Bipolar 2 From Inside and Out

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Mental Illness or Autism?

The other day I inadvertently created a firestorm on facebook. Someone posted: Question: What makes schizophrenia a mental illness and autism not a mental illness? Answer: Politics, advocacy, and marketing.

I didn’t understand the thrust of the post, so I asked a question: “Are you saying that autism should be classed as a mental illness or that schizophrenia shouldn’t be?”

Then the floodgates open. There were over 100 responses to the post, of which mine was just one. They ranged from “autism is not a mental illness” to “autism is a form of mental illness” to “autism is a developmental disorder” to “schizophrenia and autism are both neurodivergent conditions.” Few, if any, seemed to address the original question of politics, advocacy, and marketing. (I have no knowledge whether any of the responders were medical or other professionals; persons with one or the other diagnosis; or family members of those with the, let’s call them conditions for now.)

Some people responded that the term “mental illness” should not be used, because it was inaccurate, or stigmatizing, or both. They found the phrase “mental illness” offensive. “Mental disease” was suggested as a better alternative, though for the life of me I can’t see much difference between them. To me, “illness” and “disease” mean basically the same thing. One can go down the rabbit hole here. Is MS a condition or an illness or a disease or a disorder? Is a broken leg a condition? It’s certainly not an illness – unless it gets infected – or a disease. Someone said that mental illness implied a permanent condition, rather than a challenge that can be treated. My bipolar disorder can certainly be treated, and is. But it is also a permanent condition.

Some of the phraseology that was most often used to define autism were neurodivergent, neurological condition, developmental disorder, neurological condition that often presents with mental illness like anxiety. But neurodivergent was also used to described schizophrenia, which was sometimes linked to brain anatomy and genetics. Some classed them both as “disorders of the brain.”

Others pointed out societal or functional differences or other definitions – schizophrenia can be used in court for a “diminished capacity defense”; autism is listed in the DSM-V (Diagnostic and Statistical Manual, considered by many the gold standard for definitions and symptoms of mental illnesses); the age of onset for autism is three, or three to 18, while schizophrenia is usually diagnosed at 18 and over, but not always; autism used to be called childhood schizophrenia; schizophrenia is caused by over-pruning of the neurons, which disrupt the normal growth of the brain; ASD could be a result of disruptions in normal brain growth. Someone pointed out that with both autism and schizophrenia, there are different levels of severity.

Various books and articles were cited. Challenging questions were asked: Do those who insist that autism is not a mental illness think having a mental illness is shameful, whereas having autism is not shameful or perhaps is not an illness at all. Others considered treatments: Medications can help with mental illnesses but are not generally prescribed for autism. People with one or the other condition do not qualify for treatment.

And some responses were entirely cryptic: B careful what you wish 4.

But back to the original post. I think the poster was trying to say that the autism community did a better job of spreading the word about the condition and thereby defining it, in this case as not-a-mental-illness.

And it’s true that – whatever you think of them as an organization – Autism Speaks has gotten the word out about autism. They excel at awareness (of themselves as well as autism). They organize huge charity walks. They have numerous TV commercials. Their puzzle piece symbol – again, whatever you think of it – is for many the easily identifiable graphic that says, “autism.”

Mental illness, whatever you prefer to call it, does not have that same kind of presence in the public eye. For one thing, there are so many different conditions that it’s hard to choose one to spotlight. Depression seems to be the condition-du-jour. The conversations around it are that anyone can have it and there is help available, which is all well and good. But the vast majority of these messages come from people who are selling or associated with medications or call-a-therapist lines – money-making operations. Nor do the ads always get depression right, many making it seem like no worse than a mild hangover.

SMI (serious mental illnesses such as bipolar disorder and schizophrenia) are only now entering the public discourse, and again, mainly for advertisements of drug treatments. The ones for schizophrenia seldom discuss any symptoms of the disorder – they just show a happy person playing a guitar or some such desired outcome. They don’t convey much about the condition of schizophrenia, its symptoms, how it affects families, or much of anything else.

