Forgiving Ourselves, Snarls and All

I’m backsliding this weekend.

Backstepping, falling off, backsliding, riding the Struggle Bus – however you’d like to put it, I am sitting a few steps back on my journey this weekend.  I can see the footprints in front of me, marking how far I was a few weeks ago, when I decided to pursue my passions and leave a steady job because I could.  Last week, I submitted a piece of fiction to an online publication – my first attempt at publication, I’ll have you know.  That’s probably a few steps ahead of where I’m sitting, plopped down on the road and rocking back and forth.  It’s a comfort thing.  Don’t worry.  I’ve had three panic attacks in two days, and right now there feels like there’s a river of clamor running just under my skin.  Everything feels noisy. I’ve changed my shirt three times today because everything itches.  I’ve been letting the noise leech out of my skin slowly: yoga and classical music helps tremendously.  I’m beginning to feel a little bit more like myself as I write this, exhausted and finally sedate.

My wonderful boyfriend picked up on it before I did, and it took him suggesting a walk for me to realize that I’d been grinding my teeth for the last half-hour while trying to read.  I’ve always found physical activity the most effective treatment for my episodes, and if I’m lucky, they happen on a Sunday, so I can dedicate two hours of yoga to resetting my brain.

I’m not always sure why these episodes happen.  Sometimes, I can pinpoint an obvious trigger – hunger, impending sickness, poor sleep, or stress.  It’s easier to forgive myself when I can detect the cause of the panic.   Isn’t that the case for all of us, though?  Isn’t it easier to forgive behavior when there are mitigating circumstances?

I’m beginning to realize, though, that looking for an excuse – a mitigating circumstance, a trigger – to explain and justify my panic just encourages me to keep blaming myself.  Yes, it’s important to understand our triggers, so that we can understand our reactions to them, but we don’t need to understand our triggers to forgive ourselves. When we make reasonable cause a prerequisite for forgiveness, we punish ourselves more harshly when we feel ways we don’t understand. That way of thinking makes a panic attack more acceptable in certain circumstances than in others. It validates people who ask us, “What have you got to be depressed about?”

The unfair truth is sometimes we don’t have anything to be depressed about, or afraid of, or anxious about.  We just are.

It’s that knowledge – that my brain is often setting off smokebombs and flares in response to no threat – that makes me feel prickly.  It makes me feel tired.  More than anything, though, it makes me feel guilty.  I feel guilty because I worry obsessively about showing that side of me to the outside world – letting the snarls and thorns grow on the outside and prick the people I love.  I can’t count the number of times I’ve apologized to my sweet, understanding boyfriend for the way I am this weekend.  Of course, it was always unnecessary and he always made sure I knew that, but I wasn’t really apologizing for his sake.  I was apologizing for me, to soothe myself, to reassure myself that I was controlling whatever damage my snarls were wreaking on the world around me.  I wasn’t sure what justified my episode this weekend – I’m still not entirely sure – and so it seemed to me that I didn’t deserve to be afraid. I was mad at myself for messing up the progress I thought I’d made. I couldn’t forgive myself for feeling this way and let myself ride it out.

But here’s the thing: it’s never about whether you deserve to feel sad or anxious or mad or terrified.  The feelings exist because they exist.  You didn’t cause them, and it’s not your fault.  

I’m slowly learning to trust the people I love to tell me if I hurt them, instead of assuming that my anxiety will seep out of my skin and infect them.  They are strong, and they are capable of taking care of themselves.  They love me, and they realize that my mind sometimes goes too fast, like a broken carnival ride.  Sometimes I have to write those things down, so that when my mind’s a maelstrom of white noise and I feel like if I open my mouth I’ll just scream, I can look and remember that I’m loved.   People with mental illness aren’t stupid, but sometimes when our minds short-circuit, we need reminding.

I’m also learning that recovery isn’t a road.  I’ve always liked checklists and recipes, because if you follow the directions exactly, nothing bad can happen to you.  People with anxiety try to make their lives into checklists, and in true fashion, I’m guilty of doing that to the recovery process.  I find myself assuming that if I do everything I’m supposed to do (medication, exercise, diet, meditation) that I’ll just keep getting better and better and someday I won’t have any problems anymore.

The truth – as always – is more complicated than that.  Living with anxiety means living with it.  There’s no cure for mental illness, only treatments.  I’m never going to not be prone to anxiety, and some days I’ll have episodes.  Some days, I’ll have episodes for no reason other than the way my brain is wired.  The measure of my recovery won’t be the total absence of symptoms, but the fullness of life I’m able to achieve given the brain I have.  In that respect, I’m doing fabulously.  I’ve done brave things not without fear, but in spite of it. I have built relationships, full knowing that they will cause me emotional stress.  I’m slowly learning to let go.

And I’m slowly – oh so slowly – learning how to forgive myself, regardless of the reason for my fear.  It’s a difficult process, but a necessary one, if I’m ever going to love myself the way I need to – snarls and all.

Snarls and all.

We Didn’t Start the Fire: “Just Get Over It” Has Never Been Sufficient

“Everyone ‘these days’ has got depression.”

“We used to just call it being sad – I didn’t need to pop pills after [insert traumatic event].”

