How Depression Feels

"It's like drowning . Except you can see everyone around you breathing."
~ Anon.

You Wake Up Saying

“It’s not that you wake up one day, saying, I’m going to kill myself today. It’s that you wake up every day, saying, I’m going to try not to kill myself today.”

~ Deborah Treisman
(David Foster Wallace's editor)

Unfurl Your Fingers One By One

Nothing anyone can do will open it. It hurts all over to be frozen shut, and it seems final. I feel that way a lot. I can't let go.

All I think you can do is try to remember warmth. The more you remember, the better the chance your fire will grow. You have to thaw from the inside. 

And then it might be possible to offer your open hand to life again.

Change.org Petition to Fund Research to Cure Mental Illness

Change.org Petition

Organizations like change.org can command MUCH more attention and influence than individuals. So please sign this petition (no registration required - just one click) to increase funding for research on mental illness. We need better treatments, and maybe even cures.


http://www.change.org/en-CA/petitions/to-the-president-and-congress-fund-research-to-cure-mental-illness

Do You Really Want to Know Your Future?

A discussion is going on among my Facebook page's members about whether bipolar disorder is a "progressive" illness. Does it usually worsen over time despite medications, therapies, lifestyle changes, social support and all the other ways we've been told or believe will help? Is it possible to cut the number, frequency and severity of episodes? And if it is, could this eliminate or ameliorate the damage done to our brains' anatomy, neuronal function and cognitive skills?

Virtually all sources agree that UNTREATED bipolar disorder will worsen over time. And once a brain has had a manic or depressive episode, it becomes many times more likely to have another one. Left untreated, this process ("kindling") accelerates: more and more episodes, worse in severity, oftentimes rapid cycling and mixed states.The brain structure and neuronal function change.

But what about TREATED bipolar disorder? The impression most popular sources give is that if intercepted early and controlled with medication, bipolar does not have to be progressive or degenerative. Things will start looking up, they say.

But, as you know if you have this disorder, even started early the treatment is hit and miss. It works sometimes, others not, and there's a seemingly lifelong pursuit of the right medication cocktail. Does that kind of treatment -- the real world kind, what people actually get -- interrupt or stop the natural progression of the disease?

The literature is not clear. Some say the process can be halted; treatment will give us an outcome close to "normal." Personally, I have my doubts. It's an established fact that people with mental illnesses die an average of 25 years earlier than people without one. More is going on than just lack of treatment or lack of supports (or lack of housing, money and jobs). The 25 year life expectancy gap gets more disturbing the more you look into it, because it turns out that it is true even after controlling for suicide, co-occurring disorders and lack of health care (and those other "lacks" I mentioned). Mental illness itself seems to make you die earlier. You are more likely to die of cardiovascular disease or diabetes if you also have bipolar.Why remains a mystery.

People on my page, called Bipolar Over 30, talk a lot about how our bipolar disorder seems to be getting worse as we get older. Treated early and steadily or not, we still tend to have more and more episodes over time, and/or they are more severe and disabling, and/or we have permanent cognitive deficits and collateral problems that make life very difficult. We find ourselves more and more disabled by it even if we had and continue to get the best treatment. BUT NOT ALL OF US DO. There is wide variation among individuals.

What do you think about this? If you are middle aged, has this happened to you? Do you see a lighter or a darker future ahead for you?

I tend to believe the research that says bipolar worsens over time and so does our ability to function day to day, for "anecdotal" reasons: I see it in myself and others I've talked to. I think popular sources that say otherwise are whitewashing things, being "positive" in hopes of motivating people -- perhaps mercifully but not honestly, and perhaps not very helpfully in the long run.

But how should you handle this information if it's true? Does it rob you of hope and motivation to continue? What does it mean for your outlook, expectations, planning, -- and for your family or caretakers? Does it profit anyone to receive this information, earlier or later in their lives? Would you want to know in advance if your bipolar disorder will probably be a degenerative brain disease just like M.S. or Parkinson's, albeit with the same uncertainty about any individual's outcome? 

Personally, I want to know. But, knowing, I will live out the rest of my time on earth as if I didn't.