As for other psychiatric conditions, there is much silence. PTSD is discussed, but only of the “wounded warrior” variety, not the kind that can result from other traumas. Anorexia/bulimia, OCD, social and generalized anxiety, narcissism, and the whole spectrum of personality disorders get little to no screen time.

There is growing discussion about things society – and especially first responders – should know or do about people with psychiatric conditions, but those are largely at the talking stage and a few pilot projects. When the subject hits TV, it is usually triggered (sorry) by an individual incident and is more likely to involve unorganized protests rather than coordinated efforts to address the larger problem. And at times, it seems that no one is listening.

Especially to the people with “forgotten” mental conditions – those that don’t have drug treatments or celebrity proponents or coordinated responses. It’s not that I think autism doesn’t deserve the attention it gets – though clearly there are more discussions to be had around the subject. I just sometimes despair of getting attention for mental illnesses.

But to go back again to the original post, mental illness and autism are two different things that cannot be easily compared. But it is true that autism, at the moment, has an organization with a loud voice behind it. Mental health, not so much.

Mental-Illness-and-Drug-Abuse

One thing I’ve noticed about all the political rhetoric about plans to deal with mental illness is that they always lump it in with drug abuse. Like the two were the same thing. Like the solutions are the same. Like the causes are the same. Like the two are somehow related.

It’s true that many people with mental illness have substance abuse issues. And lots of drug abusers also have mental disorders. But people with varicose veins also have acid reflux. That doesn’t mean they’re related.

Of course there are similarities. Drug abuse seems to be controlled by the pleasure or addiction centers of the brain. And mental illness has to do with a malfunctioning brain. But just because the same organ is affected doesn’t mean the causes – or the treatments – are related. The causes and treatments for the lung ailments cystic fibrosis and asthma are not the same.

The various conditions that we call mental illness may be centered in the brain, but we’re a long way from knowing exactly where. Serotonin receptors? Maybe. Other neurotransmitters? Possibly. Drug treatment seems to work by trial and error, at least in my experience. Every time I’ve asked a psychiatrist how a psychotropic medication works, the answer is invariably “We don’t know.”

Treating drug abuse with other drugs is counterintuitive. Besides, it largely doesn’t work. Antabuse merely makes alcoholics so sick when they drink that they prefer to remain sober. Narcan can pull an opioid abuser back from an overdose, but it does nothing to prevent the next one. And methadone has its problems as well, especially since it’s an opioid too.

Many people break the chains of alcohol or drug addiction with the help of 12-step groups. Such groups have no effect on serious mental illness. Even therapy groups have limited results with people who suffer from psychiatric brain disorders. Support groups can help some of them cope with the problems associated with mental illness, such as loneliness, frustration, fear, and, well, lack of support. But healing is a hard thing to come by, and seldom is found in a circle of people with similar severe psychiatric conditions.

Part of the 12-step approach to addictions is surrender to a Higher Power – not technically the Judeo-Christian God, but the functional equivalent for most. God has not proven to be a reliable cure for mental illness, though of course prayer can help sufferers deal with their suffering and find comfort amid their troubles.

So why do politicians make the assumption that what will be good for one condition will be equally effective for the others? That funding directed at mental health problems and drug abuse can be used for the same types of treatments and treatment centers? Admittedly, politicians are not generally well educated about either mental illness or drug addiction. That’s why they have advisors, who should be able to explain the differences and the nuances to them. And that’s why there are organizations with members who have studied the problems – or who struggle with the conditions themselves – who can inform those who control the pursestrings as well as the general public about what is needed.

It’s convenient to want to deal with mental illness and drug addiction in the same way. Treatment centers, hospital beds, and halfway houses may play a part in dealing with both problems. But hospital beds for detoxing, for example, are different from hospital beds needed for those with serious mental illnesses such as schizophrenia or psychosis, which may necessitate a long, difficult stay.

