Yesterday was World Mental Health Day and after reading this post about two episodes of Star Trek: Voyager that focus on mental illness I wanted to share my story.
“I need a name for the cup.”
It was a week before Thanksgiving. Almost, but not quite, Eggnog Latte season so I’d settled for Pumpkin Spice. Decaf, of course, while I was on antidepressants.
“Emma.”
This is my Starbucks name because my real name is difficult to pronounce correctly. I add details to her life while I wait for my orders to be completed. Emma is a substitute teacher and an author of children’s books. Unpublished, but hopeful. She also writes songs and covers local events for a travel blog. Emma is a little bit younger than me and a lot less damaged. She’s not getting coffee on her way to an intensive outpatient program for psychological and behavioral health. She’s never been a mental patient. But she is on antidepressants. Everybody’s on antidepressants.
I started with Prozac. There were other, newer and suggested to be better, drugs for depression and anxiety but I wanted the original, the most famous. The one splashed across magazines, the one in the titles of books. I wouldn’t agree to take something mind and life altering unless it fit into the story I wanted to tell.
Monday afternoon was community meeting. Everyone in the program and all the counselors in one room to talk. We had big group meetings every morning to touch base and go over the daily schedule but this was a different event. It wasn’t a time for therapy. We spent a lot of the time discussing kitchen manners and assigning chores for the week. Or the counselors did. Because it wasn’t a time for therapy there wasn’t any requirement for talking and because there wasn’t any requirement for talking nobody did any.
But the third week, I spoke up. The question was posed if these meetings served any purpose — was our collective of people, a variety of ages, races, backgrounds and psychoses, a “community” anyway? And one of the counselors asked the room at large if anyone was willing to talk about if he or she felt like a member of the community. No one said a word. A moment of awkward and bored silence passed by. And then I raised my hand.
“Yes, ” I answered. “I think there is a community here but no, I don’t feel at all as if I belong to it.”
“Why?” was the reasonable follow-up question.
“Well, I don’t smoke.”
The whole room laughed at the response but I didn’t mean it to be funny. I wanted to talk about it. Part of me wanted to belong and was scared I never would. Part of me was happy being different and was scared this program would change me into one of them.
“So, you think a lot of the socialization takes place during breaks.”
I nodded. When else is socialization taking place? The program took place while the rest of the population were at work or in school — our job was to get better, to learn how to live our lives so we didn’t have to be here anymore. So of course the socialization took place when we were not working.
And everyone smoked, including some of the counselors. More than half the patients were addicts, and even those of us whose diagnosis fell outside the addiction sphere might be considered to have an addictive personality. Smoking is an addiction we were allowed. Just not one I have ever indulged in.
I used to wish I were more inclined to damaging or compulsive behavior. I was mad I was not a cutter, or a drunk, or a shoplifter, or reckless with driving or sex, or “really” anorexic, or “really” suicidal. I was enamored with the glamorous insane. I wrote a lot of bad poetry in my attempt to be Sylvia Plath.
I wasn’t diagnosed with Histrionic Personality Disorder until I was twenty-five years old but suddenly, finally, my whole life made sense.
I play to the audience.
Not for applause or approval or validation. I watch the world watch me and take cues from their reactions to develop my identity. But I don’t mold myself to the response, the audience ideal. I choose which directions to take and which to ignore. And I am always looking for new and different directions and reactions. Always pushing and always playing.
I got glasses when I was in second grade. We had health and fitness tests at school which included a simple vision test — read the third line, E E G L H Y, that kind — and I failed mine entirely. As I was in the highest reading group they knew it wasn’t a question of not recognizing the letters, so it was recommended that my parents bring me to an ophthalmologist. This was very responsible of the school. They didn’t realize I had failed the test on purpose. I’d taken the same type of exam the year before, passed and heard nothing more about it. So I wondered, what happens if you don’t pass? It was pure curiosity coupled with audacity. Or I was a brat.
The eye doctor my parents brought me to was ninety years old. Well, he was probably sixty something but to six year old me — ancient. Which made it only easier to utterly fail that test, too. I ended up with bifocals. Tiny bifocals with pretty pink frames. I was quite pleased with myself. This was all very exciting compared to what happens when you pass (i.e. nothing) and I got lots of attention for it. From the school, my parents, the eye doctor, the eyeglass specialists, the other kids. Of course I couldn’t see a thing when the glasses were on, and the too powerful prescription gave me a horrible headache. But every time I took the glasses off my teachers, warned by my mother that I would probably be self-conscious about it, would tell me to put them back on. This continued for a week until finally someone realized I could see much better without the glasses than with them.
In third grade, I failed the hearing test. This was even easier than the vision test. I don’t have hearing issues, but the tests involved listening for small beeps and you also need a reasonably good attention span for that kind of thing. I’d always been easily distracted and that played right into failing the hearing test. Again, the school told my parents to bring me to a specialist. And again, they did, though they had learned something and I saw a not ancient and very thorough Ear, Nose, and Throat Specialist. The tests went on for a full day and it was no fun at all. I was poked, prodded, forced to watch Looney Tunes, and finally hooked up to what looked like tiny jumper cables for my ears. It was a very long day and there was no way I could keep up the “I can’t hear” act. According to the jumper cables I have slightly better than average hearing.
