Mental Health Monday: Introductory Post

Monday, June 2, 2014

Once again, welcome to Monday. You may recall that last week, I talked about being a part of Mental Health Awareness Month, a blogger event hosted by Blog of Erisred and Uncorked Thoughts. I have decided to post on Mondays about a few specific topics, and I will probably also throw in some random posts throughout the month if I read or hear something interesting that relates to mental health. Also, if you have any questions about mental health, feel free to email me or leave me a note in the comments and I'll do my best to answer them.

So, what makes me an "expert" on mental health? Well... I'm not. At least, I don't work as a mental health professional or have any real training in mental health. However, I've been dealing with mental health issues for more than half of my life at this point, and for better or worse, I don't see that ending any time soon. I feel that even though I'm not a licensed professional, I still have a lot of good (?) experiences to draw on and I would love to be able to use what I've been through and continually go through to help others with any issues they may be having. Also, it breaks my heart that so many people still are ashamed of having emotional or psychological difficulties, and as such, fail to seek help that they so desperately need. The goal behind Mental Health Awareness Month is to help wipe out the stigma surrounding mental health and mental illness, and if my little corner of the internet can help that happen, then I am all for it.

I've talked about my mental health journey here before, specifically in this post and this post, but those are both snapshots of where this journey started and where it's going. As far as I can tell, I have had anxiety and some level of depression for most of my life. Yes, even as a child. And no, I wasn't abused or neglected; my home life, aside from being the child of divorced parents, was pretty darn good. My mom loved my brother and I more than life itself, we always had food, clothes, toys, and friends, and we were encouraged to be ourselves and pretty much do what we wanted, within reason. I had no real reason to be depressed.
Looking back, I realize that I started to feel "different" in about 3rd grade. I had been to a few therapists a few different times to help me "deal" with the divorce of my parents, which happened when I was only 4. My dad moved to Florida and we were still living in New Jersey, so I didn't see him often and I missed him a lot, but other than that, I was a mostly happy kid. In 3rd grade, I started to recognize that I didn't quite fit in, though. I didn't play sports or have the newest, most expensive clothes. I would rather read than run around at recess, and I actually liked our teachers and learning. In fact, if I could have, I would have spent more time hanging out with the teachers and lunch aides than with my classmates. Honestly, they weren't all that interested in hanging out with me anyway, so it would have worked out. 

So, nerdy, 3rd grade Alison realized really quickly that she was not part of the "cool crowd" and that sucked, because every kid wants to be "cool". Being smart and liking books? Decidedly "uncool" when you're 9. Things got worse in 4th and 5th grade, and if "bullying" had been a big a deal then as it is now, I'm sure something would have been done about how I was treated. At one point, a group of girls formed a "club" to talk about how much they didn't like me. And then told me about it. Because 10 year old girls are horrible creatures. I tried to ignore it and mostly I succeeded, but still, it was no fun. 

(I guess this is the place where one would put a "trigger warning". So... consider yourselves warned. The following materials may be upsetting to some readers.)

Then middle school happened and oh, that was a treat. Glasses, braces, magically growing boobs overnight, and still being decidedly "uncool". In 7th grade, things really got terrible, probably between hormones and feeling socially disgusting. I had a few good friends, but middle school is social hell, regardless of how many friends you have, basically. I'm not sure when exactly or why, but it was in 7th grade that I started having self-harming behaviors. I will never understand or be sure what drove me to that, but it happened. And then I couldn't stop it. I continued with these behaviors, keeping them a secret for almost 3 years. Well, I kept them a secret from my mom. A couple of my friends knew, and the guy I was dating at the time knew, and I guess in our heads, it made sense for no one to tell anyone. 
In the middle of 10th grade, my mom found out, practically lost her mind (Which, looking back, completely acceptable response for a mother to have at that point) and immediately got me into therapy. At this point, I had lost a ton of weight and was dealing with disordered eating and a terrible body image, was barely sleeping, and was also having suicidal thoughts. My psychiatrist, who was also my therapist at the time, started me on my first anti-depressant and so my long road to mental stability began. I had no idea that 15 years later, I'd still be on the same road.