This is not the place to discuss involuntary commitment or AOT (assisted outpatient treatment, also called “outpatient commitment,” a form of involuntary treatment in the community) for severe mental illness, except to say that involuntary commitment is not an option applied to drug abusers, however much the conditions are conflated. They are complicated issues, and ones that I am not qualified to speak to.

But until we can convince people, and especially those who pull the political strings, that alcoholism, drug abuse, and mental illness are separate subjects that need different kinds of attention and support, we won’t make sufficient progress on either problem.

Jenny’s Back!

Jenny Lawson (aka The Bloggess) is back with a new book to accompany her wildly successful Let’s Pretend This Never Happened and Furiously Happy, plus the coloring book that I can never remember the name of.

Her new book, Broken (in the best possible way), which debuted at #3 in the New York Times, takes Jenny’s weird and out-of-the-ordinary sense of humor and adds more laughs, as well as more serious material.

I haven’t counted how often she talks about vaginas and “lady gardens,” but I bet someone will. And f-bombs abound. (Hardly surprising, since the most requested way for her to sign books is “Knock, knock, motherfucker!”)

Note: If you’re at all a sensitive soul or offended by certain types of language, steer clear of the chapter on “Business Ideas to Pitch on Shark Tank.” It’s raunchy even by Bloggess standards, which means it’s beyond simply raunchy. Of course, if you were a sensitive soul who objected to certain types of language, you probably wouldn’t have picked up this book in the first place.

Jenny’s previous book, Furiously Happy, dealt a lot with struggles against depression and anxiety – Jenny’s own and other people’s. The new book goes into those subjects in more depth, including a personal narrative of using TMS (transcranial magnetic stimulation) to deal with her treatment-resistant depression. There’s even a picture of her using the device.

She also reveals her own “really serious and raw stuff” – experiences with avoidant personality disorder, imposter syndrome, ADD, OCD, tuberculosis, rheumatoid arthritis, anemia, depression, anxiety, and suicidal ideation. So be ready for a bumpy ride.

There are also sweet, sad, funny chapters about her family, and especially how they are dealing with her grandmother’s dementia and Alzheimer’s Disease. And there are chapters that are not sweet, funny, or sad, where she rails against insurance companies and their unhelpful (to say the least) ways. These chapters and passages, I am certain, nearly every reader will identify and agree with.

And, lest you think this is a complete departure from Jenny’s funny stories, rest assured that there is plenty of what Jenny herself calls her “baffling wordsmithery,” including times she lost shoes while wearing them, dog penises and condoms, attic vampires, arguments with her husband Victor, embarrassing moments shared with other people (those who inadvertently say IUD when they really mean IED, for example), roller skating monkeys, dubious beauty treatments, the perils of being an editor, the perils of cooking and cleaning, taxidermy (of course), and high school proms.

As for the title, a broken lawn ornament (not Beyoncé the chicken, thank goodness) leads Victor to explain the Japanese concept of kintsugi. According to this practice, philosophy, or art form, broken ceramic items such as vases or teacups are repaired with a fixative mixed with gold powder, which creates something new, stronger, more artistic – and beautiful at the broken places, a theme which runs throughout the book.

What sets Jenny’s books apart from other humor books and from other books on serious illness, especially serious mental illness, is her ability to connect – both readers to herself and readers to each other. Her humorous chapters are over-the-top funny and many evoke a sense of “Yes! Me too! That could/did happen to me!” Jenny even includes instances when people have shared their own stories of faux-pas with her and by extension, with all her readers.

Her serious chapters are educational, descriptive, and occasionally searing. She tackles tough topics with fortitude and forthrightness, educating as well as illuminating. Far from being a textbook on serious mental illness and chronic illnesses, though, her stories bare the truth and present the subjects powerfully. They give hope and understanding as well as connection.

Connection. That’s Jenny Lawson’s superpower.

Grief and Mood Disorders

Grief and mourning are hard for anyone to get through. When you have a mood disorder, it’s even harder.

