you are in that place do WHATEVER it takes to comfort yourself. Anything but that. I know that I hate when people say this but it will get better. When I first heard that I thought 'you just dont get it do you?' This will never get better. I am pained to say that I learned that this is in fact true. It does get better. Even if it gets only a little better... its better. And then it gets a bit better than that.. and so on.
I have made a decision now that I am recovered (however temporary that may be). If I am feeling that I am there again, that there is only that option, I will go to the emergency room and will sit with supervision until I can manage again. I think it is important to make decisions like this when one is lucid because it sticks with you when you are not and it can be the only voice that will get through your pain when all other voices cannot.
I am still healing from being in that place. I think that feeling of being so close will be with me for the rest of my life. I think this is a good thing, for maybe it will remind me how thankful I am that I did not commit suicide.

Remembering

The sight of your wrists
It makes my skin float,
my milky whites ache

So close

They feel transparent
Tear-able
A scratch will open
Pouring
Warm
Sick

Cheeks flushed and cold
Ears ring
Skin on edge

So close

The skin rattles
Ever thin
Pumping
Sound of pouring
Breath stalls
Fear breaks

So close

Calming now
Milky whites clean
Firm
I will remember how close

Looking Back

I keep a mood journal. Well, a very biased mood journal. I only really write in it when I am depressed. It does help me keep track of how I have been feeling, however. Sometimes I look back over it to see if I have made any progress and it can be shocking.

I am easily addicted to things whether they be substances or practices. I made a special section in my journal talking about addictions and last night I read my entries. It really made me see how addiction is linked to my depression. It seems I grasp for anything to distract me from the pain. Each episode I have tried different things - a consequence of doctors telling me not to drink, for example, because it is a poor way of dealing with pain and so next time I pick up a new substance to replace the coping mechanism I have lost. I have used alchol, pot, cigarettes, cutting, sex, food deprivation and even the habit of gaining attention as a means to cope. Whatever seems to work, for however short of a time, I cling to. I dont know how I will ever be able to get away from this. I have had years of therapy and yet substances and practices are still the most effective way of feeling better fast. I guess thats why they are addictive though isnt it?

Looking back last night did allow me to see that addiction is part of my illness that doesnt really affect me when I am doing well. Reading back also allows me to recognize the pain I have endured and that I have always made it through - sometimes I really do not know how. At the risk of sounding too positive, I think looking back is a healthy way of recognizing and learning from the past.

Update on Me

Well its been 6 months and Im glad to say I dont have very much to report. No news is good news when it comes to mental illness prognosis! I have had some minor tweeks to my med regime but nothing too extensive. I have some bad days but Im lucky that they are never worse than minor inconvenience. It seems I have stabilized for now. I am still going to acupuncture every two weeks - which helps both depressive and manic symptoms. I missed my appointment two weeks ago so I went a month without and definitely felt the difference. Recently my doctor and I (do you like how I pretend it is a partnership?) increased the dosage of my main antidepressant just to cover the last remaining symptoms I have, so I hope that goes well.

Side effects are still pretty mild. One strange one has to do with my vision: I get blurred vision and I have to consciously focus my eyes at times. I have glasses and it seems like my prescription is wrong, but I have had it all checked out and everything is fine there. This time to time blurred vision is really annoying. I have also found that my eyes cross really easily. I never use to be able to cross my eyes at all and now it seems my eyes enjoy it: anything gets close to my face and *pop* there goes my eyes. My doc says she has never heard of visual side effects but I figure the 'experts' never know everything (or anything really) about the medications they serve.

As for the police inquiry nothing has come of it. We reported it to the police (and we were very lucky to have a kind and understanding officer) but never heard anything of it. I am still convinced it was someone who works or worked in the building. Following this, I still do not feel completely secure in my apartment as I am always concerned that when I arrive home without my partner there will be someone there. (I know my doctor would have something to say about that: "forget this being a rational fear, I bet it is your anxiety acting up, plus a little paranoia we should keep an eye on").

Thats it for now. More to come...

