When I Finally Fell

Nine years ago, on the first day of December, shocked, dazed, and bewildered, I found myself sitting in the "quiet room" off the waiting room of the ER of Northwestern Memorial Hospital in Chicago. My belongings had been taken away from me and there was a security guard at the door. At one point someone inquired about his whereabouts over the radio and he responded, "I'm sitting on a 64." That was me. A 64. I didn't need a code book to tell me what it meant. A 64 was a psychiatric patient.

It could be said that landing in a psychiatric hospital was my destiny from the moment I was born with a brain that couldn't properly produce and process neurotransmitters the way healthy brains can. It was inevitable that at some point my depression would plunge to depths beyond what I could cope with. Moving to Chicago that August had set in motion the events that would land me in the quiet room.

I graduated from college in May of 2003, spent the summer working at a mortgage company, and then, in August, moved to Chicago to pursue a MFA in Writing at the School of the Art Institute of Chicago. The only time I'd been to Chicago prior to the move was when I visited in late July to look for an apartment and the only person I knew was one of my best friends from high school.

One of the school buildings on
Michigan Ave.

I loved Chicago from the outset. I loved the old buildings, the big-city energy, and riding on the el. I loved that much of the School of the Art Institute of Chicago was housed in skyscrapers; how cool is that? One of those buildings was on Michigan Avenue, across the street from the Art Institute of Chicago (the museum) and there was a cafeteria on the 12th floor with a phenomenal view of the lake and Grant Park. I hadn't expected the waters of Lake Michigan to be so turquoise! It was one of many things about the city that delighted me.

I lived with my friend when I first arrived, having been unable to find a satisfactory apartment during my brief visit the month before. She lived in Roger's Park, at the far north end of the Red Line, when I first moved there, but shortly afterward she relocated to Hyde Park, as she was starting graduate study at the University of Chicago. The trip from Hyde Park to downtown had to be accomplished by bus, a less congenial form of transportation in my view than the el, which spurred my efforts to find my own place. I ended up with a great studio apartment in Logan Square.

My first apartment was on the second floor at the bottom of the "U" of this courtyard building.

It was spacious, as far as $500/month studio apartments go, with a separate kitchen, a walk-in closet, lots of windows, and had recently been refurbished with new kitchen counters and cabinets, a new fridge, a fresh coat of paint, and the floors had been refinished. Shortly after I moved in, the landlords replaced all the windows, too. It was my first place of my very own, and I loved it accordingly, taking great pleasure in cleaning it from top to bottom every week. I liked that the buildings across the alley from my kitchen window had back yards, so I had a view of nature rather than the wall of another building. (I also, at night, had a view of rats swarming the dumpster behind a restaurant, but that, too, had its own charm, since it was part of living in a big city.) I liked that my apartment was just off the far end of the Logan Square Blue Line el stop. I also loved the address of the apartment itself: 2649 ½ N Spaulding. It was the "½" that delighted me: I hadn't known that fractions were permitted in an address!

My little kitchen!
(I took only nine photographs during my time in Chicago--this is one of them.)

I had also, much to my surprise, fallen in love. My high school friend had introduced me to a coworker of hers as a potential roommate and friend. The roommate option ended up not working out, but it had been practically love at first sight for both of us. He lived in Logan Square, too, and I loved walking from my place to his and marveling at the old apartment buildings on Kedzie.

In those first months, Chicago was, for me, the buildings I'd read about during my history of American architecture studies: Burnham and Root's Mondanock Building, walking past Louis Sullivan's Carson Pirie Scott Building every day on my way to school, the iconic Sears Tower, and the view north along Michigan Avenue of the Wrigley Building, the "corn cob" buildings, the Tribune Tower, and the John Hancock Building; it was the taste of Indian food on Devon Ave, vegetarian food at the Chicago Diner in Boystown, nachos at the Heartland Cafe just down the block from my friend's Roger's Park apartment, chocolate chip pancakes at the Bongo Room in Wicker Park, the Puerto Rican dishes cooked up and offered for free one night a week for a time by the motherly bartender of the Whirlaway in Logan Square, and last but not least, Pasta "YiaYia" (a divine concoction of feta, cinnamon, brown butter, and garlic) at Logan Square's Lula Cafe; the Picasso statue downtown, the view of Graceland Cemetery from the Red Line, the bizarre (in my opinion) wood fire escapes on the back of every brick and stone apartment building, the black dust in my apartment (no doubt from the coal-fired power plants still burning in Chicago at that time), the unfortunate sewer aroma that emanated from every storm drain, the constant cacophony of horn-honking Chicago drivers, swarms of pigeons with missing toes (frozen off during the frigid winters?) perched on the underside of the elevated line that rose over Wabash Ave outside the building that housed most of my classes, and the pleasure of stumbling upon the vibrant sounds of the Hypnotic Brass Ensemble, as this was during their early years when they were still playing on the streets of downtown Chicago.

A portrait of the artist as a young graduate student.

Not everything was easy. As part of my financial aid package, I was supposed to get a work-study job at SAIC. Unfortunately, I moved a little too slowly to secure a position, so many filled even as I applied, but I was also hampered by my terrible social anxiety, which made me unable to even enter the offices (or sometimes the buildings) where open positions were available. This inability to get a work-study job weighed heavily on my mind--and was hard on my finances. And while I very much enjoyed my classes, particularly the elective art course I was taking, I had unfortunately been assigned a writing advisor who was a terrible match for me. He was the sort of person who loved critical theory and I was the sort of person who decided not to become a literature major because I loathed that way of thinking about writing. He criticized the first pieces of writing I submitted to him as not being current enough; I protested that I had just moved to the city, I didn't know enough about where I was to even write about it. And then, when I tried, he dismissed my efforts as cliched. At that time, I was so shy and anxious and insecure that I struggled to show anyone my writing at all, sure that it was not worthy of being seen, and his blunt and sardonic remarks confirmed my fears. I swiftly developed a terrible case of writer's block. It's a truly demoralizing thing to have writer's block when you're in a writing program and I was not well enough at the time to advocate for myself. Things were starting to slip out of my control.

