Tag Archives: PTSD

Journalist Comes Out About Having Mental Illness

I want to share an article that I found interesting, it is a post written by Mark Joyella, a journalist and former television reporter who has just recently come out about having a mental illness to help fight the stigma that surrounds it.

His article, Screw Stigma. I’m Coming Out takes us on a journey through his fear of being identified as a mental health consumer to a place where he feels comfortable sharing his OCD diagnosis.

For someone in the public eye, I found this article to be extremely thoughtful and well written, as well as reflective. I think his journey can be related to anyone who has questioned their own diagnosis or felt self conscious about the idea of having a mental illness, not just for folks who have an OCD diagnosis.

In any case, I suggest checking it out… and for Mark Joyella, a big high five – thank you for being brave enough to come forward about your experiences!

Anxiety Begets Anxiety

Yesterday I was in the office of a G.I. specialist, as my stomach has been hurting quite a lot lately. You see, I’m an eater. A foodie. So… it is an odd occurrence for me to have to try and convince myself to eat something. Lately it has been so painful in the moments after eating that my desire for food has shut down.

<enter G.I. specialist>

She said she wanted me to do an endoscopy (where they put a rod with a camera down your throat to look at your stomach) to which I replied in a favorable way.

They put you out for that, right?

I couldn’t imagine them not.

Well it is scheduled for tomorrow, and as I read through the mound of paperwork they gave me about the procedure (which contains a lot of instructions but not a lot of actual information) my heart skipped a beat.

Semiconscious sedation.

My pulse quickened, my throat constricted, and someone threw another log on the fire in my stomach.

All night all I could imagine was having a panic attack right in the middle of the procedure while that thing was down my throat.

Heck, I practically had a panic attack yesterday morning from getting an ultrasound of my stomach.

I don’t seem to have any say in when these things happen, all I can do is some deep breathing and closing of the eyes (and can you do deep breathing with a scope down your throat?).

This morning, still panicky, I called the doctor’s office to see if I could switch to full sedation. The receptionist said I could, but I could no longer have the procedure tomorrow.

And here is my dilemma. The more time that passes between now and the procedure, the more anxious and panicky I will be. If we had done it yesterday, I was cool as a cucumber, practically sedated on my own, but the notion of anticipation doesn’t bode well for me.

At this point I am waiting to see who will win out. The anxiety about the procedure itself, or the anxiety around waiting for the procedure to happen. I know either way it is going to be wildly uncomfortable, and I am waiting to speak to the nurse to get more details about the procedure before I make my final decision.

Of course, there is more to it as well. I need a chaperone because of the sedation, and getting that straightened out has really been the hardest part. Having to schedule a new appointment all over again would undo the work I did yesterday, and my chaperone wouldn’t be for sure. Without a chaperone, they will cancel the appointment when I arrive.

It’s an edgy morning. I’d better force-feed myself some breakfast.

The Global Assessment of Functioning (GAF) Scale

Every once in a while I am faced with paperwork concerning my mental health. This has happened with insurance companies, state programs I have applied for, and even the medical records I have requested and snooped through (hey, I should be allowed to know what they’re saying about me, right?). Upon looking at this paperwork, I am generally surprised by what I find -not due to the content (though sometimes I am) but because of the paperwork itself. The way the questions are phrased and answered, the way sections are broken up, entire ranking scales I knew nothing about… obviously there is a system that I have been completely unaware of. I mean, heck, I’m no doctor, I’ve never been trained on what all of this means, and if I didn’t go back and read the paperwork attached to my diagnosis I would never have even known such scales existed.

I thought I would take a little time today to talk about one scale which I have seen several times in various situations, but never really knew much about until recently. You know me, I am all kinds of interested in different ways to quantify my bipolar experience, so I found this scale particularly interesting.

It is called the Global Assessment of Functioning (GAF) Scale. I guess Global suggests it is used throughout the world, and it came to my attention because I noticed this scale popping up on several of the items I have rifled through in the last five years.

