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Wednesday, July 28, 2010

Showing My Hand

Any card player knows that the last thing you want to do in order to win the game is to show your hand. It is important to keep your cards hidden so that when you make your move to win, no one expects it and you walk away triumphant with all your secrets intact, leaving your opponents wondering how you did it.

When I started this blog, I decided that I would show my hand, so to speak, and would write about my mental illness in all its glory without leaving out the parts that might be hard to face or that I might want to hide. So today I will show my hand, expose my secret, risk losing the game...

About three months ago I started hearing voices. It was one of the scariest and most confusing things I have ever been through. It was hard to identify at first. It started with the sound of car doors closing, when there were no cars around. I would hear it and expect to see my parents walking into the house and when they didn't come, I'd walk to the porch and see that they weren't home. The first couple of times, I dismissed it, since occasionally we all think we hear things we don't actually hear. But this persisted. And then came the voices.

It was like having a crowd in my head, sometimes chanting the same thing altogether, sometimes all speaking at once, but saying different things. They were always there--like a loud whisper at times or a screaming mob at others. They were there to tell me that I wasn't good enough, that I was a burden to those around me, etc. Depression and low self-esteem have been a problem for me all my life, so hearing these things was nothing new really, except that it wasn't in my thoughts, it was coming from the voices in my head. Then came the demands. These voices started demanding that I pay more attention to them, that I do what they wanted, that I obey because they were never going to leave me alone, that they were just showing me my own desires anyway, so it was ok to listen...I fought with the voices for about 2 weeks before I finally gave in to their demands. I tried to kill myself. As usual, it failed. This time, though, it wasn't failing a suicide attempt, it was failing to succeed in the mission the voices had given me. They were angry and I was tired.

I don't know how to explain what it's like to hear voices. As I read over what I've written, I know it doesn't capture the experience. I keep wanting to insert that I'm not crazy, but once you get to "this level" of mental illness, it is hard to make that assertion because media and society are not kind toward those with hallucinations of any kind, but mainly because it makes me feel like I must be crazy. I have friends with different mental illnesses who have experienced both auditory and visual hallucinations and because I know these people, I have never thought them "crazy." I know that they are people with mental illnesses whose illness sometimes gets the better of them, even when they are doing everything "right"--taking their meds, using their coping skills, etc. Sometimes things just get too big, too powerful, too much for one person to handle. Sometimes a person needs some help.

First, I lied. I was already the "crazy" relative in the family; I didn't want to add to it. Lying, however, is only appropriate when Shelly supports it and I knew this was not a lie she would support. So, I got help. I admitted that I had lied and I confessed the voices to my family and my psychiatrist. They didn't run away screaming, I'll give them that. Although, admittedly, some may find out when they read this blog. What I found from those I did tell though, was support. There were a lot of questions to answer, and I know my family doesn't understand the experience, but they understand that it's scary. They understand it's confusing. They understand that I'm playing a card game they've never heard of.

I was put on a new medication once I told my psychiatrist about the voices and am happy to say that it has worked for me. I still hear the sound of car doors closing, but that I can handle. I have added coping skills to my set and am more equipped than I was before. I am learning to accept my new diagnosis and adjust my view of myself and my mental illness. Sometimes it is hard to separate the two, but I'm working on it.

Life is not a card game, but if it were, this is me, showing my hand. Professionals in card games will show their hand when they are teaching the newbies, when they are trying to show a newcomer how the game works and why they have made this move, or avoided that one. I don't know that I am teaching anyone anything, but am hoping that somehow showing my hand helps someone else. Not only that, but in this case, my opponent is mental illness and showing my hand, revealing my secret, is the play no one expects and is what makes me walk away triumphant.

Monday, May 24, 2010

The Ghost of a Good Mood

You know what I'm talking about. We chase it. We've all felt it at one time or another, or at least we think we have; the hazy outline is there just ahead, but manages to elude us everytime.

After adjusting to my leg brace and learning to navigate the social curves involved in being a child with a disability, it was time to face my future. The doctors informed my parents and I that I would be wearing a leg brace until I stopped growing, which they estimated would be at 18 years old. At age 6, as far as I was concerned they were telling me I would wear it until I was 100. As I got older, the impact of the brace hit me more and more often.

When I reached adolescence, it was especially painful for a while. At an age where one already feels awkward and uncomfortable in their own skin, I also had my leg brace to put on each morning, highlighting my insecurity in the world. I envied other girls my age who simply worried about their hair. I envied my two best friends who fought about whose nose was bigger and measured only to find they were the same length. I raced after them by trying to fit in with the clothes they were wearing, but I could be only semi-successful as that brace always made itself known.

