Anniversary

From W.S. Merwin:

On the Anniversary of My Death

Every year without knowing it I have passed the day

When the last fires will wave to me

And the silence will set out

Tireless traveller

Like the beam of a lightless star

Then I will no longer

Find myself in life as in a strange garment

Surprised at the earth

And the love of one woman

And the shamelessness of men

As today writing after three days of rain

Hearing the wren sing and the falling cease

And bowing not knowing to what

A little back patting

Today I was thinking about what I've done during the past three months since I've been out of the hospital. It's not a long list, and it's not in order of importance or date, but it means something to me, and I thought I'd share it with you. [I know that's totally a run-on sentence.]

• I found a psychiatrist and a psychologist. They make up my international mental health team.
• I renewed my commitment to Sam in front of our families and closest friends. It was awesome.
  
• I presented some of my work before an audience of my colleagues, and I got thoughtful questions that showed they were listening. I was (this part is important) able to answer them. So there.
• I made out the checks for my hospital stay, the ambulance, and another mental health bill. Get this: there's a Vanderbilt Medical Group and a Vanderbilt Medical Hospital, and they both billed us. And riding in an ambulance is not nearly as cool as one might think but it's also less expensive.
• I applied for and got student loans, a labyrinthine process.
• I gained a little weight, but it's not meds weight, so I'll be able to slowly take it off.
• I got a new tattoo. 
• I started working on the diss again. Although I sometimes panic about my topic and its scope, it's good to be seriously working again. It's especially good to be working in a healthy way, without mania.

So that's my list. I don't feel that productive, but looking at the things I've done makes me realize that my therapist is right: I am getting stronger.

&

This week has been a little chaotic. So I have a few updates of varying interest:

• Dave is probably gone for good. Janer seems much happier--relaxed, affectionate, and less likely to attack the dog.
• I've called several of you in a panic recently. The calling is a good thing for me because it means I'm leaning a little on friends during a rough patch. Don't expect it to stop any time soon.
• I'm not sleeping at night and am having some racing and divided thoughts. Like having an intense conversation while contemplating a movie I watched recently and trying to figure out how one would go about replicating the table and chairs. It's not that I'm distracted, particularly, from conversations: I can contribute meaningfully and pay attention to the line of conversation. It's just that my mind seems to need more input to function adequately.
• My diagnosis has officially changed, by which I mean that the doctor I'm currently seeing as my primary doctor (not someone who has seen me a few times in the hospital) has changed my diagnosis to bipolar disorder I. I'm actually a little relieved by this change because 1) it's more in line with what I think the diagnosis should be; 2) in my opinion, it's not as bleak as bipolar II; and 3) I have a better sense of why my personal course of action should be. I've been counting deep breathes while visualizing each number: its size, color, and font type. Ones are small and yellow; fours are big, blue, and sans serif. The exercise actually is calming when I make myself focus only on the numbers. 
• Sam and I are struggling right now. We're at the beginning of a difficult, probably long process, but I'm trying to work, with Sam, on not allowing every argument to lead to catastrophe. Smaller, sober arguments are better than the loud, passionate, drunk arguments we often have.
  
• I still need to ask you, my friends, to help me with reality checks, an infelicitous phrase but I can't think of a better way to put it. To say it longer, though, I have trouble with distinguishing between my true feelings and my disordered feelings. It's like the difference between temperature and climate. If I am to be vigilant about my mood disorder, I have to know what's healthy first. I'm working on it in therapy, but you can do much to help me by letting me know what seems unreal or out of control.

That's the sum of it today. Sorry for the fragmented nature of the post, but there's a lot happening that must be expressed.

Anniverse

Last March, I started writing this blog. I was beginning to feel better (I thought), and I had some stuff to say. For example, I noted that my blood serum level for lithium was on the low end of therapeutic but that Chris said it was fine when combined with lamictal. How wrong was that!

