Bipolar 2 From Inside and Out

Posts tagged ‘mental health’

The Creative Bipolar Brain

Sun or shade
feel or know
safe or strayed
stall or flow

Thought or whim
drought or rain
sink or swim
heart or brain

Stop or start
bound or free
light or dark
bipolar me

I have a lot of friends who are creative – writers, musicians, singers, woodworkers, knitters, and other craftspeople. I also have a lot of friends who have assorted mental or emotional disorders – depression, bipolar, PTSD, OCD, autism spectrum disorders, and probably many more that I don’t know about. In many cases, the two categories overlap.

Common wisdom holds that there is a link between creativity and madness. Look at Van Gogh, for example. People have spent years debating what specific disorder he may have had, but nearly everyone agrees that he had something. The question is, would he have been the great artist without the mental or emotional disorder? Or, perhaps, would he have been an even greater artist if his brain functioned in a more typical matter? Science so far has given us no answers.

Many creative people realize that their everyday functioning is impaired, but they are reluctant to seek treatment for it. They fear that tampering with their brain or thought processes will somehow inhibit their creativity – make them less than they were in some fundamental way. When you start tampering with brain chemistry, who knows what will happen?

It’s a valid concern.

Throughout my life, my brain has been all that I have, or nearly so. My intelligence and creativity were the things I was most proud of. How could I risk losing those simply because I was eternally miserable? The question seems absurd now.

Eventually I decided that I had plenty of brain cells to spare, and that if taking Prozac took away a few of them or lessened their ability, I could live with that. (Just in case, I took up pursuits that are supposed to strengthen the brain – math puzzles in addition to word puzzles, music in addition to writing. Not everything I tried was a success, but I hope they stretch my brain muscles.)

My experience with that first psychotropic med convinced me that Better Living Through Chemistry is not just a chemical company’s slogan. It turns out that – surprise, surprise – thinking more clearly and feeling more well-adjusted actually empower one’s creativity. My output changed from poems full of young adult angst to creative nonfiction, personal essays, and the occasional short story. I now make my living doing freelance writing and editing – an unstructured process that I couldn’t have made a go of before having my mood disorder treated. The ability to concentrate – to focus – is what enables me to sustain a creative effort.

So to all those people out there who wonder if they are sabotaging themselves and their creative impulses by seeking treatment, I say go for it! You have nothing to lose but your immobility. You have everything to gain – the ability to create, to express yourself and do it clearly, and the possibility to create something truly wonderful.

Sylvia Plath was a poetic genius. But she could have given so much more of her talent and vision to the world if she had not killed herself. Perhaps her poetry, had she been treated for her mood disorder, would not have been as searing and powerful. The point is, we will never know. Would she have become more ordinary, or more extraordinary? Dying young obviates the answer.

I believe – for me – that psychological treatment, appropriate medication, and more stable moods have expanded my creative process. And I try to prove it every week when I post in this and my other blog. Whether I succeed is for you to determine.

Have I lost a step? Maybe. But two forward and one back beats the hell out of one forward and two back.

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Not Waving but Drowning

Consider this a trigger warning. The third section is going to talk about some difficult stuff, although in mostly general terms.

Here’s a list of how I know how bad my mood disorder is at any given time. Being bipolar, I cycle in and out of these phases, along with periods of reasonably competent functioning and even, occasionally, contentment or even happiness.

There are basically three stages of increasing dysfunction.

Starting to Sink
My sense of humor takes a hike.
I need more alone time.
I take mega-naps.
I forget that music can help.
I snap at my husband.
Noises irritate me.
I can force myself to work.

Floundering
I don’t want to eat.
I turn off my phone.
I sleep up to 14 hours a day.
Attention span is one hour (or one average book chapter).
I can trick myself into working.

Going Under
Can’t sleep.
Can’t work.
Can’t read.
Attention span: 15 minutes max.
Thinking “Maybe the plane will crash and I won’t have to deal with this anymore.”
Regretting I flushed my stash of pills.
Urge to cut.

Fortunately, I am well-medicated enough that category 3 doesn’t happen nowadays, though I remember it clearly and am appalled. At that point, the only things I can do are keep seeing my doctors and taking my meds. And remember to thank my husband when I come out of it.

(The title of this post is from a poem by Stevie Smith. The last two lines are: I was much too far out all my life / And not waving but drowning.)

