Hiding mental illness behind the mask

At some point in everyone’s life, there is the dream of being an actor. We watch movies and picture ourselves starring alongside our favorite performers, walking the red carpet and receiving an award.  It’s a glamorous life, one envied by many.   I never thought that I would become an actress, but along with my diagnosis of mental illness came a new identity, a persona was created and the acting skills I didn’t know I had emerged in order to ward off any indications that something was the slightest bit off.

The charade goes like this.   You are invited to a party and have agreed to go.  The day of the event arrives and suddenly anxiety starts building, this alone will begin an internal breakdown of who you really are.  Dialogues begin of what people will say when they see you.  Will they remember the time you made a minor mistake at work three years ago?   As the scenarios begin to take form, self-esteem takes a hit as you look for something to wear , other than the “comfy clothes,” you wear at home.   By the time you get to the front door you have yourself convinced that everyone will know you are sick, they will judge you and see what a mental illness is really like.   And just like that, you smile in the mirror, as a small voice in your mind yells, “ACTION.”  It is time for your performance.

This can be a similar dialogue on any day; the problem is it occurs too often.  Over time it becomes normal and in the desire to hide the illness, we hide ourselves instead, often without realizing it.  The person we create becomes who we are and our true self becomes a person in the mirror that we never really see, because it is a reminder that we are not who we want to be.   So, in order to protect our already fragile minds, we go within, create a life we think is perfect and “press play.” 

I would give anything to be myself most days, but I am not sure I know how anymore; not completely anyway.   I long to be the person I was before I became “sick,” the athlete, the super-mom,  the friend everyone turned to.   Now, instead, there  is always that part of me that is on guard, afraid that if I reveal too much of who I am then my ‘secret’ will be out and that is the fear, the truth and what people will say.   So, the act continues, no awards are given, no speeches are made and there is no red carpet to walk down.   This is a private performance created in the mind amid the maze of medications, doctors, diagnosis, illness and stigma. 

Making the decision about psychiatric medications and treatments

There are times I wish there was one drug to work for everyone.  I went through years trying to find a combination that worked for me, to be stable (if that is possible), keep the psychosis and mania to a minimum and depression at bay.  Part of the issue I faced in the early years of my diagnosis was being in the military, I moved around a lot.  So, just when I found find a good doctor and felt comfortable with them, it would once again be time to move.  I got to the point where I didn't care much anymore, especially when it came to one of the last doctors I had.  He rarely listened to what I had to say, I was on two medications and I was having awful side effects, I begged him to change them.  He would sit behind his desk and fill out his insurance forms for the visit.  After a few visits and no help I did the only thing that sounded logical to me, I weaned myself off all medications.  I'd had enough.  

Fast forward to a year and I crashed, hard!  It was then I realized that I was not going to be able to do this alone, I had to be on medication in order at least keep some level to stability.  The journey would become harder than I thought, but after three psychiatrists and psychologists, I found not only a medical team I could trust, but also a medication combination that was helpful.  It was not an easy road however; it took several attempts to find out that my system rejected just about every new drug that had come on the market.  In addition, the Anti-Depressants I was taking were actually causing some of my mania.  With that off the list it came down to relying solely on mood-stabilizers, anti-psychotics and anxiety medication, but as we slowly ticked off the list of medications I could not take I became more discouraged.  The main hurdle we faced, in my eyes, was the extent of my diagnosis, Schizo-affective was simply the tip of the iceberg, it also included General Anxiety disorder, PTSD, and Dissociative Disorder.   Thankfully I had a doctor that would not give up.    

In the end we came up with a combination of Lamictal, Neurontin and Klonopin.  The first two keep me stable, for the most part (not drug is going to make this go away completely) and the later helps me not only sleep (my brain refuses to shut down, especially at night), but I can take it during the day if I am having an anxiety attack.  It is important to add that medication alone was not the answer, at least for me, and while we discussed medications he decided to approach the subject of ECT, (Electro-Convulsion therapy).  The idea more than scared me, but I was desperate and I trusted my doctor.  I checked into the hospital, was admitted to the psych ward and for the next 10 days had five treatments, and then I had three treatments as an outpatient.  The experience as not what I expected, my only side effect was bad dry mouth afterwards, and a headache.  

