Tag Archives: mentalillness

Lasciate ogne speranza

In this post, as the Klingons’ Second Rite of Ascension calls for one to say, tIqwIj Sa’angnIS I must show you my heart. I both warn you all and apologise in advance; I’m unloading a lot of stuff here in order to help me push it out of the unhealthy residence it’s been taking up in my head. One of my best friends has suggested I write more #weirdthingsivedone posts, especially since she claims I somehow manage to scale new heights of Peak Nerd in her eyes every time we talk. (I’m not sure I’ve ever been complimented so wonderfully in my entire life.) And I will do that in future posts, I promise. But for now, here, I need to wax maudlin for a short while, so I ask for your indulgence while I do.

I read this small chunk of prose by a poetically-inclined denizen of Facebook a couple of nights ago – the ancient historians call these prose fragments gobbets when set as stimulus fragments for essay exams, and that term I’ve been utterly unable to get out of my head for every single one of the fourteen years since I last did an ancient history essay exam – on the news feed of a friend, and I haven’t been able to get it out of my mind for a couple of days (a wonderfully pleasant Friday evening notwithstanding, spent picking out new glasses and having dinner with the same dear friend who accused me of perpetual apex geekery – that was a perfect distraction that I desperately needed and am grateful for). I don’t know if it qualifies as prose-poetry as such, but certainly the style isn’t typical of standard prose; far more highly emotive, a cry of empathy with the deeply wounded. Because of the psychological place I was in, reading this piece was like a shout into a vast canyon with perfect acoustic balance, echoing countless times within the vaults of my mind and the power to silence it or call it back utterly out of my control.

I know what it feels like to live on the edge of loneliness
to have every hope crushed and everything you touch die
and to try so damn hard only to realize
nothing is going to change anytime soon
so you deal with the pain the best you can.
Reggie Nulan

I’ve been entrapped by this proselet largely because it feels almost like this Reggie Nulan has looked straight through – perhaps past – my eyes to see directly into the darkest, grimmest walls of my mind, and has unhesitatingly read the spidery scrawled inscriptions of my worst fears, shallow glyphs scratched weakly into prison walls of piled grey stone by the most anguished part of my psyche. My October was exactly like this verse says. It was a period during the start of which which I did feel occasional snatches of something like motivation, a feeling I hadn’t had in some time: motivation to work, to write, to move forward with my life in aspects that had previously been stagnant and beginning to grow heavy on my shoulders. It was a time during which I didn’t just make plans, but also took steps to – as the revolting business jargon would phrase it – action those plans. (As the great philosopher Calvin – no, not that one – puts it, verbing weirds language.)

Eek. I just wandered off searching for that link, got distracted, and fell into the Internet for about half an hour. I can’t even think about this for long enough to get through the writing of a full post on it. I’m sorry. Where was I? October. That’s right. Much as I’d have liked to forget. September came to an end on quite a high, with notifications via email that one of my academic articles had just been published and two further articles had been accepted for publication in the professional journals. This is probably, I’m pretty sure, what gave me the motivation to start building on the momentum I was experiencing: to keep it rolling forward while it was there, and try to avoid falling back into the lethargic inertia I’m prone to. (I’ve long since come to the conclusion that Newton’s first law of motion has relevance to more abstract forms of progress, too – that an object in motion tends to stay in motion, and conversely, an object at rest will tend to stay at rest.) I was getting my medication régime back under control with the assistance of a good psychiatrist, some academic success had come my way in the form of these three papers, there was promise of upcoming paid contract work at my alma mater, I’d had an offer from a friend to move out of the living situation I’m in that’s contributing to my worsening health, and I was feeling ready to step back out into the world of romance by asking out someone who in recent months I’d been both getting to know better, and growing to fancy, roughly in lockstep with each other.

None of these things have really worked out, though. It brings clouds to my eyes just to type that, but it remains true nonetheless. The romantic thing didn’t work out, which isn’t a problem in and of itself (particularly since the person I fancied had the immense integrity and wondrous grace to sit down with me and talk honestly and openly about why it would be best if we not date, at least for now) – it just feeds into a long, long history of romantic missed opportunities, missteps, and failures to act (more than forty in all; I counted once, in a particularly deep fit of despondency) that always, always make me criticise and harshly judge every aspect of myself to see in which ways I don’t measure up. In addition, my friend’s offer of moving out of my problematic living situation had to be cancelled entirely at the last minute because of the breakup of her relationship (that week was not a good one for relationships – another couple I know also had their civil partnership come to a screeching halt at that time). And I feel doubly awful for that because I know my friend and her partner were both themselves struggling with serious mental health issues, issues that ultimately contributed to their breakup but that must have caused them extraordinary hurt during that process and that make me feel really guilty for feeling upset about the situation for my own (and utterly selfish) reasons. The offer of work I’d had has also had to be postponed several times for a variety of reasons mostly revolving around people being in the field or caught up with other commitments that couldn’t be broken, taking me past the end of my third full year without full-time employment and making me feel even worse about my prospects for beginning to build a life that I can in any way take joy in. As a consequence of these three situations – romance, habitation, employment – I’ve taken a solid backslide even under the increased dosage of the medication my psychiatrist has been working with me on (no doubt situational rather than fundamentally biochemical, which at least does give me a tiny but mathematically non-zero degree of consolation), which has subsequently impacted upon my ability to focus on the writing of further academic papers, on the writing of job applications, and on the continuing effective conductance of my life on a day-to-day basis.