A long sleep

Well, I have been away for quite some time now havent I? After vacation came school and with school came all that pesky homework. I really blame myself, however, for not keeping up with writing. As I have mentioned, not even my partner knows that I write this blog and writing it from home became a bit of a problem as my computer sits in the living room. I have also been disapointed to find that I have very little to inspire me to write. There is a lot going on in the world of mental illness and yet I have not been able to tap into it. I follow a number of organizations on Twitter and yet still no inspiration.
Starting up work again - very part time now and hopefully again this summer - will free up some time to write (how bad is that? I save my writing time for when I am on the clock! I blame myself, I honestly work so fast I generally work myself right out of a job daily and so have some free time). Hopefully the inspiration will come!

Vacation

I will be going on vacation on wednesday so I wont be posting until late next week. For now Ill just let you know that I am talking with the police tonight about the break in, and leave you with a post on gender and mental illness:

Mental Illness and Gender: Some Musings about S.E.X

I am constantly thinking about sex. (Shocking I know as I am a woman! (sarcasm) But nonetheless true) Unfortunately, my musing are often about how little I am having . Psychiatric drugs are the ultimate sex drive killer. They do not, however, kill my desire to want to have sex - I miss my sex drive!

Something I find interesting, however, is the way this side effect intersects with gender. Stereotypes dictate that men have an unlimited and always existing desire to have sex; women on the other hand, are believed to generally not want to sex. There is also an understanding that in hetero relationships it is women's 'duty' to fullfill their man's sexual 'needs' putting thier lack of drive aside. There for, withholding sex was an intentional act used as means to control men and/or gain influence in the home - which may very well be/have been to women's advantage especially if this was/is the only means by which they could acquire this power - but this belief remains a stereotype.

Things in the social world are always much more complicated (much, much more) than stereotypes allow. First of all, some women may have a higher 'drive' for sex than some men; some men may use sex to gain influence, some women may not; some individuals may not have sex at all; some women may be in relationships with other women, some men with men, or some people may have relationships and sex with a group or groups of people. What do we even define as 'sex'? I think of it as the umbrella term for all intimate acts of a sexual nature (assuming that 'sexual nature' are based upon physiological responses). These acts vary from penetrative sex to sensual massage.

But I digress.

Women (and men) on psychiatric drugs and other medications which lower sex drive exist in a world with these assumptions on how they should act in regard to sex. I find that when I have little to no sex drive guilt creeps up and makes me feel as if I am 'failing' because I am not fulfilling my partner's sexual needs. Plus, I fear that I will be precieved as using sex as a means to acquire power in my relationship.

Rationally I know that these things are NOT true, yet these ingrained stereotypes eat away at me resulting in an even lower desire for sex; plus I can imagine how hard it must be for men dealing with the stereotype that they always want sex when they do not.

Along with dealing with internalised stigma regarding mental illness in general, assumptions about the relationship between gender and sex make those taking sex drive killing drugs a little bit harder.

Med Thief Update

Well I regained some of my confidence in my sanity this morning. I found we were missing about $20 worth of rolled coins (though they were kind enough to leave $1.50 in pennies... thanks?). At least now I am confident that it was someone else and not just me going crazy... Thank God.
Dealing with my building manager and soon the police. Ah well.

Part of me is just sad for this person as they are motivated to steal meds that dont have high retail value (do they know someone who is sick, or are they desperate and HOPED they would be valuable); they stole $20... obviously they NEED $20; this person spent A LOT of time in our apartment (the coins were in a drawer in my kitchen with my tea...)
I d like to meet this person just to ask why they took what they did, what is going on in their life to act this way. And if they are just a royal asshole, then I like to be able to tell them off! ha

