(Dis)Orientation

This is like a meta discussion in graduate school: talking about talking about the disorientation that I've been dealing with. When I discuss it, it's always in the context of what I did while disoriented: nearly took a header off the front porch, fell into my car, fell headfirst into the bed. But I feel like what I should be talking about is what it feels like to have to talk about "the spins" or this rolling deck type motion that comes over me.

I hate having to discuss this. It makes me feel weak. This whole situation makes me feel weak and small, and at times, I hate myself for being this way. "The spins" are getting worse. I can hardly make it into the bathroom late at night. I nearly fell in the tub the other day. There are so many near misses. When it snows, I will surely bust my ass on the paving stones. Jb has taken to walking behind me, as if he'd catch me if I fall. He watches me, to make sure I make it in the door, up the steps, across the yard. And all I'm able to say about it is, "I can't help it."

For the most part, I don't want to talk about what's happening to me. I had a professor who told me that even silence is a form of rhetoric, and so it is. My silence says that I am, in some small place, ashamed. This is even worse now that I've started getting the shakes. When Jb and I go out for a smoke, I start to shiver and my hands start shaking. As it's coming on fall here, he's right to ask me if I'm cold. And sometimes, I say, "Yes," and sometimes, I say, "No" -- without any more explanation than that, though the true answer is always, "No."

All this silence, all this guilt, over a year since I went on FMLA at work. Around six months since the hospital, and in some ways, I'm worse. How can BP show up at 33 and just wreck your life? Oh, I know, I know. The signs were there. I made excuses. I didn't see them. But if they were spikes in the Richter scale of my life, this breakdown was the Big One. And yet, I still don't know how to talk about how I talk about it.

Time to Come Clean

Therapist appointment today. Nervous about discussing last week. The depression seems to have lifted. I'm feeling anxious and revved up today, despite having the wonky balance issues and having given blood this morning. (I actually fell into my car, which is better than falling out of it, I guess.) It's the nervousness of coming clean to the therapist. I know it. And all I want to ask is, "Does it ever get better?" Because, god, I don't know if I can relapse like that again. It will be the hospital next time. It was too difficult dealing with it on my own. And all the time, I wonder when Jb will break. Because I see the strain. I can't bear to put him through this. It's hard enough for me. I can't imagine what it's like for him.

In Passing

So, it's passing. I think. I hope. That was probably the worst I've been since the hospital. Jb and I have a rule: no killing myself. Wednesday, it was a hard rule to keep. Thursday and Friday, I just wanted for him to come home. Smoked a lot. Rocked myself on the porch stairs trying not to think about it while I've got Leonard Cohen's "Everybody Knows" playing through my head like that last strip of film that keeps slapping against the reel--over, and over, and over.

I should have gone to the hospital Wednesday. I should have gone Thursday. I was that bad. But I couldn't stand the idea of another stay, starting back at square one. It had taken me 5-6 months to pull myself out of the last one, and since the first hospital stay, I swear it's as if I get worse and worse, and never better. Or there's the hope of better, and then the crash hits. I'm always waiting for the other shoe to drop. But mostly, I couldn't put Jb through the strain of another hospital stay.

This weekend I have Jb as a babysitter. I've an appointment Monday with my therapist. Another Wednesday with my psych. It'll give me things to do, keep me in line.

Out of the blue, a woman I'd struck up a friendship in the ward called me. Last time I'd talked to her, she'd been convinced she was going off her meds and talking about suicide. I couldn't call her after that; I didn't want to know. I couldn't deal if she had. It was so good to hear her voicemail, to know she wasn't a fallen comrade, that I cried. When I called her back, I was suicidal, and she was completely manic. I couldn't keep up with her, as slow and dumb as my brain had gotten. But then again, how do you keep up with someone on a manic kick?

Crazy-Ass Welcoming Committee

This blog is not entirely solopsistic, though it might seem so. But truly -- beyond wanting to bash my head into a wall -- I am putting this down for posterity. Because no one invites you into the Bipolar, unemployed, uninsured, disability club. And frankly, someone should. There should be a full-blown, crazy-ass welcoming committee. And in it, there should be information on FMLA, the American Disabilities Act, the EEOC, and your local Department of Health and Human Resources. Because you will never see Oprah touting the latest diet craze: The Poverty Diet.

Department of Health and Human Resources: Your state has one. It is like the DMV. No one will explain anything to you. Checkmark anything that might give you money. They would be very happy not to give you any resources at all. They are helpful like that.