Ultimately, all this is why I feel so keenly the sting of the wound that propelled Reggie Nulan to write his lovely but heart-wrenching prose-poem. Living on the edge of loneliness feels like my reality at the moment; I feel lonely at virtually every moment, even as I try to push myself to address it, to connect with friends, to remain in contact with people I care about. And all that I hoped would come to fruition during October shrivelled on the vine. Life is as stagnant now – moreso, perhaps – as it was at the end of September. At moments like this, I almost fear that my depression and my anxiety are the correct and true way of experience, slyly and underhandedly suggesting that optimism is abhorrent and hope to be shunned. On one level, I’m used to feeling that in my own head. I suppose it just causes a rather deeper ache to feel that the universe around me should be nodding its head so vigorously in agreement.

Lasciate ogne speranza, voi ch’intrate.
(Abandon all hope, ye who enter here.)
– Dante Alighieri, Inferno III.9

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22 Days of Musing: 22

22. A letter to the sufferer.

So tonight is the last night of the 22-day challenge I set for myself in lieu of doing the 22 Push-Up Challenge, which asks one to record 22 push-ups a day to raise awareness of those suffering from mental health challenges, particularly combat veterans. And I thought what might be a good way to bring the challenge to a conclusion is to address the sufferers directly. To anyone who might read this who suffers some form of mental trauma or anguish – any psychological illness that in some way holds you back, that prevents you from socialising with friends, from forming romantic relationships, from even getting out of bed some mornings – I have a few things I’d like to say to you.

My dear, beloved journeyer through the valley of the shadow of death:

I feel pain like yours. No-one else feels your pain – no-one can – but I, and others, feel pain similar to yours. The pain you feel is the result of an illness, not a failing. You are wonderful. You are enough. You’re simply sick. It’s okay to be sick, and being sick is not your fault. If you can’t climb out of it alone? Still not your fault. There is help available if you can reach out for it, so please hang in there until you can summon enough strength from within yourself to make that step of reaching out. Please hang in there. You are wonderful. You are so very enough. I can’t and won’t promise that the darkness will pass; nonetheless, there are things that can help to make it more bearable. Seek counselling. Talk. Whether with a counsellor, or a psychologist, or a psychiatrist, or even the lone and last friend that you can trust, talk about your feelings, your emotions, your stresses, your worries, your fears, or your emptiness. Call one of these numbers, if you have no-one else to talk to:

Military: ADF Health (in Australia) – 1800 628 036 (24 hours, free call)
Military: ADF Health – +61 2 9425 3878 (24 hours)
Military: Walking Wounded – 1300 030 364 (24 hours)
Civilian: Beyond Blue – 1300 22 4636 (24 hours)
Civilian: Diverse Voices – 1800 184 527 (3pm-midnight, free call)
Civilian: Lifeline – 13 11 14 (24 hours)
Civilian: Suicide Callback Service – 1300 659 467 (24 hours)

Do those things that do help you to feel again. Visit a friend. Give yourself a manicure. Start a journal. Watch two hours of gambolling kittens on YouTube. Take yourself out on a date. Order your favourite delivered take-away food. Soak in a hot bath for an hour. Take pleasure in something small. Make sure to take your medication, if you’ve been prescribed it – it’s not a crutch. You’re simply sick. It is okay to be sick, and being sick is still not your fault. Your life has unfathomable value, and a value perhaps most unfathomable, right now, to yourself. Taking your life is an escape, but not a solution; you are unique and your life has value because of the unique combination of gifts that you possess. The trauma, or the genetics, or the sheer accident that visited a psychological ailment on you are not your burden to carry. They are not your fault. They do not get to define you. Your past does not define you; your present will not torture you forever; your future is, even though you may not see it from the bottom of the pit, far brighter than the despair and the terror and the agony that you’ve suffered. Even if you feel you need to tell yourself so, this is not your fault, and brighter days will lie ahead, whether they be temporary – in which case, cherish them while they last – or permanent – in which case, do the same thing. Above all, find people who can be your people. They’ll help to show you the way out of the darkness, and they’ll help to take care of you when you can’t take care of yourself. They see the good and the wonder and the positive and the immeasurable value in you, because they’re outside of your mind, not obscured by the blurred, dusty, warped filter through which you judge yourself.

