Accepting my mental illness as long-term

There are all these pieces of paper in my house. Pieces of paper relating to my mental health.

There are discharge summaries from the hospital. Discharge summaries from the crisis team. Letters from my psychiatrist to my GP. Letters booking me in for psychology appointments.

There are all these packets of pills in my house. Pills relating to my mental health.

There are pills in the cupboard where I keep the cereal bowls, to be taken in the morning. Pills in my bedside table, to be taken at night. Pills in my purse, to be taken when my symptoms overwhelm me.

Until fairly recently, I looked upon these things as the trappings of a short-term mental illness. I assumed that in time, with enough medication and enough therapy, I’d be able to shred the paperwork and flush the pills down the toilet. I assumed I’d be cured.

That changed when two little words on all those pieces of paper became three: when my official DSM-IV diagnosis changed from ‘depressive episode’ to ‘recurrent depressive disorder.’

It wasn’t really a surprise. Depression is something that’s plagued me since my teenage years – over 20 years ago. I’ve not always sought medical help, so my episodes haven’t always been officially documented, but it has never felt far away.

The change of diagnosis, however, has caused a bit of a conflict in my mind. On the one hand, I want to fight against it. Recurrent depressive disorder? No way! This is something I can and will overcome. I don’t want to be on medication for the rest of my life. I don’t want to be in therapy for the rest of my life. I don’t want to be an 80-something still taking a daily cocktail of psychotropic drugs and agonising over the contents of my brain. Give it a few more months, and I’ll be back to normal, OK?

But on the other hand, it’s made me want to surrender. And right now, that is the stronger, more vocal part of me. The problem is that the line between acceptance and surrender seems very fine.

Acceptance means recognising that this is a long-term health condition in the same way that diabetes or chronic fatigue syndrome are long-term conditions. It means acknowledging that I’m going to have to take medication for a prolonged period, maybe even forever. It means acceding to regular appointments with various doctors and therapists. But it means committing to doing what I can to stay well.

Surrender, however, is different.

Surrender means giving in to this illness. It means assuming that at some point, I’m going to end up back in the psych hospital again. It means losing faith in my medication, my therapy and my self-care strategies.

Most worryingly – but most convincingly – it means that I cannot see myself living a life that doesn’t end in suicide. I’m not suicidal right now; far from it. But it seems inevitable to me that my life will end by my own hand.

Right here, right now, I want to accept, but I feel pulled by the irresistible force of surrender.

I don’t yet know which will win.

Is it okay to be not okay?

I always get emotional in my psychology sessions when I’m asked to recognise that what I’m going through is real and hard.

To my mind, it’s months since I was discharged from hospital. I’m well medicated, I’m coping with work and the kids and keeping vaguely on top of the house. I’m trying to get involved with church things again and trying to be a good friend. Compared to where I was, everything is rosy.

But in today’s session, I acknowledged that actually, I’m not okay. Not really. Yes, I’m functioning, quite well, in fact. But I’m still not well.

I tell myself that it’s ‘months since’ I was in hospital, but Claire says it’s ‘only a few months.’ A small semantic difference that recognises that I’m still on a path to recovery, and not necessarily anywhere near the end.

Hearing her say things like that brings up a whole range of emotions.

I feel reassured that I’m doing okay, despite not being okay.

I feel validated that my condition is real and really bloody horrible to live with.

I feel guilty that I’m not stronger, not doing better.

I feel anxious that at some point, all the cards are going to fall.

I feel sad to think that actually, this might be forever.

It’s all a bit of a mess in my head at the moment. I feel like I’m having to overcompensate for the times when I was acutely unwell by trying to convince myself and everyone else that everything is just fine now. But it’s not. I know that in my heart. I still feel fragile, vulnerable. I still feel like the pieces of me are only just holding together. And I know I should try to get used to it – the acceptance part of acceptance and commitment therapy – because chances are it’s not going to get any better. Chances are I’m always going to be a step or two away from a breakdown.

It’s exhausting to feel like this, exhausting and lonely. And I’m really not okay.

Practising self-care when it’s just too hard

I’m officially not feeling very well at all. Time will tell whether this is a minor dip or whether I’m plummeting again. I’m obviously hoping for the former, but at the moment, it’s impossible to say. All I know is that right here, right now, I’m not in a good way.