Though I didn't realize it at the time, one day in a thrift store I found the solution. Passing an aisle, I saw a pair of bright yellow socks with tvs all over them. I bought the socks immediately. Thus began my love of fun socks and one of the best coping methods I found for being a kid with cerebral palsy and a leg brace. Soon, instead of despising my brace, I was happily picking out fun socks to wear with it. If my brace was going to draw attention to me anyway, I was at least going to have a little fun and wear socks that would show it off all the more. It was about having a choice in the matter. It was like my socks gave me the opportunity to express how I was feeling that day--my brace was telling its own story, telling the world that I was different, but my socks became a way of showing the world I was the same, or that yes, I was weird, but not for reasons they may have originally thought.

In depression I have faced a similar battle--the learning to accept things as they are, while holding onto the hope that I will reach "18" when things will finally change. It is different for everyone, but I found that for me, one of the best ways to cope is with this blog, and with sharing my story in other ways. I have found that it has helped me not only accept the depression, but helping change the social stigma towards those with mental illness makes me feel like I have some choice, like I am putting on my fun socks to show the world a side of depression they may not have seen.

The nature of depression often makes us want to hide it until it is revealed in an act of cutting oneself, of drinking, of a suicide attempt and then people are shocked and scared. If I can help people understand the way we live, the way depression and mental illness walks beside us, the way we chase the ghost of a good mood because our lives depend on it, than I will wear fun socks everyday. Though my leg brace is gone now, my fun socks have become a part of me.

Tuesday, March 16, 2010

Shelly Supports Lying

There comes a point in each disabled or mentally ill individual's life where he or she will have to face the public. "The public" can be anyone from friends and family to co-workers or strangers on the street. As a person with a mental illness, I sometimes feel as though it is obvious to the world around me, as though there is some sort of mark or sign that says, "I am different. I am not your equal because I face depression daily and you cannot handle this weight I bear." And while I do not wear any such sign, as a kid with cerebral palsy who'd had corrective surgery on my achille's tendon, the leg brace I wore was a visible sign that I was different.

As I've stated before, people tend to fear what they are ignorant of. After learning to walk with my brace on and entered "the world," it was almost like walking into foreign territory. Physical abnormalities of any kind draw attention and my leg brace was no different. At the grocery store, I received everything from blatant stares to veiled glances from those who tried not to look at it though their eyes betrayed them. Parents who I have no right to judge judged me when their children asked questions as I walked by and they held their children closer as if to shield them from whatever ailment I might have. I found myself welcomed into a new community, though; the instant bond of the handicapped, the disabled, the visibly flawed. Even at age 6,  when I crossed paths with someone in a wheelchair or with some other man made apparatus, I had a newfound respect for them and we would give each other a silent nod, smile, or just a look of understanding.

Attending a new school or church was especially interesting. Here were people I would spend time with, people I would get to know and who would get to know me rather than just passing me in an aisle in the store. The curiousity was always evident, but social guidelines generally prevented questions people were dying to ask. Sometimes friends would finally muster up the courage and stutter their apologies about bringing up the subject, but would I be offended if they asked why I wore a brace?

In truth, I didn't mind answering questions at all and often found them humorous. They were the kind of questions that are humorous only because someone else is ignorant about a subject with which you are well aquainted, but it was fun nonetheless. Among my favorites were, "Do you have to wear it in the shower? Do you have to wear it when you sleep at night?" It was especially fun when friends wanted to try my brace on for themselves. Forgetting how long and painful it had been to learn to walk again myself, I would laugh hysterically as they stumbled around awkwardly with the device intended to help me walk the way my friends walked with ease.

While explaining my cerebral palsy and leg brace to my friends was not an issue for me, I did find it tiresome to explain to strangers who were brave enough to ask. I found that in explaining the truth, people were bored and suddenly seemed to regret asking, and so in an effort to please the public, simplify my life, and have a little fun, I invented all sorts of stories to explain my leg brace and horrify people. "Well," I'd begin, "I used to have this turtle named Tor-Tor. Tor-Tor was my best friend and we did everything together. One of his favorite things was to go out into the yard. One day we were outside and he got away from me. He went into the street and I noticed right when a car was coming. I ran out to try to help him and..." I'd pause for effect, "the car hit me and killed Tor-Tor and now I have to wear this brace." Such a sad story compelled my listeners to apologize to me and immediately silenced any question they might ask.

People love a dramatic story like that. It is short and devastating and gives them something to tell their friends about so they can share a moment of pity for someone. But that is all they want--a moment of pity, more than that and it is uncomfortable.

