Women’s Issues: Living with Mental Illness
Profound pain and shame make it extremely difficult to share publicly my mental illness. This essay is no exception. My greatest hope is for women to shift from denial or ignorance to acknowledgement, embracing me as I cope daily with my mental illness. This is a critical shift in thinking. Some of you may recognize yourself, a friend or someone you love dearly in this piece. No one need not bear this illness alone.
The onus on women to meet society’s expectations far exceeds that of men. This is not news. It simply raises the stakes for those of us coping as best we can, teetering on a pin head to keep it together. We shoulder the primary responsibility to care for those closest to us, especially our children. Daily stress can take its toll emotionally, in and in some cases resulting in a breakdown. Without a support system in place, the end result can be devastating, leaving our children profoundly impacted, often taking their coping strategies far into adulthood.
“But every family is dysfunctional,” an oft heard cliché which serves only to diminish my plight. There are resources available now to help me and my family to communicate with each other, to engage in a dialogue about what my mental illness is, how to spot when I’m in trouble, and above all, how to support and include me in community. If we educate ourselves on this issue we can save lives. Mental illness is not cured, it is managed. I am not ‘crazy’ or less worthy. I am a woman just like you.
The effects of childhood trauma, abuse and or neglect prior age five, altered my young developing nervous system’s coping mechanism to manage stress by putting me on high alert, hyper vigilant for the first sign of trouble. My cortisol levels spiked early and often, ever ready for the next event preparing me for emotional survival. Often I would simply check out of the present moment, a dissociative skill I used to survive situations of severe emotional distress. I have become stress intolerant as an adult. This is the invisible disability where no one seems to believe me when I am doing well.
It is now an established fact that the earlier the first onset of depression, the more likely more episodes will follow, with each episode more intense that the previous one. I began at age four, next at age seven, then nine, fifteen, twenty, twenty-six, thirty, thirty-seven, forty-nine and most recently at the age of fifty-three.
I went untreated struggling day to day, often simply to survive with devastating effects on my quality of life. I wanted to get help but had no idea where to turn. As a child I would isolate spending most of my time in my room or outside, alone. Friendships were fleeting continuing well into my young adulthood. I chose isolation over engagement for fear of exposure. Confused and with profound despair I could not understand why my life seemed so worthless.
Years later I re-created my trauma in my own family, terrorizing my child and husband with rage attacks much like my Mother had done to me. I would erupt with a hair trigger. The guilt haunts me to this day.
I was born into a deeply troubled family as my parents’ marriage had fallen over a cliff by then, plunging towards implosion. My Father self-medicated with alcohol for his PTSD from the front lines of the ‘Battle of the Bulge’ in WWII. My mother drank as well, self-medicating her depression and Bipolar disorder. My three older siblings claimed all the emotional nurturing available, leaving none for me. I was eighteen months old when we moved to Toronto, Canada: a tremendously stressful event for my parents to be sent away, leaving the friends, family and support systems behind. All for the benefit of the family company. Alcoholism, extramarital affairs, an attempted suicide and divorce ensued. The kidnapping by my Mother at age eight, would follow, taking me to southern California where my darkest years lasting until the age of fifteen. Because my home was not safe, I was robbed of the energy I needed to grow, learn and discover healthy life experiences. The oft cited, ‘children are so resilient’ was nothing more than a mask I wore, a mask imprinted to the depth that I duped myself into thinking I was okay.
As early as age nine, I became trapped in a revolving door waiting for my mother’s next demand or crisis. I was pulled into a care taking role for her, only to suffer her drunken rage attacks and frequent night raids. She would enter my room, flick on the overhead light, pull everything in my closet into a heap on the floor and demand I pick up my stuff and put it back, organized. Crazy making? You bet! During later years PTSD disabled my every effort to reach life’s next milestone. I used to hear the common refrains: Why don’t you just snap out of it; Why haven’t you married by now; Why aren’t you working; How come you left your job; Why haven’t you found a job yet; and the best one of all, by a physician: “Why are you so depressed? You are intelligent, articulate and attractive with everything going for you.”