On one side, my sun-lit street, on the other side, total darkness

I can vividly remember walking down Spaulding Ave one sunny afternoon in early October and having this sense within me that I was teetering on the edge of darkness. I could picture it so clearly in my mind, the razor thin line on which I walked, the bright Chicago sun on one side, the black depths falling away to the other. I didn't know at the time that I was experiencing my seasonal changeover from my summer hypomania--which had given me the energy and enthusiasm to embrace this move to a large, unknown city--to my wintertime depression. But the metaphor of teetering on the edge of darkness was very apt, and around the end of the second week of October, I fell.

My $75 purple comforter was only
marginally effective at keeping me warm 

The weather changed, becoming cold. I had spent the past four years in Florida, so while I was well-equipped to handle the summer heat of Chicago, I was ill-prepared to withstand the chill. After fretting a great deal about the price, I bought an artificial down comforter. (I'm allergic to real down.) I also purchased an extremely unflattering "sleeping bag" coat. At night I would huddle under my new comforter with my heavy coat over me, too chilled to sleep. My apartment was cold because I was too embarrassed to call my landlord to say that the radiator in my main room wasn't turned on. It was my first experience living with radiators and I thought maybe there was a valve you turned, but this radiator didn't have a handle on the valve and I didn't have a wrench large enough to turn the bolt. I was worried that somehow I had missed something that I was supposed to know and therefore couldn't stand the thought of exposing myself to my landlord's ridicule: this is how you think when you have social anxiety. I also couldn't bring myself to ask them to unplug the drain in my bathtub, so every time I took a shower I ended up in nine inches of slowly draining water that served as a mocking reminder of my failure to be a normal, functional human being.

Money was also worrying me a great deal. My parents, before I graduated from college, had told me not to expect them to support me, and I took this to heart. Thus, I felt I couldn't ask them for help as my savings dwindled and I remained unable to get a job. Having failed at getting a work-study job, I tried and tried to bring myself to ask for a retail job, but couldn't ever work up the nerve. The holidays were approaching and the Magnificent Mile was crowded with shoppers as I walked up and down Michigan Avenue and through every floor of the Water Tower mall, trying to will myself to walk into stores and ask for a job. Even when the stores had "help wanted" signs posted, I still couldn't make myself ask for an application. I spent many afternoons this way, feeling more and more like a failure. I hadn't been able to afford to fully furnish my apartment, so the box my eMac came in served as my desk; I ate my meals sitting on an upside-down plastic wastebasket with my plate on my knees.

In addition to my lack of a job, writer's block, and cold apartment, I was also beset with racing thoughts that kept me awake late into the night as I worried and worried and worried and worried. I told some of this to my parents when I called home and they provided coaching and encouragement, but as the weeks passed and I still failed to call my landlords and get a job, I starting avoiding my parents' calls, letting them go to voicemail and only occasionally calling back. I was too ashamed to admit I hadn't made any progress.

My drawings with text explored the
possible nature of God.

The week before Thanksgiving was Critique Week at the School of the Art Institute of Chicago. There were no classes; each student was assigned a time and a date when he or she would present work from that semester to be critiqued by a committee. This was extremely nerve-wracking for me, as I dreaded being judged, and my critical, sardonic advisor was on my critique committee. My critique wasn't until Friday, so I had all week long to worry about it. The night before my critique, after having dinner with my boyfriend at his place, he dropped me off at my apartment as he headed out of town. The water in my building had been turned off earlier in the day for maintenance and I discovered, when I got home, that the pipes were groaning and howling at high volume. Fortunately, I was able to catch my boyfriend before he left (this was in the days before everyone had cellphones), and he let me stay at his place. I slept better there than I would have with the pipes serenading me at my own, but I was still so nervous that I broke out in hives while taking a shower that morning. The work I was presenting for my critique was a series of drawings with text that I had been working on for my art elective class; I may not have been able to write, but I had been able to get a lot of good artwork done. Still, I was so anxious that I had to sprint for the bathroom, my stomach in revolt, while I waited for the committee to arrive. My critique went well and I did appreciate that my advisor understood it better than the others. Afterword, he told me I could have been bringing my drawings to our meetings, but I hadn't wanted him near them. I was sure that he would ruin them for me with his cold, rational assessments. Later, he sent me a rather condescending email, calling me "kiddo," and told me that maybe I just wasn't mature enough for grad school yet. I may have been the youngest student in the MFA Writing program, the only one who had gone directly from college to grad school, but I knew the problem wasn't one of immaturity. The problem was anxiety. But I didn't know what could be done about it.

The following week was Thanksgiving, which I spent with my boyfriend's family. I had met most of the attendees of the dinner before, but fretted enormously ahead of time over what I should wear and felt, as soon as I was dressed, that I was wearing exactly the wrong thing. I don't imagine anyone else gave it any thought, but I spend the evening feeling awkward and foolish. I was waiting, too, for the imminent onset of my monthly premenstrual migraine.

At that time I was getting a three-day migraine every month. They were quite severe: I'd spend those three days in a shadowy underworld of pain. I was used to having a mood drop with my migraines, especially as they abated, but this time, the drop was unusually severe. I found myself unable to sleep on the night of the 29th of that month, feeling more and more agitated as I was beset by a frightening desire to hurt myself. I'd had some thoughts of harming myself in the past, but I had made it very clear to myself that this was a line that was never to be crossed: it might be contemplated, but never, ever acted upon. For the first time, I found myself very much in doubt of my ability to resist the urge. Every time I tried to block the idea from my mind, it would think of a new way I could injure myself. Walls suddenly seemed like places to bang my head, windows were things to be smashed and jumped through, every corner of every shelf and desk and table presented itself as an instrument for pain, the razors in the bathroom cried out to be used, the knives and utensils and the blue flames on the stove in the kitchen started singing a siren song, and the urge to run out into the traffic on the busy boulevard was powerfully strong. I sat in bed, I dared not move, as my world morphed into a horror movie. I knew it wasn't right, I knew I should wake my boyfriend, I knew I should ask for help, but I couldn't bring myself to express my horror. I clawed at my forearms with my fingernails, hoping it would suffice, that it would ease my desire to inflict pain upon myself with more dangerous objects. Eventually, I slept. I have no particular memories of the next day, which I likely spent in a migraine daze, trying to shut out the need for injury that had woken in the night. But again, late that night, the desire rose to a level of torment. I was shocked, appalled, flabbergasted, bewildered, utterly opposed to the idea of hurting myself, yet I seemed to be drawn toward it as powerless as an iron filling drawn toward a magnet. I didn't know what to do. I knew full well that I wasn't in my right mind, that things had gone terribly wrong and beyond where I'd ever been before, but I had no idea what one did in such a situation.