I tell you all this from the darkness of my own mental illness, and I hope that some small part of what I’ve suggested, and of my reflections over the course of the last twenty-one days on my own experiences with mental illness – its causes, its triggers, its symptoms, its pain, its treatment, its passing – can help to provide even a small piece of the map that will help you to find your way out of the despair. Paradoxically, this despair, the little-death of depression, reminds me sometimes of the fiercely defiant words of House Greyjoy from the novel series A Song of Ice and Fire, which I leave you with now:

What is dead may never die,
but rises again, harder and stronger.
– George R. R. Martin, A Clash of Kings

Thank you for allowing me to share these thoughts with you over the last three weeks, and much love to you, fellow traveller. I hope your days in the dark will be short, your years in the light will be long, and that you too will rise again, harder and stronger.

– A fellow journeyer

22 Days of Musing: 21

21. It’s okay to not be okay.

Hoookay, folks; tonight’s reflection is going to be a relatively short one, I fear, as I’ve come down with a rather nasty case of cellulitis on and around my left elbow and resting it on the arm of the chair to type is causing it to ache rather unpleasantly. I’ve already been prescribed a good heavy dose of erythromycin, though, so don’t worry about me (at least, not until my arm turns black and falls off entirely – let’s try and avoid that, shall we?). Nonetheless, I’ve just found out that this week, from the 9th to the 15th of October, is National Mental Health Week, and focused upon the now-passed World Mental Health Day on the 10th. This is a week in which to reflect on mental health as a phenomenon, as an experience, as a burden, and try to ask ourselves what we can do or improve on to help both ourselves and others to move closer to a state of mental wellness, and I think it’s apposite, then, that I reflect on that. This kind of awareness campaign is incalculably valuable, I believe, because such a powerful stigma still exists even now against talking honestly about one’s less-than-ideal state of mental health in a public arena. People are in varying degrees content to ask a friend how their treatment for cancer is going, how their broken arm is mending, whether their cold has cleared off; but when it comes to mental illnesses like depression and schizophrenia and PTSD, we really lack the cultural ability and social framework within which to engage with those kinds of conversations. There’s a feeling pervading almost every niche of society, even now in 2016, that feeling mentally ill is still something that it’s proper manners to keep the fuck to yourself, as tightly wrapped as a pharaonic mummy – to the point where I even found myself apologising to my psychiatrist when I burst into tears during my last session with her. Prima facie, this should be completely ridiculous, the idea of apologising to the very person I should be opening my feelings to for the very act of opening my feelings to her in what felt to a part of my brain like it was an excessive, if not outright shameful, manner. I fight this feeling every day, battling hard to maintain a matter-of-fact attitude towards my own mental illness (while not being cavalier, of course) when I discuss my health issues with others. Awareness campaigns of the sort we’re seeing in the National Mental Health Week give me great heart for this reason. It’s one thing for me to model the kind of approaches I’d like to see when it comes to engaging with mental illness more generally (and even here I’ve been told at times that I share too much, that it’ll hurt my future career prospects, that it’ll scare people away from me, et cetera – ironically, mostly by an ex-partner who herself was at the time suffering from rather serious mental health issues that were at the time going undiagnosed and untreated), but having the backup of organisational-level efforts like National Mental Health Week, the It’s Okay To Say (If You Don’t Feel Okay), and the R U OK? campaigns to normalise the discussion of mental illness in public is truly cheering for me. It’s a big public display of support for the mentally ill in general, and for me in particular it helps to reinforce the small, serene voice in my head that tries so very hard to convince me that I’m allowed to speak up while being constantly drowned out by the other voice in my head, the shouty Don Rickles-impersonating motherfucker on the megaphone. So if I can make a request of you, dear reader, I’d ask that you please do something this National Mental Health Week to show your support for those with mental illness, even if all that is is to ask a suffering friend if they’re okay, and listen without prejudice. And if it’s you that’s suffering, please look to those around you to try and start building a support network. There’s a wonderful quote I like from, of all places, Tumblr; some time ago, a user going by the alias tahtahtahtia posted this to their Tumblr blog, which I reproduce here verbatim.

today my anthro professor said something kindof really beautiful:
“you all have a little bit of ‘I want to save the world’ in you,

that’s why you’re here, in college.
I want you to know that it’s okay if you only save one person,
and it’s okay if that person is you”
– tahtahtahtia

22 Days of Musing: 20

20. Counselling my future self.

Last night I got into a little of a rambling reminiscence about the first painting I did as self-treatment for a fairly black phase of depression, and I shared the painting itself, which I’m now realising that I probably should have done tonight so that while I talk about it, it’d be here in front of you. But never mind – I may as well share it again here, and since it’s my blawg, what I say goes. This isn’t any kind of a democracy, after all.

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Ú-chebin galad anim. Acrylic on canvas, January 2013.