Later that year, after my first boyfriend (and then "LOVE OF MY LIFE" of course) broke up with me and it was December, so on top of being freezing, it was the end of the term and I had about 900 things on my high school plate to do. I also was (and continue to be) a high-anxiety human being, so everything stressed me out about 38 times more than it should have. At that point, something inside me broke. I told my psychiatrist that I didn't feel safe being alone, and she told me that because of that, she had to call the local psychiatric hospitals because she thought I needed to be admitted. She told me to go home and pack a bag, and when I asked her how long I'd be there, she said she didn't know. I barely remember that evening. It was a Thursday, because I was supposed to be at regional orchestra rehearsal, so I left a note for my stand partner that said I wasn't going to be there. I didn't tell anyone where I was going. I got to the hospital and the powers that be decided that I wasn't enough of a "risk" to be admitted as an in-patient, but they wanted me to do extensive out-patient therapy. For the next two weeks, I didn't go to school. Instead, I went to the hospital and sat in therapy all day with a bunch of other kids, ages 12-18. I talked to a psychiatrist, who was a total jerk, and I did a lot of random types of therapy that may or may not have helped me. The only thing that did help was being "away" from the world and away from all of the crap that had been swirling around me in my daily life. Rumors raged at school, with people thinking I had mono to people thinking I had gotten pregnant. When I came back, I just told people I had been sick. No one else really asked and I didn't want to talk about it. I hid the scars as best I could during gym and tried to move on with my life.

Eventually, I got out of high school and went to college. In between, I went on and off anti-depressants, trying new cocktails to get my brain on straight. Things would work, then stop working. I would wean off to try and not be on meds that made me feel like some kind of reject, only to go back on them when I nosedived back into depression. I was officially diagnosed with Major Depressive Disorder and Generalized Anxiety Disorder, but I was also treated for OCD, panic disorder, and dysthymia. College wasn't particularly terrible, but I did have a few relapses of self-harming behaviors and a few times where walking into traffic seemed like the most viable option. Fortunately, my therapists and doctors throughout that part of my life kept me mostly out of harm's way, and I even survived applying to medical school. And I got in! 

Then medical school happened. I graduated from college in mid-June, and 6 weeks later I packed most of my earthly belongs, a long-haired miniature dachshund, and Gershwin into my Hyundai Tiburon, along with my then-boyfriend, and we drove 1300 miles to Florida so I could start medical school. This was just full of horrible ideas. I didn't want to be dating this guy, let alone moving in with him, but I felt like I couldn't go alone and that maybe I'd change my mind. (Spoiler alert: I did not. We broke up 3 weeks later. I still feel guilty about "making" him move there, even though he said he wanted to.) I moved into a one bedroom apartment and for the first time in my life, I was living alone. I hated it. I lived in a first floor unit, and every sound made me think someone was breaking in. I didn't feel safe, despite the fact that I lived approximately 3 minutes from my dad and Davie, FL is not known for its crime rate. I made a few friends, some of them that are some of the most amazing people I've met and who I will be friends with forever, and jumped in to classes with both feet. At the time, I was unaware that I might as well have jumped into the deep end of the ocean with cinder blocks tied to all of my limbs. Shit got bad, and then it got dangerous.

Within a few weeks, I was so stressed out that I was barely sleeping, having dozens of panic attacks a day, and could barely function. I started seeing the psychiatrist at the school to manage my meds, and the poor guy had probably never dealt with someone so aggressively mentally ill before. I also started seeing a therapist there, but he wasn't as good as the one I had left behind in Philadelphia. Things went from bad to worse when exams started because my test anxiety went through the roof. It was to the point that in the middle of an exam, I would leave, throw up, then come back and finish the exam. I cried all the time. I couldn't study because all I wanted to do was sleep. By the end of the first semester, I was on 2 SSRI's, an atypical antipsychotic, and a daily Xanax dosage just to get through the day. Of course, when you're totally snowed on psychiatric drugs, it's hard to do anything, so my choices weren't really all that great. I slipped back into my self-harming behaviors and withdrew from my friends and family. I failed two courses that I knew that I had to retake that summer, and if I didn't pass them that summer, I wouldn't be able to go to second year and I'd be left behind. Then, the guy I was dating, who was pretty much the worst person for me to be dating EVER, broke up with me very unceremoniously during our lunch hour. I wasn't particularly over the moon for this guy, and in fact, he was really kind of a jerk, but that just pushed me right over the edge. 
A few days later, a few things happened. One was that as I was walking to school, I thought about how if I just got hit by a bus on my way across the highway, I wouldn't have to deal with anything anymore and how that was suddenly more attractive than being alive. I knew that probably wasn't ideal. Then, I started getting really paranoid and also hallucinated. That earned me a trip to the neurologist, and also made me feel like I was absolutely psychotic. The third thing was that the dean of students, who also happened to be our histology and neuroanatomy professor, pulled me into her office and asked why I looked like I was going to walk into traffic, and I told that it was probably because it had been on my mind recently as an option. She (wisely) recommended that I take a leave of absence for the rest of the year, and I was shepherded upstairs to the Dean's office where I signed my life as a med student away until August of 2009. I remember being concerned about having to go to my lab that afternoon, but the dean reminded me that I no longer had to go to classes at all... so I went home and got into bed. For two weeks.