The onset of mania often escapes notice, masquerading as just feeling better. Looking back, I see that last April marked the peak of blog-writing, coming in at 21 posts. I made a little graph to test a hypothesis: did the number of blog posts for each month indicate vacillating moods? The results are in. Last April (21), September (14), and this February (10) look like spikes in an otherwise downward trend. I should say, however, that May's posts were fewer than April's, but they were prolix. It's an illustration of how mood works in me. More posts mean more to say, but fewer posts can still mean pressured speech and a desire to get out all of the stuff I have to say, all at once.

I don't know what counts as the onset of mania and what just counts as feeling better. I don't know how to measure how I feel, even, as I wrote some posts that seemed lighter in tone because I was hiding my misery so that no one stopped me from fulfilling my plans. When mood is the question, nothing becomes an answer.

More journal entries

On February 7, I promised pieces of my journal entries for three reasons:

1. I want to remember how punishing my stay in the VITA unit was.
2. I want to remember the insights I had during my stay.
3. I want to convey to you what it was like in there.

During the long night of January 24, I had trouble sleeping in part because of a huge medication change. To pass the time, I started a short story, "The Designated Hitler." Here are the first few sentences: "She had a bulge, tender and hot, on the inside of right elbow. And she cried because she could cry because she was not dead. '"Am I the monster or the miracle?' she asked herself."

The next day, on the 25th, I wrote: "Having a really hard time." On the 26th, a doctor lent me a book by Kay Redfielf Jamison, called An Unquiet Mind. Jamison quoted someone named Hugo Woolf: 

 "To be sure, I appear at times merry and in good heart, talk, too, before others quite reasonably, and it looks as if I felt, too, God knows how, well within my skin. Yet the soul maintains its deathly sleep and the heart bleeds from a thousand wounds."

The quotation still reverberates for me because--and this one is funny--I want to avoid intellectualizing my feelings. It's easy to hold feelings back by thinking about them instead of experiencing them. I am a woman of extremes, we now all know, and trying to cry a little is scary to me still. I was afraid I would never stop crying, and I'm working really hard on realizing that I can stop when I let it out a little at a time, when I feel sad about something specific, rather than about my lot in life. You'll see me cry, which is also scary but I'm trying to work on letting people in. I'll write more about my hospital experiences, but also about my triumphs of heart and hand. Stay tuned to this station.

A dirty secret

One of the mental habits I'd like to break myself of: hating just a little bit people with great experiences, like loving a hometown, enjoying the memory of grade school, having great parents. Sam and I watched most of Dan in Real Life, a lovely movie with Steve Carrell playing Dan. Although the main character is tortured and morose, his family is extraordinary. I guess they have to be for the movie to work, but I found myself tearing up. Is this self-pity in action? Is it longing? Is it evil? Whatever it is, I need to figure out how I can stop feeling this way and realize some of my own good luck.

The social worker

Mary Ann Howell, my assigned social worker, is a walking disaster. A little backstory: this balding, rotund woman was supposed to be a key support for me when I was in the VITA unit, but she has fucked up at every turn. She likes to blame those fuck-ups on me. The most important task I gave her was to send a short letter to the deans of Arts and Sciences and the Graduate School and to the Director of Graduate Studies in my department. 

After--literally--several weeks, she finally accomplished this task poorly and after a lot of foot-dragging. This week I received a packet of letters, back-dated by several days and mailed in a hand-addressed envelop. She sent these letters to the associate deans of those schools, rather than to whom I told her. She didn't identify me as a graduate student in the English Department, so they have this random name of someone somehow connected to the university, probably.

What's worst is that one of the letters was incorrectly addressed to "Mildred" Bergquist, rather than Francille Bergquist. The grammar is terrible. She has effectively lessened my credibility rather than added to the solution. This is enough to make me seek out her boss and make a formal complaint.

Insurance

Is scary. They list everything they might cover, what they plan to cover, but I want them to be a little more definitive. Okay, a lot more definitive. 

In other news, I'm loving Kimya Dawson. And I'm remembering that accessaries aren't so bad. 