The depiction is of the elven queen Galadriel from The Lord of the Rings (portrayed in the films by Cate Blanchett) farewelling the Fellowship of the Nine as they leave the forests of Lothlórien. While the theme is admittedly maudlin, it’s also deliberately rich in symbolism. It draws upon Galadriel’s own fate, and that of all her kind: destined to fade into the West as the world passes from the Elves’ dominion, she passes the responsibility for the destiny of Middle-earth into the hands of those she farewells, and to Frodo she gives a gift of light even as she herself recognises that she will soon diminish and go into the West. That’s what the Quenya inscription says (and devising a Quenya translation and tengwar transcription of the phrase, which is spoken in the film only in English and never shown in writing of any stripe, was intended also to give me something to occupy and interest my brain).

Lyen antanyë i silme Eärendilwa, ammelda elenelma.
Nai cálë lyen nauva mornë nómessen,
írë ilyë exë calmar isintanier.
[I give you the light of Eärendil, our most beloved star.
May it be a light for you in dark places,
when all other lights go out.]

Because of this desire to develop a symbolic structure for this work, not only the topic of the painting, but many of its details, were also specifically selected to bear meaning of their own. The deep blue tone of the background symbolises the sensation of depression that was crushing me at the time under its enormity; the expression on Galadriel’s face, a calm and yet slightly sad acceptance of the inevitability of her fate, was intended to suggest my feelings of becoming resigned to – though still not at all pleased with – enduring the long dark. The broad, empty space between her and the light she gives freely to the one she farewells represents the distance I sensed between myself and normality, the pure but faint and solitary luminosity of the star Eärendil likewise representing the ethereal and perhaps almost illusory possibility of a brightness coming to render the dark powerless. All were intentional symbolic choices on my part. Even the golden hue of the inscription recalls the beginning of one of Galadriel’s verses of lamenting the autumn of her era:

Ai! laurie lantar lassi súrinen,
yéni únótimë ve rámar aldaron!

[Ah, like gold fall the leaves in the wind;
long years numberless as the wings of trees!]
– J. R. R. Tolkien, Namarië (Farewell)

The title I gave to the painting, Ú-chebin galad anim, similarly constructs an allusion to another Tolkienian reference. The phrase is in Tolkien’s other major Elvish language, Sindarin, and means “I have kept no light for myself”; it parallels a similarly-phrased line from the linnod or verse aphorism spoken by Aragorn’s mother Gilraen as she gave her son over to the Elves for protection:

Ónen i-Estel Edain; ú-chebin estel anim.
[I gave hope to the Dúnedain; I have kept no hope for myself.]
– J. R. R. Tolkien, The Lord of the Rings: Appendix A

What I sought to do with this painting, I suppose, was to imbue it with all of the feelings of chagrin and emptiness and pain and hopelessness and fatalism that I was experiencing at the time, to memorialise and immortalise those feelings in pigment on canvas. The conceptual framework of The Lord of the Rings and its story and mythology was merely a convenient, though rich and familiar, symbolic language in which I could cast those thoughts visually. But my aim in doing that was actually not to wallow in the blackness: far from it, in fact. Instead, my thought was that by exploring all of these sensations as I painted, I would seek almost to entrap or imprison the dark, agonising feelings within that moment of time, and thereby allow me to project and communicate hope, and cheer, and well wishes for my future self – the one that would later see and experience the completed depiction and all its rich symbolism – even as I couldn’t see hope for myself in that moment. And in some ways it seems, strangely, to have succeeded; whenever I raise my eyes to the painting as I walk down the hall towards my room, I see Galadriel looking straight back at me, raising her hand in empathy and peace and love, and symbolically passing to me a little of the light, and the hope, that when I first put brush to canvas I’d been unable to find – or keep – for myself.