Finally, on Monday, December 1st, 2003, I realized that, as a student at SAIC, there must be a student health center I could go to. I was able to get an appointment with the doctor that morning and I presented the problem to her as an unusually severe episode of my typical postdrome migraine depression. After voicing dismay over the general severity of my migraines, she sent me to see the counselor to discuss the self-injury urges. When the counselor heard what I had to say, she cancelled the rest of her morning appointments, hailed a cab, and took me to the hospital.

The counselor spoke to the triage nurse in the emergency department on my behalf. It was 12:05 in the afternoon. According to my records, security searched me at 12:10 and I was placed in the quiet room. And there I waited. I had nothing to do. There was a TV with the volume turned down and poor reception on the wall, but I had no interest in the daytime talk shows being aired even if I could have followed their progress. At one point I was escorted to the bathroom to provide a urine sample; later, the security guard outside the door arranged for some lunch to be brought to me. It was a turkey sandwich. I am a vegetarian, so I had to make due with eating the roll. At 2:00, I saw the intake psychiatrist. She decided that I needed to be admitted. At 4:15 I was moved to a small bay on the edge of the ER to wait for my medical exam. A new security guard watched me from across the hall. I began to cry and quickly overwhelmed the meager supply of tissues I had on me. There were no others to be had in the little room and I was having to wipe my streaming nose and eyes on my hands. That was the lowest point, crying under the impassive gaze of the security guard with snot all over my hands, not knowing what was in store for me, feeling frightened and alone. After what seemed like an age, the security guard left her post and came back with a box of tissues. When a nurse came in to get my vital signs, she was very kind. "You're doing the right thing," she said. They let me call to leave a message for my boyfriend. "I'm at the hospital," I told him, but I was too confused and overwhelmed to remember to tell him which one. At length, I was medically cleared for admission to the psychiatric unit. That meant I was transferred to what, I discovered in my hospital notes, is called the psychiatric emergency department. It was now 5:50 in the evening. In the psych ED, I was placed in another small room, this one with a bed, a small table, and two chairs. All of the furniture was bolted to the ground. There was a door communicating to an office where psych nurses were doing paperwork, I presume, and a one-way window through which they could watch me. I was told to change into two hospital gowns, one with the opening in the back, the other opening in the front, and was given footies, the hospital socks with rubber treads. They interviewed me again, I believe, going over the information I'd given to the admitting psychiatrist and other details. But mostly I sat there on the bench-like bed, cold, hungry, and forlorn in my hospital gown. I'd been clinging to keep control over my depression and anxiety over the years, clenching tighter and tighter in recent weeks, digging in with everything I had, and now I'd let go, had signed over my authority of my own sanity to the professionals at the hospital, and was plunging, numbly, toward I knew not what. At long last, a bed opened up for me in the psych unit. I was placed in a wheelchair with my belongings in various bags on my lap, and an orderly and a guard took me via skybridge to the building where the Stone Institute of Psychiatry was then housed. At shortly after 8:30 in the evening, I was admitted to the locked 8 West psychiatric unit where I would remain until the evening of December 12th.

The hardest phone call I've ever had to make was the one I made the next morning when I called my father to tell him I was in a psychiatric hospital.

A description of day-to-day life in a psychiatric unit deserves its own post, though I will say that it was much more mundane and certainly more well-lit than the psychiatric wards of pop culture's imagination, but the reality of being in close quarters with some of the low-functioning patients, especially when you were a nice, very anxious girl from the suburbs like me, was not always easy. One of the notes in my chart mentions I was upset about an incident the day before when another patient became "agitated," a term that does not adequately convey the experience of seeing a belligerent schizophrenic patient tackled and sedated by the nice nurses and mental health workers. But in all of the days I spent in psych units over the next two years, I only saw that happen twice, and while it was extremely unsettling and the possibility that such a thing might occur kept me on edge much of the time, the truth is that I met many very nice, very normal people in the hospital and the vast majority of the low-functioning patients were completely harmless.

Patients tended to self-segregate according to diagnosis, so I spent most of my time with the three other patients who were being treated for depression. One of the other patients was a girl, L., one year my junior, and we got along very well together. It helped immensely to have this other "normal" person my age to talk to! Every time I left the hospital, it was with numerous email addresses of other patients and promises to keep in touch, but once outside the hospital, the desire to remain close usually fell away. I am rather sorry I didn't keep in touch with this girl; I would have, but I lost her email address and didn't find it until nearly two years later. I decided it was unlikely at that point in time she would wish to resume the intimacy that was so helpful for both of us in December of 2003. If L. should happen to read this and recognize herself, I'd like to say that I've thought of you often over the years and wished you well!

I've previously said that, conversely enough, needing to be hospitalized for psychiatric reasons is one of the best things that ever happened to me. I cannot possibly underscore deeply enough what a relief it was for me to discover that my inability to respond to the world like I thought I ought to was not because I was a profoundly flawed human being, but because I suffered from a brain chemistry imbalance. It was also heartening for me to learn that I not only suffered from a brain chemistry imbalance, but a very severe one. I'd suspected as much, in a way, that what I felt was beyond the norm for depression, but it was an affirmation of sorts to be so sick as to impress an inpatient psychiatrist, who dealt with the sickest of the mentally ill on a daily basis. Quite frankly, the doctors and mental health workers who treated me were amazed that I'd coped as well as I had for as long as I had for how very, very sick I was. Suddenly, I went, in my understanding, from a person who was terrible at coping with life's challenges to someone who had been doing an amazing job of coping! It was SUCH a relief. I can't emphasize it enough. And thus I was able to forgive myself for years of not being able to feel happier or less anxious.

What happened next is apparently fairly common for people who have been holding themselves so tight for a long time to keep themselves together: I sloooooooowed down. My thoughts slowed, my speech slowed, my gait slowed. The slightest distraction could interrupt my train of thought. I felt loose and limp and sometimes loopy. I laughed for no reason. A little bit of this could be attributed to the medications my psychiatrist had put me on, but part of it was the reaction of a mind that had finally, at last, been allowed to let go.