I'm still trying to figure out a lot of things and to recall more things about my recent experiences. I want to learn how to express more love. Oddly, I don't myself have a lexicon for love, for which flaw I blame my parents. It's the only dependable use they have. 

This blog has several different kinds of posts, and to my mind, right now, the current trend is toward edited, thought-out entries and sprawling posts, with little oversight and lots of digression and spilling-over sentiments. Sometimes the later kind transform their ideas and emotions so that a more carefully crafted post can contain them. Sometimes it's all just raw.

Ground rules

Okay, here are some ground rules in the crazy-person hospital: no alcohol of any type, including that which is found in shampoo, toothpaste, and deodorant; no computers, which means no working; no cigarettes, no laces for shoes; no belts; no personal connections among patients. Some of these rules worked better than others. I mean, there's a reason why deodorant has alcohol in it.

Some ground rules for this blog: no pulling punches; no publishing all of my nut-case journal entries; no editing for length when content is more important (in other words, I can be much more wordy than I am here); no hiding from myself or from you, my friends.

I must ask you to abide one rule: please comment, even if only to indicate that you've read what I've written. Blogging can be a lonely pursuit. I imagine that someone reads any of this and finds meaning in it, but in my heart, conjecture rules. I imagine the worst, and silence can turn into anything, really. 

So, please comment, please. Even if only to tell me that you get the message. It doesn't have to be complex. Just let me know you're out there.

First day: 1/26

Caution: What follows is raw, like a wound that seeps. Names are changed to protect sinners and saints, mostly because sometimes you get both in one package. This is a portion of what I wrote, and it is perhaps the most palpable for me. It tells one of the sets of feelings associated with my suicide. 

My life is unmanageable. I'm powerless over my bipolar disorder. How could I not be? I need to find a way to manage not just my bipolar disorder but how I feel about my bipolar disorder. C. talks about remission, like cancer. The word itself is connected to the word intermission, a short break that happens once. Between the large portions of time. Remission may happen more than once, and the concomitant is that depression and mania may happen again and again. I'm still fairly young, and the prospect of experiencing this set of feelings again and again is enormity itself. So my life, my disorder, my moods and thoughts are unmanageable. I am powerless.

On 1/26 I began writing in a journal, which serves now as a memory device. I'll try not to edit the very difficult stuff. I wrote a lot on 1/26 because Dr. M took me off all meds, including meds for sleep. I was pissed the entire night. Next, Part 2 of this same day, in which I explain the various kinds of bipolar disorder.

First, some categorization

In the first few posts, I'm going to try to convey what happened in VITA (Vanderbilt Institute for the Treatment of Addiction). I was in that ward because the other adult wards had no available beds. It was actually quite useful to be in the VITA ward. For once, I was the sane person in a room full of crazies. More on the ward itself later. First, some sense of the schedule.

• Vital signs: blood pressure, pulse, and temperature. They collected these "signs" three times a day: 6:00a, 9:50a, 3:15p
• Meals three times a day: 7:45a, 12:00p, 5:15p
• Groups: 9:00a, 11:00a, 1:00p, 4:00p, 6:30p, 8:00p. The last time I list here was devoted to AA meetings. 
• Sleep: lights out at 11:00p, with little dispensation.
• Other activities filled up the spaces in between. Here are the times that were unstructured: 8:15a–9:00a, 10:15a–11:00a, 12:30p–1:00p, 2:00p–4:00p, 6:30p–8:00p, 9:00p–11:00p. A total of just over 7 hours, dispersed through the day. Part-time time you might say.

In the coming days, I'll encapsulate material from my journal. Much of it is raw. Some of it may be crude reckoning of my faults, but I hope that by evaluating it, I'll remember how dangerous and terrible were the events that got me to this point in time. Finally, I may give additional commentary on those journal entries that are unfair or unreasonable.

Please know that I do this to help, not to indulge in self-pity, or punishment, or in any way boastful. I deeply regret what I did.