22 Days of Musing: 19

19. Paint yourself out of a corner.

Actually, because I mentioned it in last night’s reflection as well as the nominee I chose – a friend who happens to be a spectacular artist herself – I find myself thinking more about painting, a pastime that I mentioned I’d engaged in on occasion. This might seem to be well and truly off point, but I promise that I have a reason for talking about this. I’ve never considered myself particularly artistic; although music’s always had a role in my life (or at least, it did up until depression set in in earnest) and I enjoyed playing and listening to music of a wide range of types, I’ve always thought of myself as having little to no skill at all in the visual arts. Many years ago (and we’re talking many years, as in, back when I was in high school) I did ponder taking up the art of cartooning and took a workshop to that end, and in all fairness it’s true that I do appreciate the beauty of a unique piece of visual artwork. There was great wonder and excitement in visiting the art and archaeology museums I’ve experienced around the world – the National Gallery in Melbourne, the Metropolitan Museum of Art in New York, the National Archaeological Museum in Athens, the Getty in Los Angeles – that contain spectacular examples of art both ancient and modern. At the Met, I fell in love with the work of Johannes Vermeer; at Olympia, the Hermes and the Infant Dionysos of Praxiteles. But largely, my experience of these artworks has been with the understanding that I could neither imagine nor execute works of such beauty and vividness, and with this knowledge I was, and remain, largely content. But in late 2012, about eighteen months after starting on my first antidepressant medication, I experienced another period of darkness mainly focused upon the time around Christmas (a holiday that in recent years has come to give me less and less joy, to the point where I no longer look forward to it at all; but that’s a story for another time, I think). Each time I’ve fallen deeply into the pit of depression, I’ve noticed something that has deserted me; in this instance, it was my ability to maintain focus for any length of time. Even when I wished to write an email to a friend, I’d write perhaps one sentence, then have my focus begin inexorably drifting in a manner that I found I was unable to control – such that it would take me weeks to write and send an email to someone I wanted to stay in touch with. And so it was in early January of 2013 that I found myself scrabbling for ways to claw back some of the focus that had by that point entirely deserted me. What I decided at that time was that I needed to find something that I had a solid theoretical knowledge about, but that I was entirely unskilled at: something that wasn’t time-sensitive but demanded periods of specific focus, something that, because I wasn’t naturally skilled at it, would occupy many parts of my mind all at once in order to execute successfully. And what I decided upon was painting. At the time I’d only recently rewatched Peter Jackson’s The Lord of the Rings trilogy, a story and fictional universe I’ve always taken much enjoyment from, and so it was from here that I drew inspiration. And I was successful, in the main; after three weeks of this self-administered focus treatment, this was the result, which now hangs above my door in a place where it looks over me every time I go into my room. (Forgive the curvature at the top and bottom; to get a sufficiently detailed shot, I had to take the photo from close enough to cause this distortion as well.)

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Ú-chebin galad anim. Acrylic on canvas, January 2013.

Unlike some of my subsequent paintings, which have been done largely just to keep my hands and my mind busy, with virtually every aspect of this painting I spent much time developing the theme and filling the piece with rich symbolism; it quickly moved past being simply a picture to paint, and has come to take on a more deeply therapeutic role. The role of this specific piece of work in my self-treatment for depression has been significant, and I think I’ll explain exactly how in tomorrow’s reflection, as it’s a little convoluted.

22 Days of Musing: 18

18. Swings and roundabouts.

Forgive me tonight for going down a bit of a grim direction, but this is something that I think needs talking about just as much as any other aspect of mental illness, and especially depression; while I’ve touched on it previously, there’s more I’ve realised I needed to get out. One of the aspects of this illness that I’m still wrapping my head around even now is the challenge of working out how to set up mental and physical spaces in my daily life that can assist me in breaking out of a phase of anxiety or depression when it happens. For some people, it can be a small trigger that sends them into a tailspin that might take days or weeks to recover from. One such small thing in particular I’ve heard of is a show of fireworks. To the average person with a tolerance for noise, they’re a joyful, raucous and beauteous display of celebration, and every New Year’s Eve I love to watch them (usually at a party with dear friends), vivid bursts of incandescent greens and magentas and cascades of golden sparkles, watching the phantasmagorical tones illuminate friends’ captivated faces in shades neither sun nor moon could ever produce. But fireworks are explosives, of course, and to a military veteran suffering from PTSD the sharp reports of exploding fireworks – and indeed, also the smell of gunpowder that often lingers after a large pyrotechnic display – may be indistinguishable from sounds of gunfire and artillery combat, thence triggering an episode of intense anxiety, or even a full-blown flashback. I’m immensely grateful that this association is not one that I suffer from, but nonetheless, there will be times during the course of some days where someone might say something insensitive, or even something that reminds me of a traumatic event in my past, that will set me off. And the phrasing of such events as “triggers” is exactly right, in my experience: like a gun’s trigger, or a set mousetrap, the right (or wrong, as it were) pressure will switch on those unhealthy, unproductive thought processes almost immediately, and the stimulus will make you think of one thing, which then leads to another, and then another, and before you know it you’ve fallen back onto the carousel of crazy, the vicious cycle that you know intellectually is bullshit but you can’t stop yourself from being dragged into anyway. There are, however, ways in which you can gently help yourself down off the madness-go-round. This is related in some ways to the “Spells of Coming Forth into Daylight” metaphor I used in a previous blog post. My personal set of spells is fairly neatly delineated into tools in my environment, tools I can summon physically, and tools I can summon mentally. Long work with my psychologist and psychiatrist has given me many conceptual tools with which I can analyse my thoughts, and try to step outside the illness to look at a scenario more objectively rather than letting emotions run away with me. But when I’m in the middle of a dead phase, summoning such conceptual frameworks can be challenging in itself, when there are no emotions, just sheer emptiness and vacuum. This is where the physical (or at least quasi-physical) manifestations of my brain repair kit come in handy: they’re unarguably present and direct stimuli that can remind me of cheery things even in times when I can’t think of such things unbidden. In my phone case, I have a small pamphlet from my psychologist giving me a step-by-step guide to overcoming a panic attack, which has come in useful more than once. On my phone itself, I have a carefully-curated collection of digital images and videos, every single one of which I’ve saved only if it’s never failed to bring a smile to my face on an absolutely involuntary basis. There’s an image macro of Lyanna Mormont snipping back at Ramsay Bolton. There’s a video of a cute little marching band made up entirely of cartoon cats. There’s another video of my little nephew, burbling formlessly for a few seconds before he spontaneously grins and sings the word “Pickles!”. When I’m feeling poorly or defeated, these little digital pick-me-ups are pure gold: they help to create a tiny chink in the robust armour of the anguish, and remind me that emotions do exist, that they’re things that people feel, and that they’re things that I can feel too. And around the room that serves me as workspace, there are more permanent fixtures – the tools in my environment that I mentioned just before – also aimed at breaking me out of the darkness before I fall in too deeply. The three trophies I amassed from winning poker tournaments. A whiteboard prominently bearing reminders of effective ways to minimise negative feelings and improve the impact of the positive (above the aphorism your current situation is not your permanent destination). A canvas I painted myself, bearing a quote from the film Clerks II that’s always struck me deeply (even moreso considering the film is supposed to be a comedy):