So what is the Global Assessment of Functioning Scale?

The Washington Institute On-Line Training and Assessment contracted by the Washington State Mental Health Division calls the GAF scale:

A 100-point tool rating overall psychological, social and occupational functioning of people over 18 years of age and older. It excludes physical and environmental impairment.

Which means this ranking scale is a tool used to rate functioning (not symptoms) in three areas (psychological, social, and occupational).

Since the GAF scale is used to rate functioning (and not symptoms) your score could potentially be constantly changing (that is, if you’ve got bipolar disorder, for example, and have been having symptoms intense enough to change your level of functioning). Generally, the closer you are to 100, the better you are functioning. The scale is also used to quantify disabled-ness, as the closer you are to zero, the more disabled you are considered.

The GAF scale is broken down like this:

Superior functioning in a wide rage of activities, life’s problems never seem to get out of hand, is sought out by others because of his or her many qualities. No symptoms.
Absent or minimal symptoms, good functioning in all areas, interested and involved in a wide range or activities, socially effective, generally satisfied with life, no more than everyday problems or concerns.
If symptoms are present they are transient and expectable reactions to psychosocial stresses; no more than slight impairment in social, occupational, or school functioning
Some mild symptoms OR some difficulty in social, occupational, or school functioning, but generally functioning pretty well, has some meaningful interpersonal relationships.
Moderate symptoms OR any moderate difficulty in social, occupational, or school functioning.
Serious symptoms OR any serious impairment in social, occupational, or school functioning.
Some impairment in reality testing or communication OR major impairment in several areas, such as work or school, family relations, judgment, thinking, or mood.
Behavior is considered influenced by delusions or hallucinations OR serious impairment in communications or judgment OR inability to function in all areas.
Some danger or hurting self or others OR occasionally fails to maintain minimal personal hygiene OR gross impairment in communication.
Persistent danger of severely hurting self or others OR persistent inability to maintain minimum personal hygiene OR serious suicidal act with clear expectation of death.

Your doctor or clinician might be asked to rate you with this scale in situations of requests by your insurance, if you are going through an intake at a hospital, if you are applying for state or federal disability programs, and the like.

I recently had an insurance agency ask my psychiatrist to give the highest GAF score he would attribute to me for the last year, and that was how my curiosity became piqued by this scale. I had also seen this in passing on medical records from when I was hospitalized. They gave a GAF score for when I entered the hospital, as well as what my score was when I left. Obviously at that point they want to see some kind of improvement on your part in the scale.

The GAF scale is found in the Diagnostic and Statistical Manual – IV TR (or just DSM as many of us lovingly refer to it) in the section on “multi-axial assessments”. You can also find the whole scale online by just googling it, or by following the link here for the Washington Institute On-Line Training and Assessment.

I wondered for a bit if this rating scale is generally supported globally, and I did find an article in the British Journal of Psychiatry about a study done to test the validity of the GAF scale in 1995 (which you can find here). They concluded;

GAF proved to be a reliable and, within the limits of the indicators used, a valid measure of psychiatric disturbance in our sample of the severely mentally ill.

There are other versions of the GAF scale that have been modified, but apparently don’t stack up quite as well as this original scale.

In conclusion, this was really just something that I find interesting personally, but I also think it is important to understand things like medical records and paperwork that has been filled out by your doctor. I don’t think knowing about what tools our doctors are using is important because we should interfere with their work, but because understanding how our doctors operate can help us maintain a better relationship and get the best care possible.

The Intense Delayed Response

I would say that if there has been anything in my life that has protected me from the potential criticism of people (for having bipolar disorder), or from feeling shame about my wild emotional reactions, the delayed response would be the key.

In times of having an overwhelming response, this response might occur immediately. Other times (and more often for me) the whistle on my emotional kettle starts wailing, but instead of exploding right there, the kettle is moved to the back burner. It may sit, looking completely docile until company leaves, and then it resumes the process of “exploding”.