I hope to be posting an actual mental illness/feminist post ASAP

Med Thief? This makes no sense

So last night I go to get my many many pills out so I can take them as well as to get out the ones I will take in the morning. I sit on my bed, open the drawer of my bed side table and reach in and grab…. Nothing. ALL my pills (the bottles and all) are gone: the ones I was using, the extras I have for later this month, a box of sample meds I was trying out and sleep meds that I don’t often use. My vitamins are still there along with a couple other things (pen etc) but its like the meds were never there because the drawer is arranged in the same way just there are spaces that are empty! I do a double take, get a big wave of the heebs (heeby jeebies) and boot it to where my partner is. Im like, 'all my pills are gone', hes like, 'what?' And im like, 'their gone, all of them', he stands their quiet, contemplative and starts to look worried. I tell him, 'don’t freak out, if you freak out ill freak out'. I am getting very worried and begin to think I may cry. We go in to the bedroom (me already looking over my shoulder paranoid) and I show him the empty drawer. Then he asks me, 'are you sure you didnt moved them?', 'no' I say. I ask him 'did you move them?', he says 'no'. Then he says, 'that only leaves one thing', and im thinking 'oh god someone was here'. We check to see if anything else is missing and nothing is. All our valuables are there. Nothing is stolen. I get him to check all the closets and under the bed (ha) for this pill thief and find nothing. We take time searching to see if one of us, I don’t know, slept walked and hid them… NOTHING. Now we are wondering if someone stole them to sell on the street? (a bit of a stretch in least)... but how would they know I had them and where they were!? We don’t think they are even worth anything! We are both thoroughly confused. We decide to call security in our building even if it is just to give them a heads up that Possibly there was a theft. Of course the guy on duty is confused too. Everyone I have told is confused and eventually gets the 'you probably just moved them' look on their face - but I honestly didn’t! I never move them because I only take them before bed and the morning plus why wouldn’t I have moved my vitamins too?

So all this means one of three things:
1. someone broke in – this is very bad
2. my partner took them and is denying it…hence some bad stuff going down in our relationship
3. I did it in some sort of 'out of it' state and don’t remember, and therefore have some serious mental awareness problems that are cause for alarm.

I think 2. would be the best hey?

Of course I was unable to take my meds that night or this morning and was having withdrawl before I was able to get to the Pharmacy, I had to pay for more drugs a few weeks early and missed work due to this little field trip. Sucks.
I am pretty stressed but at the same time I am shockingly calm because as for now I dont know for sure what happened so im in this weird state of limbo denial... mmm feels good

Ill update later

Limited View

It is amazing that even with my numerous years of experience I am still able to down play my symptoms when I am between episodes. Perhaps this is a tendency which contributes to the number of people who have a mental illness who do not seek and sort of help. For example, in my last post I mentioned how the side effects of my new meds were making it hard for me to rationalize my use of them and that hypomania was preferable. Of course this weekend on a particularly symptom heavy day I thought, okay these side effects are better than experiencing this hypomania all time. In both cases I saw my past experience in a much greener light.

Considering when you have a cold and you suddenly realise just HOW NICE it is to be able to breath easy out of your nose, with mental illness when the going is good (between episodes) or particularly difficult in a one sided kind of way (side effects) one may down play the worst of things and think, 'it really wasnt so bad'. Some times it shocks me, especially considering how many times I have been suicidal, one would think I would be cognisant of just how bad it was!
Is this not about down playing one's experience, especially when it comes it is stigmatized? We need to give ourselves more credit for enduring they diagnosis and experience of mental illness. It is difficult; even if we justify this solely by the fact that often one of the most important diagnostic factors is whether or not symptoms disrupt ones daily life. So how do we do this? How do we give justice to our experiences? Generally I would think keeping a journal during those hard times to remind ourselves would be an effective strategy, but I would be afraid that may trigger an episode or at least make me very sad and potentially ashamed. Perhaps reminding myself how deserving I am of this recognition for my strengths by repeating a relevant mantra or saying would be sufficient?