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In Defense of the Armadillo

Let’s consider the armadillo. Better yet, let’s consider this brief video. Take note of the armadillo’s defense mechanisms, if you will.

I have always identified with the armadillo, for a variety of reasons. It is the symbol of Texas music, which I love. I have a purse shaped like an armadillo. I also have toy armadillos, crocheted armadillos, wooden, stone, cement, armadillo jewelry, you name it. My uncle and I have a catch-phrase: El armadillo amarillo de mi tía es sobre la mesa.

What does all this have to do with bipolar disorder? I’m glad you asked.

Most of all, I admire the armadillo for its defense mechanisms, which resemble some of mine. For those of you who skipped the video, here’s a recap.

The armadillo has armor (obviously). I have tried to construct a similar impervious shell. When I have been even partially successful, it has proved counterproductive. When you wall off feelings, you wall off the good ones too.

The armadillo rolls up in a tight ball. I isolate. This has also proved counterproductive. If sorrow shared is halved and joy shared is doubled, then isolation – well, you do the math.

The armadillo leaps vertically when threatened. My anxiety makes me jump and release fight-or-flight hormones. This defense is also counterproductive, both for the armadillo and for me. One of the armadillo’s main predators is the automobile; the armadillo jumps straight up to bumper height. I waste energy on panicky behaviors even when I’m not threatened.

The armadillo has a low body temperature and is therefore useful for research on leprosy. This is not a defense mechanism, but it is a Fun Fact to Know and Tell. I have never had leprosy.

All things considered, the armadillo is not a good role model for a person (me) with bipolar disorder. But I like them anyway. They remind me that I need to check whether my defenses are doing me harm rather than good.

Plus, with my armadillo handbag I get lots of practice in the social skill of making light conversation strangers – and even children!

Erma

Erma

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The Lighter Side of Insomnia

I’ve had insomnia. Lots. January seems to be an especially bad time of year for me. A sleeping pill reduced the frequency, but nothing banishes it completely – the obsessive thoughts, the catastrophizing, the worrying, the worrying about how worried I am. We’ve all been there at 3:00 a.m., trying to will ourselves to sleep.

What could possibly be light-hearted about that?

Just this: An actual x-ray of my insomniac self:

T-shirt by Headline Shirts. Photo by me.

Indeed, my friend Leslie and I, both afflicted with insomnia, recognized this as our mutual problem. We began to end our late-night commiseration with the sign-off, “Death to Hamsters!”

Our mutual friend, the incomparable, incorrigible Tom Smith, heard of this and ran with it. Here is the result, for your amusement.

Imagine, if you will, this performed as a sing-along with a hundred people joining in on the chorus. It may not put you to sleep, but at least it puts insomnia in some kind of loony perspective.

At least it does for me.

Notes:

No hamsters were harmed in the making of this blog post. A rubber duck may have been squeezed, but it had nothing to squawk about. So if you’re with PETA, chill already.

Lyrics to Hamster Brain available here: http://www.tomsmithonline.com/lyrics/hamster_brain.htm.

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Why I’m Not Like Sheldon Cooper

Obviously, I’m not a man or a theoretical physicist or a character on The Big Bang Theory. But also, I can’t say, as he often does, “I’m not crazy. My mother had me tested.” I’d like to have that t-shirt, but it would be false advertising.

I am crazy and my childhood was entirely free of psychological testing.

It probably shouldn’t have been, because the crazy had taken full hold during my tender years. Crippling depression. Massive anxiety. But both my parents were ordinary folk from Kentucky transplanted to a bland Ohio suburb. They stayed true to their roots and never considered testing or counseling for me or my sister. According to their upbringing, having crazy relatives might be upsetting or embarrassing, but that’s just the way it was. You tried to shelter them from the outside world – and vice-versa – but you didn’t involve agencies or doctors or hospitals.

My crazy got too obvious to ignore when I was in junior high school. I developed a nervous tic – my head would jerk up and to the left uncontrollably. This was very distracting, not only to me, but to whoever was sitting behind me in class. It got me noticed.

It did not, however, get me to a psychologist or other mental health professional. I didn’t want to see one anyway, because I had the irrational notion that being “shrunk” would go on my permanent record and I would never get into a good college.

Instead, I was taken to our family doctor. He prescribed Valium, which did stop the twitching but did absolutely no good for my depression.