Because of this, I spent a long time hiding the fact that I had bipolar disorder, and though the people who knew me best were not surprised by such a notion, those that were my acquaintances often seriously doubted this diagnosis. After all, they had never seen any of these emotional “explosions” -so how could they exist?

Even when I was younger and undiagnosed, I hoped someone would approach me about my behavior. Unfortunately, most of the time (like at school) I could hold it together relatively well (for a while), and things wouldn’t come back and hit me until getting home. Not openly exploding in front of others felt almost like a curse, in that regard, because nobody seemed to believe that I was having any problems with my mood.

The same has been true at work, only there I’ve considered this delay a godsend. Being able to keep it together the majority of the time only to go home and have the acts of the entire day effect me all at once left me feeling like my job was less at risk, but the fact that everything hit at once meant mood-swings that would shake me to the very core.

And then there is the third situation where this has been an issue. In times of trauma or anxiety or discomfort, the kettle still gets put on the back burner. It might be a situation where I desperately need to let my reaction out immediately, after being harassed, or after a panic attack, or after a particularly harsh conversation. It almost feels like everything is fine at first, there is no need to talk about what happened to let anything out because it often doesn’t feel like there is anything there. I can’t hear the kettle, I don’t know it is boiling, so when I get home and it blows up in my face, things are ten times worse.

Is this something that other people with bipolar disorder face?

Is it a result of years of stuffing my feelings away without letting them out, now I automatically stuff them away even though I feel inclined to deal with them immediately?

Or is this an issue something else? Namely anxiety? Perhaps this is happening because of anxiety being the prevailing mood or feeling in the moment when I expect a response, and it isn’t until it dissipates (or triggers a response?) that the emotional response can occur?

I don’t know.

This came up though with the Suicide Prevention Workshop I attended the last two days.

First off, I have learned that the Geodon I am taking now is helping raise my mood in a general sense, but it is not effecting how I respond to stress and anxiety.

After the first day of the workshop (which, it hadn’t occured to me that talking about suicide for two days straight would be depressing -I was definitely wrong) I was extremely overwhelmed. I got home and it was just as I had described, there was an explosion of intense emotional reactions.

Obviously the topic of suicide can be upsetting, but I felt like anxiety (mostly around being in a classroom-type setting) was what was really prevailing.

With bipolar disorder, it often seems like my emotions sit right below the surface of my being, ready to make an appearance at any moment. Going into this workshop, I considered the notion of what it means (and what it takes) to be a healthcare professional (as I was the only one there who wasn’t). I admit there have been times in my life, in the more recent years, that I’ve considered the possibility of going back to school to be a social worker or a therapist… but I wasn’t sure about my ability to realistically interact with intense emotional content with someone (like suicidality) without being affected myself.

If the first day was any indication, I was affected. I came home and flopped on the bed, face in the sheets, and just cried. 

In the workshop, I had felt awkward, I had felt overwhelmed, and now that I was home, I felt discouraged. Most of the content felt like it was over my head (as someone who isn’t a healthcare worker) and my anxiety had been so high that the reaction once I got home knocked me off my feet.

I decided not to go to the second day of the training, and I wrote the following:

“Unless something that stabalizes my mood or relieves my axiety pops up, I would never realistically be able to break into the world of the health care professional but will more likely be set only in the role of consumer instead, as things have been for as long as I can practically remember.”

I even impulsively emailed one of the workshop trainers, saying I didn’t think I could complete the second day.

And then… I didn’t sleep.

At 2 am I checked my email and she had emailed me back. She said she “understood but really hoped I would reconsider and be there.”

By 4 am I had decided I was going to finish the workshop. I felt better, and I really did want to know how things were all going to come together.

So I went. And I went knowing that when I got home last night, I would probably feel like shit. I would probably cry, my head would feel overflowing with information and like it was a sponge that needed to be wrung out, and I was right. 