By the 12th of December, my mood and my new medication had stabilized to the degree that my psychiatrist was willing to discharge me, but she did so with reservations. I was still very sick. But my insurance coverage had run out: it had a limit of ten days per year for inpatient psychiatric hospitalization. So back out into the world I went, heartened by my new diagnosis and not realizing exactly how unwell I still was or how long it would take to achieve balance. But I had never been well. I thought it was rather funny, when I read over my chart notes recently, to see that I reported having experienced episodes of "mild" depression over the years; now I know that I had been suffering near-continuous depression, with some very severe episodes, since I was ten years old. At the time, though, depression was my norm. I had no idea what true happiness felt like. It wasn't until years later, after I'd been diagnosed as bipolar II, put on lithium, undergone extensive Dialectical Behavior Therapy, and gotten most of the drug Geodon out of my system, that I would experience happiness untainted by depression or anxiety.

It would have been lovely if I'd been able to find out I was bipolar II and had been put on the right medication without having to go through the trauma of getting so off-balance and such a danger to myself that I required inpatient psychiatric care, but I consider myself lucky that I was only 22 when it all began. Had I stayed slightly less off-balance, I might have continued on, deeply unhappy, anxious, hating myself, and just barely coping for years. Instead, it worked out that my last inpatient stay was in February of 2005 and by the time I was 26, life was on a steady, upward trajectory and I was experiencing joy on a daily basis. So yes, I was lucky to be hospitalized.

Inpatient treatment also gave me a chance to see others with mental illnesses up close. I now have far more compassion and understanding for low-functioning individuals whose traitorous brains leave them only tenuously connected to reality and are unlikely to ever be well. As uncomfortable as they may make us, they deserve the best possible care. I fervently hope that psychiatric medicine will continue to improve and more and more individuals will be able to break free from the tyranny of a dysfunctional brain and know the relief that I've felt.

It was a cold night when I left the hospital in the company of my boyfriend; I remember that they offered me a warm coat from supplies for needy patients they kept on hand, but since I had several warmer coats waiting for me in my cold apartment, I declined. I was done with the hospital. My problem was diagnosed, they'd found a medication I could tolerate, and I was sure everything was just going to get better from there on out. I didn't know that within a month I would be back in 8 West. But I DID get better, even though it took longer than I thought it would, and I got much better than I ever dreamed I could possibly be. So I will declare the 12th of December to be a day of awakening, a day of finally moving forward, a day of hope.

And if you happen to suffer from a psychiatric condition, or suspect maybe you do, and things start getting really scary and you feel like you're not sure you can control yourself anymore, go to the hospital. They know what to do. Ideally, it's better to get treatment before you get to the point where you need to head to the ER, but psychiatric disorders have a way of making you act against your own best interests, so if it comes down to needing to be protected from yourself, call 911 or have something take you to the hospital or take yourself. An inpatient psychiatric stay might be the best thing that ever happened to you; it was for me. Finding the right treatment can take time and it can be so hard, but getting your psychiatric condition under control is SO worth it! Feeling good, feeling balanced, feeling normal, being able to respond to the world in a normal way: it's an amazing feeling. Don't let any of the stigma attached to mental illnesses dissuade you from seeking the treatment that you need because there's no reason to be ashamed of having some issues with the way your neurotransmitters are functioning. Get help. It's worth it.

My life has never been the same since the December 1, 2003. But that's a good thing. Being in a psychiatric hospital may sound terrible, but it was far more terrible to feel the way I did for years prior to the hospitalization. I may have been in a locked unit, but it was there that I was first able to begin the process of finally breaking free.

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

The 5th of July and the Executioner Within

From time to time in this blog, I take on some heavy topics and this is one of the heaviest.

Suicide.

I've mentioned before that we each carry a private calendar in our heads where we have recorded the anniversaries of losses and that most of mine have to do with major mental health crises. July 5th is one of them.

A little background: I went home for a couple of months after my second psychiatric hospitalization in January of 2004, but returned to Chicago in the spring, determined to get my life back on track, resume grad school in the fall, and in the meantime, look for work. Looking for work was always very hard for me because it forced me to do the kinds of things that my social anxiety made the hardest to do, like make phone calls and approach people and ask them for favors (like giving me a job). I tried to force myself to do at least one job search activity each day, but it was very hard and my inability to make myself do these things made me feel really bad about myself. I spent most of my time at my boyfriend's apartment because I couldn't face being alone with my depression in my nice little studio apartment with no internet, no TV, no movies, or other distractions. He often worked swing shift, not arriving home until 10:30 at night, so rather than leave his place and not being able to come back until he got home after dark, I simply didn't leave at all. Finally, I managed to get a full-time job through a temp agency. I was so quick to pick up the skills required that within two weeks of starting, my supervisor was having ME train the next round of incoming temps. It was also a swing shift job, at a busy office in one of downtown Chicago's skyscrapers, so from 2:00 to 10:00, I worked on projects like putting weekly drugstore ad circulars on the web. I befriended one of my coworkers who also lived on the Blue Line so I didn't have to walk alone through the dark and eerie streets of downtown to get to the el station and I was doing well enough (and was tired enough!) that I could once again stay in my studio apartment. I still wasn't doing great--my medication doctor was concerned about my overall lack of progress--but I was doing so much better than I had been in previous months that it looked like my life was getting back on track.

The 4th of July was on a Sunday that year and my boyfriend and I spent it with a longtime friend of mine who was also a former coworker of his; she'd been the one who introduced us. I'd lived with her before I found my own apartment, but hadn't seen her since September because she was down in Hyde Park going to school at the University of Chicago and Hyde Park might as well have been on the moon because there's no good way to get there by public transit that is both safe and convenient. But on the 4th of July, my boyfriend and I drove down there and spent the day with her and her fun roommates and a few other friends. The evening culminated with eating pizza while watching "The Omen" and being very silly. It had been a good day and I was feeling happy as we drove up Lake Shore Drive on our way back to Logan Square. I remember that the windows on the Blue Cross Blue Shield Tower, overlooking the north end of Grant Park, were lit to spell out the word "Taste," as in "Taste of Chicago." My boyfriend and I had gone the day before and eaten all manner of fried things as well as an excellent matar paneer from an Indian restaurant we planned to visit soon. Life seemed to be looking up.