“People in America only think they’re depressed. Try being in a third-world country. I went to Africa on a mission trip and everyone was so much happier. Maybe it’s because everything is simpler there, or people are more grateful.”

“Americans eat too much fast-food and spend all their time on their phones. Want to be happy? Go outside and get some exercise!”

“People would rather take medicine than deal with their problems, and that’s really sad.”

Have you ever heard any of these lines?

Have you ever said any of these lines?

The number of people being treated for mental illness is on the rise.  Now, science tells us that we can’t confuse incidence with diagnosis: just because a disease is being diagnosed more, it doesn’t mean it is actually happening more.  We might just be more aware of it than we were.  Our standard of living is better than it has been, and maybe we’re just less willing to put up with debilitating fear and depression than our forefathers were.

But if you read the comments on any article about anxiety, depression, or any other mental disorder, you get the sense that there’s a large group of people who just want you to get over it.  They think that depression and anxiety and schizophrenia are modern conditions, caused by a society of smart-phones and easy answers and divorced parents and gay marriages. They think that doctors give out drugs like candy and that there is a cabal of psychiatrists and psychologists who profit from this new “American hypochondria.”  They will tell you that people weren’t depressed during the Great Depression, that no one had anxiety during Vietnam, and that the cure for all ills is taking walks in the sunshine, turning your phone off, and being grateful for what you have. People who are not doctors will tell you that you don’t need medication.  People who are not psychiatrists or psychologists will tell you that you don’t need therapy.  In short, if you can’t manage your life, then it is your fault, and America is riddled by people who can’t manage their lives.

Let’s get one thing straight: mental illness is not new.

The Ancient Greek physician Hippocrates hypothesized that mental illness was a biological, not spiritual, condition in 400 BC.  If the name Hippocrates sounds familiar to you, it’s because doctors to this day take the Hippocratic Oath.  Hippocrates is possibly the most influential figure in Western medicine.

Anyone versed in medieval literature is familiar with the humors.  I don’t mean Eddie Izzard. For those of you who aren’t gigantic nerds, the humors are bodily fluids that ancient and medieval doctors and scientists theorized were responsible for various aspects of personality.  The big four are black bile, yellow bile, phlegm, and blood – they represent the four major temperaments, or moods.  If a person is healthy, then Hippocrates theorized that all four humors are balanced. An imbalance in the humors caused any number of personality issues – what we now think of as mental disorders.

Melancholy or melancholia was one such condition.  A person suffering from melancholia (comparable, though not completely, with modern-day depression) was thought to have an excess of black bile. They were often despondent and prone to uncontrollable mood swings.  Now, modern medicine has punctured the theory that the body is made up of four fluids.  We also no longer believe that blood causes anger or phlegm causes apathy. I think the hypothesized cause of mental illness is a lot less important than the fact that doctors were asking questions in the first place.

What does this mean? It means that even though ancient and medieval doctors weren’t able to see inside the body and the brain – like we can now – they accepted that there is a distinct link between our mental health and our physical one.  The ancient Greeks also tried to treat mental illness using herbs and therapeutic activities.

The smartest people in the world have been treating mental illness as a biological condition for thousands of years.

Let that sink in.

Not only did ancient and medieval doctors try to treat mental illness, but authors also featured people with mental illness in some of the most famous works in the Western canon.  You can’t read Hamlet without thinking the Prince of Denmark’s life would be better if Elsinore had a grief counselor on hand. Poets like Goethe explored the “melancholic” temperament that led young men to commit suicide for love or grief.  People with mental illness are everywhere in literature and history.  Abraham Lincoln wrote often of his depression and suicidal thoughts.  Winston Churchill called his recurring depression his “Black Dog.” Leo Tolstoy suffered from “hypochondriasis,” a constant fear of illness.  And there are more.

We live in a linked-up society, in which we know far more people than ever before. Our social networks are a web that stretches wider than the village or city block of our grandparent’s day. Of course we’re going to know more people who suffer from mental illness.  Not only that, but we are privy to a host of information – constantly streaming – that makes it seem like we’re in the endtimes when it comes to mental health.  But it’s simply not so.  Go through any Southern family album with a grandparent. Do it. I dare you.  You’ll hear all about Cousin Louis, the recluse (agoraphobia or social anxiety); Grandpappy Turner, who burned hot and cold all his life (bipolar disorder); Aunt Millie, the hypochondriac (acute anxiety). We have always been here.

And there have always been names for our diseases.  In the 19th century, a person suffering from what we now call clinical anxiety would be called a “neurotic.”  A person suffering from depression might be called “melancholic” or “depressive.” “Nervous illnesses” were considered to be a phenomenon of wealthy women, but now we know that biological factors – particularly childbirth – wreaked havoc on the physical and psychological wellbeing of women, particularly those without proper support.  “Rest cures” were prescribed for the wealthy, but if you were of the working class, you were out of luck.  We don’t know how many people in the pre-NIH era suffered from these ailments because people didn’t talk about them.

Well, now we do.

We talk about our breakthroughs and our breakdowns, but we didn’t invent them.

We’re just unwilling to simply live with them.