But, last night the crying lasted less time. I felt more like exhaustion than despair, and after 30 minutes of pretending I couldn’t move my arms or legs and laying with my face in a pillow, I stood up and helped cook dinner.

And it was done.

I still no longer feel compelled to be a therapist (or, at least, I am a bit more wary of the notion now); and if anything I really appreciate the role I have now. Unless a miracle drug suddenly cures bipolar disorder, I will always play the role of the “consumer”. That doesn’t mean, though, that I can’t talk to all of you about it like I have been, or support the actions of others like I have been, or that I can’t use the suicide prevention training that I have just received.

I feel good about doing what I’m doing now, and now that I am certified in suicide prevention, I feel much more prepared for those emails you send me in crisis, and even those messages you send me when you’re not.

I’m not a therapist, but I am someone who has probably felt how you’ve felt… and I know how scary, and how hopeless life can feel sometimes.

I truly believe with all of my being that there needs to be a place where these feelings can be expressed safely, and you can know that if you need to talk about it, you can always reach me at host@thebipolarcuriousblog.com

The Batman Massacre; Mental Illness?

I’ve tried, for the last few hours (since waking up) to write something, but my morning has been engulfed by report after report on the tv.

By now I’m sure you’ve heard about the shooting that occurred overnight in Colorado at the midnight showing of the latest Batman film. If you haven’t, turn on the television -I know it is being talked about here on (literally) every channel.

As I’ve watched the reactions from folks I know in Colorado, people on facebook, twitter, and the like I have began feeling overwhelmed with the anger and sadness that spans the country.

All I seem to be able to think about, though, is what must have been going through the head of the young man that did this.

Could mental illness be a factor here?

I mean, there have already been reports by witnesses that said he claimed he was the Joker, which is exactly the sort of delusional claim I would expect from someone who would commit a crime like this.

And this is what tends to upset me, because I know that doesn’t change what he did, but I think it should change the way we look at it.

I also know that many people who begin having problems with mental health are terrified to seek help because of the way mental illness is perceived in our country. If that was the case here, and that fear is what created an avalanche of issues that triggered this event, I think we all have something to regret.

I know this is all speculation at this point, but this is straight where my thoughts have gone.

I think each and every one of us has a responsibility to seek help if we become emotionally overwhelmed or notice changes in our mental health.

In the long run, that one step may save the lives of ourselves or others.

A Fear Filter

I didn’t really begin feeling too overwhelmed (or overwhelmed enough to freak out) until last night. The possibilities of a starkly different future were playing out in my head on repeat, and that conflicted feeling when my diagnosis came up last week reappeared.

Feelings surging on all fronts, yes feelings, no feelings, what ifsmaybes, sometimeses, all fighting for attention.

When I look into the crystal ball of the future, this is what happens. Too many variables, can not compute, my brain about explodes trying to see an outcome, to make an accurate prediction of what lies ahead.

Obviously, I can’t see the future. I know that. I am a regular human being (though, I have had a dream or two that seemed to contain elements that occurred shortly after upon waking) who has grown out of the notion that I can predict what is coming.

My therapist says that me trying to see what is coming is pretty much just me trying to prepare myself for potential disaster. Catastrophizing, they call it. Looking into a possible future to imagine the outcome, and then preparing for it in real life.

Doesn’t sound that harmful, right? I mean, couldn’t I just keep on doing that and feeling prepared (although, doomed)?

Maybe not.

For me, anxiety thrusts me into those crystal balls sometimes whether I want to or not, and when I see that future I have an emotional response. Suddenly, my mind racing so quickly that I am sucked back into reality in an instant, I am thrust into another future possibility, and then another, and then another. It is pretty much like the worst type of time travel there ever was.

The feelings from these linger, sometimes completely oppositional emotions or thoughts, and the overwhelming part comes from not being able to shake them off and no longer being able to process which of those feelings is valid and which are a product of a completely made up future.