And then the next morning, on Monday, July 5th, 2004, I woke suicidal.

It was a complete and utter shock. It was also wholly unlike how I'd imagined being suicidal would feel. I'd always thought suicidal feelings would be something that would creep and grow over time, that there would be a downward spiral over days or weeks, that it would center around a belief that life wasn't worth living. That was not my experience at all. I didn't WANT to kill myself. I felt like I HAD to.

It was a terrifying experience. It caught me completely off-guard. In some ways it paralleled my experience with urges to harm myself, which had always manifested in a frightening need versus a deliberate desire. But to have your own mind want to murder your body without any "I want this" feelings attached? It was horrifying and appalling. I was too shocked to even tell my boyfriend what I was going through, even though he'd already seen me through two psychiatric hospitalizations. I did the only thing I could think of to keep myself alive: I lay in bed and didn't move. Well, I think I got up to use the bathroom once. But I didn't eat, didn't speak, just lay as flat as I possibly could and tried to outlast this treacherous urge. I had a nasty headache, but I didn't dare get up to take any Advil because I knew I'd be unable to stop myself from taking the whole bottle.

So throughout that long day I wrestled with the part of my mind that wanted to exterminate me. I reminded it of all the people who loved me and who I loved in return, my talents and potential, my recent progress, things I loved about living. In return, that terrible part of my mind responded by making a plan. I'd been warned that if I was ever experiencing suicidal ideation and came up with a plan for carrying out those thoughts, it was time to get help IMMEDIATELY. I tried my utmost to shut that plan out of my mind. The terrible part of my mind responded by telling me that if the Talking Heads song "Heaven," containing the lyrics "Heaven is a place/Where nothing ever happens," came on (my boyfriend was listening to the Talking Heads while he worked at his computer within sight of the open bedroom door), I was to carry out the plan immediately. I was starting to doubt my ability to resist that order.

A good friend of my boyfriend's was in town and that evening, my boyfriend, who'd been unable to get me to tell him what was wrong and who had been watching me with worried eyes all day, stood in the bedroom door and asked if I would mind if he and his friend went over to the neighborhood bar for a little while. I thought it over. By this point, I knew, without a doubt, that it I were left alone, I would try to kill myself. My plan was well-rehearsed: all it required was for me to be left alone for a while. I'd spent all day giving myself reasons for living and had every single one crumble against the cruel iron will of the suicidal part of my brain. But as I gazed at my boyfriend standing in the bedroom door, looking helpless and worried, I realized that I could live for him. I could easily imagine how devastating it would be for him to return to the apartment to find that I'd attempted to kill myself in his absence. He'd stuck by me and tried so hard to do everything he could for me while I'd been so sick despite struggling with some fairly substantial depression himself. It was so tempting to succumb to the urge to kill myself. But, for him, I made myself say, "I think you'd better stay here."

And so I lived.

Of course, the battle was not over yet. The next day, terrified by what I'd gone through, I called up the useless therapist I'd recently fired and explained what had happened and he gave me a brilliantly useless answer. ("Eat some ice cream!") The day after that, because, unlike the suicidal urges, that nasty headache still hadn't gone away, I called up my medication doctor and explained my situation to him. "Go to the ER. NOW!" he said. So my boyfriend took me to the ER and they gave me Demerol in an IV for the migraine because it WAS a migraine, even though I'd never had one that felt like that before and I hadn't had any since I'd started taking Wellbutrin in January. (It would go on to be my first "transformed" migraine, lasting two weeks, eventually broken when I was given anti-inflammatory injections every six hours for two days.) When I woke up from the blissful, narcotics-induced sleep, they admitted me to the psych unit once again because, as the intake doctor said, my case had red flags all over it. I would spend twenty-six days in the hospital that time and was only discharged because my parents insisted on it and swore they'd look after me. My doctors had been planning to send me to the county psychiatric hospital (I learned later); I'd had two more episodes of suicidal urges while I was in the hospital, including one just two days before I was discharged into my father's care, who'd flown out to Chicago to bring me home.

(It was very strange to feel suicidal in the hospital where there was nothing that could be done about it. It was a very strict psych unit, much stricter than the one in the hospital near my home I went to once, and I appreciated that. No one was allowed to wear a belt or even shoelaces, the utensils were plastic, the windows were unbreakable, there were no razors or scissors, and the staff was extremely alert and watchful. Patients who were considered immediate risks for self harm were placed under 24 hour observation, but they kept an eye on everyone. If they hadn't seen you for a few minutes because you were in the shower, say, they'd knock on the door to check. I believed that I couldn't harm myself there, so it was a strange feeling to have those urges, sort of like floating.)

When I came home from the hospital in August of 2004, I was capable of sitting, sleeping, and crying, but not much else. My parents were true to their promise to the hospital doctors and kept me safe. I was never left alone, all the sharp items and medications in the house were kept under lock and key, they ferried me to numerous appointments, and spent thousands of dollars on the medications and therapy not covered by my insurance. I have absolutely no doubt that if I hadn't had this intensive and extensive care, I would be dead by now. Sooner or later, the side of my brain that was bent on my destruction would have triumphed.

My scary experience with suicidal urges that came more-or-less out of nowhere helped me understand, at last, that with my bipolar II disorder, I wasn't facing a minor medical inconvenience that was a small pothole in the road of life. I am, in fact, living with a medical condition that is potentially fatal if not properly treated. I have to say, it was years, long after I'd stopped having any thoughts or urges, before I was able to trust myself enough to allow my parents to permanently remove the kitchen knives, the household item that worried me most, from their locked box. I now have faith that my treatment will hold and I won't be blindsided by a sudden need to kill myself, but the experience I had a couple months ago, when a different brand of lithium proved ineffective, showed how quickly things can disintegrate. Within three days, the destructive part of my mind had returned and was already starting to think about self-harm. It took all of my coping skills just to tread water until I could get my regular brand again. In other words, time and therapy have not eradicated the lethal aspect of my disease; it is merely kept at bay by a cocktail of chemicals that I must ingest daily.