Enter depression. Unlike cerebral palsy and my leg brace, depression has a much different impact on my life. It is generally not outwardly apparent and people do not want to know about it. Depression is not just a story about one event in someone's life. While there are people who are blessed with a "depressive episode" or depression that may be attached to a single event and is later "cured," those with chronic depression or another mental illness bear that weight everyday feeling isolated from everyone else.

Questions people ask about mental illness are seldom funny and often frustrating. "Have you taken your meds? Why don't you just 'get over it?'" In Adult Partial Hospitalization, Shelly emphasized again and again that, while annoying, a question of medication from a loved one was a (flawed) way of saying, "I am concerned about you. I love you and taking a pill is something that can be done in a situation where I am so powerless to help you." And to those who do not deal with mental illness themselves, it can be exhausting and annoying to hear someone talk again and again about how miserable they are, but for as much as they hate hearing it, the person feeling it hates it a thousand times more. If it were simply a matter of "getting over it"--we would.

After a stay in Partial, one of the biggest concerns patients shared was re-entering the "real world" and facing all the questions co-workers and friends and family would ask about their absence. Knowing that people were concerned, we wanted to let them know we were doing better but knew it was not appropriate for one reason or another to tell everyone about our mental illnesses and the real reasons for our absences from "life." And so we would look to Shelly, the woman who told us it was ok if we heard her voice in our heads (but other voices, we should be reporting to medical personnel) and the woman who had helped us get to the place where we were ready to enter the "real world" again, for answers.

Some were surprised to find that in this instance, Shelly supported lying. "It's none of their business," she would say. "If you are not comfortable telling them about your mental illness, make something up. You don't have to lie, but it's fine if you do." And in our lighter sessions, we'd create all kinds of stories to share with "the public" and laugh as they got more and more outrageous. While a "cover story" was a new idea to many of the "Partial people" (as I liked to call us), as a child with cerebral palsy and a leg brace, I had learned long ago how to satisfy the curiousity of people who didn't really want the truth, but to hear a story that would provide a moment of sadness, sympathy, and pity before they moved on to the next one.

I have been working on this post for weeks now. I like to be able to write a post with a neat conclusion--to provide that "story" that my readers (however few you may be) can hear and walk away from feeling satisfied. The truth, though, is that for people with mental illness, it has no neat ending. It is a weight we bear daily. Some days it wears on us more than others and some days it is almost unnoticeable, but even on the best day, it is there, lurking in the shadows, in the stillness, in the silence, in the quiet of our souls. We cope daily and when we are lucky, we are stronger for it. Some things, however, just have no tidy ending. Some stories have no satisfying conclusion.

Thursday, February 4, 2010

Therapy Hurts

Anyone who has been through any kind of therapy can tell you that it hurts; and not in an "ouch" way, but in a I'm-going-to-kill-my-f@#$$%%&*^-therapist-next-time-I-see-him-but-I'm-in-too-much-pain-to-do-it-right-now kind of way. I have had the opportunity to experience just that feeling many, many times in my life.

As a child of cerebral palsy newly fitted with a leg brace, I had a daunting task ahead of me: I had to learn to walk again. Learning to walk is no easy undertaking and I think that it is only because they are unaware of what's in store for them that babies even attempt it. As a five year old who had not had any problem with the way she was walking previously, I was frustrated and confused when I put on my brace for the first time and it was uncomfortable and foreign and rather than helping me walk the way all the adults in my life had told me it would, I found I couldn't walk in it. I remember crying in the clinic that day and feeling alone, because no matter how I cried and tried to explain how this thing--this brace that I would have to wear for the next 13 years or so--was not helping as promised, but was hindering me instead, I had no choice. It was there to stay, but my five year old self could not understand the long term rewards of the surgery and the brace in the face of the present confusion, fear, and frustration at the loss of a skill I had mastered (in my mind) as a toddler.

So began my therapy and my pain. It was necessary to exercise my leg and foot to keep my achille's tendon from shrinking back to where it had been before and to strengthen and re-train my muscles to walk properly. While I had previously walked toe-to-heel on my left foot, the brace forced me to walk heel-to-toe, which my foot did not understand at all, and my muscles did not appreciate. Though I couldn't articulate any of it at the time, it felt like both my body and my parents had betrayed me.

Through no fault of her own, my physical therapist was the arch enemy of my heart. As a naturally shy and obedient child, I did as I was told in my sessions with her, but I conjured up all sorts of torturous experiences for her in my head--things like having to spend time with my brothers, and wearing itchy wool skirts, and having gum in her hair and sand in her pants. All the stretching and exercises she made me do and the way she'd manipulate my foot this way and that in our sessions hurt and worse yet, she had my mom's support, which my mom demonstrated by making me do the exercises my therapist provided to work on at home.