Whenever my family went on vacation I wrapped my wrist or ankle with an ace bandage, making up injuries that only afflicted me as long as the car trip lasted. One year I even brought along my younger brother’s crutches left from when he’d been run over by a bicycle on his last day of Kindergarten.
Inevitably someone at a gas station or fast food restaurant along our way would ask about my injury. I made up a different answer every time. I was a gymnast, a dancer, an ice skater, a cheerleader. They believed me because my answers made sense and I told my stories with conviction. I didn’t feel guilty because I didn’t think of it as a trick. The point wasn’t the lie, the point was the response. It was an experiment and I only wanted to learn.
“Grande decaf pumpkin spice latte for Emma?” I thanked the barista and found a seat by the window. Emma had to finish her coffee before going into her classroom. I could bring it with me but I had ten minutes before I had to go.
In middle school my dentist gave me a fluoride gel to spread over my teeth after brushing. I told my camp counselor it was a medication and she watched me swallow a teaspoonful every night for a week. Luckily it wasn’t poisonous. But when I was older and my various counselors and physicians suggested benzodiazepines for my Anxiety, or selective serotonin re-uptake inhibitors for Depression, or even vitamins for Anemia, I avoided them with the same conviction.
I resisted medication for months, years, because I was afraid of what I might lose. I was scared it would make me dull. And dumb. I was afraid any medication strong enough to quiet my mind would silence my mind. Silence me. I was never any good with silence.
I was born at the very end of the year and starting in first grade I was always the youngest and smallest girl in school. I was five years old, walking to school on a path through the woods. Tiny, blonde, constantly questioning everything even then, looking for rabbit holes to fall down because reality was so boring. I grew up, but not so tall that I became any harder to dismiss unless I shouted, unless I made so much noise and such a fuss that no one could ignore me. What if the pills took away my voice forever? I would rather stay in Wonderland.
I didn’t mind my anxiety meds, the ones that helped me sleep. Two months before Starbucks I’d found myself in the emergency room. And I spent the whole night. I wasn’t bleeding, I didn’t have a virus, the only emergency was me. In the morning I was released into the outpatient program. It ran 9AM to 3PM Monday through Friday; I attended for six weeks. And medication was a requirement. I had to show resolve and commitment to getting better.
I met with a psychiatrist twice a week. She was the only medical doctor on staff, the only one could prescribe, and that was all she did. She would ask questions but only to determine which medications were required for my treatment. I met with her on my first day and she did a full intake. It was the fourth full intake I’d gone through in as many days and I’d been through at least another four over the previous six months. I knew every question she asked and after that first meeting I knew what to answer to get my way.
Lorazepam is dangerous. Habit forming, even addictive, and too much can kill you. That was exciting. I had one bottle of ten pills from my visit to the hospital and the psychiatrist gave me a prescription for another twenty. I would likely survive an overdose but it was enough to make a statement and that was an exhilarating thought.
Midway through the program the psychiatrist asked me if I needed a refill. I had taken maybe five of the pills I’d already been prescribed but I could have gotten another bottle of twenty, at least, if I’d answered yes. One of the tiny pills would calm me down and help me sleep. Thirty held power. Forty-five is bordering on trouble. Maybe it was a test, to see if I was becoming reliant on, or addicted to, the pills. If so I passed because I declined. I didn’t want enough pills to kill me. I didn’t want to be tempted to take them or sell them — I had a friend in the program who frequented pill swapping message boards and Ativan was one of the most popular. Maybe it was the Prozac kicking in and helping me make better choices but I’d decided I liked the story of triumph over adversity more than the one about a beautiful madness. I didn’t just say no to more pills, I went home and flushed away the ones I had.
My relationship with antidepressants was far more complicated. I’d avoided the long term wonder drugs known as SSRIs for so many years they’d become my Jabberwocky, terrible and necessary, and instead of standing up to my monster, I was forced to let it consume me. But then something strange happened.
The medication worked. I didn’t lose my ability to write or speak or dance. I didn’t lose my ability to think. Everything slowed down for a while but it wasn’t any harder to be me on my meds. In fact it was easier, just as they’d told me it would be. Three weeks into the program I got, suddenly, better. I started speaking up. I made friends in group. I volunteered to write a quote of the day on the chalkboard in the common room. Every morning, as soon as I arrived, I went to the board with my notebook of inspirational words. I’d been collecting them for years and here, finally, they had a purpose. I became more active in every facet of the program. I was so proud of my progress I didn’t make the connection to the medication until much later.
The Prozac was working but the psychiatrist wanted to switch me to Paxil. She said she considered it stronger and safer, better, but I imagined the drug company sending her to Hawaii. I didn’t like the psychiatrist. She made no effort to get to know me and I found her far too easy to manipulate. If it was easy for me, it’d be easy for them. But I’d started Prozac so I had the cachet and Paxil was the New Prozac so what did I have to lose in switching? I agreed.