If you had any sense whatsoever, you’d fucking stop trying to bray it up with the rest of the sheep and live your life the way it makes sense for you!
– Randal Graves (Jeff Anderson), Clerks II

It’s never just one tool for one job, you see. The protean nature of mental illness means that the sufferer may often need a whole arsenal of methods through which to learn how to deal; and while my toolkit remains far from complete, the tools I have are at least sharp and efficient, and get ever more so as I continue to accumulate insights and support from my psychologist, my psychiatrist, my doctors, and my allies.

22 Days of Musing: 17

17. Division of psyche.

Today I’m continuing on from what I was writing yesterday about the rather complicated question I’ve been asked a few times: has my transition had any positive effect on rectifying, or at least helping me to manage, my mental illness? I think the simple and brief answer would be yes. As I noted yesterday before deciding that I had too much more to write on this topic and calling for an intermission of sorts (so go now and refill your popcorn), I do feel more able to push through my anxiety now to express my feelings, whether that be in expressing love and caring or in engaging in verbal self-defence, and that’s an undeniable advantage: it’s an identifiable improvement in a specific aspect of my mental illness that allows me to live my life more effectively. But although my transition has certainly done some small things to ameliorate my state of mind more generally, particularly in the area of my anxiety, both the depression and anxiety do still remain to wreak their particular brand of psychic mayhem every so often. For many trans folk, the presence of a mental illness is largely caused by their dysphoria, their feeling of alienation from the body they inhabit, or the fear of how those around them will react to their coming out, or the clash between their perception of their true gender and the perception of stigma from broader society that causes them to engage in self-doubt and autoflagellation; for such people, the process of transition is one that brings substantial and effective relief from their mental illness. If you’ll recall the statistics I cited last night, a transgender person is six times more likely to be currently suffering a depressive illness than a cisgender person. Nonetheless, that doesn’t mean that depression in trans people is always and necessarily caused by being trans and the consequences thereof. I’m reminded of the medical maxim known as Hickam’s dictum, which states: a patient can have as many diseases as they damn well please. This idea is often proposed as an intellectual counter to Occam’s razor, the better-known axiom to many students of science (even though it comes originally, much as many scientists would be loath to admit, from theology).

Numquam ponenda est pluralitas sine necessitate.
Plurality must never be posited without necessity.
– William of Ockham,
Quaestiones et decisiones in quattuor libros Sententiarum Petri Lombardi

In the medical context, the usual logical maxim of Occam’s Razor – which would counsel a doctor to seek a single underlying cause to explain the entire range of concurrent symptoms in a single patient – may end up failing (as it usually does when the hypochondriac seeks WebMD for an explanation of a range of apparent mild symptoms that would be exhibited only in, say, the early stages of kuru or pneumonic anthrax or something), because it’s statistically far more likely that a patient has two or more common diseases, rather than a single rare one. This isn’t to say, of course, that being transgender is a disease (it isn’t) or that there’s no relationship between being transgender and having depression (there is). But I suppose the point is that in my case, although my anxiety certainly stood as a grand obstacle in the way of my coming out as transgender, my mental illness is not really a secondary effect of my being trans and the social consequences of being trans, as it so clearly can be for many other trans folk; it’s more that my illness and my transness exist as two separate parts of my psyche (albeit parts that are in communication with one another, that influence and inform one another at times). Whatever it is that causes me to feel the blackness of depression, the challenges of being and coming out as transgender have only been a small contributing factor – if indeed they have contributed at all – which just means that I’ll simply have to continue to work on discovering what else the ætiology of my illness might be, what else contributes to it, what else triggers its symptoms, and what else might help to defeat it.