Depression can linger longer than one might expect. A death, for example, might tip one over into a clinical depressive episode. There are no funeral etiquette books on how to cope with feelings like that. All they will tell you is what to wear to a funeral and what’s an appropriate remembrance to send or what to say at a viewing or funeral service. There are no emotional guides that tell you how long it is appropriate to mourn a loss. The feelings come as they will and stay as long as they stay.

A lot of the emotions associated with depression may visit you, or even move in and stay a while. If you are “lucky,” a period of numbness may get you through the funeral and any other formal observances. But that’s far from guaranteed. Depression may express itself as deep and inconsolable sorrow. Sometimes, there’s no way to turn off that feeling or wait to express it.

There can be anxiety too. Will all my egregious relatives behave themselves or will they do something embarrassing? Are customs from another religion the same as mine or not? It’s easy to get all tangled up and even immobilized. You may be tempted to avoid the whole situation. But if this was a very close friend or loved one, you want to do your best to respect and honor that person, even if you don’t know quite how. It’s even more anxiety if you have to ask yourself how you’re supposed to get through it all.

Grief and mourning are also emotions that may strike you after a death or other loss. You may cry unexpectedly, whenever the emotions hit you. You may wake in the middle of the night and feel the absence of someone all over again.

There aren’t any rules that cover grief and mourning. You feel how you feel for as long as you feel it. Some people try to shame the bereaved into restraining their grief or setting a limit for how long it should go on. The fact is that a loss may leave a hole in your heart for years to come, or forever.

Anger is also an emotion that may come. It’s one of the classic stages of dealing with death, along with denial, bargaining, depression, and acceptance. Anger is harder to understand and harder to control. Some people will not understand that you can feel anger when a friend dies. But my friend just died and I am angry as well as sad that I did not get to see her before she died, even though I know that it was impossible, given the circumstances. People may understand anger a little if the person died by suicide, but it seems inexplicable to many after a natural death.

I can’t tell you how to deal with those feelings. I am dealing with them myself right now. I am trying to hold myself together, to do what is “right” – to keep my grief on hold till I can express it fully. It’s not usually a good idea to stuff your feelings in a box, but sometimes it’s needful, and getting through the ceremonies attendant on a death may well be one of them.

Perhaps the hardest thing to get through is the fact that these emotions and the memories that they bring with them may crop up at unexpected times. Even decades cannot lessen the sorrow of some losses. Good emotions and memories of your loved one – and it need not be a close family member – will help. They may pop out of nowhere, just like the depression does. But these emotions you can hold close to you. If you can remember any of them when the bad times come, that may ease your grief for a while, though it cannot erase it.

Grief, depression, sorrow, anger, and other emotions are appropriate after a death. And don’t let anyone tell you otherwise. They may not understand that such emotions aren’t only for family members and the very closest friends. When someone has touched your life, in whatever manner, your emotions are valid and your grief allows you to express them. Whether you have a mood disorder is irrelevant.

Functioning While Bipolar

Bipolar disorder is a funny thing. Mine leaves me alone part of the time. Until it doesn’t.

I have had full-blown depressive episodes, with the sobbing and the immobility and the wretchedness and everything else associated with it. I have had one major episode that lasted for three years straight, plus everything else from minor breakdowns to that vague, lingering miasma that comes when you’re untreated and you don’t know that what is really happening to you is clinical depression.

I have also had full-blown anxiety attacks, the sort that leave you twitching all over, feeling like you’re about to jump out of your skin, gasping for breath, and imagining that every driver on the road is swerving into your lane. I’ve twitched and shaken and stammered. I’ve scratched myself. I’ve hidden under the covers until I can’t breathe. I’ve taken anti-anxiety meds that did nothing at all.

Right now I am sufficiently medicated and have been relatively stable long enough that I think what I have is functional depression or maybe high-functioning depression, or whatever you want to call it. I have enough wherewithal to work part-time from home, do other writing-related projects (like this blog and my other one), and do assorted tasks like paying bills and making business-related phone calls. (Occasionally, if the phone tree is lengthy enough and the person on the other end is uncooperative enough, I have a small-scale meltdown. My voice goes up in pitch and tears start rolling down my face. My husband takes over the transaction when he notices that.)

