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Maybe it's the physical pain. Maybe it's the ongoing, seemingly relentless medical appointments. Maybe it's the frustration of shingles pain that won't quit. Maybe it's the disappointment of having a body and brain that are extremely dysfunctional and riddled with problems too personal and stigmatized to discuss. Whatever the cause, the sadness that weighs on me is profound and seemingly ingrained in my personality. Except it doesn't show because I swallow it.
I told Dr. G that I was sick and sad and discouraged. She asked me about being sad. I told her that I was tired and it felt like the stress in my upper back was the burden of hiding everything that causes me pain, especially bipolar disorder. I explained that as I became stable after the Big Melt of of the mid-2000s, I vowed to act as I had before my illness became manageable only through medication and self-discipline. If the people around me were unable to believe the illness was nothing more than self-indulgence, then I would respond by proving that not only was I OK and functional, but that my illness would never, ever visibly manifest itself. In other words, I put a tremendous amount of energy and effort into acting as if I had no illness at all.
Dr. G listened. She found it very troubling that I was putting so much pressure on myself. She was appalled when I said it might be self-pitying and weak to feel sad, frustrated, and cheated of a life I had lived with enthusiasm. I may have survived periods of true suicidal threat, but I felt no victory on this point. Instead, I could only see the things that had been taken away from me, along with everything the central pain syndrome had stolen, as well. Although the loss was a tragedy, it did not serve me in any way to feel sorry for myself. I just wouldn't.
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Dr. G was deeply concerned. She explained that when chronic stress--be it physical or emotional--is placed on the brain, the result is a gradual shutdown of the nervous systems, but only as progressive damage and inflammation consume the body.
I shrugged. Dr. G leaned in close and said, "May, listen to me. As your doctor I must tell you. You are literally killing yourself. If you keep living your life this way, you...are...going...to...die."
A tear rolled down my cheek, quietly followed by several more. I wanted to dispute what Dr. G was saying. I lacked the ammunition and the energy. I told her that I was capable of doing and being so much more than what had become of me. By allowing myself to be ill, by even accepting it, I would never achieve my true potential.
Dr. G thought about that for a second, her brow furrowed and her head tilted to the side, looking at me with a frown. She took a breath and said, "Where is it written that you have to achieve your potential. Geez, were you nothing but hypomanic for three decades straight? Do you understand that what you accomplish in that state is not on the scale of 'normal?' Overachieving tends to benefit more people in more ways than it ever does for the overachiever, you know."
Dr. G stood up somewhat abruptly and said, I have some prescriptions for you. She rummaged for a pad, and once she found it, she scribbled quickly. I wondered what new drug I was going to have to take on this quest for a body at peace with itself. The eight daily medications I take already seemed excessive. How could there be even more?
Dr.G handed me the two little blue papers. The first said,
Allow yourself to feel:The second had the name of two therapists Dr. G believes are effective in their practice and a good match for patients like me. There are other patients like me? Dr. G assured me I was not alone. She asked me how many times the gynecologist had recommended I see Dr. G. I thought about it and said, "Many times over the course of three years." Dr. G. leaned in close and said, "I am not Jacki. I am not going to 'suggest' this, and that's why it's a prescription--you need a therapist."
--sad
--cheated
--a sense of loss
--tired
"Why? So I can accept and commit?"
"Yes," she said. "It may be the only thing that calms your nervous system, relieves the pain that has remapped your brain, and rebuilds your immune system."
After the appointment, I sat in my car in the parking lot and cried. I disagreed with my beloved Dr. G on every point. I did not feel it was OK or even safe to accept my feelings of devastation or my disappointment with my life. It was as if she hadn't heard me about not wanting to accommodate the illness. Overachieving put me on the fast track to being the person that other people actually admired and liked. It has always been the thing I have valued most about myself, and I believe this is true of those who know me. Without that, I would be nobody, an unremarkable woman who nobody else would even remember.
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Not yet.
