Today I received a notice from our insurance company. My neuropsychologist who did a neuropsychological assessment on me had sent in his claim. The diagnosis: "Secondary persistent mental illness". I laughed when I saw that. It was a gut reaction. After I had a half second to realize what I had done, I wondered why I did it. There was nothing funny about it.
However, deeply engrained in me is the stigma of mental illness.
Somewhere along the way, I had learned that we make fun of people with it. They're "crazy". "Insane". They belong in the "funny farm". As a kid, if someone seemed a little "half-baked" or "not quite with it", we said they needed to go to Fulton. That is where the state insane asylum was.
As an adult, in groups, mostly with my sisters, we poke fun at ourselves. There are plenty of times when one of us will do something out of the ordinary and a joke will be made. Invariably it references mental illness in some form. It is all in fun. We laugh. It's probably carry over from when we were kids. No harm intended, but the underlying message is there: it is acceptable to make fun of those with mental illness.
What is mental illness and what is the cause? These are questions I have pondered for years.
I have struggled with depression off and on all my life. Actually, I think part of it is simply my temperament. I lean towards melancholy. I react to things slowly and ponder or brood over them for a long time. They leave a big imprint on me. I am extremely sensitive. If it is something positive, it is life-giving and causes me great joy. If it is something negative, it is devastating. I go over it again and again in my head. In a way, I repeatedly injure myself, often after sensitively picking up on something that wasn't meant to be hurtful at all.
There is a perfectionist who lives in me who never is quite good enough. I set unreasonable standards for myself and set myself up for failure. I procrastinate because if I can't do it right, I won't do it at all. Usually I believe I won't be able to do it good enough, so it goes undone. That creates self-imposed pressure as the "thing" hangs over my head, looming larger each day and beckoning me to come fail.
I have a built-in mechanism that is self-defeating. Naturally, that leads to depression.
My first seizure happened when I was 13 years old. To this day I take medication for epilepsy. Throughout my adult years it has been mostly under control. However, through my teen years, it was not.
I had grand mal seizures (convulsions) in the presence of others. I told myself that it didn't bother me, but it did. At a time in life when a teen tries not to stand out in any way, I was doing so in a big way.
It was a scary time for me and for my family. We didn't know what was going to happen, or when the next seizure would take place, or if it would, or if I would get hurt.
I was fortunate for the most part. There were no serious injuries. Once I had a seizure in the bathroom and broke my two front teeth when I hit the bathtub in the fall. That was fixable. Traumatic, but fixable. Many people with epilepsy have it so much worse. I do count my blessings where the seizure disorder is concerned.
There I was. In high school. With a brain on the fritz, feeling socially rejected and depressed as a result. Some of the time. Not always. I had a boyfriend for two years, which was the best thing that happened to me. I felt accepted and cared for just as I was.
I felt like my brain was my enemy most of my life. With our brain regulating our emotions, well, it's been a free-for-all.
Did I have a mental illness when I was in high school and experienced depression off and on? Or in college when the same happened? Or in married life when the "off and on" became more pronounced and more often? Or were they simply depressive episodes?
And is it caused by this genetic temperament predisposition that may be enhanced by familial brain chemistry tendencies towards depression?
It seems there are more questions than there are answers. But at this point in my life, according to the doctors, it is official. I am mentally ill.
They change their minds as time goes on as to what the diagnosis is: Post Traumatic Stress Syndrome, bipolar II disorder, chronic major depressive disorder, major depression with psychosis, bipolar disorder - not otherwise specified, and the ambiguous secondary persistent mental illness, which really isn't a medical diagnosis at all.
I have had a nice stay in a psychiatric hospital for three days to keep myself "safe" - a.k.a. "from committing suicide". I wasn't in any danger of that but a doctor said I was so off I went. The place had more detox patients than mentally ill patients.
The doctors have tried over thirty antidepressants in an effort to alleviate the depression. None of them worked for one reason or another.
Then a couple of months ago, my doctor had his "ah-ha" moment. Maybe I wasn't suffering from depressive disorder after all. (Excuse me?) Maybe it was a mood disorder. (Oh, now I'm just moody!)
Evidently antidepressants will not treat a mood disorder and can actually make it worse. Anyone who watches television sees the commercials advertising the antidepressants. There are warnings that the medication can actually cause worsening depression and suicidal thoughts.
Then my doctor got a sly little grin on his face. "Do you know what three of the drugs are that we use for mood disorders?" He named off the three medications I already take for epilepsy.
I had decided that day I was going to march into his office and tell him I wanted to go off the antidepressants totally. He beat me to the punch. He prescribed an antianxiety drug for me to use as needed, mostly for insomnia. As I write this at 1:20 a.m., it's obvious that isn't working that well either.
The depression still comes. But it goes. I now have depressive episodes rather than consistent depression. I finally have regular, good ole-fashioned good days. And anxious days, when I am not down but wound up. I have learned to take it one day at a time. Yesterday I had a good day and wanted to believed that I was going to be ok for good. However, experience has taught me that tomorrow could be different so I should just appreciate yesterday for what it was and not to make "mood plans" for today.
Good thing. I had a major meltdown today. The sky fell. The world was dark. I didn't want to live, but I wasn't suicidal. The pain I felt was overwhelming. I couldn't even talk.
I grabbed a cat, which is always good therapy, unless the creature won't sit on my lap and let me pet him/her. Even that didn't work out today. So I took a nap, which is always a good thing. I wake up and my dark, painful loop in which I was stuck was interrupted by the sleep. My mood was better when I woke up.
If I hadn't run out of anxiety meds, I would have taken them which would have helped.
Since being off the antidepressants, depressive episodes are usually triggered by something. Today it was the notice from the insurance company with yet another mental illness label applied to me.
I have listened to those much wiser than me. I have read endless articles on the subject. I have thought it over and come to agree with all of the facts: mental illness is just an illness. "You are sick," my doctor told me at the last visit. "This isn't something you 'snap out of'."
Not really, though.
I confide in a few people about it, yet am embarrassed. I feel like it is a weakness - a moral or character weakness. A lack of fortitude. It was pointed out to me that while this is not true, mental illness can make one weak.
The brain is sick. In some people, the pancreas is sick. Or the liver is sick. The difference is that when the brain is sick, it can affect one's behavior and emotions.
I have made progress in how I feel. I can look back and see how I felt so much worse several years ago. This gives me hope for the future. Good professionals have helped me along the way. My family has supported - or rather - put up with me.
For now, I live today. I will go to bed and maybe sleep. If not, I will see how my energy is tomorrow.
I have my new prescription of anxiety medication, so I am ready to take on another day of trouble if it greets me.
Someday maybe I will accept mental illness as a sickness and not a weakness. Maybe then I can begin to accept myself. Perhaps the perfectionist that lives within needs to die a slow death in the process.