Later, during my college years – at a good school, I might add – I had another run-in with Valium. This time my symptom was pain like a railroad spike being driven into the side of my head. Naturally, I thought it was a brain tumor.

I went to the doctor, who said, “I can do any test you want, but I can tell just by looking at you what your problem is. Your jaw is crooked.” He diagnosed me with temporomandibular joint (TMJ) disorder, explained that tension made my muscles contract unevenly and cause excruciating pain in my temples. He sent me away with a prescription for Valium. Which helped with the stabbing pain, but again not with the depression. (Also, I was self-medicating with wine, which just made the crazy train run faster.)

It was not until years later, after college, that I got half a diagnosis – depression – and a non-Valium prescription – Prozac. And many years after that until I got the more accurate diagnosis (bipolar 2) and an appropriate regimen of drugs, which does include Ativan, but not prescribed alone or with wine.

And that’s another thing I don’t have in common with Sheldon Cooper. He’s not taken any psychotropics (or wine) and is happily stuck in his supposed non-craziness. I’ve accepted my craziness, gotten help for it, and am slowly rising, if not above it, at least to where I can peek over the top of it.

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Family Matters

No one in my family understands me.

Actually, no one in my family understands my illness.

My mother-in-law doesn’t believe that mental illness exists. And in a way she has a point. If she hasn’t experienced something, for her it doesn’t exist. Most people are a bit like that sometimes, especially regarding mental disorders. There are only a few varieties of broken arms, and when you’ve got one, you know it. When you’re talking synapses and neurotransmitters, thoughts and feelings, it’s obvious why “invisible illnesses” aren’t obvious or well understood.

I didn’t understand my disorder at first, either. I remember driving past a building with a sign: South Community Mental Health. I didn’t know what I was feeling, but I was pretty sure it wasn’t mentally healthy. I went in and began the journey.

My family had the following reactions when I told them I was going into therapy and when I first started taking medication:

Dad: Just as long as I don’t have to go.

Mom: I’ve heard Prozac is a ticking time bomb.

Mom (later): I thought you would feel better after you found a good job.

Sister: Why should you spend $100 a month just to talk to someone? (The clinic was on a sliding scale, so I actually paid only $5 per visit.)

I understand some of those reactions. Dad had heard about how psychologists blame parents for messed-up kids and he wasn’t going to someone to be told he was crazy, and a bad parent besides. And his fear was not that unreasonable. Dysfunctional kids often do come from dysfunctional families. But underlying my disorder was brain chemistry. I never asked him to join the couch gang.

Mom watched Phil Donahue (for you youngsters, think Dr. Phil). And there was at first over-prescribing of Prozac and suicides once the patients gained enough energy. Plus she thought my depression and anxiety were reactive and would clear up when my living situation was more stable.

My sister, I don’t know. I don’t understand her either. I’m sure she has psychological problems too, of one sort or another. But I’ve been diagnosed, so I’m the crazy one.

My husband, who has a background in psychology, “got it” a little better once he stopped trying to “fix” me. But he never understood in a visceral way until he had his own first meltdown.

“You know how you’re feeling now?” I said. “Try feeling that way for a couple of years instead of a month.” Later he did. So at least he knew what half of bipolar was all about. He still hasn’t felt the rapid cycling or the constant roller coaster or the extreme physical and mental battering of going on and off medication after medication, hoping the next one will do more than make his hands shake worse or his memory turn into Swiss cheese.

Still, it’s better to be partly understood than completely dismissed, and to have a family that tries. And to have a family of choice that does understand, because a lot of them are in the same leaky, patched boat.

I could have done a lot worse.

 

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The Abilify Saga Continues

It turns out, Abilify works for me. Except now I have to work for Abilify. To afford it, I mean.

I now wake up around 7:30 or 8:00 instead of 10:00. I can concentrate long enough to read whole chapters of books, and am enjoying that immensely. I am able to get showered and dressed and go out to run a few errands. I can decide what to eat and even recognize when it’s time for me to eat.

And I can work. I have taken on a mega-project, which has required my attention up to eight hours a day, researching, writing, editing, and proofreading. I don’t know how well I’m doing (there are some differences of opinion about that), but I’m doing it, goddammit.