As I grew older, of course my perspectives changed and I understood that the brace and the exercises and the therapy were necessary and that I was lucky to have them. And while that knowledge lessened my laothing towards my therapist and evaporated the emotional betrayal I'd felt, it never diminished the pain of the therapy sessions because the goal, always, was to make my leg/foot stronger, which required pushing the limits of what the muscles in my left leg could do to try to match the strength and agility of the muscles in my right leg and foot.

I do not have the same strength and agility in my left leg as I do in my right, but the efforts of the brace and therapy were definitely not wasted. I have seen those with my same condition who did not have the surgery, the brace, and the therapy for one reason or another and their physical abilities are limited far beyond mine. In fact, today only a trained professional can tell that I have cerebral palsy. I live with the effects and some limitations daily, but it is nothing I can't compensate for and nothing noticeable to those around me.

Therapy for depression is another beast altogether, but I have also found it to be necessary to my ability to cope with my mental illness. There are different therapies available and some are more helpful than others. There are times in my life where I really need individual therapy. I need the safety of having one person hear my struggles and help me find my way through them. I need help looking at past trauma with the knowledge I have as an adult rather than only the feelings I had as a child. Other times, group therapy is much more helpful. I need the support of my peers who are the only people that really understand what it's like to live with depression and all that it means. I need that group where I am "normal"--where the playing field is even, so to speak. I need to hear how others cope, what works and what doesn't, rather than hearing a doctor who does not face mental illness tell me what will help. Sometimes I need both. I need my individual therapy where the therapist is focussed only on me and not on keeping the group in a productive, healthy line of thought and I need the group that shares my experiences.

I know many people with mental illness who do not go to therapy. I used to wish I could be like them. I used to think they were stronger than I was and that I should be able to go without therapy as well. While I do believe that everyone must walk their own path and do what they think is necessary for their health, from my own experiences and what I've seen from those who have gone to therapy and those who have not--it is the difference between dealing with an illness that only a trained professional can see and having that illness exposed to the world because without the therapy, the disability is obvious.

More important though, than what the world can see is the quality of life. How miserable it would be to limp through life when a brace, some therapy, and exercises make it possible to dance. For me, the brace is my medication and the exercises are the coping skills I've learned in group and individual therapy.

I won't pretend that therapy is pleasant--it's not. It hurts and it is hard. Often there are days where after therapy, I feel like nothing at all was accomplished, I can walk no better than before and my heart aches from the work I've done. But that therapy that hurts so much now is slowly strengthening my health and teaching my brain to see things differently; to look a possibilities where I previously saw only problems, to hope in a future instead of putting my energy into a suicide attempt, to walk heel-to-toe instead of toe-to-heel.

In the case of my cerebral palsy, the leg brace and therapy I was forced into ended up saving me more than I realized. While my doctors had originally said I would have to wear the brace until I was 18, because of all the work I did, I was able to stop wearing the brace at age 12. It was a wonderful and surprising day when my doctors evaluated my progress and gave me the news and it would not have been possible without that painful period of therapy.

As for depression, I doubt that I will ever go without medication and I am ok with that. I don't know if I will always need theraputic support or if I will be able to cope without it. I am still learning about the limitations my mental illness brings in my life, but even when it's slow, even when there are setbacks, I know there is progress. And while therapy hurts, it also helps.

Sunday, January 17, 2010

Shelly and The Brace Man

 For about the past year or so, I've wanted to join a book club. Though I feel ridiculous admitting it, I haven't done it yet because I am scared. My fear comes down to two things: I might hate the other people there, or they might hate me. I want to join a book club because I love reading and I am always looking for other people who have read the same things I have so we can discuss it or who enjoy the same kind of books I do so we can recommend books to each other (and discuss them). In particular now, since my move to Oregon, I also think it would be a good way to make friends, which I have a hard time doing. I have found two book clubs in my area and have even checked out the books they are reading from the library so that, should I have a burst of bravery, I will be prepared to go. And yet, with the meeting time about a week away, I am already talking myself out of it.

I have learned that people are generally scared of things they are not familiar with. As a child with cerebral palsy, I had a lot to fear because I rarely knew what was coming next. Since my family did not have a lot of money, when it was time for my cast to come off after my achille's tendon surgery, we headed over to a clinic for children like me. The doctor came about once a month, I think, so whenever we were there, there were tons of other kids and it was generally an all day event to see the doctor and the brace man.

I met the doctor for the first time when we were ready to take my cast off. I remember him as a very creepy man who I hated to see every time afterward. He was tall and skinny, balding on top with thin grey hair down to his shoulders. I remember thinking that his nose looked more like a beak. After seeing tv shows where people have to do community service for some conviction or another at places like clinics, I have wondered if it was that type of situation with the doctor there. He never seemed happy about his job and I was certainly never happy to see him.