SSDI/SSI: Whether you are truly disabled or not, you will not get this. If you even apply for disability insurance (i.e. the government's money), they will reject you off-hand, and if you truly want to be stubborn, you need a lawyer and copious notes of dates and days before the government will let you pry any money at all from their cold, dead hands.

Hospitalization: There are good and bad mental wards. Your PCP probably knows something about this, as might your therapist or psychiatrist. Ask. All mental wards are not the same, but they are a little like prison. Keep juice boxes and fruit to trade for other useful items.

Food Stamps: Do not be fooled by the rhetoric. If you want your SO to be able to use the card, he can. No one checks who it belongs to. Do not, however, put their name on your application for food stamps unless you are married. If you do, you will not receive enough money to feed a gerbil.

The Poverty Diet: When the DHHR determines that, though you've been fired and have no money of your own, you aren't eligible for emergency food stamps, become religious. Religious charities are the number one place to receive donated food. Humbling, yes, but your stomach ain't rumbling.

Temporary Disability Assistance: There is such a thing, but you aren't supposed to know. This is why you check every box when you are in the DHHR. This can be hidden under something called Temporary Cash Assistance. Do not be fooled.

FMLA: Yes, you can take nearly 12 weeks of leave under the Family Medical Leave Act. Your employer, however, will not like you, and most likely, they will find another reason to fire you -- if they don't force you into a voluntary resignation.

EEOC: You will spend half your day waiting for the three appointments they have available that day. In your appointment, they will listen very kindly, then tell you they cannot help you -- unless you wish to make your employer conform to the American with Disabilities Act.

ADA: The American with Disabilities Act does, indeed, protect your right to certain accommodations within reason. Your employer, however, has a much different definition of "within reason" than you do.

Unemployment: If your doctor has signed a paper telling the State that you are unable to work for a year and if you receive temporary disability from the state, you cannot get unemployment. Unemployment is only for people able and willing to work (i.e. though the body may be willing, the mind is not; your mileage may vary).

Medical Assistance: You can apply for this, too, from your local DHHR. While you're virtually guaranteed some sort of declaration about your food stamps and temporary disability within 30 days, medical assistance is a totally different beast. The medical assistance board is always backed up, and apparently, no one has -- or will divulge -- their phone number. You will rot for three months or more before you hear anything about this. Once you do, you'll understand why it's worth the wait.

Medicaid: Your medical assistance has been approved. If you're lucky, you get a nice shiny packet explaining things. If you're not so lucky, you get a phone call telling you that you have two days to find a Managed Care Organization and a PCP. However, once this is achieved, you will realize that when politicians talk about the Health Care Crisis, they are not talking about Medicaid. Medicaid is what it must be like to live in Canada. Your prescriptions are $1, your visits to your psych, therapist, dentist, and doctor are free. As are a host of other disasters.

Bankruptcy: It happens. You can't get unemployment, the state barely pays you enough to eat, and it could be months before you get medical assistance. In the meantime, you are accruing debt and medical bills as if you can afford to. Call your Credit Counseling Service. Then call your local Legal Aid office. They will waive all fees for their assistance. Go figure.

Psychiatrists/Therapists: Believe it or not, the title does not always fit the figure. Psychiatrists and therapists, the ones with the shiny credentials, may suck wombats. Most nurse practitioners and licensed social workers are far more caring. It can leave you dumbfounded when they actually listen to you.

Seriously, these are all things I wish someone would have told me. I learned it all the hard way, and not everyone wants to self-educate. These tidbits are valid, however, and have been learned through harsh real life experience or from other patients in the mental ward.

Big Mistake

HBO had Girl, Interrupted on their OnDemand channel listing, so I told myself I'd watch it, when Jb wasn't home. And it's not me, it's not what happened to me, or where I went. It's the 1960's for Christ's sake. But there's so much there that rings true, and when the head nurse dumps Winona Ryder in the bathtub... I had to stop the fucking movie.

Valerie: You know, I can take a lot of crazy shit from a lot of crazy people - but you... you are *not* crazy.
Susanna: Then what's wrong with me, huh? What the fuck is going on inside my head? Tell me, *Dr. Val*. What's your diag-nonsense?
Valerie: You are a lazy, self-indulgent *little girl*, who is driving herself crazy.