A Stash

I did something today that was strange and unsettling, but I'm not going to undo it. I there are others who understand why, and even some who've done the same.

Three days ago, I suddenly tripped and fell into a reeling depression. An incident among my family in which I played a key role - a bad role - devastated me. In just those few days I've gotten increasingly suicidal; in fact on the day of the incident I took a small overdose (small because I took them one by one and after seven I blacked out). My husband came home to find me passed out and barely responsive so he confiscated my supply of that drug. 

Today I woke up still feeling desperate and full of dread, so immediately, frantically, I searched my mind for sources of more of that drug. No ideas. But I made myself come downstairs, fed my dogs, ate breakfast, read the paper, went on the Internet and began to feel better. I even thought maybe that awful incident wasn't as momentous as it seemed. Maybe I hadn't caused a major irreparable rift. It could be just a bump in the road. But when I went to get coffee in the afternoon, I saw a bottle of leftover pain medication next to the coffee machine, enough to kill me.

So, without feeling suicidal or even depressed anymore, I STILL HID THE PAIN PILLS WHERE NO ONE BUT ME COULD FIND THEM. And it was such a relief. Even though my mood had just changed from really bad to okay, and I knew that happened all the time, and probably would continue to do so - I still wanted a suicide tool in reserve. Just in case one time it didn't and I stayed in hell.

In the end, all that matters to me is that I'm not trapped at the bottom of that pit with my suffocating hopelessness, flaming pain in every cell of my body, and screaming in my head that never pauses even for a minute and will never end. So I stashed the pills.

Does that make me brave or a coward?

We Die Too

 

Let's put aside all arguments about whether or not there is a clear statistical relationship between mental illness and violence for a moment. Doesn't it bother anybody besides me that no one gives a damn about the mental health care "system" until they need someone to blame for a tragedy? Then we all start talking about how to strengthen the rules on involuntary detention and commitment, how to identify "dangerous" mentally ill people and do something or other with them, how to increase "access" to mental health treatment (which often does not exist) and somehow restrict access to guns by scary and dangerous mentally ill folks whose futures we have foreseen to feature acts of violence against others and/or, secondarily, themselves.

We die too.

I live in the state of Virginia. After the Virginia Tech massacre in 2007, in which 32 people died and 17 were injured, Virginia pumped $38 million into the mental health care system, a relatively large boost but not massive. Seven years later that's all drained away and things have returned to how they were before that tragedy. Until now. New bills will ramp the funding back up and try to "fix" the broken mental health system. Why? Because two months ago a prominent state senator, Creigh Deeds, was stabbed by his son, who then killed himself.

We die too.

This incident is tragic. Mr. Deeds is a fine man, who has now lost a son as well as suffered an injury. Today he acknowledged publicly that "the system failed" his son. He is right. And in response, bills to change and fund the mental health care system are on the table again. A large portion of them address the specific procedures, programs and legal restrictions that resulted in Mr. Deeds' son being released after two hours because he was not deemed a danger to himself. Those aspects of the mental health care system are some of many that are "broken." But there are others.

And we die too because of them.

Those failings and inadequacies of the system kill many more people than the ones in high profile tragedies. Mentally ill people do kill, as do people without mental illnesses. But mentally ill people themselves also die in droves -- by suicide, by illness-related disease, because of homelessness and victimization resulting from their illnesses, because of family dysfunction their illnesses contribute to -- and many of those lethal conditions are directly caused by a lack of basic mental health care.

Those are tragedies too.

Mentally ill people are dying by the thousands everyday but no one pays attention because they have not injured or hurt anyone else. Suicide killed 35,000 people in 2007. We are dying too, on a very large scale.

And that is tragic too.

Yes, we should increase funding for the mental health system. We should make access simple and immediate, we should give special attention to anyone showing signs of violence -- we should do all of the things Virginia is talking about doing, but we should do it not just in the name of the victims of high-profile shootings and assaults. We should do it in the name of the mentally ill who suffer greatly from their illnesses every day and seldom become violent. Yet violence is done to them every day by their illnesses, silently and invisibly. Their minds, their hearts and often their lives fall victim to painful and incurable illness.

We die too. And those deaths are tragedies. They are tragedies too.