Attachment Theory

My therapist quoted/read some of this to me in my last session and said that a lot of the people he treats for major depression with multiple recurrences have “disorganized attachment.”

In lay person’s terms, I gathered, this means that you have a feeling of being unsure where your place is and you don’t ever feel safe.  Even when you are safe and secure, you feel like the very ground is about to swallow you up. This sense of distress often causes you (meaning me) to walk around feeling under siege until you (I) internalize the threat and decide to destroy myself because at least then I know when it’s coming.

I think this is a great metaphor or actually lived reality for children with chronic illnesses. We know that we are going to die. We are confronted with that often and early. The adults in our lives don’t have the tools to handle taking care of us because our bodies refuse care. We decide to take on that job ourselves but we do a really shitty job of self soothing or self care. Our instincts is to decide that we are better off dead.

It was recently the anniversary of September 11th and the feeling I remember strongly having that day was not the sense of security being taken away and needing to be shorn up, but merely another confirmation that the world was always already falling apart. That we are never safe.  And I wished, in my 20yo everything is about me way, that I had been in the towers when they fell, because that would at least explain coherently why I experience life as a free fall.

Looking around my apartment this morning, I have a sore throat and the political climate is awful but I’m not being flooded, nobody is coming after me, and I have people who love me. And yet my experience of life is still that I’m in so much pain and mortal danger.  This is not true. I am okay. I just don’t feel okay.

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Feeling your feelings

I had a no good very bad day yesterday. Not because I was depressed but because of normal life and logistical stuff. Accidentally not hitting “set” on my alarm, forgetting long acting insulin and glasses at home, etc.

After feeling like a total failure at life and berating myself, I was trying to stop being mean to myself, using that old “what would you say to a friend who overslept and forgot their glasses…” trick.

It is sometimes hard for people, like me, who are very intellectual and thoughtful, to buy into something that seems simplistic and self-help-ish, like “feel your feelings and let them go.” or “you can stop this.” or “through is the only way out.” You (meaning me) want to counter with some good situations where someone might have to run from their feelings, you want to say “it’s more complicated.” But sometimes it isn’t, it’s annoyingly simple. So I went into the back storage area, cried about feeling like a failure but also kept telling myself that it was okay to feel this way. That it was temporary and it wouldn’t take over and make me kill myself. And it worked. For the most part. I cried I felt bad and then I went back to work.

And I woke up in time today to write about it and get to work without rushing.

on books as solace and books as escape

when I was busily avoiding high school with suicide threats, attempts, and general emotional chaos/destruction, the only thing that would help me exist was my books. I read everything and anything – sweet valley high for the melodrama, simone de beauvoir for the trenchant existential analysis, books about kids stuck in hospitals with cancer, books about young women growing up in apartheid South Africa, books about King Arthur that I had to read in the middle English because… I don’t know. I wanted the real story. I must have been the only 14yo in my freshman class to read all of Mein Kampf and beg my parents to send me to language school in Germany so I could study to read it in the original language. Of course, I could spend time doing this because I spent zero time in school or on my actual school work.  I desperately wanted to know things and understand and also desperately wanted to be anywhere but where I was.

I think I went to my doctoral program for similar reasons.

Right now I’m in the middle of three books. One is a rereading of a young adult favorite about magic, one is Arundati Roy’s “The Ministry of Utmost Happiness” and one is George Saunders “Lincoln in the Bardo.”  Between all that reading, I’ve been rewatching “Buffy the Vampire Slayer.”  I’m dissociating pretty hard.  I learned this as a coping mechanism at a young age.  It has benefits and drawbacks, like all coping mechanisms.

I feel connected to the stories that I read, I feel less lonely, and yet i have the overwhelming sense of dread that comes from putting off something important. That Sunday-night-is-coming feeling that all the ways I feel are just waiting for me beyond the pages, that going to grad school and reading a ton of books and opening myself up to all these other stories actually did nothing to help me deal with my feelings. Even though they helped me get through 35 years of life.

My current romantic partner isn’t a reader. This is yet one more thing that we don’t share. And I think it is all connected. He doesn’t have emotions that feel overwhelming. I think books are where I meet my best friends.

On letting the state in

There are a few things that the state is good at. Mental health care is not so much. Don’t get me wrong – I am quite happy that there are community mental health agencies that handle the mental health needs of those of us without private insurance or deep pockets. But there is still a huge donut hole of coverage where the normal “I need therapy once a week and a psychiatrist visit every 6 weeks” leaves off, and the more acute “I am seriously struggling to get by and keep myself safe” begins.  There is little they can do that is right away that isn’t a crisis prevention service.