So on that first visit, as we removed the cast, he wanted me to get off the examination table and walk around a little bit. He warned me not to put too much weight on my left leg because it would be weaker since having the support of the cast. At 5 years old, I was convinced that that was the dumbest thing I had ever heard! I was walking just fine (to my knowledge) before having surgery, had finally been able to walk on the cast w/out crutches after the surgery, and walking now would be no different. So I hopped down from the table and would have fallen had not the creepy doctor been prepared to catch me. I was shocked and puzzled by the weakness of my left leg. Though the doctor had warned me about it, nothing in my experience prepared me for it's seeming malfunction. I then walked carefully around the room and the doctor happily passed us (my mom and I) along to The Brace Man.

The Brace Man (the only name I ever knew him by) was one of my favorite people in the world. He was a little overweight and very jolly and was clearly happy working with kids. He had me smiling and laughing the moment I met him and I always looked forward to that part of the visit, even though it was often physically painful to meet with him. He was always saying the kind of outrageous things that kids love, things like asking me if I was sixteen (which, at 5, I found hilarious), asking if I had a boyfriend (when I hated boys), etc. He always explained what he was doing, though usually he'd make a joke about it first. The first time I met with him, I had to be fitted with a brace and later, as I grew, we would repeat the process. This involved lots of measurements on my leg and he would have to draw all sorts of lines all over my leg with blue ink that would not wash off for days. He told my mom when to come back for the brace and would give me friendly admonishments about going easy on the boys as we left.

The Brace Man made an impression on me for several reasons. He knew I was shy and was able to draw me out without embarrassing me (as people sometimes do when they meet someone who is shy--they just comment on your shyness and how you are blushing, making everything worse and your desire to flee merely increases). He explained what was going on so that I knew what he was doing and why, making it much easier to feel comfortable with him. He understood when what he was doing (tightening a brace, for example) was painful and would let me cry, but also make me laugh again afterwards so I always left my sessions with him on a good note and even looking forward to seeing him again.

Depression, I think, is a lot like my visits to the doctor, at that clinic. There are a bunch of other people there, but they don't look exactly like you do, and you can tell some of them are in worse shape than you are and some better. You don't know exactly what's coming during that visit and when you sink into that darkness, it is hard to say that you'll make it out. No matter how many times you've been there, each time is a little different and each time you think "How long do I have to do this? How long will I have to keep coming back here?" But hopefully, while you're there, you find a Brace Man to help you figure out a little bit of what's going on, laugh through the pain, and make it ok when you have to visit again for a new brace (coping skill) or just adjusting the one you already have.

When I met Shelly at Adult Partial Hospitalization, she became my "Brace Man." Never have I met someone who's connected with me so well on what my depression is like in all its stages and been able to reach out to me in that darkness to say, "Here's what we need to do" and "Yes, you will get out" while helping me laugh in the midst of all that pain. My visits to The Brace Man were necessary in helping me learn to walk again and learn to walk properly so that my achille's tendon would not just shrink again and leave me with a permanent limp. Shelly, my other "Brace Man" helped me learn that my visits to Adult Partial were also necessary for my recovery from depression. With depression, when I'd land back in that clinic, back at Partial, I couldn't help but to feel like a failure--like the lessons I'd learned, the skills I'd developed were wasted on someone who could not make them stick. Shelly helped me learn that just like those visits to The Brace Man as a kid were necessary-- because I was growing, so what one brace could accomplish for a time, a different one would be needed for later because that old brace just wasn't adequate anymore--visits to Partial were not something to be ashamed of, but something to embrace as part of my recovery. And though often painful and scary as we adjusted this coping skill or tried that one, Shelly let me be myself, met me where I was at, and helped me laugh through the pain.

For better or worse, I often hear Shelly's voice in my head, giving me a new perspective or catching me in a thought process I know I can (and for my health, should) stop. Lately, as I've thought about this book club, I hear her again and again saying, "Really, Larissa. Just try it. What's the worst that can happen? You are not going to run out of the meeting screaming...and even if you do, so what? Just don't go back to that one again. But you and I both know you won't. Maybe it will suck...maybe you'll hate everyone there and they'll all hate you. But maybe (and this is something she always loves to point out to me)...maybe you will like it! And would it be so horrible to enjoy something every once in a while? I know this is a risk for you, but try it. It's a "safe" risk, in that it's a risk you can take that does not have the world riding on it. It's a chance to make some friends who share your interests. Even if you never go back again, just try it." And at this point, with Shelly in the flesh, or Shelly in my head, I generally get annoyed because either way, she's right. Sometimes risks are worth it just to find out that you can do something, even if you discover you don't like it or it isn't what you wanted or needed...you can do it when you were scared you couldn't.