And I’m a basket case. Living with major depression disorder untreated is like crossing a room walking on a mix of floorboards that are missing, rotted out, unstable or supportive. Inevitably your leg falls through, or you wrench an ankle, or trip. Maybe you have a lucky day and walk across the floor hoping that it will support your weight and it does.
A few months ago on a Tuesday afternoon during my weekly knitting group, I sat on the large upholstered couch listening to the conversation.
All were the normal topics for women: husbands, households, travels, children, pets, friends and the like. And relatives. The veterinarian began speaking of her brother who is homeless. She went on in detail, slowly steering the emphasis towards his mental illness and alcoholism. She carried on about the relentless efforts of family to provide housing and medical care to no avail. “He’s schizophrenic, bipolar, I don’t know what exactly.” “He’s crazy” she said, over and over again. With each mention, another stake plunged into my heart. “He talks so fast you can’t catch up.” “You know, crazy, not like an ‘institution’, crazy like ‘wild.’” If only they knew that a ‘crazy’ was among them. Yes, I have been hospitalized in ‘crazy’ institutions twice to save my life. Yes, I manage my illnesses with medication and distress tolerance skills.
The conversation left me cold, bantering on about ‘crazy’ people as though I would never be an unqualified member of the group. My fear is that they have no true understanding of how to accept and support women who live with illness like me. We can learn how to listen and be there when a woman is in need of help. Just a willingness to listen is golden. I need to know that it is okay to accept medical treatment, to seek the help of qualified doctors, and that you will not walk away.
When in the throes of a major depressive episode I struggle to function, to carry out the most basic tasks. I perceive life in varying shades of gray devolving into the darkest of black ink during the night. That is the worst time, and dangerous. My thoughts are of desperation, acute pain and trying to find a way out. I am without hope or the ability to experience the simplest of joys. Always tired, and exhausted so easily.
Years ago I would struggle to get out of bed, get dressed, eat, catch the commuter train into the city, and walk into the office for another day. I would show up, yet was unable function mentally in order to perform the tasks expected. With no friends, I became increasingly isolated from all that is daily life. My father and stepmother thought I was ‘fine’ and had no needs because I was the competent and reliable one. They perceived me as such because they had no emotional capital available. All had been consumed with my older siblings and my father’s health.
With absolutely no emotional life skills I was expected to leave the nest and find my way into adulthood, alone. My fear was profound. I didn’t know how to operate in the ‘real’ world. The problem? I took all my trauma baggage in tow.
I replicated my childhood experiences in every aspect of my young adulthood. Then, at the age of twenty-four, I began to wake up realizing that life could be better. I fell deeply in love with a man unscathed with trauma. I craved his acceptance and delivery from all that had passed before me. He made me breakfast the morning I left for Cincinnati. I cried inside. Needless to say, the dating relationship did last long.
I sought professional help but their assessments underestimated the depth and severity of my illness. Each practitioner low balled my issues, resulting in poor diagnoses and less than effective treatment plans. I would eventually trip again, falling into another black hole of despair, like riding a roller coaster you cannot control. I lost confidence in the medical profession. There was no one to support me. Those closest to me would turn and walk away when I needed them the most. I had no friends beyond a casual acquaintance. If I did have an opportunity for friendship I blew it.
After twelve years, at age 36, the watershed event presented itself. My Mother asked for help. Alone, I researched treatment programs nationwide for her. During the family week portion of her treatment, I became educated about addiction, mental illness and my role in the family. It was if I reached for the door knob, inserted a key and felt the tumbler click for the first time. I came to understand I’m not so crazy after all. My treatment had been delayed, denied and deemed unworthy for thirty-seven years.
Yes, I am stable, for now, and most grateful. Yes, I still trip and fall over a traumatic stress trigger, yet I recover more quickly now. However, I still fear another severe depressive episode. They are always worse than the one before. I don’t ask for pity. Far from it. I want to live, not merely survive. With support I can.
That day during the knitting group I wanted to stand up and say, “I am not ‘crazy!’ Really? No, I am a woman like you.” I lacked the will to do so, fearing their judgment. So I wore my mask choosing to sit, knit, and listen.