22 Days of Musing: 13

13. “He’s just another number, right?”

I’d like to start tonight’s reflection with some cold, hard, and objective data about mental illness in the military. They make for pretty harrowing figures. In any given year, around 5.9% of Australians suffer from depression. For serving members of the Australian Defence Force, this increases to 9.5%, an increase in prevalence of 61%. Similarly, the risk factor for post-traumatic stress disorder (PTSD) rises by 60%, from a base rate of 5.2% in the broader community to 8.3% among serving ADF personnel. For veterans the figures are less clear, but among Australian Vietnam veterans the rates of unspecified depression and PTSD are 9.5% and 17.1%, respectively, comprising a 61% and a whopping 228% increase over the background level. We live, sadly, in a world where stimuli for psychological injury are all around us. In the military in particular, people are put into situations they never should be forced to confront, ordered to do things they should never have to do, and potentially take the life of fellow human beings. Of course that’s going to fuck you up. Human minds come in all kinds – one of the great beauties of human diversity, one I’d have no other way – and the truth is that not all of those minds have the capability to witness genuinely traumatic events and just allow them to pass on by, as urged by the character Earl Coley in another of Tim Willocks’s novels, Green River Rising:

Walk on by, brother, ’cause there always a reason for it you don’ know about. An’ even if they ain’t no reason at all, it’s not your fucken bidness.
– Tim Willocks, Green River Rising

I’ve been immensely fortunate, in my third of a century up until now, to never really have witnessed a situation where I had to convince myself that it wasn’t my fucken bidness. And even so, my psyche is still one of those that doesn’t deal well even with minor confrontational scenes either. Watching two of my family members argue is about an even-money chance to make me shut all my emotions down and head into a depressive phase. But even in such circumstances I know it’s not the minor confrontation that’s really the problem, so much as it is that the minor is the last straw, the one feather-light weight that, along with the rest of the emotional load that my mind can’t stop carrying, serves to finally break the camel’s back. Learning how to put down the burden of accumulated experience and pain so that you’re no longer being squashed into the ground under its weight can be one of the great challenges of coming to deal with a mental illness. For me, I’m (slowly) starting to learn how to allow the little straws to bounce off my back, instead of continuing to accumulate in and around the crevices of the load I’m already carrying and weighing me down ever further, but even so I still feel much of the time as though I haven’t yet learned how to put down the bulk of the load. And with PTSD, the load is often unimaginably greater. Have you ever watched M*A*S*H? This is perhaps my favourite TV show of all time – not least because its mix of comedy and high drama helped to get me through the utter blackness of my own worst phase, but also because of its unflinching approach to the depiction of mental illnesses like depression, dissociative identity disorder, and indeed PTSD, illnesses often triggered by the atrocities of war at greatly increased rates I started this reflection by discussing. I can’t imagine how hard it must be to put down a psychological burden like the kinds shown in that series. As Hawkeye himself says: “Nobody forgets what happens here. The secret is learning to live with it. For all of us.” For all of us indeed.

22 Days of Musing: 9

9. The scene is set.

In tonight’s reflection I was finally going to tell the story of coming to realise I needed psychological treatment, the one I alluded to previously. But after having attempted to write out a retelling of the story in the fullness it requires, I realise that I’ll need to put that off just one more day and use this post to set the scene first, by talking about my first experience of recognising depression in myself at all. This is necessary to a comprehensive telling mainly because the first experience helped me to understand what depression even was; as I described in the very first of this series of reflections, I’ve felt anxiety to a greater or lesser extent ever since I was very young (at least since I was about eight), but even though depression runs strongly in my family and has had substantive impacts upon it for at least thirty years that I know of, I had no understanding at all of the concept of depression while I was growing up. Indeed, nobody ever really taught me what mental illness was in a more general sense; these were things I had to discover for myself as I grew up. Consequently, I always thought of myself as little more than cowardly or even afraid, rather than having an anxiety disorder, and though I do remember times through all my years of school when I felt isolated and alone and incapable – and cried many tears of pain in those times – I don’t know that I’d have referred to those episodes as depression, not as such. Once older, though, I had a better grasp of what depression truly is, and it was after catching up with an old primary school friend in March of 2008 that I wrote this in my first blog:

I can’t remember the last time I felt something I could truly class as “depression”; whenever it was, it was a long time ago. But I began to feel it yesterday, and can’t yet shake it… Not sad, not angry, not upset; just drained and empty, like there was a black hole inside my head sucking all of the positivity out of me. Perhaps someone who’s had clinically diagnosed depression can say whether this is it, but it sure as hell felt like it. It was a horrific feeling, and I’m still trying to work through it.

