Mental Chains – Guilt, But Mostly Shame

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Getting to the heart of depression and anxiety is always difficult.

Firstly, the mind is really good at tricking itself, hiding the real problem in plain sight and digging around it in search of a fast solution. Being honest with yourself can be very difficult since the reality of self is so easily obscured by depression. “I’m fat, I’m ugly, no one likes me,” I may say. Or, more deceptively, “I feel this way because of all the times I’ve screwed up.” Often, the number, severity, or amount of time since the perceived mistakes will be irrelevant. The mere memory of them will cause a downward spiral that can feel impossible to escape from. Without the ability to look on the bright side of just about anything, how could anyone be expected to rise above the strength of such thoughts?

Don’t get me wrong – my medications have been sent from heaven, and help me feel 1000% more in control of my mind than I would had my doctors and I never discovered the correct cocktail. But that doesn’t mean every day is filled with rainbows and unicorns. In fact, yesterday (Thursday), I could not pull myself out of a day-long pit caused by pain and discomfort, namely the inability to breathe and a bad headache right in between my eyes.

Anyone would get down from pain like that, I suppose. But my pain wasn’t the true source of my depression. It was the one-two punches of guilt and shame that came with my inability to function that knocked me out.

Simply put, guilt is the negative feeling associated with acting in a certain way contrary to your personal principles. On Thursday, I failed to make it to work. Accordingly, I felt guilt for not having been the faithful and dependable employee that my supervisor and co-workers (hopefully still) expect me to be. “Well,” you might say. “Why didn’t you just go to work? You would have avoided all that guilt if you’d just gone and done your work!”

True, sure. Guilt is a powerful motivator to do better, to improve, to actually act correctly. But you’re missing the second reason for my depression: shame.

Shame isn’t feeling sadness and fear due to your actions or choices. It’s feeling sadness and fear because of who you are, resultant of a poor evaluation of self. As this article by Jay Boll for Esperanza entitled “Shame: The Other Emotion in Depression and Anxiety
describes, “Shame is sometimes confused with guilt. But there’s an important difference.  Guilt arises from a negative evaluation of one’s behavior, while shame arises from a negative evaluation of one’s self. Guilt is the feeling of doing wrong, while shame is the feeling of being wrong.  As such, guilt can be a powerful motivator to change one’s behavior for the better. Shame can have the opposite effect, making a person feel that change is hopeless because the problem is one’s self.  This is what makes shame such a toxic emotion.”

Perhaps to my detriment, guilt is the lesser of the two evils, and the one feeling that gets ignored. I wouldn’t make the choices I do otherwise. I feel ashamed of the person I am, and so it is my innate reaction to any negative emotions to withdraw and become insular. From that shame comes the guilt of not having done what I promised to do, and it spirals in on itself until I’m pretty much not able to do anything at all.

“Victims of trauma and abuse are especially susceptible to toxic shame,” Boll continues. “But it does not take an abusive childhood or severe misfortune to experience dysfunctional levels of this emotion. More often, it results from shaming messages we receive from parents, teachers, other authorities, and peers that we internalize and tell ourselves over-and-over.”

Believe me, I have a lot of negative shaming messages in my brain that it just relishes to replay again and again, some from my mission, some from work, and some from school. I have many negative interactions with teachers, for example, that make me internally shy away from classroom settings, and make me hesitate to raise my hand or ask for assistance. It’s why I’ve done so poorly in classes and why the upcoming semester (that starts Monday) fills me with such dread, even though I’m only taking one class.

Know why I hate talking about politics so much? Shame. Know why I have such difficulties talking about religion with other people who aren’t my immediate family? Shame. Know why I’ve quit or lost work opportunities, preferring to be caught dead than be seen losing control of my emotions? Shame. Know why I haven’t been on a date in over ten years? Shame. Know why I continually fail to show up to church a decade after coming home early from serving my mission? It’s shame. Shame for failing to become the strong and independent individual I had half a mind to become after I graduated high school. I feel shame for not being stronger than my bipolar depression without chemical assistance, shame for not being more outgoing in my personal life, shame for liking video games and daring to believe myself a writer or game designer. I feel shame for being politically open-minded but innately conservative, I feel shame for being a member of the Church of Jesus Christ, and I feel shame for all these powerful emotions of sadness, anger, and fear that I’ve been told I’m not supposed to feel as a man. I even feel shame for suffering from things I have no control over, like sinus infections, colds, and possibly even sleep apnea (this is being investigated at the moment).