Hiatus broken

I tried to kill myself. It's a senseless act, and the only one responsible for it is me. Now that I've figured some things out, I'm going to spill them on this blog. 

The first (and most important) issue is horrifying to me and to my friends: If a person wants to kill herself and thinks about death constantly, she's not going to let on how awful she's feeling. Otherwise someone could stop her. So, please don't think that anyone's at fault except for me. I struggled with bipolar disorder, thought I was don't all the right things (therapy + meds), and I still felt miserable. I'll always struggle with my illness on some level. But I must never again fall for the illusion of suicide as an answer to the constant questions that plague me. I'm making my promise here: I will not do it again. I plan to learn how to come up with solutions and how not to dwell on death as though it were a sweet exit from an otherwise terrible life. 

The second insight: I should have called someone first and I should have been emotionally open enough so that I could figure out who I should have called. I isolated myself. It's no one's fault but my own. I tend to deflect my feelings by intellectualizing them, like researching the best ways to killing myself. (It's actually quite difficult to do, apparently.) Too often have I tried to keep up my emotions at bay, until it's too much to bear. So I need to let my guard down. It'll hurt but not nearly as much as I have hurt in the past.

Third, suicide leaves no notes. It silently embraces the abyss. The abject punctures the myth of self-knowledge. As Kristeva puts it (and yes, I'm doing this even here), "The corpse, seen without God and outside of science, is the utmost of abjection. It is death infecting life." She believes that we trail our abjection through life, like the shadow one wants to flee but is always attached to us. 

Again, with a little less drama: each person carries her own corpse around, hurrying away from death as much as she fastens herself to it. I guess that is still a little too poetic, and I'll try to say it better next time. The long and the short of it is that my mistakes will dog me for life. My regret, my shame, my despair. 

S., I'm so sorry that I did this wrong to myself and to my friends and to you. I cannot say it enough. 

Dry

Sam's decided to go dry for a while, and I'm very proud of him. Yes, I'm proud of him for making a decision to take a break from drinking, but that's not all. I'm proud of him for the way he made his decision. What's more is that he's doing it for all of the right reasons. 

Now, I know that one of Sam's personae is the happy-go-lucky, super-friendly, "shots are on me!" kind of guy, and that he loves meeting new people in bars. (Thanks!) This persona won't become dessicated by a break, and I like to think that Sam's new temperance might be in service of his bar-loving side. In the meantime, I get to enjoy a heightened view of Sam's other wonderful sides. All in all, this is very good.

I'm proud of you, Sam, and I love you a trillion, million love units.

Sweet Sam, patient in my hour of need

My headache isn't that bad, my nose isn't too runny, and my throat doesn't hurt that much. But the fatigue and congestion are starting to get a little old. I slept almost 20 hours yesterday, and my head feels like a gnocchi. 

I'm under whatever is under the weather.

Seeing problems

I'm thrilled that Obama won, but now that it's Thursday (2 days after the historical victory of the spirit of our great country), I'm back to thinking about me. I'll bring it back around to the political, so bear with me.

When I was a very small girl, I had night-terrors. I would wake my parents, my father would try to soothe me with milk and tales of tryptophan, and then he would send me off to bed. They eventually got a little impatient with that routine. So I got into the habit of getting myself out of bed, drinking some milk, and reading on the living room couch.

One night (I was probably around 8), I awoke from a nightmare, and we were out of milk. I got my book, but feeling especially sorry for myself, I sat on the couch and cried. The sobbing woke my father, and for some reason, I didn't want to tell him why I was sad. Instead I blamed it on the book. (In retrospect, the book, The Secret Garden, may have set the mood.) He took it away from me and sent me back to bed. I assigned fault to the book, and my father accepted that assignment. (The truth came out later. That night and others like it were nascent expressions of what came to be my mental illness.) No matter why I lied—shame, my need to please, their demand for me to be perfect—this memory strikes me as a metonym for the lies my family used about my true need for help.