But secretly, I know depression is lurking and can rear its ugly head again with little or no provocation – a trigger or nothing at all. So can anxiety, which is how my brain usually responds to hypomania. It’s a little like those commercials for psychotropic meds you see on TV, where the person has a little sign with a smiley face and hides behind it. Except that’s not quite accurate.

I understand that high-functioning depression is also called “smiling depression.” That’s not my experience of it. I’ve almost never been able to “fake it till I make it,” slapping on a happy expression when inside I’m dying. Besides, it doesn’t work, as far as I can tell. The depression or the sorrow always leaks out around the eyes. I’ve seen this in myself and in other people.

Before I was treated, I used to have what you’d call “resting sad face.” Once a boss of mine encouraged me to smile more (and is there anything more annoying?). I didn’t feel particularly sad at that moment, though I’m sure that I had at least a low-grade depression, like a low-grade fever. But I was at my job, and functioning even then, if not very well or cheerfully.

The phrase “high-functioning” gets used a lot to describe certain varieties of autism. I don’t have autism and I’m not an expert on it, but my suspicion is that high-functioning depression is similar in some ways. I don’t always react the way other people expect me to. I feel out of my depth a lot, especially in environments with lots of people or lots of noise. But that doesn’t stop me – or lots of other people – from carrying on with what I need to do to be a functioning member of the populace.

But back to bipolar disorder. Even if someone seems to be “high-functioning” doesn’t mean he won’t have a meltdown sooner or later. Even someone who “slaps on a smile” may let it drop once she is alone. Even someone who is “coping well” may not be coping at all tomorrow or next week or next year. Sometimes you can’t tell on the surface what someone is going through inside. Like I said, bipolar disorder is a funny thing.

Bipolar Disorder Has Turned Me Into a Pouty Child

I am blessed with many friends, online and off, who are as dear to me as anyone can be. We have laughed together, cried together, eaten together, danced together, sung together, joked together, mourned together, and loved together.

Now that I’m back in my cycles of depression and hypomania, hurtling around like a marble in a shoebox, I haven’t heard from any of them.

A lot of the contact I have with friends is on Facebook, and I have almost entirely stopped posting or replying, or otherwise interacting there. No one seems to have noticed. At least no one has called or IMed to check on me.

Am I ghosting them? No, because I don’t want the relationships to end. In fact I very much want them to continue. My scattered moods, primarily depression, have sapped my ability to reach out. It may be that they assume since I post my blogs every Sunday, I am all right.

I desperately want someone to reach out to me. This is selfish and childish and unworthy. If I want human contact, I should be able to reach out and initiate it myself. But I haven’t been able to. Between the exhaustion of depression and the exhaustion of hypomania, it’s difficult to make any kind of effort.

The memes say that if you have a depressed friend, reach out to them, even when they can’t reach back. And there have been times when my excellent friends did that, back when I had been in the Pit of Despair. And they kept reaching, even when I didn’t respond.

I guess I miss those days – not the Pit of Despair – but the little parachutes of care that rained down and demanded nothing. The phone calls “just to check in” or to distract, the invitations that I was never going to be able to make myself go to or reciprocate, the awful jokes that I might not even be able to laugh at.

I understand that everyone is fighting their own battles these days, with isolation, anxiety, panic, and other reactions to the pandemic, the lockdowns, the vaccines, the separated families. Mental health struggles, especially including depression and anxiety, are spreading to people who have never experienced them before. A lot of people are suffering, and a lot of people don’t know what, if anything, they can do about it. People have had to resort to Zoom weddings and funerals and outside-the-window visits to relatives in nursing homes.

Part of the problem, I suspect, is that I have been so relatively stable and functional for so long now. I made it through a tornado and a year of home dislocation and all the associated disruptions and bureaucracy without having one of my famous meltdowns. So, now, when even I have not been expecting or experiencing any psychological trauma to speak of, it’s easy to understand that no one else has seen it or noticed.