Painting by Morwenna Morrison
9 comments:
May, you might end up hating my guts and banning me from your comments for this, but I HAVE to say it. I have to, because you are a beautiful person and I care about you. Here goes, my humble and vastly unpopular opinion (please don't hex me) --
You are absolutely right not to accept and commit yourself to being a sick person. Why would you accept such a pile of baloney? I don't think you are 'mentally ill', May, and I think the cocktail of poisonous drugs you take are what could kill you. THEY are what is frying your nervous system, but the drug companies and the doctors don't want you to know it! Bipolar is not what needs accepting here, but I think you know that. I think you know that very well. Bipolar and mania are a convenient way for society to explain away the emergence of unhealed trauma. That sort of thing is NEVER pretty and people will do ANYTHING (even kill you slowly) to shut it up. Maybe you can find a therapist who doesn't buy into the bullshit spewed forth by the medical establishment and who can help you listen to and care for that terrorized little girl who still desperately clings to life inside you. SHE is who needs accepting. Don't let them kill you, May. Save yourself and go back and rub it in their faces. You CAN do it. I see you a few years from now explaining their own denial, blindness, and helplessness to them and encouraging them to commit to accepting it. Jesus, May. YOU ARE POWERFUL. Gather it up, honey, because it is obvious from your recent posts that you are beginning to see through the lies. Save yourself before it's too late. Please. The world would be a much shittier place without you. Not because of what you can do for others, but just because of what you are.
I think we'll always have to agree to disagree on the etiology of my conditions. I know what I have, I have what I have, my body came up with it on its own, and I don't deny that; however, I eschew the advice that I must do less in order to be well. I bristle at the prescription to embrace yoga, meditation, life adjustments, EFT, ACT, intuitive healing, whatever. I actually prefer to take medication if that can make me behave in a socially appropriate and rational manner while diminishing the depression and anxiety that have dogged me off and on my whole life.
Keep in mind, medical treatment has been my idea and my choice. It was my choice to see a psychiatrist and it was my choice to pursue the prescribed course of therapy for BP. I have it and that's that. I tried every which way to prove that I didn't, but in the end, I had to agree that the diagnosis was correct. I was on the wrong medication for a while, but now I'm not. I could not function before, but now I can. I just hate that I have something that is so stigmatized and, frankly, embarrassing and unpredictable. I resent that I had to ratchet down my participation in life in order to keep the BP demons at bay. And believe me--there is nothing desirable about experiencing their horrible influences.
I'm not denying my illnesses. I am digging in my heels about having to change my life to accommodate them. I want the treatments I pay for to fix me. In lieu of fixing, I want to be restored to the physically active, mentally sharp, witty, over-achieving self that I once was.
I believe the medical establishment is probably right-on in its assessment of me, but I want a solution to my troubles that does not exist--yet.
Lynn, there is nothing all that traumatic in my background. No sexual abuse, no horrific acts witnessed, no terrifying events survived. At most, there is a family history of mental unhealthiness and a sister who made it her life's work to convince me I was worthless.
What I meant to convey in my post was this: I have a lot left to do, and I cannot afford to sit out the rest of my life. To do so would be a personal defeat. I've reduced my life so much already and I'm not happy about it. I'm not yet convinced I can't survive my nervous system on my own terms.
I may not agree with your conclusions, but I can't hate you for having an opinion.
Embracing the medical model is certainly a choice that can be made for most. It is good to have choices. The only reason I brought this up is because you have acknowledged before that medicine does not yet seem to have a solution to your troubles. And I know you don’t want to sit out the rest of your life. Of course you don’t. Hardly anyone would and I understand that very much.
Also, I am quite certain that if I went to a psychiatrist I would eventually be offered the same label that you were. I can look at the criteria myself and know that this would be a strong possibility. The problem is that it fits many, many, many people. Especially trauma survivors. There is nothing at all stopping me, or anyone else, from listing a group of ’symptoms’ and attaching a label for them. Anyone can do that. It would be more convincing if those who took the treatments did not have their health so negatively impacted for their efforts. I just think there is way more to the story of most mental health diagnoses.
And this stood out for me in your reply:
“…there is nothing all that traumatic in my background. No sexual abuse, no horrific acts witnessed, no terrifying events survived. At most, there is a family history of mental unhealthiness and a sister who made it her life's work to convince me I was worthless.”
I can’t imagine how it would not be traumatic to be raised by a borderline mother and to have had a sister who made it her life’s work to convince you of your worthlessness. And this line from your blog keeps ringing through my head - ‘Why isn’t it okay to talk about the pain of sexual abuse?’ I have looked for it before, but can’t find the post anymore. I do remember it was one of those that expressed your dissatisfaction with your treatment. I just want to point out that sometimes people ‘decide’ that something was not traumatic, but what happens inside of them might have another opinion. That’s all. And whatever course you take, I hope you can find a way to have peace - AND to have your cake and eat it, too. I TOTALLY understand not wanting to pack it all in and live life on the down-low. I don’t think anybody really wants that. No matter what, I hope you find a way to have something much better than that.