Now being the challenging patient that I am, and while the ECT worked to ease my depression, it brought on mania.  We didn't see it at first, it was subtle, but there was something going on.  12 months later I was back and had a second round after I hit bottom again after losing my cousin to suicide, his death destroyed me and sent me into a severe mixed episode.   Since the last sequence of treatments had help with the depression, this time my doctor knew we had to take a different approach.  It is most common to administer the treatment to one side of the brain; however, for me he decided he had to administer to both sides in order to balance out the depression and mania.  It was like my mind was fighting itself for control and he was making every effort to call a truce.  There was some success with the treatments and balance was restored, but there was a part of me that had hoped that it would make it all go away, I was growing more and more tired of it all. 

I began tracking my symptoms a few years ago; I watch how my mania, depression, anxiety, psychosis and sleep fluctuate from day to day. With the graph I can see what may have been going on that day to cause more a depressive state and what may have caused anxiety.  It’s not fool proof, but it can give a general overview of what may trigger some of the mood swings and then I can make any changes I may need to. 

In the end, yes the ECT did help and the medications continue to keep things in check - for the most part.  Over time I realized that we must live with these illnesses as they are, work with a good medical team, and have a strong support system.  Without all these pieces in place we run the risk of continuing to hide behind our mask and tell the world we are “OK,” when what we really need is help.  

5 Reasons We May Fail When Trying to Stabilize Mental Illness

It’s been over 21 years since I’ve been diagnosed with Schizo-Affective disorder, (a combination of Bipolar Disorder and Schizophrenia) and in that time I have learned what is takes to not only survive, but live with my diagnosis.

When I was first diagnosed I was sure I could do it on my own, most of us do.  We believe we know better than the doctors, after all we know ourselves and what we are capable of.  We don’t set out to fail, as with any illness we want to feel well and capable of living our lives fully.   Mental Illness is different, with such a stigma attached; feeling the need to hide it offers one of many reasons  to stop treatment or even start. 

#5 – Hospitals:  If you’ve spent time on a psych ward you would understand it is not a place to learn about your diagnosis in its full extent.   It is a group of individuals trying to understand how they got to be where they are and what they have to do to leave and get better.  The nurses, techs and ultimately the doctors can talk and prescribe medication, all the while hoping that when their patient is discharged they will continue treatment, though there is no guarantee.   So, yes hospitals have their place, they can start the process, but it’s a long term solution that is needed. 

#4 – Medications:   With so many medications available, it is hard to find the combination that will work.  Often times it can take months and multiple tries to find what is right for you.  Sadly, there is no one drug that will work for all mental illnesses, is it trial and error.   In some cases, side effects can lead to further illness and/or hospitalization.   This can be why treatment is often stopped, the endless frustration from not finding a treatment that will work can be overwhelming.   

#3 – Doctors:   It takes time to find a doctor you connect with and feel comfortable talking to, if not you may be less likely to listen to them.  It can take time, but it is important when you are serious about your treatment.   Psychiatrists and Psychologists alike are there to help, but it is a two way street, so understanding on both sides is vital. 

#2 – Friends and Family:  We may have heard a friend or family member say that the diagnosis is just something the doctor made up, you were just a little sad for a few days, or being told it’s not something to talk about, what will people think?   Knowing those you rely on the most are not supportive, or willing to listen and help, can set the cycle in motion again This ultimately leads to medications not being taken, doctor visits cancelled and the mind spinning looking for answers.  In the same breath, the opposite can also be true, family can promote the illness in order to keep their loved one medicated and “under control.” 

#1 – Ourselves:   It is our human nature to believe we know more than those who are telling us what to do, feel, or say.  The idea is adopted that the illness does not exist and that if it is ignored, it will go away.  Doctors can talk all they want, medications can be taken, but if we want to believe we are fine and go on with life as we see it, then that is what we will do.  It takes time for the realization to sink in that this is a life long illness and some help is needed, we are not super human, though there are times we believe we are. 

I know there are many more reasons or ideas that can be used to explain why it is so difficult to stabilize these illnesses, but if just one of these sounds familiar, then it is one step closer to finding the peace that is so desperately wanted and needed.

  

Remembering who you are, you're not your illness.

If you change the wording a little, "Can you remember who you were, before mental illness told you who to be?"  Does it sound a little more familiar? 