Then there’s my husband. He is my rock, my caregiver, my “emotional support animal.” Ordinarily, he takes up most of the slack in making me feel seen and heard and cared for. But unfortunately, he is having depression and anxiety of his own right now. He has recently had health problems, has changed jobs, and has physically strenuous activities he must complete, within a deadline. Of course, he is reacting with depression and anxiety of his own. And when both of us are depressed and anxious at the same time, it’s not pretty. We don’t have enough psychic stamina to help ourselves, much less each other.

So, I understand why it isn’t happening. But I miss the check-ins I’m not getting. The calls that don’t come. The personal long-distance reach-in. The wave from outside the window.

I’m not quite to the point of, “Nobody likes me. Everybody hates me. I guess I’ll go eat some worms.” But close.

Hypomania and Exhaustion

I’ve done so much. I should feel exhausted. I do feel exhausted. Why do I keep doing so much?

The answer, of course is hypomania, or maybe a mixed state.

I had been thoroughly depressed over my writing, as I sent out query after query to agents, and getting back rejections or the horrifying limbo of “no response means no.” I kept doing this for nearly four months, until I had apparently run out of agents to query. (I know that can’t be literally true. There are thousands of agents in New York alone, but I had been through all the usual lists and gone pretty far down the Google pages.) Yet I trudged along, depressed but pushing myself. Get the queries done. Get my work done. Get these blogs done. Go to bed. The same the next day. Call it functioning depression. I was still in motion, doing what I told myself had to be done, but enjoying none of it (or anything else).

Then I got an invitation to try out for some work-for-hire (which is sort of like ghostwriting, only different). Instantly, preparing submissions (three of them!) for this gig consumed me. And I kept on with the queries, the work, and the blogs. But I was tipping over into hypomania.

I wrote the submissions insanely quickly, when I knew I should have taken the time to analyze them, polish them, try a couple of different drafts. But no. I found myself pushed to get them done and get them out there. Or rather, I pushed myself to do it.

My submissions were rejected, but this time instead of slipping back into a funk of depression, I wrote a nice note saying that if another opportunity like this came up to please consider letting me apply again. They responded to the note, seeming astonished that I had sent it, and complimenting me on my attitude. Nothing like a pat on the head to keep the juices flowing.

It was at about that point that hypomania truly hit. I focused everything on my writing. I reworked the first three chapters that I had been submitting to agents and submitted them to still more. I started taking on extra work assignments. I took only brief breaks to eat a bowl of soup, then plunged back into it again. I had trouble getting to sleep and trouble sleeping, even though I was so exhausted that I turned in early each night. And I woke early, ready to keep on keeping on.

Then the miracle happened. I got a positive response from an agent. They wanted to see more of my work. I tweaked the newly revised first three chapters and sent them in. Now I’m waiting, nearly bouncing out of my chair, for them to respond. I just know that they will want to see the whole novel and become my agents. I do know that the deal is a long way away from being sealed, but hope after so long of slogging through my depression, hypomania has taken control.

I am (sort of) still contemplating my WIP (work in progress, a sequel to the novel that might now become real), thinking I need to rethink it entirely or try a different plot altogether. I am still taking on extra work, though it exhausts me. During my brief breaks from work, I scour the internet for presents for my husband’s birthday, and spend more than I had intended for more presents than I had planned.

And I am writing this blog post the day before I need to post it, rather than the three to four days I usually allow myself to write it. And I still need to polish the post for my other blog. And pay bills. And find a place for us to get a health check that’s required by my husband’s employer. (I have already set up appointments for our vaccine shots.)

I think it is most likely that if the agent rejects my work after all this, I will once again sink into depression – the I’m not worthy anything, I’m a fool to have put this much energy into it, I should just give up kind. Cutting back my activity to the bare minimum – work and blogs. Sleeping more, enjoying it less. Enjoying everything less. My old familiar functioning depression that is only possible because of the meds I take that don’t allow me to swing too far down.