For a few years after this I continued to experience phases of this sort; often (though not always by any means) it would happen as a result of a romantic failure. Always the potential of actively approaching someone in the hopes of kindling a romantic relationship has brought on deep and terrible anxiety in me, moreso maybe than all other challenges, though these reflections are not the place for me to go into that issue in great detail (it plays a role in tomorrow’s reflection, though). In any case, this event in 2008 was the first time when I felt the utter emotional deadness and sense of futility that more recently have become almost normalised for me. A most frightening and unsettling aspect of that first phase of depression was not just that it was so foreign to me at that point, but also that it occurred almost as a kind of neurotransmitter crash after an occasion that really was not negative in any identifiable aspect whatsoever. I’d spent a wonderful, pleasant, fun, deep, charming, exciting night catching up with a woman who I’d not seen in twelve years and yet seemed to have a great deal in common with me, from musical tastes to book preferences to hopes for the future to favourite foods and drinks; we were almost the same height (I stand 185 cm, 6’1″ in the old money, and she was shorter than me by less than an inch), and we’d even both undergone exactly the same type of spinal surgery  at almost the same time in late 2007. I felt an extraordinary kinship with her, in addition to all the rich promise that romantic attraction conveys, and to have such an ecstatic emotional state collapse in on itself so devastatingly afterwards – and indeed, so rapidly – felt very strange and unwelcome. But it was only a relatively temporary phase, prolonged though it was by her ungraciously toying with my further attempts to get to know her better, and it passed soon enough without professional assistance. In 2011, however, I was not so fortunate. And this segues neatly into the Big Bad Tale.

22 Days of Musing: 8

Day 8. Shadows and daylight.

Tonight’s reflection is going to draw on some poncy philosophy, which I hope you don’t mind: as I said to a good friend today, many people have said many things at many points in history, and many of those words are far better than mine. I spoke in yesterday’s reflection about the way in which depression’s intractability is owed partly to the fact that it disables and attenuates exactly that part of the psyche that would otherwise help the sufferer seek treatment for it. For some people, this disabling of their drive to act is so entrenched that it prevents them from seeking that help at all (and I know someone just like this, someone who suffers from chronic untreated depression and a fundamental lack of self-esteem, but who’s rationalised not seeking further help by cultivating in themselves a mistrust of the entire field of mental health professionals based on a prior bad experience). Such is the paradox: those who need the help most desperately are often those who have fallen so far down into their own private abyss that they can no longer see light anywhere. And like the cavern dwellers in the seventh book of Plato’s Republic, who’ve similarly become so accustomed to seeing only dim shadows cast by fires on the wall as their only and therefore apparently “true” perception of reality, they may often lash out at one who’s ascended up out of the darkness to see the world we know illuminated and enriched by sunlight:

Would he not provoke laughter, and would it not be said of him that he had returned from his journey aloft with his eyes ruined and that it was not worthwhile even to attempt the ascent? And if it were possible to lay hands on and to kill the man who tried to release them and lead them up, would they not kill him?
– Plato, The Republic: VII.517a

Plato sought to speak primarily about education – or perhaps enlightenment is better – and its lack, but this is absolutely relevant to understanding depression as well. One who spends long enough in the pit becomes accustomed to the absence of light, and comes to accept an almost perfect dark as the norm, but such a one may also resist all attempts by others to raise them out, either through sheer inertia or active contrariness. My own experiences with depression have shown me that you have to realise it yourself: that if you need help, you must seek it out yourself, and all the help others can give you is of use only if you can first find a shred of will that still survives on the floor of your oubliette, even if it be hidden at first beneath inches of dust. There’s another metaphor involving illumination that I find useful in this aspect, though this one from Egyptian thought rather than the Greek. The funerary texts we call the Book of the Dead were used by Egyptian people to ensure that a part of the soul – the ; roughly, the sum of attributes that go to make an individual unique – was able to continue living after the death of the corporeal body. In Egyptian, these texts were referred to as rw nw prt m hrw “Spells of Coming Forth into Daylight”. I like this phrase and its cultural context as a metaphor for moving forth out of depression as well: emerging from the darkness of an emotional death of sorts, and entering into the daylight of renewed emotion, of being if not fully able, at least better able to feel pleasure; joy; humour; wonder; love. To do so, you have to write your own personal rw nw prt m hrw, in a sense. If you want to come forth into daylight, others can offer “spells” – techniques with great potential or exercises or materials for thought – that have worked for many people before you, and they may well work for you too, but you need to try them in order to discover which ones will succeed for you, and then you can add them to your own spellbook so you can reuse them when necessary. It’s a powerful thought and reassuring, that a written list of thought exercises from the psychologist, loving texts from friends that can be reread later, a folder of silly image macros that always call up involuntarily chortles, a hand-painted canvas with a strong fortifying quotation on it, can together act as a small (or sometimes large) push forward in helping me come forth into daylight – or, at least, come forth out of the darkness.