I slept. I barely ate or showered. I fed the cats. I didn't talk to anyone. I saw my psychiatrist and my therapist. I took my meds. I took a lot of Xanax simply so I could sleep. I had no idea what to do with my life now that I wasn't a med student. I couldn't stay in Florida, but in my head, I couldn't go home. The path that I had been on hadn't simply changed direction, it had disappeared and now I was standing hip-deep in swamp muck, feeling totally powerless against whatever the world wanted to throw at me. One particularly bad evening, I was talking to my mom about how I was feeling "weird" and somehow, I admitted that I was thinking about taking all of my pills and just going to sleep. Forever. My poor mother, 1300 miles away and a social worker, immediately told me to call the school's crisis line, and that if I didn't, she was going to call the police and my father. (Interestingly, I was more concerned about her calling my dad than I was about her calling the police.) I called the crisis line, and as soon as I uttered something about wanting to kill myself, the woman on the other end of the phone told me that she was calling the police and that I needed to stay on the phone with her. I wanted to talk to my therapist, and it turns out that he was there that night, but I didn't even think to ask. 

The police arrived about 10 minutes later. I remember thinking that I should probably get dressed and put on a bra, since I hadn't done that in about a week, and I didn't want men in my house if I was braless. (Priorities, people.) There were no lights on in the main part of my small apartment, just a bedside lamp in the bedroom. The officers asked if I had any weapons, and for some reason, I said that I had 2 cats. This confused everyone greatly. The officers came in, looked at all of my medication bottles, asked if I had taken anything other than what I was supposed to have taken, and then told me that I needed to get dressed because they were taking me to the emergency room. I burst into tears. I called my mom from the backseat of the police car and cried the entire way to the hospital. They dropped me off at the ER and I filled out a form that said that I was there for suicidal ideations. Then I found out that I was in the wrong ER, and had to go to the psychiatric ER. The nurse started giving me directions and the look on my face was enough to tell her that I couldn't get there by myself. (Plus, it included crossing a street, which sounds like a terrible idea for a suicidal person who had thought about walking into traffic.) 
I was escorted to the correct ER where someone took my phone and my purse and locked it away, I was put into a hospital gown, someone stuck an IV in me, took some blood, and then started asking me what felt like hundreds of questions. At some point, my dad and step-mom showed up, which meant that my mom had called them after all. They were both crying, which only made me cry harder. The nurse who was helping me was a very nice man from the Bahamas. At least, I think he was very nice. I have no idea what he was saying because his accent was so thick and I was so tired and delirious. It was kind of like when you're talking to a puppy and they have no idea what you're saying, but they're pretty happy about it because you sound nice. That was the state I was in.

After they determined that I wasn't actively dying, on drugs, pregnant, or in need of any real medical attention, they admitted me to the general psychiatric floor and told me that I'd be there for "a few days". I was still crying at this point. The only bed they had at the time was in the "quiet room" that locked from the outside, so I had to sleep with the door cracked. They took me off ALL of my meds (super idea, guys), gave me an Ativan, and I went to sleep. Somehow. The next day, I moved into a legitimate room with a real bed (and a roommate who wasn't too terrible), and spent the nexrt 36 hours crying. It was like my face was leaking. There was nothing I could do. I also started shaking like a leaf because I was going through withdrawal from being abruptly taken off of my medications under the auspices of "you weren't on enough to make you withdrawal". Except that I totally was. The psychiatrist there was also a jerk, only saw me once, put me on a drug that made me so nauseated that I spent the last two days in the hospital throwing up, and then told me that I was nauseated, vomiting, and shaking because I was "anxious". I was afraid to refuse the meds because I thought they'd keep me in the hospital longer, so I took them and just prayed that the nurse would get me meds for my nausea. I sat through hours of group therapy, but spent most of my time in my room, lying in bed, reading old magazines that my step-mom had brought to the hospital. My dad visited me every day, and Constance and Michelle came to visit me one night. Michelle even brought her dog, Byron, because he is a certified therapy dog, so I got therapeutic puppy snuggles. (For science!)