Oh I can really feel the effects of these drugs... well just the side effects

So Im trying out a second anti-psychotic trying to control my hypomania. Not going so well. In fact, I should mention that if this post doesnt make much sense its because im drowsy, groggy and generally a little confused.
I now understand why so many people with mental illnesses go off their medication. Having suffered from only moderate depression (compared to those who are hospitalized with severe symptoms) I havent had to take ridiculously high levels of any drug. Now that I am on this cocktail of drugs Ive been blessed (sarcasm) with a plethora of side effects. Not only do I have no sex drive I have dry mouth (which caused 4, count them 4, cavities), headaches, dizziness and other effects I cannot remember at the moment. Now I can add drowsiness and a general feeling of confusion and out-of-it-ness (okay i know thats not a word, but it does describe how i feel!)
Considering I can have these new symptoms OR be hypomanic, I choose the latter! (Well at least until i can get back to my doc at the beginning of next month.) I know that I need to deal with my up swings to ensure these swings do not get any worse, but this experience sure has given me the experience needed to understand why people in manic stages often do not take their meds.

A Rant: (Bear with me)

My psychiatrist has diagnosed me three times at three different appointments, each in a frighteningly short amount of time. I was referred by my doctor because of how complicated my major depression was. That appointment she agreed with my first doctor and increased my dose of my already prescribed anti-depressant. On my second (or third) appointment she told me that I seemed to have 'bi-polar tendencies' that she was concerned about. She added an anti-convulsant to my regime to help ensure I did not swing into a full manic episode. At this point I felt this was all very reasonable BUT was concerned at how fast she would diagnose and treat. She had not known me for any more than three sessions (so MAYBE 1.5 hours) and she was giving me a drug that has very serious rare, but real, side effects. A month later, still convinced of her diagnoses of Major Depression with Bi-Polar tendencies, she added another anti-depressant to offset the negative side effects of the first one as well as to raise my dose in general. Not a month later, when I felt another increase was needed she started discussing with me Borderline Personality Disorder. Convinced that this is what I had she said that therapy would work better to treat it than drugs and so would not increase my dose. I asked her why I was on drugs at all then and she said it wouldn't hurt so might as well stay on them as they may end up helping.
I didn't see her for about three months as she felt my therapy would be a better resource. When I did go back and discussed the problems I was having she uped my dose of the first anti-depressant. My check up appointment 2 weeks later I told her about the hypomania I was experiencing because of this change - she added an antipsychotic to help. When these where highly sedating to the point i was so drowsy i couldn't function at work, she decided I needed a different brand. I am starting those today after I go for blood work as these have a risk of increasing something in my blood (cant remember what) that can potentially be very harmful. She wants to get a baseline measurement of my levels of this components so it can be monitored.

What the fuck!? It really pisses me off, and worries me, that her seemingly baseless 'diagnoses' give her the justification she needs as a doctor to give me mind altering drugs that all have side effects, minor and severe. I am not saying that I do not appreciate what she is doing, because I do, and I'm glad to have a doctor who specializes in these drugs so i have the best chance of having a stable and functioning life but common! I know that in the future Dr's and patients will all look back at these practices with horror (as every generation has - lobotomies use to be common practice and now we are appalled by such treatment). Essentially the treatment I am undergoing now is the class shot gun method: "because we do not know exactly how drugs like these work, we will see how they effect you and then adjust from there... okay you seem to go a bit manic so we will add this...we will see what happens now..."
I feel like I am a tower of china. Imagine someone who is trying to stack all the china in their house; it wobbles and sometimes they have to hold their breath hoping it wont fall; when they think they are finished they walk away slowly so as not to disturb the tower but inevitably it begins to falter so they take off the most problematic pieces and think of a different strategy for adding them to the construction.
Do the limits of our knowledge for the treatment of mental illness mean that we are always bound to fall?