Is that all I am? A lazy, self-indulgent "little girl?" Because I don't fucking feel crazy. I don't talk to myself, I don't cut myself, I don't lose complete touch with reality. But I can't stop crying, and part of me wants to be back in the hospital, back where I had friends, where I knew people, where seeing someone get discharged was enough to blow you over so that you were lying in bed all day. And each day new people rotate in and out, in and out. But you know the score, and when you snap, the staff is paid to deal with it, not like your boyfriend, not like the ones you love. And every day gets harder and harder.

Jb and I had a fight last night, and he walked out on me this morning--without even a word. Got dressed and left. And it's my fault. It's my fault. I feel like I'm going to explode. Like that game you played with dandelions, singing, "Mama had a baby and its head popped off." At least in the hospital, you all spoke the same language, and when someone broke down, you understood. No one judged you, no one asked anything of you, no one cared what you did as long as you took your meds and showed up for meals. But now things matter, and I can't even commute to the therapist without feeling like I'm going to throw up.

Oh, So Girl, Interrupted

I'm also having this need to read things like The Bell Jar, and Prozac Nation, and Girl, Interrupted. Or to at least Netflix the movies made from the books. Everything is so Sylvia Plath. In the hospital, you'd have morning group, right? And they always wanted us to start out with some pithy quote on the board that was meant to buoy us through the day. There were more than a few of us that looked around at each other, all aware that the only thing we had in our heads were snippets of Plath, Parker, lyrics and rhymes of the mentally ill themselves. We were the girls who did not know how to play nice in the ward, the ones that complained about the staff late at night in the dining room, the ones who didn't care if they left group in the middle of it, the ones who slept during the day to make it pass. Except for visiting hours, we thought the whole thing a farce. The only thing they cared about was that you took your pills at 9am and 9pm and kept yourself washed and clean.

Lost It

Completely flipped the fuck out at the psych's. Anxious all the way there, pacing the office while I waited, he'd barely sat down when I started trying to talk to him about work. Couldn't sit for my nerves, just kept walking back and forth, and goddammit if I didn't start crying. Told him about how my job had forced me out, the deal of unpaid leave for insurance, the lack of a determination from the county, everything, and his reply? Why didn't I take the voluntary resignation, go on unemployment and take Cobra. And I had no reply for that, except that Cobra's expensive. But now I don't know. Maybe that's exactly what I should do. The situation couldn't be worse than the one I'm in now, and even after paying for Cobra, I couldn't be bringing in less than the county's giving me. So why the fuck not? I plan to look into it.

But what truly pisses me off is that that was my appointment. How's the Klonopin? Sometimes it's enough, sometimes it isn't. I don't go out unless I'm with my boyfriend. It's too hard. Do you have enough Lamictal? No, I'll run out this week. Do you have any samples? No, Lamictal's going generic, so they're not handing out any samples anymore. (Then it doesn't matter because I can't fill this prescription until I have the money anyway.) Are you seeing a therapist? I'm on the waiting list for one. Why? Because they're sliding scale. You're making an appointment for one when you go out front. Do you need to see someone today? No, don't worry about it. I always worry about it. You're seeing Nicole in one week and making a therapy appointment.

And out the door. What the hell did that do for me? I'm hustled off to his psychiatric nurse practioner for prescriptions and off to his wife therapist for her 15m of infinite wisdom: "Take a 10m walk, take one thing at a time . . . " Because, you know, I'm not a fucking moron who hasn't had successful and useful cognitive-behavioral therapy before. I've a Master's degree for Christ's sake. I'm not an idiot. I think it's time to take things into my own hands, to shut the hell up, dust myself off, and get out there and do what needs to be done. No more cowering. No more safety net. No more allowing myself to be weak. I need to muscle through. No excuses. If I'd done that, I would have never ended up in the hospital or lost my job.

And to top off my day? My fucking computer won't boot. I'm so screwed.

7:45 p.m. Up and Down the Merry-Go-Round

It can be the best day one minute, then one song -- one song -- and my eyes are burning, my heart's aching, and something in my stomach turns sour. I want a cigarette more than life, and even then, the tears start to well up.

Early in the day, Jb and I drive out to Cracker Barrel. All the way there and back we listen to country, Dave Carter and Tracy Grammer, my music, and sometime in the last few weeks, Jb's bothered to listen to some of it, has learned to appreciate some of the songs. It means so much to me that the car flies down the highway, the wind blows in the windows, and everything is green, lush, flowing. And I'm happy; I'm content. Nothing sparkles, the colors don't glow vibrant, so intense they light up my heart, and the pure feeling, the feeling of the moment doesn't overwhelm, doesn't fill me to the brim, not like it used to. And I miss it. The day has been beautiful. I recognize that, appreciate it, but I miss the ecstasy of it. I miss the unnatural high.