This is a huge blow. The past four or five months have been blissfully stable. It’s seemed as if my meds were finally right, and that I could move on from the sheer hell of what came before. The thought that the medication is stopping working is honestly terrifying. I’m already having to supplement with PRN meds: something I haven’t done for months. But I know that my condition is recurrent. I know that the nature of it is that there will be lows. The question now is whether the meds are ‘right enough’ to stop this turning into something bigger, to stop my descent before I get to the depths I’ve dragged myself through before.

Today, I feel thoroughly let down by myself. I was dragged out this morning to the spa by a couple of friends from church. They meant well, I know, but the pressure they put me under made it impossible to say no, even though I needed to. So I went, and I forced myself through three hours of small talk, my face strained by the smile I tried to paste on. I felt on the verge of an anxiety attack the entire time. And predictably, it’s taken its toll. I was meant to be having friends over for dinner and a dip in the hot tub this evening, while Ian’s away. But I can’t. I’ve run out of energy, physical, mental and emotional. So I’ve cancelled. And I feel like crap about it, like the worst friend in the world, unreliable, self-centred, a total waste of space.

I know this is self-care, and it’s what I need to do. But it doesn’t feel like self-care. It feels like giving up. It feels like I should try harder, fight better, man up, so to speak. It makes me feel so guilty.

The problem is that this might be a mental disorder, but it’s so much bigger than that. It’s hard to put into words how it feels, but it saps the energy and the life out of me. It makes me feel physically ill. My hands shake and my heart pounds, and my eyes fill up without my permission. It makes me feel like a husk, empty, hollow.

I feel homesick all the time, even though I’m at home.

So tonight, I’m practising self-care. I don’t feel I deserve it, but I’ve had a shower and put my pyjamas on. I’ll watch a bit of gentle TV with Tom and then go to bed when he does, at nine o’clock.

Will it be enough to drag me out of this incipient hell? Will I wake up tomorrow morning feeling more able to face the world. I don’t know. But I’m trying.

 

So how do I stop this?

It’s creeping over me.

The sadness, the tiredness, the bleakness.

I want it just to be a blip; I’m scared it’s not.

I went to bed at 7pm last night, too exhausted to even eat dinner. I slept till 7am and thought I would wake up feeing better for it, feeling like I’d recharged, but I still feel just as sluggish and foggy.

I slept for an hour and a half in the day, too: something I only ever do when I’m not well.

I stood in the queue in Co-op earlier and had to fight the urge not to drop my shopping and run out.

I’m feeling equal parts of desperately needing to talk to someone, to cry on a shoulder, and of wanting to hide away and pretend the world doesn’t exist.

Why is this happening? I don’t know. I know I’ve been overdoing things lately. Things have happened that have made me feel rubbish about myself. And there have been a few triggering things, too.

But I should be stronger than this. I should be able to push through it.

What if the medication that I thought was a miracle cure has stopped working? I genuinely don’t think I could bear it if that was the case.

Surely, surely I deserve a break?

 

 

Sometimes

 

Sometimes…

I don’t want to pretend everything is fine when it isn’t.

I want to talk about the devastation that mental illness has wrought on my life.

I want it to be okay to be not okay.

I want to answer that ‘How are you?’ question with, ‘A bit down, actually.’

Sometimes…

I need a hug but I know I shouldn’t ask for one.

I want to tell someone how it really feels.

My feelings start to scare me, and I realise how easy it would be to backslide.

I want to press the pause button for a while.

Sometimes…

I want to scream and cry at the unfairness of it all, this evil, evil illness that has changed me forever.

It looks like everything is great, but that’s because I’m overcompensating frantically so you don’t see my weakness.

It still feels next to impossible to get out of bed and face the day.

I wish I could magic myself straight to Heaven.

Sometimes I wish the pills had worked.

Sometimes I wish I wasn’t me.

Sometimes I wish someone knew how I felt.

 

From suffering comes healing

The day I was admitted to a psychiatric hospital was the worst of my life.

I remember sitting in the dining area late at night, waiting to be seen, sobbing so hard I could barely breathe and begging my husband to take me home.

I remember seeing a doctor who explained that if I didn’t stay voluntarily, I would be sectioned. I was in a no-win situation.

Physically and mentally, I was in a place in which I’d never, ever dreamed I would end up.

It felt, that night, as if my life had ended.

In fact, it was a new beginning.