Yeah, I know. Effing weird, right? For me, if “going crazy” were a tangible feeling, this is one of the ones that I have that I would say it must feel like. Feeling a handful of conflicting things at once and being unable to discern which one to follow can be a nightmare. To me, it isn’t quite unlike losing my sense of self entirely -sitting in a crowded room of people talking and being at a loss for what to do next.

I have been listening a lot to the Mental Illness Happy Hour podcast (which I would highly recommend, even though I already have a couple times) and a lot of people spend time talking about fear. Some people make decisions based on fear, or admit to not having lived a full life because of fear, and one of the things that scares me is the prospect of being old and looking back at my life, thinking, “WOW, I sure spent a lot of time afraid for no good reason! Too bad I didn’t get to do any of the things I wanted to because I was mortified.”

Unfortunately, there is no “off switch” for fear (as I learned the hard way when I had that panic attack at the top of the space needle), but we can chip at it, and I am hoping that after long enough, I can be all… you know, zen or something.

After all,

“Fear leads to anger
Anger leads to hate
And hate leads to suffering.”

Or so the good Master Yoda teaches us.

Last night as I lay in bed for several hours without sleep, distraught, with a million things going through my mind at the speed of light and those conflicting emotions pouring down on me I wondered what things inside my head would look like if I put a filter on them, filtering out all of the emotional responses and thoughts that were coming from a place of fear. 

I pulled out my mental microscope:

Added a (filter) – No Fear

And after the lens focused, there I was at a strawberry farm buying a couple flats of rather delicious strawberries. It was sunny, and I laughed.

And palm trees swayed in the breeze, with ukuleles playing in the distance, and unicorns jumping over rainbows.

(Maybe I made that last line up, but that’s how good it felt).

Oh, I thought to myself, it feels awfully nice without all of those other assholes bossing me around and making me feel confused. 

Then I promptly fell asleep.

That whole world of fear and anxiety is a weird one, and it has a way of creeping into my life when I’m seriously distracted by stress or big events or responsibility. Before I know it I am in that crowded room with no recollection of how I got there and seemingly no recallable knowledge of how to go about leaving.

How long will it be before I turn into Leonard Shelby from Memento? Because tattooing myself with exit strategies seems like a normal solution here. Who would mind a thigh covered in words of encouragement though, I mean really? Is there a better way to remind myself to use that filter?

That’s the notion I am working on exploring next.

The Psychiatric Cocktail

For anyone who has ever googled something like, “will combining lithium and alcohol kill me?” -we know drinking alcohol while taking psychiatric drugs isn’t reccomended, but is it “safe”?

I realize this is a bit of an odd topic, but it is something I’ve never seen anyone else talk about. I know plenty of people who drink alcohol while taking psychiatric medications for various mental illnesses, and even though doctors always seem to say that we shouldn’t combine these things, they never seem to say outright (at least to me) that we can’t.

Before I dive into this, I know that there are plenty of reasons not to combine alcohol and mental disorders (let alone the medications prescribed for them). I know that for me, alcohol has triggered depression on and off -which (surprise) never quite helps make one the life of the party. Folks with mental illness are also  more prone to develop substance abuse problems, so avoiding drinking might mean avoiding an addiction. Some people use alcohol like an additional medication because of its relaxing/numbing abilities, but these “positives” can quickly be surpassed by such negative effects as liver failure and acting like an all around asshole.

However, some people don’t use alcohol as an escape, and I think it is fair to want to enjoy, say, a flute of champagne at a cousin’s wedding, or a glass of wine at ladies night, or a beer with your woodfired pizza at happy hour. These are the primary reasons I had for searching out this information.

The first time this concern really came up for me was when I began taking lithium at the beginning of last year. I’d taken a couple medications before that, but I was not yet 21 at the time so despite being young, alcohol had not yet made something of a permanent presence within the structure of my social life.