I may be pushing myself a little too hard, despite the new energy and focus. The other day I had to force myself, one pitiful step at a time, to address a dozen Christmas cards. “You have the list, you can put the addresses on the envelopes. You’ve got enough stamps, you can surely put them on the envelopes. (Don’t call me Shirley.) Better put return addresses on. You can do that much, then stop. You can slip the cards into the envelopes. How hard can that be? You had them printed with your names, so you don’t really have to sign them if you don’t want to and won’t have to fake your husband’s signature because he’s not here. That would be too much. Now lick the envelopes. All you have to do is stick out your tongue. Might as well take them to the mailbox. You need to get cat food out of the car anyway. Okay, now you can crash. Egg sauce, Ted.”

Many’s the year when all that was Just Too Much. According to the Mystic Law of Reciprocal Cards, we get about four nowadays, and are very grateful for those.

And grateful for the Abilify. Except it’s $800 a bottle, even for the tiny dose I’m taking. I got one free month and one discounted month ($650) from the manufacturer and have spent a lot of time since worrying and seeking solutions.

There will (we hope) be a generic in April. Yay.

I know someone who was taking it and has some left over.

I know someone in Canada.

Will my doctor prescribe a higher dosage so I can break them in half and stretch them (and the cost) out?

I may have at last solved the problem. After hours on the phone and hours more on hold, we finally have new insurance. It costs about as much per month as a bottle of Abilify, but the drug benefit kicks in before we’ve paid the deductible (which is way lower than previously). So our many, many other drugs will magically shrink to $15 per – or less with mail-away – and we’ll come out ahead. A little. Probably. If I can keep up the pace on work.

Plus, now we have dental, and oh lord do I need that. But that’s another story for another time.

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Happy Humbug

It’s a truism that holidays are difficult, not to say hazardous, for those of us with mental disorders. But there are a variety of reasons and a variety of reactions and – dare I say it – a variety of coping mechanisms.

First, let me say, that despite the fact that I was already depressed or bipolar as a child, the holidays were marvelous. Our granny, maiden aunt, and uncle lived a few hours away and we spent Every Holiday there. (My uncle drank, but not when we were kids.)

On Thanksgiving, we’d arrive, the adults would eat themselves into a coma, and then nap while we kids were sent of to the movies.

Christmas was similar, except that we’d get up, open presents from our parents (and “Santa” for the biggies), pile into the car, and head to granny’s. The adults would eat themselves into a coma, and then nap while we kids were sent of to the movies. (I specifically remember The Sting and The Andromeda Strain, during which I saw my first picture of a naked male butt.)

There was no tension involved – no grand dining table, no fancy dress, no distant relatives, no formal manners. We’d simply fill a plate with home cooking, perch on a sofa (which was called the davenport) or chair, and chow down.

My birthday falls between Thanksgiving and Christmas, but poised well enough between the two that it was never combined with either one. Back then, birthdays were simple – cake and frosting from box mixes, four to six neighbor kids, presents (no gift bags), and maybe a couple of party games. (It was at someone else’s birthday party that I was traumatized during a game of Pin the Tail on the Donkey.)

How could anything in later life measure up to those?

Well, it couldn’t. My first Thanksgiving away from home was when I was at college, and we ate lasagna, not turkey. I believe it was the first time I had lasagna. Ever.

Since then all the holidays have gone downhill, or I have.

Any more, they’re a chore, a relentlass gray blob from November through January. (Halloween starts it off. I can’t get with that either.)

For years, I kept up some of the traditions for my parents’ sake. My mother in particular loved everything to do with Christmas – the Macy’s parade, the tree with my father’s favorite old smudge-faced angel on top, crocheted holiday sweaters and snowflakes and handmade ornaments from her foreign penpals and neighbors and church friends.

.muzz3

My first Christmas in my own apartment, I had a small fake tree. When I got married my husband and I tried to get into the spirit with surprise gifts and selecting and decorating my mother’s tree and inviting a divorced friend to dinner with us.

But I was sinking rapidly. At various places I worked, all the ladies sported store-bought Christmas sweaters and sweatshirts (Halloween ones, too) that I thought were just awful. But one year, in a desperate attempt to fit in, I bought holiday sweaters on sale in January to wear the next year. Of course, by then I had lost the job.

Dan and I continued the tradition of dining with our friend John, but our venue changed to Chinese restaurants, where we were kept company by Jews, pagans, atheists, and, no doubt, other depressives and bipolars.