We come home, and suddenly, I can't stand being here in the dark when the day's so beautiful. I get antsy, something beneath my skin starts to itch, for the sunlight, for relief. Waiting on Jb, I'm surfing YouTube and I'm watching some Firefly montage to "Ain't No Reason" by Brett Dennen, a song I've never heard before, and it hits home unexpectedly:

There ain’t no reason things are this way.
Its how they always been and they intend to stay.
I can't explain why we live this way, we do it everyday.
Preachers on the podium speakin’ of saints,
Prophets on the sidewalk beggin’ for change,
Old ladies laughing from the fire escape, cursing my name.
I got a basket full of lemons and they all taste the same,
A window and a pigeon with a broken wing,
You can spend your whole life workin’ for something
Just to have it taken away.
People walk around pushing back their debts,
Wearing pay checks like necklaces and bracelets,
Talking ‘bout nothing, not thinking ‘bout death,
Every little heartbeat, every little breath.
People walk a tight rope on a razor's edge
Carrying their hurt and hatred and weapons.
It could be a bomb or a bullet or a pen
Or a thought or a word or a sentence.

There ain't no reason things are this way.
It's how they always been and they intend to stay
I don’t know why I say the things I say, but I say them anyway.
But love will come set me free
Love will come set me free, I do believe
Love will come set me free, I know it will
Love will come set me free, yes.

Prison walls still standing tall,
Some things never change at all.
Keep on buildin’ prisons, gonna fill them all,
Keep on buildin’ bombs, gonna drop them all.
Working your fingers bare to the bone,
Breaking your back, make you sell your soul.
Like a lung that’s filled with coal, suffocatin’ slow.
The wind blows wild and I may move,
The politicians lie and I am not fooled.
You don't need no reason or a three piece suit to argue the truth.
The air on my skin and the world under my toes,
Slavery stitched into the fabric of my clothes,
Chaos and commotion wherever I go, love I try to follow.

Love will come set me free
Love will come set me free, I do believe
Love will come set me free, I know it will
Love will come set me free, yes.

There ain't no reason things are this way
It’s how they always been and they intend to stay
I can't explain why we live this way, we do it everyday.

It brings me down to a level I haven't been at for almost two weeks now. I'm ready to cry. I can't understand the meaning of it all, and everything seems momentary: this too shall pass, this too shall pass. But no one ever acknowledges that also means that this happiness, that passes, too. And we're left on the up and down of a merry-go-round, holding tight to a pole, sometimes brave enough to reach for the brass ring, but mostly so frightened that all we can do is hold on tight and close our eyes and wait for the world to stop.

The worst is that I remember the hospital again. I remember how faithful Jb was, coming every night for that single hour they allowed visitors, and twice on the weekend. Every time he came, and when he left, the girls in the ward made such fun of me: "You know he loves you; you can see it in how he looks at you," "Oo, J-----, hug me, too!" Even the nurses, one of them noting how'd come in the middle of the night to bring me something when I couldn't, and hadn't, slept for three nights in row. She told me if he didn't so obviously love me, she might have a go at him.

Half the women in ward sat in group and talked about love, failed relationships, divorce, and every single one of them got a sort of hungry look when Jb was with me, as if they'd give their selves for something, for someone, to look at them like that, to make life more bearable. And all I could think, swallowed by the deep water of depression and lost to the currents of my own thoughts, was that love couldn't fix me. I had the perfect boyfriend; he loved me, was there for me, supported me in ways I'd never expected anyone to support me. But love couldn't fix me.

9:59 a.m. Morning

Crawled back into bed around 7 and slept until 9:59 a.m. I don't know if this is a good sign, or if it's merely the fact that the phone rang three different times waking me each time. I assume the latter, but I could be wrong. The credit card companies are beginning to call, circling like dogs, hoping to get blood from a stone.

And that's the problem with being mentally ill for a long period of time. You lose almost everything. This particular bout of depression started in June 2008 and was coupled with IBS (Irritable Bowel Syndrome), which made the whole thing twice as difficult. I'd have anxiety attacks on the way to work, I'd throw up outside the metro, I'd have to stop halfway to work to use the bathroom, I even had an "accident" once. Sometimes, I couldn't even leave the house. There's nothing more humbling and incapacitating than being unable to control your bodily functions. Then there was the depression on top of it, or wound up in it, and there were days the depression was so thick it was like struggling through deep water, and I couldn't leave the bed.