I was overwhelming careful when I began taking lithium, I measured out the amount of water I needed to drink, I documented what happened as the dosage grew higher, and as soon as I could really confirm that the lithium itself wasn’t going to kill me (immediately), I wanted to know if a glass of wine or a beer with the lithium would. 

Again, it wasn’t that I was planning a binge or anything, but as an individual with bipolar disorder who can be impulsive at times (to say the least) I was hoping that planning ahead (or at least having some idea of whether or not this was a terrible idea) would help me out a bit.

The trouble is, each medication acts differently for each person. And alcohol can act differently for each person. And though I quickly concluded that I probably wouldn’t die, my google search revealed little more than the fact that there are a LOT of people out there mixing alcohol with their psychiatric medications.

I think it is really important to be careful, especially when attempting to combine any two substances within the body. I realize that many people would consider me to be overly careful, but I have lost someone in my life due to the grossly twisted painkiller/alcohol beast. NEVER combine alcohol with painkillers or sleeping pills, and I would go so far as to say ALWAYS talk to your doctor or pharmacist before combining any drug with alcohol.

It is also a good idea to:

1. Check the warning label on the medication, some explicitly say, “do not mix with alcohol,” which I would definitely follow. Others say, “alcohol may cause extreme drowsiness,” or “may cause drowsiness, alcohol may intensify this effect,” which could mean any number of things. Alcohol may cause you to black out, become extremely fatigued, or feel more intense than it normally would.

2. Limit the number of drinks you partake in. Some medications, as I will describe below, actually make alcohol quite a bit less fun and relaxing, so it gets really easy (really fast) to drink only one or two drinks.

3. Don’t drink alone. Even if you’ve talked to your doctor about drinking while on your medication, it is a good idea to have another person around in case you have an unexpected reaction, at the very least the first couple times you try it.

4. Do not attempt to drive. Even after one drink, driving is a bad idea since drowsiness can be increased rapidly by many psychiatric medications.

5. Expect the experience to be different. The effect alcohol has on me is almost the opposite as it had before psychiatric medications, and I found the reaction to be very confusing the first few times I had a drink. If the reaction you have is that nothing happens, trying to drink a lot more to counterbalance it is not recommended.

My own experiences have been pretty interesting, and though the following is what I have experienced, I would not expect to experience things the exact same way. Again, medications all act differently for us, so it is very likely that the combination of alcohol with that mix will be quite different as well.

For me, combining alcohol and lithium has been one of the reasons I don’t drink much anymore (for better or worse). Basically, for every one drink I have, I have to drink at least 3 glasses of water. Dehydration and lithium do not mix, so even after one single drink (and the water described) I will wake up with a hang over. The hang over will intensify exponentially with each drink I have, basically, which is a giant bummer. I also feel less intoxicated than I normally would with each drink, which means a much bigger hangover for very little “fun”.

For a time I was taking Lamictal with the lithium, and in conjunction to alcohol the effects from what I experience with the lithium were intensified. I felt quite intoxicated after a single drink, but if I went on to drink anything more I felt absolutely nothing. The hangover was enormous (even after just 1), so I concluded it really wasn’t worth the trouble.

I don’t expect this to inspire anyone to begin drinking, but after looking I know there are a lot of people already out there looking for answers on this topic. Really, I am just hoping to inform people so that whatever decision they make is done in a safe, smart way.

Crafting a Relationship

Today is therapy day, which I am a fan of a solid 99% of the time. That 1% is usually a wandering, crabby, (frankly) pissy sort of day… and with the weather so nice today I don’t think I could be too crabby if my life depended on it!

My therapist is working on an internship, she just finished her degree -which is why her services have been so readily available to me. She is less experienced, which means she is something of a discount therapist (I think they keep those in the bin at Walmart behind the discount dvd bins) but her lack of field experience has not been an issue for our relationship.

For the most part.