The good news: if I do take my medication, I'm fine. More than fine, in fact: I thrive. I'm able to cope cheerfully enough with having a disability because that chemical cocktail is so effective. I'm able to fully enjoy all those good reasons for living that weren't enough to save me on July 5th, 2004. If you met me, you'd never guess that I have a mental illness, much less a killer slumbering in my brain.

I still don't know if my experience with suicidal ideation is anything like what others go through. I've read that most suicide attempts are impulsive acts, so maybe the notion of the downward spiral of gloom leading to suicidal despair is mostly fiction. What I DO know is that without treatment, I would be dead. The part of the brain that urges self-destruction is incredibly persuasive, seductive, and very, very powerful. Altering the brain's chemistry is the only way to effectively silence it. It's one reason why access to affordable and effective treatment is so important for individuals with a mental illness. (I also find it essential to have a dog because I know that if for some reason I were to feel suicidal again, needing to care for the dog would be my reason for living and enable me to ask for help.)

It's been eight years now since I was betrayed by my own brain and had to plead for my life with an executioner that dwelt within. I'm so thankful that I survived the 5th of July and the subsequent rocky weeks and months and have been well long enough and have enough confidence in my treatment that I can trust that I will not be ambushed by terrifying urges to end my life. And please, if you are ever find yourself thinking about suicide or planning a suicide or are beset, like I was, by a sudden urge to end your life, tell someone. Tell a friend, a family member, a doctor, a therapist. Call the National Suicide Prevention Lifeline at 1-800-273-8255. Call 911. Go to the ER. And if someone you know mentions suicide, take it seriously. You can find information on what to do and what to watch for here. No one should have to die because they feel like they are out of options or because, like me, they suffer from warped thinking caused by a biological illness. If you or someone you love ever is overwhelmed by the desire to die, I fervently hope that you, like I did, survive your own 5th of July.

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

The Best Therapist

Research indicates that the most successful scenario for treating and coping with mental illness is a combination of medication and therapy. Either one, when used alone, is not nearly as beneficial as when used together. And yet, as complicated as the medication can be (and it can be plenty complicated), it can be simple in comparison to the task of finding the right therapeutic match.

For starters, not all therapies are created equal, but there is not necessarily good information out there for patients and families to use to understand the strengths of various therapies and the differences between approaches. Furthermore, a sound therapeutic model does not guarantee that all of its practitioners are good therapists. Again, there is very little information out there to assist individuals in choosing the therapist that will be their best match, especially since someone who makes a great therapist for one person does not necessarily make a great therapist for a different individual.

And there are some bad therapists out there.

Therapists run the gamut from outstanding to good to adequate to mediocre to downright bad. A bad therapist is worse than simply ineffective; they can be detrimental to the patient's health and harm the reputation of the practice of large. Many people, once they've had a bad therapy experience, will write off therapy altogether and never go near it again: that's how damaging a bad therapist can be. It's a shame, since there are good therapists out there who could be helping those who now view therapy as worthless.

In my day, I've had two bad therapists (like the guy who told me to be kind to myself and eat some ice cream when I called to tell him--totally freaked out--that I'd woken up suicidal the day before), a few good therapists, and Andrea.

Andrea belongs in the class of exceptional therapists and for seven years she's been my invaluable guide. This week, I saw her one last time, as she is leaving the practice where she's worked all these years to explore different horizons. Although I'm sorry to see her go, she leaves me in good hands: my own. While I will take on another therapist in the practice as backup, over the years, Andrea has helped me become so skillful at managing my emotions and troubleshooting problems that I've only needed to check in with her every six months or so.

When we first met in March of 2005, it was a different story. I was in bad shape. The month before, I'd had my fourth psychiatric hospitalization in slightly more than a year's time. I was seeing a psychiatrist, but after the overdose that put me in the hospital, everyone agreed that I needed more extensive therapeutic treatment. That's how I found myself at the DBT Center of Seattle.

DBT, or Dialectical Behavior Therapy, deserves a blog post all its own to fully explain why it is, in my opinion, the best possible therapy out there. The extremely short summary is that it teaches individuals how to cope and respond to difficult emotional situations through the use of a variety of skills. It is a therapy of doing, of moving forward, of changing how you think and therefore how you feel, and it is extremely effective. I was first introduced to DBT at the psych hospital in Chicago and had seen a good therapist at the DBT Center of Seattle when I had been home for a few months between hospitalizations two and three. I was, therefore, not wholly unfamiliar with the general concept or that office in particular, but it was with Andrea that my true Dialectical Behavior Therapy education began.

As I said, I was not doing well when we first met. I remember her asking each week if I could make a contract for safety with her, meaning that I would promise not to hurt myself until I saw her next, and each week I would refuse to make that promise because I didn't want to make a promise that I wasn't sure I could keep. There are four units in DBT–Distress Tolerance, Emotion Regulation, Interpersonal Effectiveness, and Wise Mind–and it should be no surprise that we jumped right into Distress Tolerance, the unit that focuses on surviving and coping with the most painful and extreme emotions.

The first few months were hard. I wasn't really well enough to even absorb a lot of what I was being taught, but between Andrea's gentle, kind, but firm guidance and my weekly DBT skills group, the principles started to take root. Six months into DBT, I was started on lithium, and suddenly, everything clicked. From then on, my progress accelerated tremendously.