Soon enough, I had exhausted my Family Medical Leave, though my doctor supported my need to be out of work intermittently as I dealt with both the IBS and the depression. But work only has so much patience with these matters, and I could see the moment my boss and HR began to treat me as if I was a liar and lazy, instead of incredibly sick. My boss began withholding work from me, and my job satisfaction plummeted. So did my self-esteem. It was cyclic, and only fed the depression. Eventually, she took me down to HR to formally reprimand me for what she called "abuse of sick leave," the terms of which said I was not to miss work or be late for over a month. That effectively severed any ability for me to make follow-up appointments with my PCP or my psychiatrist. I was so overwrought at my loss of control, at how far the illness had taken me, and my inability to live up to my supervisor's expectations that I had my breakdown in the HR office. I went into the hospital that night. It took them nearly nine hours to admit me.

When the psychiatric intake social worker began asking me about how I felt, about whether I had suicidal ideation, if I had a plan, I had to ask Jb to leave the room. I didn't want him to know how far down I'd gone, how very lost I was, how out of control. It was after the Heath Ledger overdose, and overdose was foremost in mind. I remember her asking me, "Why?" And I remember replying, rather bitterly, "It worked for Heath Ledger, didn't it?" She said, chastised, "Yes, yes, it did." And I could tell she took me more seriously then. I admitted to thoughts about cutting, about knives and razors, and fantasies about my sleep apnea machine, my CPAP. I'd lie in bed at night, put my mask on, wait for that first rush of air, and pretend it was a sort of poison gas, an euthanasia of sorts, from which I wouldn't have to wake up ever again.

I was in the hospital for nearly a week, partly because I entered right before a weekend and they don't discharge patients over the weekend, and partly because for the first five days, I didn't even consider going home, much less ask if I could. Instead, I wandered from room to room: the day room, the activities room, my room, the dining room, back and forth, down the halls and back. I didn't speak for the whole first day, and then I couldn't stop crying. I was shaky and in shock. They'd taken me off all my meds, waiting for a diagnosis from the doctor and psychiatrist who made their rounds in the ward. Not everyone knows this, but even patients who go in voluntarily are put in a locked ward. You sign away the responsibility of your life for at least three days. After that, you can make a formal request to be discharged.

The hospitalization was my first, and while humbling beyond anything I'd experienced, it was also freeing -- to be in a place with people who understood, to know I wasn't alone, to know I wasn't even as bad off as some of the patients who'd been in the hospital again and again and again. Being depressed, having suicidal thoughts, it was normal in the ward, and something that us patients often talked about at night before snack and after our meds. Group therapy was a laugh, something I often left to go curl up in my bed, but those late night sessions with the other patients, those helped far more than anything else could have. I'd like to write more about the hospitalization, but I think that'll be another post. There's simply too much to tell.

Anyway, it was three months after the hospitalization that I could even begin to think about a future, and that's when my job forced me into a voluntary resignation. I'd already been on unpaid leave of absence, but without money for all that time, there was nothing to do but let the credit cards go, to batten down and focus on the necessities: food, rent, my meds. And all the while, Jb supported me, even when I lost everything, even when I took him down with me. Now we're on food stamps, the county has me on temporary disability and cash assistance, and that in itself is a coup, as I've found they'd rather not help you than help you.

I've lost my train of thought now, and so I'll end this post here. I know I'll have to write more about the hospitalization at some point, but I think it'll come in fits and starts. My writing is shoddy at best these days, but I am writing, and that consoles me. Still, as I start feeling better and better, I worry about the day when I'll have to retake a useful position in society. And a fear flutters somewhere near my heart, and my stomach clenches to think about it. So not quite yet. Not quite yet. But maybe soon. Sooner than I'm ready for. I can't help but think: What if I can't hack it? What if the anxiety, the IBS, the stomach pain, the depression all come back? I know I'll be nearly manic the first few months: overworking, proving myself, charismatic among the other employees, perfectly charming with the customers. But then there'll come that fall, like a fall from grace, and I don't know how many more times I can handle that.

It reminds me of the Yeats poem, "The Second Coming":

Things fall apart; the center cannot hold

It's lines like that my brain seizes on, repeating them like a morbid mantra, over and over: things fall apart; the center cannot hold; things fall apart; the center cannot hold; things fall apart; the center cannot hold; I fall apart; I cannot hold.