One year Dan was visiting his mother and I was on my own. I tried. I really did. I trotted out a festive holiday sweater and little wrapped-present earrings, and went out to a buffet that offered turkey and beef and ham. But I sat by myself and listened surreptitiously to my iPod. And not holiday music, either. By then about all I could stand was the Christmas jazz from the Charlie Brown TV show.

This year, we ate out on Thanksgiving – but not at the swanky hotel buffet we sometimes took my mother to, or any of the other mega-buffets. We went to a diner that John used to love. I had pork chops and lemon pie. On Christmas I’m likely to be by myself again and may just get festive with a Stouffer’s mac-n-cheese.

Comfort food seems appropriate, and the cats like to lick the dish. Then for dessert – Zoloft and Ativan and Lamictal and Abilify and Ambien. Yum. Visions of psychotropics dance in my head.

 

P.S. I wrote about a Thanksgiving with John on my other blog. If you’d like to see it, go to http://janetcobur.wordpress.com/2014/07/25/thanksgiving-ratatouille-and-a-near-death-experience/

And if you’d like to see my rant about the “War on Christmas,” go to http://janetcobur.wordpress.com/2014/11/09/lets-call-a-truce-on-christmas/

 

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Missing Friends

Last week I wrote about the controversial subject of self-harm. In my post, I said:

One of my dearest friends once said that if he ever found out I was a cutter, I would never hear from him again. Except for his publicly mocking me for being so stupid.

Naturally, this sort of reaction, though common, is not helpful. I didn’t tell him (or practically anyone else). And I didn’t tell him that at least two other people he knew – one fairly intimately – were also cutters.

Anyway, Tom, if you’re reading this and still feel the same, I guess this is goodbye – just not the long goodbye. I would rather skip the public mocking, though. I’ll just assume you’ve done it while I wasn’t there, mm-kay?

Finally, I got tired of wondering, withholding a part of my past from someone with whom I have practically no secrets, sometimes to the point of TMI.

So I called him and asked, “Are we OK?” At first he didn’t know what I meant, since he hadn’t read the post, but after a brief nudge I could tell he knew exactly what I was referring to.

Just as a (very rational) mutual friend had predicted, Tom chalked it up to the hyperbole of his callow youth and reassured me that we were fine.

Still.

I had lived with the fear of losing that important relationship (and being publicly mocked) for over 20 years. I had never dared mention it to any people in our circle either.

And, let’s face it, I have lost other friends and can attribute at least some of these losses to my bipolar disorder. It harms me, but it also harms those around me, and especially relationships.

I have shot my mouth off and driven away friends and colleagues with bitterness and sarcasm but without realizing how I sounded.

I have ratted out a friend to his therapist and his wife when he was suicidal, which he found unforgivable.

I have turned down invitations to go out or agreed to and then backed out one too many times. My friend gave up the effort since I wasn’t responding.

I have abused the hospitality of friends. When I was at my still functioning moderately well, I would visit and we would enjoy activities, food, conversation, and music. When I was near or at the depths, I would invite myself to visit and turn into an uncommunicative, disengaged, immobilized lump. I was a mooch and a leech, and a real downer generally. I didn’t like spending time with myself, so it’s no wonder they didn’t either.

And I miss every single one of them. I wish I hadn’t driven them away. I wish I could make things right again, now that I’m functioning at a higher level. But I can’t. And that hurts.

In some cases, I’ve tried – sent brief notes of apology. They have been acknowledged with cold politeness that does not invite more contact. I don’t know what else I can do.

Bipolar is a cyclical illness and, though I’m much improved, I can’t promise that I will never sink that low, be that inconsiderate, offend those I deeply care about again. And I can’t blame them for not wanting to deal with that. I don’t want to deal with it.

But I have no choice in the matter. And that hurts too.

Fortunately, there’s one friend I cannot lose, no matter what – my husband. He’s ridden the roller coaster with me, put up with the huge mood swings, ignored the irrational remarks, offered to help in any way, encouraged me to go out but understands when I can’t, and dispensed hugs on a regular basis. He respects alone time and is there when I need company or distraction. If things are really bad, he gets me to eat and helps me shower and takes care of the pets and picks up my refills and does whatever else needs doing.

He’s a man who takes “in sickness and in health” seriously. I wouldn’t have made it this far without him. And I won’t ever lose him, till death do us part.