But you know something? While there are many different people I can blame for the many unpleasant memories that flood my mind every time depression returns, I know my enemy isn’t external. It’s internal. It’s the shame that I don’t know how to process. It’s the ideal, impossible, perfected “me” that I’ve envisioned that keeps the real me from finding happiness in the moment. It’s taken me fifteen or so years to understand where my anger and sadness comes from, and it’s nearly impossible for me to communicate this clearly enough to be understood. I can’t even describe these things to my parents without receiving looks of confusion and concern.

I wish shame were some small thing to step over. But it’s not.

The story in the article about Mr. Boll being called “Twinkle Toes Boll” by his teacher in sixth grade despite the fact that he had been born with a clubfoot is intensely fitting with my experience. But in the deepest recesses of my reluctant heart, I know that the people who have shouted me down might have reconsidered their critical tone had they known me and my experiences. But, of course, this is impossible. Miscommunication and misunderstanding are the name of the game in this wonderful world of ours, and unless you knew me, you wouldn’t know I have moderately functional bipolar depression. No, I imagine you’d just see an undermotivated, unimpressive, and overweight male Mormon college student with a patchy beard.

That’s all I imagine my teachers and “friends” saw, too.

Speaking of his realization that he had overcome both his physical weakness and the bullying he experienced, Boll continues, “Both discoveries are instances of cognitive restructuring. In the first, I reframed my experience of shame into pride by having the compassion for myself that the ‘shamer’ never showed me.  In the second, I devalued the shamer by seeing him through other people’s eyes as the bully he really was. The sad truth is that many bullies are also driven by toxic shame, which they disavow by projecting onto others.”

This is difficult for me, since I have neither avenue of reframing available to me. I have neither friends suffering with me to let me know I’m functioning any better than anyone else with Bipolar Type-2, and I don’t have the fortune of knowing that my bullying experiences were like anyone else’s. I’ve never had a therapist ask me, “How are you able to get to work at all with what you’re experiencing?” Just once I’d like someone to acknowledge how hard I try to manage everything going on in my life, but of course no one really knows but me, so what’s the point?

How do I reframe my experiences to help me feel better about my place in life? And do I truly have to reframe every single memory that arises in my head to finally find peace?

Honestly, that sounds impossible. I suppose I’m going to have to go back to a therapist to work through this, because it’s affecting my everyday life. And that means time and money, two things I have just NO shortage of (#sarcasm).

Sorry for a hopeless extra blog today. Just a lot of sadness and frustration in my life at the moment that I don’t know how to process. Writing it out helps. Sort of.

Mental Chains – A Light Shining in Darkness

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It’s been a while since I’ve given a full update on my mental health. Considering how insidious mental health issues are in our culture, I think it’s important to be accountable to someone and share both our successes and failures. The morning of the day I’m editing this, Anthony Bourdain had committed suicide in France. His family is devastated, and even his own mother had no idea about his intentions. Here’s a man who literally has everything and has travelled the world doing things I’ll never hope to experience, a man who has been celebrated as a professional the world over, sharing a meal in Vietnam with the President of the United States and winning Emmys…

And it isn’t enough. But it never is.

I know very little about Mr. Bourdain. Yet his death makes me incredibly sad. Travel writing is a career path I’ve considered looking into. Mr. Bourdain was an inspiration, a light to many people, and no doubt he saw light in the people he met. Where does peace come from when your mind can see only darkness? As Uncle Iroh says in Avatar: The Last Airbender, “If you look for the light, you can often find it. But if you look for the dark that is all you will ever see.” Even with all the goodness around him, did he only see the dark?

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It seems like some people always walk in the light. Maybe some do. But I’m finding that this is rare if not impossible.

For the last decade of my life, I’ve known nothing but valleys of darkness landmarked by peaks of energy, positivity, and light. What I came to realize was hypomania came in irregular intervals every few months for a day at most while the remainder of the time I was lost, tired, and lonely. Hypomanic moments were magical. I felt like I’d come up for air after choking on sea water. I’m a writer, I’ve been writing fiction since I was seven, and hypomanic moments like those times enabled me to use my imagination again. (I realize the “depressed fiction writer” is a meme/trope at this point, but I’m also an English major and I write for a living, so it really is part of who I am.) After a night of no sleep desperately trying to hang on to the mania, I would inevitably come back down into the dark, and I wouldn’t be able to type a single word. My fiction sat stale in my head for years, and still does to an extent.