Thursday, January 14, 2010

On Anger

I am a cautious individual by nature. I fear falling, getting hurt, being embarrassed, making the wrong choice, answering too quickly, failing, disappointing people, breathing incorrectly---you know, the basic fears most people have.

Between my fear of falling and my cautious nature, my five year old self was scared to use crutches on my own after my achille's tendon surgery on my left leg. Doctor's orders stated that I was not allowed to put weight on my foot for a while after the surgery. My 5 yr old wisdom told me that was ridiculous, but found out it wasn't once pain upon standing showed me who was actually the ridiculous one. While I was unaware of it at the time, since my cerebral palsy is on the left side of my body, it also hugely impacts my balance--as in, giving myself even a little credit for balance is being generous--therefore making it even harder for me to use the crutches. As a result, my mom ended up helping me walk around the apartment anytime moving meant crutches would be involved.

At that time, much to my disdain, my mom felt it necessary to include an afternoon nap as part of my daily schedule. On one such afternoon, I was arguing with my mom about something (very important, I'm sure. I argued with her just about every chance I got on anything from whether or not my fancy socks should be pulled all the way up or folded down as designed to how I should wear my hair for the day.) and she decided that it was time for my afternoon nap. She got my crutches and came over to the couch to help me walk to my room as she always did. Furious as I was, I pronounced, "NO! YOU don't help me. I will do it myself!" So, my mom backed off to let me "do it myself."

It was a long journey down the hallway that day. I was scared as I wavered on the crutches on my own, but I was much too stubborn to let my mom help me. I was determined to do it alone. And I did. After that, though moving very slowly at first, I used the crutches on my own, but still recognized that I needed help for obstacles such as stairs. And in her everlasting patience, my mom was there to help me when I needed it.

It would be nicer, I think, if this little story went something more like this: because of my mom's love and encouragement, I learned to use the crutches on my own. Doesn't that sound so...Walgreen's? Or the way it would be if I lived with the cast of Full House...but I know better. All the assistance and patience in the world was not going to get me onto those crutches on my own; it was my anger that finally propelled me to take a risk.

Society often frowns on anger as though it is not ok to experience it under any circumstances. I will tell you that I disagree. There have been times in my life --sometimes lasting months, sometimes up to a year--where anger was the only thing to keep me going. It motivated me to achieve things when nothing else could, to take risks I would normally be too fearful to take, to make a change in my life so as not to end up in that position of anger again.

At Adult Partial Hospitalization, I found people who had experienced the same thing: where anger had caused them to finally get out of an abusive relationship they had been scared to leave, or out of a job that was suffocating them, or allowed them to confront a loved one who was not respecting their boundaries. Whatever the case, there was story after story, heart after heart, who knew that anger was what they needed in order to face whatever bear was in their way.

And yet, I can also tell you that I found people with story after story of how anger had trapped them, how their anger towards their past, their childhood, their present, their situations, their lives was just eating them up and locking them into misery. Even so, I am not afraid of anger and I am not ashamed when I feel angry. Anger is natural and even appropriate at times. It is what we do with our anger, how we decide to respond to it, that defines whether we are propelled to walk on our own or sit on the couch cursing the world for the fact that we need crutches.

I have been there. I have been that person on the couch cursing the world. I know sometimes it feels like the only defense we have--like if we aren't angry, if we get off that couch to try to walk without help, we are going to fall and things will be worse. The truth is, it might feel worse...it was a slow and scary walk to my bedroom the day I refused help from my mom. But once I had done it the first time, I knew I could do it again. Use your anger while you need it, but then let it go.

Let it go so that when you wake up from your nap, when you've had a chance to rest after your anger has subsided, you can say, "Look, Mom! Now I can walk on my crutches by myself!" and see her smiling back at you.

Wednesday, January 13, 2010

Encountering Bears

After discovering that I had cerebral palsy, it was time to decide what to do. After all, my limp was already apparent to those around me and doctors assured my parents (and we would later see examples) that if something wasn't done, not only would my limp become more pronounced, but because I was still growing, it would affect my spine and all sorts of organs and such because of the spine deformity.

My achille's tendon in my left leg was too short and not growing properly, which was the cause of my uneven gait. Therefore, the doctors decided that the best way to correct the problem and prevent further complications in the future would be to perform surgery on my achille's tendon on my left leg to lengthen it, allowing me to walk normally.