Paxil made me sick. Literally. I felt like I had a constant stomach flu but I could never throw up and feel better. This symptom is described as “general malaise” and I’d never understood the idea until I experienced it. It was horrible. Worse than being depressed, worse than being sick, worse than everything because I couldn’t do anything. The medication worked in so much as I couldn’t achieve a tantrum. I couldn’t sob or scream, I could barely cry. I also couldn’t stay in bed the way you do when you have a cold or a virus. I was too awake and not sick enough to be sick. I felt awful and I couldn’t explain it as anything except feeling awful.
As I hadn’t immediately associated the Prozac with feeling better I didn’t immediately associate the Paxil will feeling bad. I’d been depressed for years. I’d been anxious for even longer. I was born with my disordered personality. Feeling crazy wasn’t anything new and feeling yucky was something I associated with being on medication, being in the program, finally taking all this seriously. I thought it was how it was supposed to be, that I had to feel worse in order to get better. But as I was getting set to leave the program and going through my seemingly endless exit interviews someone connected my pallid skin and hunched shoulders to the drugs. I was switched back to Prozac for the final week.
Unfortunately the move to Paxil messed up my body’s interactions with Prozac, too and the switch back didn’t work. After about a month I was put on Zoloft. I was back to being wary about medication in general and I didn’t like what I’d heard about Zoloft. One woman told me Zoloft had so much control over her emotions she couldn’t cry even when her father died. Another had sung its praises but she’d asked to be put on it because she related to the company’s floppy blob mascot. I wanted nothing to do with that. I wasn’t in the program any longer but I was seeing my therapist weekly and I was expected to continue medication. The idea that I could be sent back — or sent somewhere else, somewhere worse — weighed heavily on me and I agreed to stick with the meds, to try Zoloft.
On Zoloft I felt fine. Fine, all the time. Never awful, there was no malaise. But never particularly good either. Just fine. And the longer I felt fine, the more I hated it. I was used to emotions that wracked my body. To fits of pique, outbursts of temper, deluges of tears. To anxiety that made my heart beat so fast I couldn’t breathe but also the delight of it falling away when I stood up to it. And that feeling of wonder and joy that cannot be contained, that must be expressed by twirling in the sun until I was dizzy. I understood my whirlwind of emotions, even the ones I’d rather banish. I didn’t understand their absence. I didn’t like feeling fine. But I could barely feel that dislike.
After six months I stopped taking the Zoloft. I didn’t do it correctly. I didn’t ask for a lower dosage, I didn’t make up a schedule, I didn’t ask permission. I just stopped taking it. I didn’t tell anyone for months. And when I did I refused to consider going back. By this point I’d been on antidepressants of one kind or another for about two years. They’d helped me. Maybe they saved my life. Certainly they got it back on track. But I was tired of feeling fine. I was tired of decaf coffee. I was tired of survival, I was ready to try living again.
I like museums, I can spend hours watching art stand still. There is so much movement in the air that surrounds it. I always want to dance. Some time after Starbucks I stepped into a room in the National Archive and found a map in the floor. Underfoot and lit up; it filled the entire room. The ceiling lights were dim, an eternal dusk, or it would be if they didn’t shut everything down once the tourists left. The Battle of Gettysburg was laid out from start to finish, a light show of footsteps one sixteenth the size of a soldier’s foot that played all day in a continuous loop. Fifty thousand ghosts died again every nine minutes and then popped up back at the beginning to do it all over.
I was fascinated. I watched the shadows battle from many angles, standing then sitting. From a bench I watched the other patrons. Most shuffled through, looking for something more interesting or less upsetting. Some read the facts on the wall or stood to watch the light show with me. A little boy ran after the lights, arms stretched out, an anachronous fighter jet. A woman touched her hand to the floor and bowed her head, a silent prayer. There were other parts to the exhibit, other floors to explore, but I stayed in the map room. I borrowed a headset to listen to the narration then pulled out my ipod and let Massive Attack drown out the crowd. I followed the footsteps. I danced along.
It was beautiful. I wanted everyone to leave, to let me have the room to myself, to dance. Or I wanted them to stay, pressed against the wall and on the benches, to let me have the stage. I wanted to dance the Battle of Gettysburg. I wanted to dance every battle in the Civil War. And then the American Revolution. And then the World Wars, in France and Russia, where ballet thrived. I wanted to turn every battle into a ballet.
It wasn’t until I’d left, until I was alone in my hotel room, staring at the ceiling and still picturing the footsteps of the dead I thought it a strange idea. I looked at a map of the bloodiest battle on American soil and imagined myself pirouetting.
Personality disorders should not be diagnosed in anyone younger than twenty years old. But an individual’s personality can be set by as early as first grade. From a young age, I had an insatiable curiosity. It might even be called a compulsive curiosity.
I never had any malicious intent. I simply wanted to know what would happen. I wanted to observe and I wanted to understand. All children are curious and push boundaries in order to learn. But ninety-nine out of a hundred will back away from a hot stove when they feel the rise in temperature in the air. I burned the fingerprints off three of my fingers when I was seven. It wasn’t enough to feel the heat. I had to hold it.