I am fairly sure that I can keep myself safe. I don’t need to crisis plan in that way. But I do need to stop feeling this bad. I need to be able to get through a work day without crying and feeling awful. I need to not hurt enough to make it worthwhile to stay safe.

Right now I’m getting safety check in type calls. They are aimed at helping me figure out if I need to go back to the hospital. The thing is, I am not going back to the hospital. Honestly, I’m just not going back there. So this removes most of the utility of these calls.

I keep feeling like my signals are crossed or something. I am not communicating what I need correctly, or I am communicating to the wrong people.

 

Updated to add — there is something truly sadistic about making people who have demonstrated they don’t have the mental capacity to navigate bureaucracies have to navigate those bureaucracies in order to get care.

Boring

It’s the start of fall squash season and I’m still suicidally depressed. I still wake up crying most days. Today I have two butternut and two acorn squash to cook for lunch/dinner at work, and I’m still crying.

I feel like I’m trapped in one very painful moment in time while the world moves through at normal speed.

For every recurrence of depression in adults, it gets harder to treat.

I haven’t found a medicine that makes these days bearable.

I have a posted of Georgia O’Keeffe’s Brooklyn bridge hanging on my walls, along with all my other queer paraphernalia.  My cat is showing me all of his toe beans.

I am still crying but I have squash to cook.

Medications and “Side” Effects

A lot of psychiatric medications were initially created to do something else.  A lot were not intended to be taken every day.  For most of these drugs, even the doctors that prescribe them do not understand how they work, only that they do, sometimes, with some people.

Most of these drugs come with serious side effects, the most common being the euphemistic “sexual side effects” that range from decreased desire to the inability to achieve orgasm.  Of course, for most people with serious depression, feeling like you want to die is a bigger damper on your sex drive than any medication could ever be.

I’ve been on and eventually off of all the following drugs: prozac, paxil, lexapro, zoloft, celexa, effexor, cymbalta, bupropion, abilify, latuda, mertazapine, trazadone. I’m now only on trintellix.  Some of these worked for short periods, others for longer, some not at all, and still others completely knocked me out so that I couldn’t feel suicidal but also couldn’t feel anything due to being a zombie.

“Working” is also not like when we say other drugs are “working.” There’s no blood test (yet) that can be done at home several times a day to determine whether your serotonin or norepinephrine is higher or lower. In fact, I don’t even know if “higher” and “lower” are the correct measures for these things. Mental illness is uniquely measured by the symptoms rather than the causes. The pills may or may not lead to a lessening of symptoms. I’m still not sure if that means that the illness is getting “better.”

When I start crying for little to no reason, I mentally check to see if I’ve taken my meds today. But I have very little faith that taking them will help.

Things that have been proven to help: good books, a clean apartment, cats, sunshine, exercise, stretching, time with lovers.  I can usually get at least two of these things per day. Maybe I should start thinking about them when I begin to cry.

Gender and Mental Health

I went to see “Girl, Interrupted” when I was 16, fresh out of my own stint at a psych ward and looking for hollywood to help me glamorize what was really a pretty boring experience.  The film was set in the past, although historical thinking wasn’t it’s strong suit, it created a kind of genderqueer mythography about the hospital.  Housing a collection of girls who were interrupted in their quests to be different – there was winona with her teenage rebellion from school, a lesbian who wasn’t able to be out and proud, an anorexic woman who wanted to stay a child, and the sexy sociopath played by angelina jolie.

My first hospital featured few sexy sociopaths, no clea duvall, and overall little gender nonconformity.  But then again, I don’t remember a lot of it because of the tiny black holes made by shock therapies.

As an adult in a psych facility, you are allowed very little gender. Or, at least, very little gender performance.  No makeup, no clothing with buttons or ties, def. no high heels, not even shower gel or conditioner that smells like girl. Everyone does art time together and we all visit the gym together to shoot basketballs to pass the time.

Overall, this synchs with the “sex is between your legs and gender is between your ears” philosophy of gender (which has lots of issues of course). When you’re on a psych ward, what’s between your ears gets relabelled in terms of compliance and functioning.  did you take your meds? how did you sleep? are you crying all the time? these are the important questions… and yes, these questions are the same for men and women, for both and neither.

Reclaiming the hospital as a queer space is somewhat problematic also because of the extreme monitoring of all bodily functions. (i mean ALL). There are tons of hierarchies and lots of badness and overall just a lot of time. But no gender.