I was diagnosed with Bipolar Type II three years ago, and my exploration of medications began. I had no insurance, so I worked with my university’s health center. However, I never found the right medication, much less the proper dose. As much as I loved my psychiatrist for her efforts to help me, my university’s health center just isn’t a proper professional medical facility. I had tried everything: Lamictal, Latuda (worst medicine ever), Risperidone, Oxcarbazepine, Wellbutrin, Lithium, Depakote, Effexor… Without a job, I then went through a state mental health program that didn’t do much good for me at all; my doctor there put me on Wellbutrin to give me more energy, but it also made me anxious and panicky — I would break down into tears at the slightest provocation. It took finding a full-time writing job that took a chance on me and getting insurance to finally be able to see a psychiatrist at my local hospital.

Finding the right doctor with the right experience has made all the difference.

Turns out I just hadn’t taken enough Effexor. My doctor upped my dose of Effexor and risperidone, took me off the anxiety-inducing Wellbutrin, and the effect has been like walking out of a dark cave. I can write again. It feels like a never-ending hypomanic episode compared to where I was. I recently got a new job, and I can write without any mental restrictions. In fact, I’m writing so much that I’m starting to run myself ragged by staying up until two in the morning every night because I’m so afraid that this newfound mental strength (which only a few months ago I equated with a limited-time hypomanic state) is going to go away.

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St. Herman’s Cave in Belize. Kinda feels like that.

I have a fear I never thought possible: I’m afraid that my “happiness” is going to vanish. That I’ll soon lapse back into the dark and not be able to write again. But I also know that I’m not on a maximum dose of Effexor, and things can always be adjusted. I’m in good hands. While treating mental issues with modern medicine is still scattershot when we hope it would be hyper-accurate instead, it got me to this point. I can write again. Even if it doesn’t last, my terrible journey has at last brought me to a state of peace that I’ll never forget. It’s been worth the mental and financial cost.

The tough part? I had been on Effexor before. But the dose had been so low, it hadn’t done anything for me. Is it frustrating to me to think that I might have gotten to this point of stability sooner had I known this? Sure, a little bit. But I know a lot of people who have gone through my same process of trying medication after medication and finding absolutely no results. Finding the right mixture of medicines to give me a solid mental foundation wasn’t a simple process. I don’t know of anyone who diagnosed and “solved” their condition quickly.

Every person is so unique, and no two people will experience the same medicines in the same manner (except with Latuda, surprisingly enough). We think we live in the “Golden Age of Medicine”, and compared to even the 1950s, this is true… But treating mental illness is still almost recklessly imprecise. Even in the United States, complete and holistic treatment is accessible to few. Psychiatrists are sometimes poorly trained to recognize symptoms, and medications are doled out too readily to fix issues that may overlap with other conditions (major depression and bipolar type-II being good examples).

But despite all the obstacles I faced, I found a medicine that has helped me rise above the darkness. “Recovery”, for what that word is worth to a mental illness, is possible. Attaining at least a sense of normalcy and stability is possible. It took the right combination of luck in my job search, finding affordable insurance through the government marketplace, and having access with a professional psychiatrist who recognized what I needed. Not to mention a whole lot of medication experimentation. No matter where your journey takes you with your mental health, never lose hope.

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Someone on my LDS mission asked me why I have faith in anything. “Survival,” should have been my reply.

Always be looking for the light in the world. Play with a puppy. Listen to a baby laugh. Rock out to music you haven’t listened to in years. Listen to the birds. Meditate. Pray. Write down your thoughts and feelings in a journal or on a private blog (or make it public like me). Get the right amount of sleep, eat right, drink lots of water, and keep fighting.

You’ll get the dark, but you’ll also get the light. Life is a package deal, but so worth experiencing until you can’t experience more. Whether you seriously wonder if you have a mental health issue or have been fighting a diagnosed illness for years and years, know I’m back here cheering for you. You’ll find clarity and contentment again. My journey isn’t done; as my other mother says, and God willing, I’ve still got a lot of years left in me. I might relapse, I might not. But I’ll have had this time of stability to enjoy. And that’s worth any price.