At the time, my family was living in Bowling Green, KY and the surgery was to take place in Louisville, KY. We had neither the money nor the vehicle to take the trip and my parents borrowed a vehicle from a friend to make the drive. We slept in the hospital chapel once we arrived in Louisville and awaited my surgery.

I was about 5 years old at the time and there are snatches of things I remember: I remember thinking my doctor was hilarious, but I am naturally a shy person and do not remember talking to him at all, just smiling ear to ear every time he came to talk to him and every time he would comment on my smile and how happy I was. I remember how he and the nurses explained everything they were doing either before they did it or as they were doing it so that I wasn't scared at all. I remember watching the nurse put the needle into my arm after she told me what it was for and getting cold as the IV fluids entered my veins. I remember being wheeled into surgery and the anesthesiologist telling me to count backwards from 100. I remember 98.

I remember waking up and being told I was in the recovery room, my mom there with me and the nurses asking me if I wanted anything to drink or snack on. I remember eating the best cookies I've ever had (to this day, I have no idea what kind they were, just that they were delicious) until they ran out. (Upon reflection, I suspect my mom told the nurse not to let me have any more.) I remember that I had a cast on my left leg and could not walk, but I don't remember it hurting, though I think it must have...the cookies must have been a very effective pain reliever. I remember being told (by someone...who it was was irrelevant compared to what they were offering) that I could either go to the Louisville Zoo or some other place since I had been such a brave girl for the surgery. I don't know what the other option was because even at age five, I was an animal lover to the core and jumped (figuratively as it was not a physical option) at the chance to go to the zoo. And yet, as much fun as I know I had at the zoo, the experience is hazy except for being pushed around in the wheelchair by my parents, and stopping in front of the polar bear tank, where a polar bear was swimming around and I pointed to show my parents, spilling my red ICEE all over my lap, making me sticky for the rest of the visit. 

In ways, cerebral palsy seems so much easier in comparison to depression. I often feel cheated by depression. Cheated by the fact that it so often feels like a guessing game for the doctors and counselors I work with. We try this drug or that treatment that has worked for x number of patients, and x number have had no problems with side effects...but then I am the one person who throws the stats, has that horrible side effect and the search is on again for the next drug, the next experiment. Mental illness cannot be treated the way my cerebral palsy could. Though medicine has come a long way in figuring out information about seretonin and other brain chemicals, it is still unable to say, "this surgery (pill, treatment, etc.) will prevent any further symptom development."

I have mixed feelings about how depression effects my memories. Sometimes I feel like it probably saves me from memories that are too hard to remember...but other times, I feel robbed--like when a hospital visit that I know saved my life is just a fog in my mind, and when I know that what saved me was not necessarily the medicine and constant medical care (though that was certainly necessary) but what someone said to me while I was there that gave me hope again (something I so often lose) but no amount of searching through the fog brings the courage I found there-- the will to live-- back to my mind again.

And as for rewards...it often feels that they are few and far between. Upon release from a hospital stay because of depression, it's like friends and family breathe this sigh of relief, thinking that if the hospital has released you, surely you are now "ok" and there's no need to worry anymore. It is not that I want the kind of worry that makes loved ones hover over me and watch my every move, but the hospital's goal is merely to reduce the level of care needed. Once you tell them in one of the many mood inventories, "No, I am not suicidal." it's goodbye hospital support and hello world that made me feel this way to begin with. Don't get me wrong here; I have very much appreciated the hospital care I've received when admitted after a suicide attempt and for the most part have been moved quite well through the levels of care: hospital stay, Adult Partial Hospitalization, then work with counselor. I just know that when you leave that hospital room it is not usually with the excitement of seeing a polar bear in a tank at the zoo, but the bear of life waiting on the other side of that hospital door.

However, bear in mind: When I left the hospital after my surgery that day for the zoo, I was equipped with a lengthened achille's tendon and a cast to protect my leg while the wounds healed. Though memories of assistance for hospital stays due to depression may be hazy, the support I've found there leaves me better equipped to handle whatever bears are waiting for me on the other side and the security of the hospital is still available to me should I need it again.

Thursday, January 7, 2010

The Beginning

My mom was worried about me at age two when I had not yet started to walk. The doctor told her to just buy me a pair of high top shoes for more support. She did it and I started walking that day, so she stopped worrying, but the trouble was just beginning.
At age four, I was on a trip from Kentucky to California with my mom, brothers, and grandpa to go to my aunt's graduation from college. My grandpa had a pickup truck with a hard top, so the boys and I rode in back. I fell asleep and was rudely awakened when it was time for a bathroom break. As I scooted out of the pickup and climbed down, I immediately fell to the ground, screaming. My left hip seared with pain and I couldn't walk. Grandpa carried me to the bathroom and ended up carrying me everywhere for several days.

