When you have a psychiatric diagnosis, there are times when it’s obvious you need help. Other times, it might not be as obvious.
I had to jump through some hoops recently to get seen by a psychiatrist with my new insurance. Among these hoops were multiple rounds of the same questions about the nature and severity of my symptoms. As I tried to answer as patiently and honestly as possible, I was aware of feeling anxiety about whether I would be deemed “sick enough” to be worthy of care.
You see, although I have been under some form of care for many years, it’s been seven years since the last time I was in a hospital outpatient program and nine years since the last time I was hospitalized outright. I’m only on one relatively benign mood stabilizer.
In recent years, I have been aware of how lucky I am to be where I am. I work hard not to throw this good luck away by falling back into addiction or other self-destructive behavior. But should “doing well” mean I don’t need help any more? Especially with bipolar, where patients are quite likely to float out the door while in a happy place, stop their meds, and wind up in the ER?
So it’s a dance. Be sure to appear “sick enough” to be taken seriously, without appearing so ill that you get a level of intervention you don’t need or want. Be eloquent enough about what goes on in your head to make sure someone knows you aren’t “fixed.”
Why? Why not just have enjoy having fewer appointments and one less thing on your current record? My reason is simple: my condition means that matter how well I am doing, it is possible for me to have a serious episode and need more help. Having a psychiatrist of record means having someone to call for an urgent meds adjustment. In the event of dire need, it means I have a name to give the ER staff.
It’s regrettable that people like me must defend our need to be responsible and prepared for trouble.
Some poems, and stories, and essays of mine are not ready to be written because they concern other people too directly. It’s a pity, because I’m sure they would be rich, and dark, and searingly honest. I know some people write memoirs and let the chips fall where they may, but for me it would feel wrong to write really raw stuff specifically about people who are still alive.
Part of my decision is based on fear, I know. The fears many of us have about confronting sources of our deep and sometimes illogical terrors. I’m all about trying to face my fears more often, but I also know my own limits and know that pushing certain things would harm people who don’t have the capacity to deal with it.
I’ve sometimes been advised to write pieces and simply not share them with anyone–don’t read them, don’t submit them, don’t self-publish them. Occasionally I do write some things for a recovery activity or when working with some kind of counselor. In general, though, I feel frustrated at the idea of writing things I am supposed to keep secret.
It doesn’t make sense. Journaling is so highly recommended for creative types; why can’t I get on board with private writing? Is it that I have a hard time giving myself permission to create without some small chance of it enriching others? Or is it just ego?
Pretty frequently, my daughter reminds me that the untouched tea, or coffee, or snack near me is doing me no good sitting there.
By the same token, getting my writing seen and appreciated by more people is a lot more likely if I actually send it out. Submitting pieces might not lead to them being accepted by a certain publication…but not submitting them definitely won’t. Reading at an open mic might not help me get new connections and meet people who like what I have to say…but not reading definitely won’t.
Recently, I sent out a couple of different pieces in response to submission calls I had heard about. Just local things, but I was very excited when one was accepted. I would like to get into a more regular habit of submitting work. I have everything I need to do it; I just need to acquire some discipline and get into a rhythm.
It helps when I have a clear notion of why I want to submit work to publications; what I want to get out of the process. I suppose what I want most is to be more open to possibilities. Also (and this part is important) I enjoy a childlike pleasure in having something out there because it means there’s always the possibility of a nice surprise coming.
An old dating show had prospects standing on a trap door above a dunk tank while being asked questions. At any moment, the contestant asking could push a button and splash! It was all over and the next person would move to stand on the trap door.
I often feel as if I’m in that situation. The feeling grows stronger when I meet and interact with new people, especially if I have a strong desire for those new people to like me and want to see me again. Everyone can have the “If they really knew me, they wouldn’t like me” feelings, but mine tend to center on a few specific things.
For example, yesterday I spent the day with a group of writers at a workshop (an awesome experience, and I am so grateful I was invited despite my lack of funds.) The social part also went well, but I did have one instance of the “trap door” feeling. It happened during lunch when the topic of psych meds came up briefly and several people expressed the common attitude of all psych meds being bullshit and/or evil.