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Cutters

If that title wasn’t enough of a trigger warning, well, here goes:

TRIGGER WARNING: Self-Harm

Recently a small discount store a couple of miles from my house was caught up in a furor because a “Princess Wand” toy they were selling (ominously named an “EvilStick”) would reveal a hidden image of a teenage girl cutting her arm with a knife. Here’s a link to a local news story about it, and the snopes.com report verifying it. If you want to, you can easily search out a copy of the image, but I don’t recommend it.

Self-Injury

http://www.snopes.com/photos/odd/evilstick.asp

The “toy” is in horrifically bad taste (so, for that matter, is the snopes article’s headline, “Wristcutters – A Toy Story”). But items that adults consider dreadful can attract kids (remember the Garbage Pail Kids trading cards?). The image of the teenage cutter looks like a macabre Halloween costume rather than anything realistic (I’ve seen it), but we don’t really know whether a mistake, an error in judgment, a misunderstanding, or a prank at the factory that went way over the line resulted in the image on the toy. I kind of hope so, because if it was intentional, that’s way worse.

But bad taste is the least of the problem. The toy and the reaction to it have introduced the subject of cutting to a wider audience, if they choose to look beyond the squick factor and think about what the image really means. Cutting is a reality that’s mostly hidden from view.

Of course, it’s not always cutting. Burning is popular too. But cutting is perhaps the most common name. There are websites devoted to it, some offering help, facts, and information on quitting (see below) – but others glorifying it as, I don’t know, a creative expression of teen angst or something.

The name does keep changing. The last I heard, the “approved” psychiatric term was “Non-Suicidal Self-Injury” (NSSI). Self-mutilation, deliberate self-harm, non-fatal self-harm, self-destructive acts, self-inflicted violence, parasuicide, and self-wounding are all names for the dangerous practice performed by desperate people. The subject still isn’t talked about much and carries a huge stigma. As if the mental and physical scars were not enough.

Some facts: Self-harm is not attempted suicide, though with some miscalculation it can lead to serious permanent injury or death. Most people associate it with teenage girls, but I’ve know at least one man in his 50s who cut himself fairly regularly. It is not a matter of attention-seeking, since most cutters hide their physical wounds.

As I understand it, the practice results from one of two phenomena: the build-up of painful pressure such as perfectionism, or a feeling of severe alienation to the point of numbness. Cutting is a coping mechanism, though a dangerous, dysfunctional, and unsuccessful one, to deal with pain.

In my case, it was probably the numbness. I was feeling a lot of psychological pain at the time (college age) and irrationally wondered if physical pain would lessen that, or increase it, or feel any different. Like I said, irrational. All this was before I was diagnosed bipolar, had a therapist, or was medicated.

I made a few small cuts on my wrist to watch the blood well up. (Ironically, they became mildly infected; I neglected to sterilize the knife.)

I wasn’t suicidal. They weren’t that kind of cuts. I do know the difference. (I didn’t realize that I could have damaged tendons or nerves in my hand or arm, perhaps permanently.) It was more like when you stand on a bridge or balcony and look over the edge. You walk away. But you know the bridge is always there.

All told, I cut myself maybe three or four times. The scars are very faint now, white against my pale inner wrist, almost invisible. The memories are vivid. A friend who’s a psychologist once asked me why I stopped. “Because I didn’t need to any more,” was the only answer I could give. I’ve only felt the urge once since, and it was easy enough to push aside. But I recognized it.

I hesitated to write and post this, though I knew I would have to sooner or later, if I meant this blog to share my experiences truthfully. One of my dearest friends once said that if he ever found out I was a cutter, I would never hear from him again. Except for his publicly mocking me for being so stupid.

Naturally, this sort of reaction, though common, is not helpful. I didn’t tell him (or practically anyone else). And I didn’t tell him that at least two other people he knew – one fairly intimately – were also cutters.

Anyway, Tom, if you’re reading this and still feel the same, I guess this is goodbye – just not the long goodbye. I would rather skip the public mocking, though. I’ll just assume you’ve done it while I wasn’t there, mm-kay?

Cutting isn’t going away if we ignore it. It won’t go away even if we do talk about it. (Or mock it, or gasp in horror.) But understanding self-injury is a big step.

If you’re a cutter, or know someone who is, here are some places you can go for information, hope, and help:

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