Saturday, 19 April 2014

Bloody, but unbowed

Recovery is a funny state. It's been a couple of months since I last wrote anything for QE - or anything at all, for that matter - and during that time it seems like there has been greater change than in the seven months prior to this more recent past.

As per my usual writing style, I don't want to get too personal because it's not really the place. This is an expat blog, not a venting ground or somewhere to bleed. However, I'm a strong advocate for sharing experiences that might be helpful to others, particularly when it concerns mental health, and in spite of the possible cost of compromising one's privacy. Compassion, shared experience, and reduction of stigma are all more important than the latter, in my opinion (getting personal already, see?!).

About six weeks ago I went to see my doctor for my annual. I asked if I could also discuss my insomnia issues, because it'd been some months (in fact, it had been almost seven) since I had been able to truly rest. I either couldn't get to sleep, couldn't stay asleep, or would be so fitfully asleep that restoration just wasn't happening. My body was starting to fall apart and just the thought of trying to sleep was making me anxious. Focus and energy during the day were all but gone - I needed to do something.

Because I've dealt with insomnia on and off for almost all my adult life, for one reason or another, I thought perhaps I could "reset" my system with a short-term medical solution; that some sleeping pills would kick-start a new period of decent sleep hygiene, where I wouldn't fear going to bed or get so worked up if I did keep waking up in the middle of the night. However, when I spoke to my doctor, his understanding and compassion absolutely blew my ideas out of the water. He explained that - as he knew I was aware, with a background in mental health and a passion for neuropsychology - insomnia is not an illness, it is a symptom. He then asked me a few more questions: how was life generally, what had been going on recently, how many times a day was I crying? As I answered the questions, I still felt like my answers made perfect sense: life was generally unpredictable and there were some days I didn't want to be conscious, but other days I could sense the joy I used to feel about living as though it were just out of sight, about to come into view at any moment. Things that had been happening recently had caused me indescribable and intensely confusing pain, but that was to be expected, given the nature of how everything broke down. I felt like the fact that I could still sense happiness and see that it is possible to appreciate positive things that happen even in this dark period meant that I was simply traversing some rough territory at that point. I'd been through worse, so I knew I would survive. I just wanted to sleep. It would be okay if I could just sleep.

That last question, though? I was crying about five times a day. Without fail, and often without an obvious precursor, and always with no control as to when. There it was: evidence of a real issue. And even then I objected: I've been through this kind of struggle before; my brain plays tricks on me but I know I can fight it; I'm in nowhere near the black space I've inhabited previously. 

Then came the coup de grรขce, "Eve, just because you feel you've been through worse doesn't mean that you're not suffering." I think I'll remember that forever, and the palpable relief that came right after hearing it. I was allowed to say I didn't have any more fight in me; that I was drained and without hope and it was, in fact, all too much. That I wanted to let it envelop me; sitting in the darkness was starting to become a choice rather than a consequence; that I couldn't cope with the wreck that had become of me and how my conflicting emotions were torturing me on their terrifying daily roller coaster. That my anger and frustration and disgust were eating me up. That perhaps I just wouldn't be okay again, that the pain was so acute that I just didn't want to be anymore, and that was just something I had to accept.

But fuck that. Fuck it, and fuck it hard. That's not who I am.

The doctor's advice was a course of two medications combined, designed to elevate mood and help with sleep at the same time. He diagnosed me with 'adjustment disorder' (which I feel I should be able to make funny somehow because it just sounds so silly), otherwise known as situational or reactive depression. The way I was feeling had been going on too long to just be sadness, he said. Although he knew I was resistant to taking medication because I felt my emotional state was logically justifiable (yes, I just wrote that), and because I did not and do not want to be on some plateau of middle-ground feeling neither joy nor pain, he advised it was worth trying for a few months to see if it could help me to be peaceful. I relented. Peace is something I knew I needed.

I'm now in the sixth week of treatment, and about 10 days ago (after several weeks of some seriously spectacular side effects as my body adjusted), I noticed that I wasn't dreading the day as soon as I woke up. It wasn't so much that I was happy about the new day, but more that I sensed the absence of my usual trepidation and hopelessness upon waking. I had a good day. I had two together, back-to-back. I was starting to catch up to that joy in the distance - it was in view. By this point I'd already had so many ups and downs that I had learned to take each day at a time. It's very important not to assume you are suddenly fine and then punish yourself when you realize you're still working your way uphill the very next day. If you have a good day - hell, if you have a good hour - then appreciate that. It doesn't have to mean anything. It was good, and that's good. There's nothing more to it.

Keeping that in mind, I've now had more good days than bad this week, and that's the first time that's happened in months and months. I'm more energetic. I'm listening to my friends again rather than finding it hard to focus on anything other than my own misery and need for solitude. I'm smiling a lot. I'm connecting again, and I'm softer. My anger and deep sadness have made way for an acceptance of sorts and, although those negative and defensive feelings are definitely still there, they aren't aggressive in the way there were before. I'm not hurting myself further by harboring emotions that contradict who I want to be, who I am as a person. As Jung says, "I am not what happened to me, I am what I choose to become".

It's more than that, though. It's recognizing that life is a path, and there's no end point (except for the final full stop that is actual death). There's no ultimate goal of total healing or wholeness, just a string of (often marvelous) events that we get to experience while spinning on this relatively tiny planet. So, while I mean no disrespect to Jung, I think that Maya Angelou put it better:

"I can be changed by what happens to me. But I refuse to be reduced by it."

This, along with what the wonderful Cheryl Strayed suggests to the left, is where I believe the true healing will be - where it is starting now. We are, as animals, a collection of cells and experiences. You quite simply are what you go through; you are changed by what happens to you because you react and learn in response to those events. But that isn't all you are. There are choices as to how you apply that learning, once you get to a point where you feel able to engage again. That's what I'm advocating now. With the right help and support (which may or may not be medication; I'm not pushing one method over another but rather saying that getting some sort of help is so important) you can be pulled to a place where genuine recovery begins. You can start to process what you're going through and accept it as part of your experience of the world, while not letting it define who you are in it. Beyond this place of wrath and tears is the possibility that each tomorrow could be a good day. Here's to that tomorrow.