I don't raise this specter of self-pity to simply rile your emotion. Rather, it's a micronic (not a word but should be) analog of what we as Americans do as a nation. We lie to each other about the "housing bubble," say, then the bad mortgages, then the interest rates, even as they compile upon adjacent economic injuries. Only crisis draws enough truth around itself, and by doing so is revealed.

As we celebrate President Elect Obama—it feels so good to write that phrase—we hope to wait for him to take office so that he can address what's happening in our country and in the world. Will we lie to each other or will we point to the tide of the next crisis? Can we even see it yet? Where is the child, the book, the father? Let me say that I have great confidence in Obama's leadership. Having a post-Boomer, Black president should cause us joy, but may it not blind us to his need to please and our demand for his perfection. May it not blind us to our continuing moral problems, both at home, abroad, and in those nebulous, lawless plots of land we refuse to claim as our own. May the smug enjoyment of our right choice not deflect our insight: Electing Obama does not make America virtuous. It simply makes us better.

The weight of 750.5 mg

A little over 3/4 of a gram. 11.58 grains. About 2% of an ounce. If you're talking Newtons (force, not figs) .007 359 890 846 5 units, or roughly 736 dynes.

I like the idea of weight as measured in units of force, as gravity pinning something down to the earth. According to Newton's third law--all forces occur in pairs, each opposite and equal in magnitude--when a person falls, the earth falls in the opposite direction. Or, I suppose, each leaps to meet the other. 

When you fall and you feel the earth is rising rapidly toward you, you're right. It is. 

And (to misappropriate Flannery O'Connor's use of Pierre Teilhard de Chardin's phrase) everything that rises must converge.

As my meds and I converge every morning and evening. 750.5 milligrams is the amount of medication I take in the morning. When I take the 5 pills that weigh so little, they pin me down to an inescapable truth: taking psychotropic (qu'est-ce que c'est?), psychiatric medications will be a lifelong ritual, part of my and Sam's management of my incurable, major mental illness.

When a person is depressed, she can fend off bad decisions by deciding to wait until tomorrow. Tomorrow might be better. When I take my meds, I remember that, at some unpredictable time, tomorrow will be much, much worse.  

I remember that the same is true for you, dear reader.

So, to lift our moods, let's hear something from Ms. Dickinson, from her posthumous Complete Poems 1924):

Today or this noon

She dwelt so close, 

I almost touched her;

Tonight she lies

Past neighborhood--

And bough and steeple--

Now past surmise.

Flight

**Disclaimer: This post is not about anything that happens on an actual plane. If you're have any fears about the act of flying, read with impunity.

Sam and I went to Albuquerque this past weekend. It was lovely to see Rory and Kim, and I look forward to seeing them when they come to visit. Or if we drive out there. But I'm never flying again if I can possibly help it.

Everyone has a terrible airflight story to relate, mostly because it's an incredibly painful experience. But this one threw me into all kinds of mental directions. I'll give just a quick description of the very worst part and bore you with the wretched details later.

We went to the airport, got tickets, made it to security. I put my computer into a bin, as you're supposed to do. I went through the screener without problems. As I was reshoeing myself, I looked up just in time to see a woman knock my computer bin off the conveyor, with enough force that it landed upside down. The TSA did their best to intervene, and I didn't actually do anything unreasonable, even though the woman was not the least bit contrite when she acknowledged that she had, in fact, knocked my computer onto the floor. I cried the whole way to New Mexico.

Tomorrow at some point, the computer will be ready for me to pick up at Mac Authority, and then I'll send my receipt to TSA, and they'll eventually send me some small amount of money not equal to what this all actually cost. It's not the money, though. It's feeling out of control, out of touch, and away from work I've put hundreds of hours into. And I feel like a total ass for even talking about this because Rory and Kim's reception was beautiful and should be the focus, not my crazy-ass, yelling at strangers, crying in public, generally embarrassing self.

Sam was wonderful about the whole thing and continues to be supportive and caring. I'm using his computer right now. So although I don't seem like it today, baby, you are the turtles all the way down.