The gears rumbled to life in my head and I began to project. So, if and when they know that I’m someone who chooses to take medication, they will have contempt for me. They’ll decide I am weak, or lazy, or unwilling to face difficult times, or just a compliant sheep controlled by Big Pharma. They’ll write me off. And if they would write me off for this, how quickly will they write me off once they know I am a drug addict in recovery? Should I speak up and tell all of these things about myself as early as possible so they can go ahead and write me off instead of wasting their time?
I felt the trap door opening under my feet. I felt the familiar brick settling onto my chest. I felt the familiar loneliness that tells me “You don’t belong. Don’t get fooled into thinking you could.”
These moments are part of life for me, and I try not to let them control my actions. I try not to let them trigger defensive counterjudgments or mentally put people into boxes, but it’s hard sometimes. I’m aware that when I do that I am judging people in the same way I don’t want them to judge me.
I used this phrase when meeting my new psychiatrist and got a quizzical look. He’d just asked me what coping mechanisms I use to deal with my symptoms. I’ve used the phrase before with others, or referred to poetry or writing as my “newest vice.” Some people get it right away, some don’t.
It’s like one of my favorite snarky T-shirts, that says “Writing…Because Murder is Wrong.” That one either gets a laugh or a vaguely uncomfortable look.
Poetry, and other writing, are indeed a coping mechanism for me. Doing them is part of my ongoing efforts to break the old patterns that want to keep me silent, ashamed, and stuck. Doing them can help me get through the disorientation or despair of an episode, or at least give me reference points before and after.
Poetry, and all art, is a form of therapy as well as whatever other purposes it has. Some might sneer at those who seem focused on this aspect of it, or draw distinctions between such people and “real” artists. I believe there’s a place for a critical voice in our process, but I also believe there’s a special corner in some hypothetical hell reserved for those whose contempt or elitism discourage creation.
The word therapy comes from the Greek root for to serve. Psychotherapy translates to serving the soul. Whether it’s our soul or others, or what the ratio is, the service exists. When we create something–anything–we influence the world.
No matter how well I am doing, I must not forget what I am. No matter how much I am enjoying being a poet, or how invested I am in being a mother, I must not forget the conditions that have the ability to destroy it all if I don’t deal with them as responsibly as I can.
I live with a mental illness, and I’m an addict in recovery. These things become less and less obvious to people as I rack up more years clean and have the good fortune to stay out of the hospital for years as well. But serious mental health crisis always has the potential to happen–and, of course, relapsing back into my addiction would bring all my progress crashing down on myself and my loved ones.
Many of the people I meet these days don’t know about my past. Sometimes I am nervous about if, or when, or how to talk about it. I don’t know to what degree I will encounter stigma. Sometimes I expect, on some level, to be “written off” as a new acquaintance gets to know me. Not that I can’t be written off for many other things about myself, or just for general social awkwardness.
At any rate, my learning and growth have to be balanced with continued maintenance. New adventures have to be undertaken with an honest knowledge of my limitations. Even when I can “pass” for normal, I have to remember and accept that I am not.
Recently I went to a reading at a local art gallery. Poets had been requested to choose a work in the gallery and write a piece inspired by it. At the reading, the artists were present and heard our work.
Few things are as personal as a painting to an artist, or a poem to a poet. I had done ekphrastic (inspired by a piece of art) poems before, but I had never done one that would be heard by the actual artist. I worried that they might dislike my work or be disappointed that my take on the piece was so different from theirs.
As it turned out, the artist did like my poem. I got to talk with her after the reading and she said the poem gave her a different appreciation for her painting. How wonderful! It gave me real satisfaction.
However, it’s important for me to remember that if she hadn’t liked it, it would have been all right. I would have regretted it, but it wouldn’t mean I had failed.
Why? Because poetry, like other forms of art, is the ultimate in subjectivity. Any piece will appeal to and repel someone on this earth. We need no justification for our reactions or our opinions. This is what makes the arts special.