It’s often said that you have to reach rock bottom before you can start to travel upwards again, and for me, that held true.

I was completely horrified to have ended up in a psych unit, but my admission marked the start of my healing.

Without that admission, I wouldn’t have had the complete break from real life that I so desperately needed, but was trying to avoid.

I wouldn’t have had the time and space my mind needed to sleep, to rest, to stop fighting itself.

I wouldn’t have met the psychologist who took the time to talk to me, to understand me, to get to know me, and to work out what I needed from therapy on my discharge.

I wouldn’t have been referred to a psychiatrist who was willing to do what no other doctor had done before: take a proper look at my medication and make changes that would, in time, lift me from the bleak, terrifying hollow of depression.

I wouldn’t have met the psychiatric nurse who visited me daily after my discharge, a lifeline for both me and my husband.

I wouldn’t have met women who, like me, had seen their lives ravaged by mental illness through no fault of their own.

I wouldn’t have known the extent of my friends’ love for me, as they rallied around me with visits, phone calls, cake and hand-holding.

My time on the psych ward was also a validation. For too long, I’d been battling with the idea that my mental illness was, literally, all in my head. That it was something I should be able to snap out of, or think myself out of. That I was a great big fraud and if I just tried harder, I would be okay.

Being admitted to hospital proved that this wasn’t something I was just making up. It proved that I had a real, serious, life-threatening illness. It made me realise that this was not my fault. It was not something I could control. And, above all, it could be treated.

I won’t deny that being in a psych unit was tough. It was scary and lonely, and I spent my time in there longing to get out.

But now I realise that it was not only what I needed at the time, but also the start of my illness being taken seriously at last. Without it, would I have got the help I needed to get better? It seems unlikely.

Back then, it felt as if things couldn’t possibly be any worse. But from suffering comes healing, and that was just the start.

 

 

 

 

If I was

If I was…

A nicer person

A better writer

A loving wife

A good mother

A capable housewife

A thoughtful friend

A stronger Christian

Then maybe I wouldn’t hurt people without ever intending to.

Maybe I wouldn’t constantly let my children, friends and family down.

Maybe I wouldn’t have lost one of my favourite jobs.

Maybe I wouldn’t feel out of place in the church.

Maybe I wouldn’t be so bloody thoughtless and inconsiderate.

Maybe I wouldn’t have to keep avoiding people.

Maybe my husband would love me like he used to.

Maybe I wouldn’t feel so lonely.

If I was a better person, maybe I’d never have got ill in the first place.

Maybe it’s just me.

 

Wrong

That’s how I feel at the moment.

I’m getting everything wrong, but more than that, I’m just fundamentally wrong myself.

I’m not a nice person, and no amount of medication or therapy is ever going to change that.

I’ve been extremely unkind and unhelpful to someone who’s in need of support, simply because I find her a difficult person to be around.

I’m going to try to put that right and help her out now, but it’s motivated purely by guilt, and I’m honestly dreading what I need to do.

I’ve upset someone by indiscriminately adding someone else to our Bible study Facebook group without thinking about how it would affect everyone else in the group.

The person I added seemed in need of prayer and support, and I thought I was doing the right thing, but no. Wrong.

So now I’ve upset a good friend and am also going to have to upset the person I added by explaining why I’m removing her.

Then today I sat in church listening to a sermon on Daniel that implied that mental illness is the result of a lack of faith.

I’m obviously too wrong for church, if my spiritual deficit is so great.

I don’t really know what to do now. I don’t know who to talk to. I’m hurting over the fact that I’ve hurt other people through my lack of thought and my mean-spiritedness, and it’s no surprise at all that no one is willing to talk to me about it.

I feel like the only thing I can do is stay away from everyone. That way, no one else can get hurt through my inconsiderate and downright unkind actions.

Lonely? Very much so. But it’s no less than I deserve.

I am

Cruel.

Unkind.

Cynical.

Bitter.

Untrustworthy.

Attention-seeking.

A problem.

A bitch.

Spiteful.

Vicious.

Unreliable.

Unchristian.

Fat.

Scarred.

Ugly.

Worthless.

Histrionic.

Lazy.

Inadequate.

Mean.

A fraud.

Frigid.

Energy-sapping.

A burden.

A freak.

Emotionally unstable.

A parasite.

Corrupt.

Evil.