When I think back to those early months (not that they are very clear), what I remember most is how helpful Andrea was in helping me confront my severely debilitating social anxiety. Together we made up a list of all the things I was scared to do and ranked them according to Subjective Units of Distress, or SUDs, which is basically, on a scale of 0 to 100, how terrified I was to do them. This list included things like asking for directions, talking on the phone, going into a store even if I didn't intend to buy something, asking a bus driver a question about stops or the route, looking at a map in public, taking the time to find the exact change when purchasing an item, making any kind of request of anyone, and dozens of other seemingly innocuous things that filled me with paralyzing anxiety. Then she had me choose one or two items off the list that I had ranked in the 20 to 30 SUDs range to do each week. It wasn't easy at first. But if I didn't do an item one week, it remained my assignment to do it the next. As items were crossed off the list, they were replaced by ones with higher rankings. Slowly this exposure therapy started to take hold, where years of cajoling and reasoning had failed. As my anxiety lessened, it became easier for me to move about the world without feeling like I was constantly being negatively judged by every single person around me. After I'd gotten the hang of challenging myself, we put the list away, but I remember when we looked at it again perhaps a year or so later. It was astonishing. Things that I had ranked as high as 70 or 80 SUDs now seemed so easy, meriting big fat zeros in terms of subjective distress in my revised view on life. The only thing that remained on the list that I agreed with was singing karaoke: sorry people, not gonna happen! It was amazing to see how far I'd come, and to this day, I still marvel at how wonderful it is to be able to do the kind of everyday things that used to fill me with terror and to be free of that sense of being constantly watched and judged. Without Andrea's advice, encouragement, and underlying firmness, I might still be obsessing over what terrible things other drivers were thinking about me because I had set my windshield wipers to "intermittent" when other drivers (and I was checking the wiper activity of every other car on the road) didn't seem to have theirs on at all. (Seriously, the thought that I might have my windshield wipers on the "wrong" setting used to preoccupy me terribly and any drive in the drizzle/rain/mist--and I live in Seattle, so there was no shortage of drizzly, rainy, misty days--was an exhausting, nerve-wracking, humiliating experience. It was a terrible way to have to live and am so thankful to be free of it.)

It could be argued that I might have done well with any DBT therapist, but I'm sure that without Andrea's attributes, I would not have come nearly as far nearly as fast. She was exactly what I needed in a therapist: friendly and positive without being superficial or exuberant; so clearly patient and kind and nonjudgmental that even I, who was so terrified of being "wrong" somehow, was able to learn to relax and trust her; clear in both her explanations and expectations; and, at the core, where it was needed, absolutely firm. I remember in one early session, during a time when I was still sorting through and dealing with suicidal thoughts, saying something somewhat glib or certainly self-centered about the benefits of suicide and her reply, that suicide really fucks up people's loved ones, shocked me tremendously. That Andrea would say "fuck" in a session was as shocking as, well, my mother saying it, or the queen. And when she said it, I believed her. That was the last time I ever indulged in fantasizing about suicide. From then on, I was wholeheartedly on board in trying to turn my thinking away from self-destruction.

And so I learned how to arrest a spiraling state of emotional intensity in its tracks; to notice when I was engaging in catastrophic thinking and how to make myself stop; how to quiet my mind when my thoughts started racing; how look for the positives in every situation instead of focusing on the negative; how to ask for what I needed and then, once I had accomplished that, how to ask for things I wanted (this was huge because my sense of self-worth was so low at the outset that I didn't believe I deserved to have needs, much less wants, and the worst possible thing would be to inconvenience anyone with something so selfish as asking for what I needed); how to separate the facts of a situation (or emotion) from the judgments and assumptions; and how to effectively respond once the facts of a situation or emotion had been established. With Andrea's helpful tutelage, I was able to leave that cringing, shrinking, petrified, miserable, out-of-control, profoundly unhappy torture chamber that was my life and enter into a positive way of being, where I believe in my worth, in my opinion, my voice, and my happiness.

It's a good thing I had DBT and Andrea at my disposal, since six months after I started taking lithium, I found myself desperately needing the skills I'd been learning. I'd started lithium because I was going off of a drug called Geodon that was causing tardive dyskinesia, or involuntary movements of the mouth and face, a condition that can become permanent if the medication causing it is not stopped. My experience with Geodon will get its own blog post one of these days, but what happened is that after six months of problem-free reductions, with me getting better and better by remarkable leaps and bounds, I slammed head-on into excruciating withdrawal. It was awful. There was agonizing pain, horrible nausea, immense fatigue, bizarre sensory hallucinations, cognitive problems, vision problems, you name it. It went on for years. And not only did the withdrawal symptoms get worse the closer I was to finishing the taper, but they continued for a full year AFTER I was off the medication. I started tapering off Geodon in 2005 and was not wholly free of its effects until 2009. And that's not counting its permanent legacy: hypoglycemia, worsened migraines, and periodic fibromyalgia. I might not have been able to cope with finishing the taper if I hadn't had DBT and Andrea to help me through one health crisis and setback after another. It really might have been unbearable. It's a good thing I was able to endure the withdrawal, though, because emotionally I am so much better completely off of Geodon!

In fact, I was able to do so well, thanks to lithium and Andrea and my year in the DBT skills group, that I was still in the Geodon withdrawal process that I started coming to my weekly therapy appointments without any problems to discuss. I'd become so skillful that I was able to tackle things by myself as they arose. It seemed silly to meet every week simply for me to report on how well I was doing, so we started meeting every other week. But even then I was managing just fine. So Andrea and I started meeting once a month. Before long, even that was excessive! In the last few years, I've been down to two or three check-in appointments a year. A lot of times, they'll just be half hour appointments to touch base. Sometimes, if I have a particular problem that I want assistance with, I'll specifically schedule an appointment to see her, but I no longer need weekly or even monthly guidance. It's hard for me to get downtown to the DBT Center's office now that I've had the chronic migraines to contend with, so we've had most of our appointments over the last two and a half years over the phone, and that's worked just fine.

Lithium, in combination with several other medications, is essential to managing my bipolar II disorder. But if I hadn't had Andrea's gentle but insistent instruction to help me cope during the seven months between the fourth hospitalization and when I started taking lithium, it's probable I would have continued ping-ponging in and out of the psych hospital, almost certain that I would have embarked too far down a road of self-destruction to easily turn back, and possible that I might have ended my life altogether. At the time we met, after years of just barely clinging to a facade of normalcy, I had become unmoored. I knew the frightening thoughts and urges that were flooding my mind were the result of brain chemistry out of balance, but I also didn't know how to stop them, and their warped seductiveness was becoming harder to resist. I was so terrified and also so appalled that I could think such things that it was hard for me to talk about them, but I trusted Andrea, and even before I was able to effectively implement the DBT skills I was learning from her and my group therapy, it gave me hope that I might someday regain control of my mind. It's not a coincidence that I have never needed another psychiatric hospitalization since I started DBT!