I know people who, when you try to tell them about hypomania, tell you to enjoy it while you have it. They don’t know how wrong they are.

Laughing Out Loud

There’s nothing funny about bipolar disorder. In fact, one of the ways that I know I’m having a spell of bipolar depression is that my sense of humor flies out the window. Nothing brings a smile or a laugh – not my husband’s awful jokes. Not my friend Tom’s silly songs. Not a funny movie like Arsenic and Old Lace.

I have been in a spell of depression for a little while now. As I mentioned last week, part of it may be reactive depression. But here’s the thing. Reactive depression feels the same as bipolar depression. You have the same sense of misery, loneliness, helplessness, hopelessness, anomie. But you know what caused it and that it will end pretty soon, relatively, unless you tip over into a true depressive episode, which can last a lot longer than that.

But yesterday I laughed. And that was a good thing. It didn’t pull me completely out of my depression, but it let me know that escape was possible, and maybe even starting.

It happened like this:

My husband and I were sitting on the couch, watching TV. I was not enjoying it. Then a commercial came on about “man-boosting” pills that increase testosterone. It promised everything: strength, leanness, stamina, and outstanding performance in the bedroom.

Dan turned to me and said, “Hey, honey. Maybe I should try some of that. Improve my performance in bed-woo-woo-woo!

I turned and looked him straight in the eyes. I said, in a solemn, deadpan voice, without a trace of a snicker: Woo. Woo. I never got to the third Woo because we both dissolved in giggles. And it felt good – not only that I could laugh, but that I could make him laugh. Just thinking about it made us laugh all over again.

Today I am back to feeling overwhelmed, if a little less miserable, but still functioning on some kind of level. I don’t think my depression is over with. But for just a moment, I saw a ray of hope. Yes, it was over something stupid. Yes, I delivered the line with a flat affect. No, I didn’t know it was going to be that funny. I even thought Dan might be offended that I was making fun of him. But the important thing is that we both laughed. 

What I’m saying is that laughter, by itself, is not a cure for depression, however much the memes and the positive thinkers tell you that it is. But if laughter happens to you, it at least reminds you that the depression will end sometime – maybe quicker than you think. The giggles are building blocks that will help you climb up out of your hole, or at least see that there is a way out.

That’s a lot of philosophizing about two words (or syllables, really), and I’m not sure the magic would happen again if either one of us said Woo. But I am taking the memory of that moment with me, for whatever strength it can give me and whatever amusement will stay with me when this depression ends.

How Depression Sneaks Up

I had a blog post all written and ready to go. It was about my fluctuating moods and my writing, and how they affected each other. Some of what I wrote is still true. The depression I suffered during my early years and the exceedingly depressive poetry I wrote during that time allowed me to learn something about how poetry works and something more about how depression works.

I wrote about how hypomania affects my writing, and that is still true. Hypomania pushes me to do my writing, even when I don’t feel like it. In fact, at times it pushes me into doing more writing than I can probably handle. Case in point: This week I wrote three samples for a work-for-hire outfit when I should have been writing or at least outlining my WIP (Work In Progress), a sequel to the mystery I have already written and have been sending around to agents.

And last night, that’s where I hit the wall. I figured out that I have sent out about 180 or so query letters and gotten only the most minimal results – rejections that said I had an interesting premise that was not right for them. Most, though, have received plain rejections or the dreaded “no response means no.” I am now second-guessing myself and everything about the manuscript.

Last night, the depression caved in on me. I spent the night in bed, not sleeping except for nightmares, and not wanting to get up in the morning.

Because my identity is invested in being a writer, though, I did get up (late), sent a few more queries, and got to work on rewriting my blog posts, which I had determined were wretched. In the blog post that I abandoned, I had pontificated about how keeping a schedule kept me going with all the writing projects and various other work I do. 

I had also crowed about my relative stability and how that was helping me keep that schedule, which was supposed to be keeping depression at bay. I found out that I lied. The fact that I have maintained functionality for some time did absolutely nothing to prevent the depression that hit me.