And perhaps part of me likes the idea that I am teaching her something while she is teaching me. A swap, if you will, of screwed up information.

The trouble with this set up is that her internship ends in August, which means we only have a handful of (maybe 4?) appointments left. I readily agreed to this plan when I started going to the clinic, but now that I am almost upon the end of this relationship I find myself very sorry to see her go.

My relationships with medical professionals (and therapists) has been spotty at best. My income and insurance situation (i.e. none, right now anyway) has fluctuated wildly in the last 10 years, which has not provided me any stability in the realm of doctors or therapists I’ve seen. I have been on a series of at least 4 or 5 different insurance plans, while phasing in and out of those plans I’ve had nothing. On top of that, I have a pretty significant distrust of mental health providers (and all doctors, really) that has stemmed out of various advice from bad ones, and my own (admittedly) irrational paranoia after being abused by my caretakers in a mental health facility at the age of 17.

It has taken me an exceptionally long time to realize that not everyone is going to attack me for no apparent reason, but I spent years showing up to doctors or therapist offices with vague inclinations that they didn’t know what they were talking about, or that they didn’t have my best interest at heart, or that they really just didn’t get me at all. Of course, I didn’t give them a chance to know me, so I was setting myself up for failure in that department, but my tally of doctor or therapist one night stand sorts of visits is off the charts. For whatever reason. For every reason. Etc.

So this relationship I have currently with my therapist is one for the record books. I don’t recall entirely when I began seeing her (I was in a pretty wicked place at the time, I don’t remember most of last year due to the ultra-intense depressive episode I had) but there was a point where I said,

“you know, I’ve made it past the hump. The point where I’ve always quit therapy, and I am amazed at how different this day feels as opposed to day one.”

I will really be bummed to see her go, mostly because the notion of having to familiarize yet another person with the goings-on of my life sounds absolutely exhausting. I find it agonizing sitting across from someone who has a completely empty concept of me that I have control of pouring things into. I have a knack for getting a little creative with the pouring, if you know what I mean… and I have a hard time not creating a mold for a character instead of me. It isn’t that I want to hide the truth, I just find it too much fun to create fiction.

I am hoping I will find some wisdom about this when I get there today, something about re-creating this kind of relationship with a therapist. I know it is fairly straightforward, but my mind wanders sometimes… and unless one of us is on track, I have trouble getting over that hump.

A Biopsy, Emotional and Otherwise

About a week ago I visited the dermatologist for the first time. I wasn’t really sure what to expect (getting poked with cold metal sticks? A giant skin magnifying glass? Maybe I watch too many science fiction films…) but I knew I wanted to ask a few questions.

After my general skin questions were answered (yes, the dermatologist said the most likely cause of my acne was the lithium I have been taking the last two years, surprise surprise) I asked about moles. Who should get them checked? When should they be checked? How does it work?

Instead of telling me she just began to look at them, and then quickly decided (though I am not at big risk for skin cancer, living up in Seattle where the sun never reaches my skin anyway) there was one mole that she wanted to biopsy.

For those of you (like me) who have never been to a dermatologist, biopsy just means they want to cut it off and study it, apparently.

I had no problem with it, jumped up on her table, she did her thing, and I walked away with one less mole.

The thing was, though… as I walked to the bus I found myself feeling increasingly alienated.

This is the first physical piece of me, I quickly concluded, that has ever been removed. Well, apart from teeth. But really, how often is a slice of your physical being removed?

Nausea crept in, and by the time I reached the bus stop the world began spinning and I had to collapse on a bench, sharing it with a silver life-size cast-iron statue of a naked man.

Over the course of the last week, this horrified feeling about a portion of me being taken has returned any time I needed to clean the area and replace the dressing.

After thinking long and hard about it, I don’t know that this is necessarily an unfamiliar feeling. True my horror and slight up-chuck reflex is a bit more present on the physical side of things, but that mental feeling of something being taken is what really bothers me the most.