Mental Illness and Gender: Some Musings about Gender Roles

Having a mental illness is taboo and those with one (or more) is a group who experiences discrimination. But of course we are not ONLY our mental illness; there are many other factors which make up our identities. I identify as a young white woman who is able bodied and is of the middle class who has a mental illness. Being as such I encounter certain issues that those of different genders, age groups, races, abilities and classes. Being a member of the privileged group, save for gender, being a woman is the one characteristic that I find to have the most effect on my experience of mental illness. While thinking over this during my weekend I came up with some thoughts. I plan to make a few installments for this topic so look for more in the near future:

~gender roles:

you may agree that the traditional role of women in the many cultures of Canada is to be productive (especially in the home), nurturing, polite, happy/sweet, and generally giving of themselves for the benefit of others. I can tell you that I am hardly any of these things when severely depressed, making it all the more difficult to function. People, including friends and family, may not realise that they make assumptions about women regarding these traditional gender roles but when I am in a state where I am not productive, and instead I am selfish, rude, depressed and in need of serious support, often people will merely distance themselves. Of course many people distance themselves from anyone, man or woman, who is selfish and rude, but I think this tendency is exacerbated by how our cultures' expect women to behave.

additionally, being a discriminated group, women are often unheard (regarding their wishes, needs and even their opinion), unseen (in many different spheres), and underestimated (in what they know, what they can do etc). When I am undergoing treatment and there is a power differential (think of when you go to the doctor and he/she has much more power to make decisions and emphasize or dismiss symptoms etc) I find that common (discriminating)assumptions end up occurring much more frequently and with greater consequences. I have often felt doctors where not listening to what i said but rather putting their education (and what they learned from books) above my personal experience, they dismiss my role in my treatment and instead want only to work with doctors, and often underestimate my strength and ability to help myself and to be a productive part of the treatment team. (Hell I think the patient should be in charge of the treatment team's direction, not its Ginny pig!)

I think this is an interesting intersection of identities that is highly complex and unique for each person. This is also highly relevant for feminist and mental health activism as well as for the call for more individualized care which needs to work outside the constraints of the DSM categories.

Shame on you

Just this year my psychiatrist discussed with me my 'bipolar tendencies' (read: "you don't really fit into our categories so I am just going to say you mostly have major depressive disorder but you sometimes have manic-y symptoms"). Its been an interesting (?) addition to my experience of mental illness. I had suspected that something like that had been going on but had never really spoken to an 'expert' about it. It was shocking how hard it was to deal with the 'diagnoses'. To me what it meant was: I will have to deal with mental illness for the rest of my life (a realisation I had denied for years and was some how forced to face then) and that it could all possibly get worse. But i digress
Lately, because my anti depressants were increased, and that can trigger manic episodes, I have been having hypomanic symptoms (I have never had a full blown manic episode). This weekend I decided to cut my hair - myself. Never a good idea. I had done that last spring but I spent a good couple hours on it and it ended up looking pretty sweet. Well this time, while I wasn't able to stop myself from doing it in the first place, I was so ashamed and embarrassed that I was doing it/had done it that after I chopped haphazardly at it I just left it. Tomorrow I am going to get it fixed (definitely going to tell my hair dresser what happened so that she isn't like "who cut your hair like this!?"). I had to remind myself that just like my depression, its not my fault that i feel this way sometimes. It is something that I should work toward controlling and avoiding, just like my depression, but not something to beat myself up over.
This is such a hard task. it took years to accept myself and my depression (and even this acceptance is quite superficial) and now i have to accept this too... grrr. I know that this is part of why mental illness creates shame - its hard to accept that you cannot be in complete control of yourself. I know another side of it is internalized stigma - I know that some people think its 'crazy' to act this way. But I think because I have no experience with these new symptoms I am having a hard time with how 'funny' these symptoms can be seen to be. My partner kinda laughed and while he had no malicious intent I was so hurt. I mean it is kinda funny... if I decided to cut my hair one day because i was too cheap to get a hair cut or something and it turned out bad that would be something worth laughing about. In this case, of course, its a bit different as i really didnt choose to do it. I didnt tell one of my friends cause i knew she would make fun of me. plus I just cant help but think how 'stupid' i am for doing something like that.
Besides repeating 'its okay, I am not weak, this is not something to beat myself up over,' what more can I do? This isnt the kind of thing that doctors often talk about - the mental consequences of the experience of being on drugs that change your behaviour in ways you cannot, and how your self perception changes when you have been dealing with mental illness and even diagnoses themselves.