Rest peacefully, Mr. Russert

Tim Russert died this afternoon. You can turn on any t.v. channel or look at any website for the obligatory language of public grieving, but, watching MSNBC, I was deeply moved by the expressions of loss by those who knew him as a man. 

To me, Russert has only ever been a face on the screen, yet his integrity and curiosity were always evident. As much as I will miss him as a journalist, his family and friends must be devastated. 

Sam and I were talking about it just now, and he said what I've always felt as well: When you part from someone you love, even just to go to the grocery store, you should say, "I love you." The future is inscrutable. Our lives are short in time's span. But we become meaningful through expressing our connections with each other, however fleeting and however flawed.

From Yeats's "The Circus Animals' Desertion":

Those masterful images because complete

Grew in pure mind, but out of what began?

A mound of refuse or the sweepings of a street,

Old kettles, old bottles, and a broken can,

Old iron, old bones, old rags, that raving slut

Who keeps the till. Now that my ladder's gone,

I must lie down where all the ladders start

In the foul rag-and-bone shop of the heart.

Proper

I've been thinking about words to do with "uptight." My online American Oxford Thesaurus gives a number of synonyms (close and far), including 1) tense, nervous, on edge, anxious, hypersensitive; and 2) straitlaced, prim priggish, rigid. 

Further exploration of the definition of "prim" yields "stiffly formal; feeling or showing disapproval of anything regarded as improper." The AOD pairs it with "proper" in its example, as in a "prim and proper lady." Synonyms range from "formal" to "prudish" to "governessy," if you can believe that one.

Now, I disapprove of a lot of things that, naturally, I think are improper, in the AOD's first definition. Personally, I think that makes me a bit of an asshole, not a prude. But what is quite interesting is the constellation of these words around the notion of femininity. To be proper is to be prim. I know this isn't news (always cross your legs at the ankles, darling!), but the persistence of the association between being anxious and being a woman still surprises me.

Hysteria had its diagnostic heyday in the late 19th and early 20th centuries. Symptoms included weakness, fatigue, inappropriate appetite (too much or too little), gastrointestinal discomfort, other pains unassociated with injury, and extreme sensitivity or (paradoxically) insensitivity to sensory perceptions. The symptoms were unfeigned and unexplainable by any other diagnosis. Until recent updates to the American Psychological Association's differential diagnostic criteria, patients could be diagnosed as hysterical without complaining about symptoms, a phenomenon known as la belle indifference. 

Essentially, hysteria was a catchall for bodily complaints that couldn't be explained by a physical examination. Or let me phrase this a different way: hysterical women were women who complained or didn't act like ladies. The APA, in the interest of reform and equality, has retained hysteria as a diagnosis but labeled it "conversion disorder" instead.

So the associations of "uptight," "nervous," "anxious," and "high-strung" with  "high-maintenance," "prim," "prissy,"and  "prudish" gestures toward hysteria, and you don't have to be Freud to see that it all still points to sex.

Do any of these terms (or terms like them) make you feel dismissed or belittled? How do they affect men (e.g., by feminizing men who worry a lot)? Can they be re-incorporated, as the word "queer" has been? I'm interested to hear your responses and ideas. 

ow!

Trazodone again. Less effective and again I have a wicked, all-day headache. You know, the kind of headache that makes thinking difficult. 

I'm as hydrated as I can get, and taking ibuprofin dulls the ache only a little. So now I have to weigh whether to keep taking it and hope that the side effect goes away soon. 

Reading the PI sheet and other information on trazodone, I thought it would be a good fit for me. In addition to its sedative effect, it works as a mild anxiolytic. For whatever reason, I usually don't experience side effects extreme enough to not take any given med, so I decided not to worry about the "trazodone hangover." 

We have plans to float the Harpeth tomorrow. I think I might rather be a little tired than how I feel now. So it's back to the Ambien/clonopin combo for tonight at least.