When we arrived in California, the tests began. Doctor after doctor examined me and could not figure out what was wrong. Finally, a specialist discovered that I had contracted a rare hip virus. Through all the testing, it also became evident that I had cerebral palsy on the left side of my body, the affects of which had been triggered by the hip virus. Some of us feel that we've gone from doctor to doctor, enduring test after test, medication after medication, from one therapist to the next with little to no results, temporary results, or treatments "for our own good" that are exactly opposite of that. Sometimes the mental illness is triggered by an event, sometimes like cerebral palsy, it's something that we're born with that reveals itself at an inopportune time (because there is really no "opportune" time for mental illness).

Though I couldn't tell the difference at all, I walked heel to toe on my right foot (which is normal), but toe to heel on my left foot, causing me to limp around. While my uneven gait was obvious to others, I was blind to it. I just knew that something was "wrong" with me because of all the doctor visits and the worried looks my parents would exchange when discussing what to do about Larissa. Depression in my life has been a little like that. I've dealt with it all my life, not even knowing that there was another way to live. Though I knew other people were not depressed, I didn't even know that there was any other option for me--like they had some secret I couldn't access but there was something fundamentally wrong with me; something people could point out, but do nothing to fix.

There is no cure for cerebral palsy. It is caused by a lack of oxygen to the brain at birth and the severity of the illness depends on how long the brain is deprived of oxygen and what kind of treatment is administered. There are several kinds of cerebral palsy, and as I mentioned, mine affects only the left side of my body. The earlier the illness is discovered, the better for the patient, as it can be monitored and treatment can be provided to minimize the affects of the illness in the patient's life. As a child at age four, I did not consider my hip virus any kind of blessing because of the physical pain it caused and the humiliation of undressing in front of doctor after doctor for examinations. However, the hip virus was what triggered all the doctor visits that eventually revealed my cerebral palsy and allowed doctors to intervene before it was too late to prevent my symptoms from worsening.

Those of you who deal with depression or mental illness may have experienced that the sooner you are able to start receiving treatment, whether it be through medication, counseling, support groups or some combination of the three, the sooner life starts to get easier. Don't get me wrong here, I am well aquainted with relapse and the devastation it brings, but I do believe (and have experienced) that the more treatment I receive that works...the less likely I am to relapse or the less harmful the relapse is. My point is that for a lot of us, depression is a lifelong companion once it arrives and it sucks. Treatment is often painful and we'd like to avoid it--the undressing of our souls for doctors and peers to examine--but like cerebral palsy, avoidance serves only to worsen the symptoms and prevent recovery.

Monday, January 4, 2010

Introduction

Over the past year, I have been fortunate enough to find an amazing amount of support from family, friends, hospitalizations, and peer support groups to help me deal with the depression that has plagued me all my life. What you will find here is a work in progress--both in my writing and in my life--and possibly the hope that surprised me and the courage I found to put my energy into living rather than dying (as Shelly would often admonish me). Speaking of Shelly...

It was Shelly who first made the comparison that changed my perspective so completely. She said it in passing during group one day, but it stuck with me in a way that lessons in my hours, months, and years of therapy have never succeeded in. I was at Adult Partial Hospitalization--again--after one of my many suicide attempts. I was ashamed and discouraged. I had been through the program twice before and thought about what a failure I was to end up back there again after attempting suicide when I had sworn off it during my last visit at Partial. The general feeling in the room that day reflected mine...we all felt like giving up, like the staff were wasting their efforts on people who would never recover, never be able to walk the way everyone around us seemed to do with such ease.
I think there was a hint of exasperation in her voice that day when Shelly said, "You guys, it's like learning to walk. You would never blame a toddler for not being able to run right away or tell him he had failed when he fell down. We understand that that baby is learning and is going to fall along the way. You have not had the opportunity to exercise these skills since childhood. Go easy on yourselves. It's like learning to walk...it takes time to change your thoughts and your habits, and of course you are going to fall from time to time in the process. And that's why we're here...to help you get back up and try it again." The group moved on to other topics, but I have considered that metaphor ever since the day Shelly mentioned it.

Perhaps it sticks out for me more than it has for others because walking has been somewhat of a struggle in my life. I was born with cerebral palsy on the left side of my body, which was not diagnosed until I was five years old. At times, it felt like the diagnosis did me more harm than good. At times, it was an excuse to keep from taking risks. At times, it opened doors to experiences that changed my life. You will find those times and more in the entries to follow. My struggles with depression have mirrored my struggles with walking in so many ways that you will see the two intertwine again and again. Welcome to my walk with depression.