And so with Andrea's invaluable help, I was able to grow from a fragile, damaged, terrified husk of a human being into a confident, balanced, happy woman. I went from being so emotionally raw that the slightest thing could send me into a tailspin and so fearful that the mere thought of ordering a pizza over the phone could send me into a panic to the point where I was able, on my days off, to get all dressed up, experiment with a little dramatic makeup, go downtown, take myself out to lunch at a nice restaurant, go to a matinee of a play all by myself, stroll around downtown while enjoying the admiring looks of passersby, check out the latest fashions even if I wasn't planning on buying anything, make a purchase at a drugstore and chat with the cashier while taking the time to find the exact change despite someone waiting behind me in line, and generally have a wonderful time. Even more remarkably, when the onset of the chronic migraines brought an end to those fabulous afternoons and left me unable to work, socialize, or even leave the house because of pain and tremendous light- and noise-sensitivity, I've still been okay. When I am happy, and I frequently am, it is a happiness as legitimate and whole as what I felt on those delightful, confident days spent enjoying the dining, shopping, and entertainment offerings of the city. I owe it all to DBT. Had I not learned how to stop myself from fixating on the negatives and instead see and capitalize on the positives during my climb out of the depths of depression, I would not have handled this disability with nearly so much aplomb!

While I have no doubts about my ability to continue to not only manage my emotions but to thrive, it has been a bit of an emotional process to say goodbye to Andrea. Walking past the Louis Vuitton store on the way to my final appointment yesterday, I recalled how it was one of my earliest assignments in my quest to conquer my social phobia to go in the store and look around for several minutes despite my belief that I was not "good enough" to be in there. It took several weeks for me to work up the courage to open the door and endure the judgmental (I was sure) stares of the security guard and sales associates as I nervously made myself look at every bag and every shoe. It's simply phenomenal how far I've come and while I remain grateful and proud of myself every time I make a phone call or go into a new situation without panicking or ask for help or any other scenario that would have been nearly impossible for me in my anxious days, it's been very moving to really remember down to the visceral level how I used to feel in those wretched days and compare it to how I feel now. I have not seen the last of Andrea; while our professional relationship has ended, DBT guidelines allow for ongoing contact between former therapists and clients if such a thing is agreeable to both parties, and we agree that it would be really nice to get to touch base now and then! I was very glad, though, when we parted, that I was able to tell her that she has made a tremendous difference in this world: she changed--and perhaps even saved--at least one life for the better. She always credits my hard work for my success, but without her approach and personality and patient coaching, I would never have been able to form the bond with her that has, over time, enabled me to succeed.

So thank you, Andrea, from the very bottom of my heart. I love the person who I am now, am no longer afraid of the world and its opinions, and I no longer need to be afraid of myself, three things that, when we met, seven years ago, I never could have even dreamed would be possible. I have been so fortunate to have known you and worked with you and thrived because you. The vastness of my gratitude matches the scope of my former unhappiness, which is, to say, immense. Thank you! Thank you! Thank you!

More Than Just My Diagnoses

I have a mental illness. I also have hazel eyes with freckle-like brown spots in them!

It's pretty common for those who have a chronic health problem to start feeling like they ARE their health problem. This can be particularly tough for people who are coping with mental health issues. Not only do mental illnesses change--against your will--the very nature of your thoughts and emotions (and therefore your actions), but often cause considerable feelings of shame as well. For many people, having a psychiatric disorder is not something they can be "out" about, so it's a burden borne alone, only enhancing the feeling of one's sick otherness. I want to remind all of those who have a mental illness, a physical ailment, or feel trapped in any kind of role ("mommy," "the fat girl," etc.) that you are so much more than your diagnosis!

My hair color at thirty.

I am bipolar II. I am also right-handed, likable, a visual thinker, creative, vegetarian, long-waisted, one-eighth Norwegian, 5'7", sensitive to medication, a good swimmer, intelligent, funny, allergic to dust (among other things), hypoglycemic, honest, a dog lover, articulate, a fast reader, afraid of heights, fond of birds, a good dancer, a night owl, a business owner, prone to seasickness, a fan of ice cream, and partial to 19th-century art and literature. I have chronic migraines, a good sense of direction, hazel eyes, a clean driving record, oily skin, attached earlobes, mild asthma, musical talent, a bunion, tight muscles, two cowlicks, a sweet tooth, a sensory processing disorder, an older sister, two chickenpox scars, slender fingers, vivid dreams, a hand tremor, prematurely gray hair, no piercings, and a perpetually runny nose.

This is part of who I am... 

I've been in a psychiatric hospital. I've also broken my right arm, shaved my head, traveled to four foreign countries, collapsed at a music festival, played violin in a youth symphony, studied German, had a colonoscopy, hit a home run, toured a silver mine, been mistaken for a boy, scratched my cornea, ridden in a race car, sung in a choir, visited 30 U.S. states, been in love, had mono, gone snowboarding, dropped out of grad school, been to London, needed stitches, chipped a front tooth, won awards, had turbinate surgery, encountered an alligator, taken photos, formed a goth cheer squad in high school, been invited to the White House, and have been awestruck by the sight of Lake Louise in the moonlight.

...as is this.

Looking at me, you can't tell that I have migraines or a mental illness or used to have paralyzing anxiety. You also can't tell that I dislike talking on the phone, prefer drawing over painting, live with my parents, have always hated seafood, learned to walk at ten months, grew up with no TV, never cared much for coffee, enjoy cooking risotto, love taking long showers, can throw a ball but not a frisbee, won't watch scary movies, never been stung by a bee, know how to make lefse, like to read the encyclopedia, can drive a car with a stick-shift, walk well in high heels, was born in Seattle, like to draw floor plans, had a stuffed dog named Humphrey, want to learn to ride horses, played lead guitar in a rock band, and liked both algebra and calculus but none of the years of math in between.

Mental illnesses? Common.
That pigment stripe? Unusual.

Furthermore, I am hardly unique. According to the statistics I found on www.mentalhealth.net, some 40 million Americans suffer from an anxiety disorder, 46 million experience depression at some point in their lives, 3.2 million suffer from schizophrenia, and 2 million suffer from a bipolar spectrum disorder. This adds up to more than a third of the U.S. population! Additionally, some 51 million Americans have had at least one migraine. I suspect I am far more unusual in the fact that I have a bar of dark pigment on my lower lip that looks like I wrote on myself with pen and I have never once in my entire life had so much as a sip of beer.

My diagnoses are a part--but only a part--of the great, tangled mass of details that add up to who I am. No matter how overwhelming your illness or situation may seem, I want to assure that this is true of you, too.

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.