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Thursday, January 12, 2012

The Darkest Evening of the Year

Whether we think about it or not, we all go through our lives referring to several different calendars. There is the official calendar, of course, the one with the days of the weeks, marked with national and religious holidays, that we use to map out our lives from day to day. There is a second calendar, unique to each person but gladly shared, that contains the birthdays and anniversaries and holidays and other joyful occasions that we celebrate together. However, most of us also have a third calendar, a deeply private one, whose dates are never written down because they are written on our hearts with scars, a calendar of pain.

This is the calendar that records the anniversaries of our sorrows: the deaths of loved ones, painful partings, debilitating injuries, and the endings of eras. Some of these "holidays," so to speak, lose importance over time. For me, the second week of October, once a time of year hallowed by death, is now the time when I celebrate the anniversary of bringing Abbey home. And it was only after the fact this year that I realized I had forgotten all about having a day of observance on the 1st of December. Eight years ago, and in many of the years that followed, the notion that I might someday cease to recall that painful holiday would've been unthinkable. I am thankful that December 1st need no longer be an important date on my third calendar. However, I thought that I might recognize instead the no-less-minor observance of the Second Week of January.

I have made no secret of my bipolar II disorder. I am adamant that it is nothing to be ashamed of and that by being open about the realities of living with mental illness is what I can do to help destigmatize psychiatric disorders and perhaps help others. That said, nearly all of the dates on my calendar of sorrows relate to mental health crises.

December 1, 2003 was momentous because that was the day when I reached the point where I could no longer cope and found myself in a psychiatric hospital. As strange as it may sound to someone who has never suffered from profound depression or any other aspect of a serious mental illness, in many ways it was a relief to be in the hospital. It was there that I first understood that I was dealing not with a flawed personality, as I had assumed, but a physical illness. It was such a relief to learn that my inability to be happy or at ease was caused by a major imbalance in my brain chemistry. I'm not saying it was easy for a nice, timid, little white girl from the suburbs to be mixed in with the schizophrenic crack-addicts that comprised part of that downtown Chicago hospital's patient population, but I cannot emphasize enough how relieved I was to finally understand what was wrong with me and to know that I was finally going to get help. I was discharged from the hospital after 12 days. My doctors were reluctant to do this, as I was still very sick, but my insurance coverage had run out. I had been started on Zoloft and I was to check back in with the outpatient arm of the psych hospital after Christmas.

I made it through Christmas okay and returned to Chicago, where I had been going to grad school, and checked in with the outpatient intake doctor. He assessed how I was doing, set me up to see a therapist and a medication doctor through the clinic, and advised me to increase my dose of Zoloft.

It was only a short time later that antidepressants would get a black box warning that teens and adults in their early 20s, such as I was, could suffer adverse effects when dosages were raised. At the time, however, all I knew was that I was soon depression-sleeping 15 hours a day. Most of my progress and all of my momentum had been lost. Finally, on some day during the second week of January (I have forgotten which one), my mother, who was concerned, talked to the intake doctor, the two of them talked to me, and it was determined that I needed to go back to the hospital.

As helpful as the hospital had been, I had assumed that having been diagnosed and started on treatment, I would never be back there again. It was so disheartening to hear that a little more than a month later that I was hospital-bound again. The first time I went, a school counselor had taken me there in a taxi. This time, because my boyfriend wasn't getting off work until 10:30 that night, I had to take myself.

In my memory, the second hospitalization was just plain hard. I spent nine days on the psych unit, discouraged and emotionally overwhelmed. There was a much more volatile mix of other patients this time, and unlike the last time, when there had been three other patients I'd become friends with, there was no one I felt quite as comfortable with as I'd felt with them. Hardest of all was the presence of a woman who was suffering from rapid-cycling bipolar disorder. It's a hellish form of the disease that causes the sufferer to whip back and forth between depression and mania every few hours. Her room was next to mine and she was on 24-hour observation, so she was usually in my vicinity and taking up much of the attention of the staff. She was a nice enough person, but in my emotionally vulnerable state, the intensity of her frequently fluctuating moods was exhausting. She also felt particularly close to the mental health worker I liked best, monopolizing his time. It was rough. But despite many low moments, it's the memory of my solo trip to the hospital that remains the most haunting.

I was living in Logan Square at the time, the Chicago neighborhood just past Wicker Park on the Blue Line. To get to Northwestern Memorial Hospital, located off the Magnificent Mile, I had to take the Blue Line downtown, transfer to the Red Line, and ride one stop north to Grand, the same route I took if I went to meet my boyfriend when he got off work. I recall it being roughly 5 o'clock on a dark and bitterly cold evening when I started out. I wore my long and ugly sleeping bag-like coat against the January chill and I remember thinking, during the 20 minute ride from Logan Square to downtown Chicago, that I was undoubtedly the only passenger on the train on her way to voluntarily commit herself to a locked psychiatric unit. It seemed utterly dispiriting. And yet, I could think of no better alternative, because as much as I loathed to go, I knew it was where I needed to be, that I would be safe there. It was with these low thoughts that I searched the dark and empty streets away from the bright lights and shops and crowds of the Magnificent Mile for the ER. I knew the address of the building that housed the psych units, and, as a side note, the hospital's maternity wards, and I thought it would be easy enough to locate the ER from there, but seemed to last forever, that slow slog through the dark streets, like a slow-motion fall from a fatal height. My long down coat seemed to offer little protection against the icy wind blowing off the lake just a few blocks away and I was equally cold and lost inside. There were other dark hours during that first year of instability that were far more terrible and terrifying, but none that were nearly so demoralizing, which is a quiet but potent poison of its own. At last I found the brightly lit emergency room and surrendered myself to the long process of admittance to the psych unit and what seemed like a sentence of unending mental illness.

I was right, on that cold evening, that treating my mental illness would turn out to be a long, hard, slow process. It would also prove to be just one of several more hospitalizations, but none of them were as hard as that second time. What I couldn't know, at the end of the second week of January in 2004, is that I would ultimately find just the right medication and just the right therapy and would achieve levels of happiness and balance that I was utterly incapable of even imagining, much less consider possible, before my diagnosis and treatment. It's turned out that my migraines, not the bipolar disorder, are what has disabled me. Oh, the mental illness certainly complicates the treatment of the migraines, and it is absolutely essential I take medication every day for the rest of my life to keep my brain chemistry balanced, but those desperate days as 2003 drew to a close and 2004 feebly dawned were not failings, as you might imagine psychiatric hospitalizations to be, but rather the first fragile but essential roots of my recovery.

My bipolar II disorder is currently stable. These days, all I need are three 15-minute check-in appointments with my psychiatrist a year and perhaps a phone chat every six months or so with my therapist. But despite how well I'm doing, and for how long, in some ways it's hard to believe that it's already been eight years since I can still so vividly remember the way I was before. Time will continue to pass, though, so one reason I wish to keep the 1st of December and the Second Week in January on my unspoken calendar is not to relive the pain, but to honor what I went through and how far I've come. By never forgetting that cold, dark, lonely night, I will also never lose sight of how amazing it is to live in a place where it is light and warm.

You can read about my first hospitalization here and my third hospitalization here.

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