I can’t help but wonder if anyone else has associated this feeling of loss, or damage to one’s being in response to receiving a diagnosis of mental illness?

I don’t remember many of the moments where I have been handed a new diagnosis of mental illness, bipolar disorder, OCD (which I remember slightly I think), PTSD, the anxiety disorder… but I do remember a range of different feelings upon hearing these things.


  • Disbelief
  • Skepticism
  • Excitement (as weird as that is, I found it exciting to have potential explanations to what I was dealing with)

The same reactions I had when I heard the dermatologist wanted to remove my mole.

It wasn’t until the moment I’m alone and faced with whatever obvious wound remained after the discussion;

  • Racing thoughts
  • Depression
  • Panic Attacks

Suddenly I could see it in the face, this oozy, gross place, uncovered by the emotional biopsy done by whatever psychiatrist, Doctor X. 

And my response is the same as looking at the place where that mole was. Horror, a grimace, and the overwhelming nagging feeling like I have just been robbed of a piece of me. A piece of what would have been a normal life, perhaps.

What confuses me the most is that I’ve had time to look at this yuckiness enough to get used to it. The emotional yuckiness, anyway, -the mole thing still grosses me out. Over the last 10 years, I’ve had time to adjust (though, somewhat slowly) to living with this “missing piece” or “wrong piece” or whatever one might call it (maybe just an odd piece), and it is something I’ve integrated into my life.

So I admit, when the mole biopsy happened I didn’t think right away of that old emotional biopsy of a mental illness diagnosis. My thoughts went straight for the idea that there may be one day I could go to the doctor who would do an emotional biopsy that slices off my bipolar disorder. They will check it in the lab, and I will receive an envelope in the mail that says everything went well.

If these irregularities in me are removed, would I react in horror? Would I feel overwhelmed with the notion that a part of my being was now lost, the way I felt about a little meaningless brown piece of skin?

They say the mind grieves when a diagnosis of mental illness is given because of the loss of a life and many dreams that will no longer realistically happen. We have to adapt, to evolve as our lives continue -with whatever comes our way.

So would the mind grieve the loss of mental illness if it was suddenly removed? Absolutely.

Part of me feels terrified to think about that, but the answer is just the same as in the opposite situation. We adapt. We evolve. Life continues.

So I will adapt and evolve with my (minus one) mole situation. Maybe I’ll be gifted a really cool scar, but until then I’ll just keep cleaning it and throw a dab of ointment on there.

Protest in Chicago After Closure of 6 Mental Health Facilities

I don’t know how many of you have been following what has been happening in Chicago lately, but on Saturday hundreds of protestors marched to the mayor’s house in protest of the recent closure of six mental health facilities in the area.

Many local patients are now without care after the closure of those six (which made up half of the facilities originally available) mental health facilities in the area and are increasingly concerned about the route Mayor Emanuel seems to be taking in what appears to be privatization of local mental health care.

This is a really unfortunate situation, and though I absolutely commend the efforts of the protestors in Chicago (they also went door to door handing out leaflets) I can’t help but feel horrified that basic mental healthcare was cut so drastically without any alternatives available for patients.

I know that here in Seattle, the mental health services are stretched very thin as it is, and without enough affordable doctors and therapists there have been wait lists months long, forcing people to go to the emergency room before viably being able to see a psychiatrist. When someone is already feeling hopeless, one of the worst things you can throw at them is denying them healthcare, there isn’t much more you can do to make someone feel more hopeless! I hope the mayor of Chicago comes to his senses and makes a change, because I’m afraid the only thing his decision will do is increase violence and suicides in the meantime.

Do you know what actions your local political leaders are taking for or against mental healthcare? I would definitely recommend checking it out, it is good to know what actions are being taken, and heck… who to vote for!

Meanwhile, this drizzly Seattle Monday morning my heart goes out to you folks in Chicago.

You can read more about the protest here…