Admittedly, this is probably a reactive depression, with my lack of success being the trigger. The thing is, it’s awfully difficult to tell apart from endogenous depression. In fact, I have known the first to melt into the second. At first you have a clear cause that would depress anyone, then you find it clinging to you long after what would seem to be reasonable. (This is subjective, of course. What is the “right” length of time to be depressed over 180 rejections?)

What’s left? Self-care, of course. Trying to sleep if I can, and squeezing in a nap if possible. Eat something, even if it’s only some guacamole and chips or a bowl of soup. Take my meds religiously. Try to cling to that schedule even when I don’t want to.

But the truth is, I’m running out of agents to submit to. I’m running out of energy to try. And I’m running out of the frame of mind to keep me functional. I’ll be okay, I know, but it may be a long, hard climb. 

Internal and External Scars (Trigger Warning)

I was a clumsy child and am a clumsy adult, so I have lots of scars. They can be categorized into three types.

Accidental scars. These are the ones that resulted from my clumsiness. I have a huge scar on the inside of my left leg from tripping over a metal milk box. (For the youngsters among you, this was the box where empty milk bottles were placed and full milk bottles took their place.) Back in the day, you didn’t go to the emergency room for injuries like that, so the scar remains jagged and irregular, coursing across my inner thigh like a river.

There’s also a scar on my right foot from the time I dropped a Coke bottle on it. (Yes, this was during the era when Coke bottles were made of glass. I’m old, okay?) And one that bisects my eyebrow, lengthwise, from when I bumped heads with another child and my glasses were pushed into my face.

Non-accidental scars. The one that I am contending with right now is a medical scar. It came from a punch biopsy of my forehead to determine what a lump was. (It was a sarcoid.) I freaked out when the doctor asked the nurse to hand him the “puncture scalpel.” Seeing my distress, he changed it to “sampling tool.” That scar is fading, though, and I hope it will soon become invisible.

Another non-accidental scar came when I was in fifth grade. Some kids and I were at a bus stop and they thought it would be fun to throw rocks at me – actually crumbled pieces of the street macadam. At first they threw them at my feet, and I “played along” and jumped over the missiles. One kid, though, threw harder and higher than the others. The rock hit me in the forehead, and I started crying and bleeding all over my mittens. I heard one of the kids say, “We didn’t mean to hurt her” as they scattered and ran, a sentiment that I somehow doubted.

My mother was sent for and I was taken to the doctor’s office, where to add more pain to the incident, I received three stitches, which were in some ways more traumatic than the injury that led to them. This scar was right along my hairline, and isn’t really visible these days. But, believe me, it still hurts.

More distressing (and the warning for the trigger warning on this post) are non-accidental scars that I inflicted on myself. These are the scars that resulted when I took a knife to my wrist. Nowadays they call this NSSI (non-suicidal self-injury), and indeed that’s what it was. I wasn’t suicidal. You could call it a suicidal gesture, I suppose. But it was not a serious attempt, was never meant to be seen, and was not “a cry for help.” In fact, for many years I tried to hide the three inch-long white lines on my wrist by wearing a wristband or long sleeves to cover them. Now I view them as reminders of how bad things can really get and what incompetent coping mechanisms I had back then.

Internal scars. Some of these are most likely related to my self-inflicted scars. They came from a variety of situations, not least of which was being literally stoned while I was an impressionable young girl. There were many incidents of threats and bullying, which begin to pile up after a while. There were the internal scars that come with depression – feeling useless and worthless and unlovable.

There were also relationships, those that ended badly and those that were bad from the beginning. They reinforced the idea that I was useless and worthless and unlovable, and scarred my psyche.

Those scars don’t show on the outside, and I have worked hard not to let them become visible through my words and actions, as I used to do. I have not been completely successful, of course. Like the visible scars, I expect they will always be with me in some form. Like the visible scars also, I expect they will become fainter and harder to find unless I go looking for them, which I try very hard not to do.

They remain, but they fade, and I am satisfied with that.

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