I can, I have always been a creative person.  I remember being 10 years old sitting on my bedroom floor making clothes for my Barbie's, or swinging on the front porch writing stories.  I always had a book with me; spending summer vacations reading as many books as I could, the hours at the library made me feel alive.  It was seen as the dabbling of a child though; no one put much thought into it or asked me what I wanted to do when I grew up.  I was told I was going to college and I would get a degree, get a job, get married and have babies.  I called their bluff, however, and enlisted in the military; I wanted to be on my own, away from the world I knew.  It never stopped my love of writing though, I continued - only no one knew.  I kept it too myself, my secret, the person I really was.

Mental illness changes many things in life and it can be difficult to silence the voices that say this is as good as it will be, the past is over, the person who was, can no longer be.  These are the lies that are transmitted with a diagnosis.  It feels as if, with the doctor’s words, comes a badge that tells us nothing will ever be the same again.

While there is some truth to this way of thinking, it's not the whole story.  A diagnosis of mental illness will change the future, that is true, but it cannot take away your past, the person you are deep inside.   There will be new challenges, an unseen battle of the mind that can make the days more difficult, but it does not mean that you are different as a whole person; it is merely a different way of living and looking at the world. 

This idea, however, does not come easy.  With such a diagnosis there is the immediate fear of stigma and being ashamed, both of which are society’s perception.  Life seems different and there is the question of how it will be now, medication, doctor visits, therapy.  Do I tell people? Friends, family, work colleagues?  These questions themselves are enough to add to the anxiety, but taking a step back can help bring it into perspective.  

If a friend came to you and said they had received a diagnosis of Bipolar Disorder, what would you do?  Think about that for a minute, what is the first thing you would do?   For most of us we would hope that we would be supportive, and there is no doubt we would be, but would there be a second of doubt and uncertainty?  Would you question, maybe for the first time who this person is?  Have they changed in your eyes? 

Now, look in the mirror - do you have these same questions about yourself?  The diagnosis of mental illness not only creates doubt and uncertainty in those around us, but in ourselves as well.  That is why we need to sit back and remember who we truly are, the person deep inside, whom we are at our core.  

Growing up you may have wanted to be an artist, but society told you that it was not a lucrative career path, were they wrong, or was it only their opinion?  With this new diagnosis, it will also be their opinion that you will hear.  Maybe now will be the perfect time to start a new career, follow that dream you always thought you couldn't have.  It can be seen as a new lease on life, a new beginning.  

While this total shift in careers or life may not be possible for everyone, it does offer the chance to explore what is inside of us a little more.  Creating a stronger and more resilient person than we ever thought we could be.  

“X” is for X-ray (transparency) #atozblogchallenge

 “Transparency is entering our lives in unusual ways and much like having individual veils lifted from a multi-veiled garment; we are now seeing the world ...”  

 For the purposes of this blog challenge; an x-ray is basically a transparency; a picture is taken, and you are able to see through the skin, getting a clearer picture of what is there.  This is what we fear the most as people in general, the idea that others would see us for who we really are.  We wear masks to hide our identity, feelings, desires and all too often our true aspirations for this world.  It is the fear of rejection that keeps us hidden within ourselves, what if they don’t agree or laugh, we are people who thrive on acceptance, without it, we are knocked down.  

This idea prompted a piece written by a friend several years ago and it the most accurate in describing what we may feel daily.   

***I’m frightened.  I’m unsure, because of what you might think of me, because of what some of you might say about me.  What you think and say, the way you act influences me.  I act as if they don’t, but they do.  Maybe you are frightened too.  Maybe the ones who will mock me the most signify the most frightened, I’m unsure.

You go by me day after day, you have activities near me, you even sit by me (though not too near, as if afraid of being misunderstood), but you don’t know me.  You form your opinions without real information.  You take the mask and try to declare the person, no, less than that, if you even understood the mask, you might glimpse the person.  How much time would it take?  How much effort?  I’m tired of hiding and I disrespect myself for sitting quietly, watching this happen to myself and to others.  We cross-space, glimpse a mask, or an opinion, and hurry along our way.  I am guilty, as are you.

What if, suddenly, we see one another for who we are?  The mask drops for an instant, followed by an embarrassed silence, a mumbled apology for being human.  Quickly we alter the subject or hurry away, frightened of what might befall us and perhaps frightened that it never will.  How many are there?  Am I one or many?  What will it take to change?  Maybe it will take only one. ****

Do you fear transparency?  Being truly open with people?  Is today to make a change and become the person you truly want to be?  What better time than now…….