After 4 days, I was released to the care of my father, and I spent a few days sleeping on their living room couch, still nauseated and shaking so badly that I couldn't even sign my name to sign myself out of the hospital. A few days later, I flew home to NJ for a trip that had been planned months prior to this escapade, and in the three days that I was home, my mom and Aunt Kathy planned my extraction from FL. I flew home, then my mom flew down a couple of days later to help me pack. And by "help me pack" I mean she packed my apartment. I was so mentally fried that I just slept and laid in bed and moved things from one pile to another. I could not make a single decision. After two days, my mom flew home and my aunt flew down from Maryland. She helped me ship things back to NJ, we got my furniture and everything donated or sold, and then she and I packed up the car and drove it 1300 miles back towards home. (Literally, the only good thing to come of this entire debacle was that I got to learn so much about my aunt, and now we are extremely close.)

After I got home, I spent the next three weeks in hiding, seeing doctors, and ignoring the fact that I was officially NOT a medical student, and on top of that, was recovering from a nervous breakdown. Eventually, I got my old job at the hospital back (I was a unit secretary) and started my MPH at Drexel. Then I started dating Ken (so okay, that was ALSO the other good thing about leaving medical school). That was in March of 2009. Now, 5 years later, I feel like the person who went through that barely even exists anymore. Yes, I'm still on anti-depressants, but I'm only on one and it's a moderate dose. I still see my therapist on a weekly basis, but I haven't felt like jumping off of a bridge lately, so I think we're doing okay. I haven't hurt myself in 5 years, even though sometimes, it's still a struggle. Things are far from perfect, but they are nowhere near as terrifyingly bad as they were five years ago. Thank God.

I used to think, back when all of this started in 2000, that someday, I wouldn't be on an antidepressant and that I'd be "normal". It turns out that some of us are "lifers" and the SSRI is part of daily life. If I was a diabetic, I'd take my medication or my insulin, so I have to treat my SSRI like it's just another medication. It's hard for me to understand why I equate the SSRI with weakness, when I take so many other medications for other medical problems and don't see those conditions as a weakness. That's part of the stigma, I suppose, and part of why I feel so strongly about breaking it down. It's not just for others, but it's for myself, as well. 

Much to my chagrin, I can't predict the future, so I have no idea if my breakdown in 2009 was my first and last, or if I'm headed for another one somewhere down the road. The fear that I have that in me, though, the capacity to be that sick, is definitely present. I was so close to ending my life that night in February that I worry that if I ever got that ill again that I might not make it. I'd like to think that I would have the strength to ask for help, but you never know how far into the hole you are until you get there. I know that I am not the same person I was at 23, and my life is not the same as it was, but I am still someone with depression. As I head back to medical school, I am working on not experiencing a weird version of PTSD, since the last time I did this turned out so poorly. I'm trying to focus on the fact that this is a new school, I am in a place where I have friends and family nearby, and I have lots of doctors looking out for me. So far, I've managed to convince myself that going back to school isn't an recipe for an insta-breakdown, so hopefully that feeling will persist.

So that's my story, up to the minute. I'm still writing it, and I'm not sure how it will end. What I do know is that there is no shame in asking for help, and that sometimes, it's hard to know just how unwell you are until someone else points it out to you. I've learned the value of expressing your emotions and fears, even if it's terrifying, and I've learned that sometimes, you need someone to be almost painfully blunt with you because they're trying to save your life. I also learned that in the end, you can't expect anyone to save you and you have to save yourself. You need help and support, but you have to do the work or else it won't get done. That's sometimes the hardest part of all of this; I am fighting part of who I am, in order to be a better... me. It's very circuitous and often doesn't make sense, but at the end of the day, I'm learning how to live a better, more controlled life that doesn't end with me under a bus. And that, we can all agree, is probably ideal.

Thanks for reading this semi-downer of a post. If you have any questions, about me, the experiences I had, or mental health in general, please don't hestitate to ask. I don't mind talking about this at all, obviously, or I wouldn't have posted it on the internet for the world to see. If my pain and experiences can help someone else, then it has all been worth it.

Be kind to yourselves, my friends.

- A


  1. Thank you for posting this. Your words are so much more eloquent than mine are on this topic, and I found myself nodding along a lot. It's brave to put your yucky innards on display for everyone to see, but I know firsthand that it can be really therapeutic as well.

    1. Aw, thank you, I appreciate it. Writing has always been therapeutic for me, and I also hope that anyone who reads this and has similar issues or thoughts might feel less alone.


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