I understand where you're coming from, but I also know my own situation better than anyone. Rejected it, agonized over it, researched it, vetted it, and ultimately realized I was going to have to live with it one way or another.
I remember you noted the reference to not being able to talk about sexual abuse. I forget where that was--in comments, I think. Anyway, as I clarified back then, I wasn't referring to myself or any experience I had. It was about two people I know who suffer deeply yet, for the most part, silently. It still strikes me as a huge injustice that these two people live in a culture that purports to advocate for the victims, but also prefers that those same victims never discuss the situation outside of therapy. One of those two is a sweet kid of only 13 years old and he has developed profound OCD as a result of his rapes. I wonder how he'll get through his teens carrying his burden but not being able to tell anyone (outside of his family) what he went through. The other person is an adult woman I know really well. She told me she hasn't slept in a darkened room in decades, despite therapy, EMDR, survivor support group meetings, and other coping tools. We've had very different experiences, but we relate to each other well on this issue of living with something every day that nobody wants to know about, and if they find out, they'll probably just speculate on how weird the victim might be as a result of the experience/illness.
I hope this extra information sheds some light on what I was thinking when I wrote about people having to keep quiet about sexual abuse.
If I didn't have to work for a living, I would probably stop taking BP medication--but not the meds for the Central Pain Syndrome and IC because, well, pain hurts and if the drugs will make it stop, I am all for that.
Yes, that does shed light, May. I never did catch your reply in comments that one time. And I understand why you say you would dump the meds if not for needing to work. I guess we each have our ways and we build whatever we can. I rearranged my life and escaped from medication and the reliance on the medical model for problems that were much less medical than what most believe, but I know not everyone can or even wants to do that. I guess it depends how on how much damage is being caused to the person. I could feel the damage. In my case it seems that the rearranging has worked out greatly to my benefit, even financially, but it took some doing and it didn't happen overnight. I understand what you mean about having to live with things that you're not supposed to talk about. Same here. Only I talked about those things anyway, which is why I don't have a family anymore. They can't stand me now, but as it turns out, even that was a huge improvement. Still - it just doesn't seem right that people should be maligned for telling the truth about whatever their situation is. I'm glad you can at least write about it and that Frank understands.
Frank is awesome. I am sure I wouldn't have survived the last five years without him.
And, I feel like I have to reiterate, Dr. G is trying to get me try anything and everything beyond conventional medical treatment for the phsyical pain. She believes that until I make peace with the emotional issues in my life, I will never heal due to the stress on my nervous system. She would be thrilled to take me off pain meds. I am resistant. I really don't think talk therapy will work, and I'm skeptical about the New-Agey approaches she's suggesting, such as EMDR, EFT, ACT, meditation, etc.
And Dr. B, my psychiatrist, is a medication management master. He knows I hate BP meds because they suck. In managing my BP, he took me from six medications (prescribed by my first doc)down to three. Because I have suicide ideation and suicidal tendencies, he insists on keeping me on lithium. Bleh. I do get blood work done regularly so other than enormous weight gain, no damage yet. Still hate everything about it, though.
From six meds to three? That is fantastic! I'm sure that will help preserve some health for you. You deserve health. I don't think talk therapy will help unless it is with the right person. Someone who really gets it and gets you. I also hate new age crap. It enrages me really, because I tried everything and all that was such a GIANT load of garbage. It made me worse. I agree about addressing emotional issues, but I don't think it's helpful to label someone with a disease and then beat the hell out of them with it by telling them they have to accept their own premature decline when they don't even have some terminal condition. The whole thing with the ACT seems sadistic to me. Maybe it's just me, but these days, when the wrong approach is even brought up in therapy, I turn into a salivating monster and end up freaking out on my therapist for what I then consider to be his incompetence. I don't get why it's so hard for people to just be real instead of hidng behind a load of crap. People can be such weenies.
Don't discount the damage your poisonous sister did -- I have one of those too. And your brothers weren't always sweetness and light to you either. Come to think of it, your whole family was pretty critical of you because you *weren't like them.* When that's instilled within you at childhood, it's awfully hard to get rid of that self-image.
I am either over that or so permanently imprinted, no therapy will have much effect.
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