I know folks have been a bit worried about me of late. My Facebook statuses turned brooding and perhaps despairing and Edvard Munch’s The Scream for my profile picture and Gustave Dore’s illustration of one of the many regions of Dante’s hell intensified these concerns.
I’ve shared many times before in various forums – in person and via the web – that I am a lifetime struggler with Obsessive-Compulsive disorder, Depression, and ADD. This makes life a bit of a roller coaster. It is the equivalent of having a chronic illness or permanent disability. Some days are good, some days are bad, and some are downright awful – always one is frustrated by what one is unable to accomplish.
I’ve spent years on medications and for the last year or so have had a combination that really seems to be working for me. I take Prozac at a high dosage (60 mg) for my OCD. This suppresses around 80% of my symptoms, leaving me with 20% (mainly those involving scrupulosity). Then I take a low dose of Wellbutrin – this seems to help me from falling into the really deep pits (though I’ve been in one recently). Finally, I take Adderall XR at a low dosage which helps me focus, stay awake1I still have to take multiple naps each day., and control emotional eating2I tend to consume large amounts of food, especially candy, chocolate, and ice cream when depressed to counter emotions..
I hope someday to get a SPECT scan by Dr. Amen and to perhaps get some additional refinement in my medications and diagnoses, but it is a rather expensive process – so for the time being, it is on hold. I also hope that in the upcoming years we’ll see some significant advancements in the treatment of mental illness – and there are numerous promising avenues on this front.
I know many are uncomfortable with psychiatric medications…especially that they are utilized to escape pain rather than deal with underlying issues. I do try to address the underlying issues as well and believe the medications take me from paralysis3Where the pain is so severe I would be essentially immobile. to a place where I can perform the sort of introspection and behavior modifications that assist these struggles. I also, however, believe that there are strong biological, chemical, environmental, and genetic components to mental illness and that it is not (in many cases) a situation which can be rectified by changing core beliefs and/or behavioral modifications (including diet, exercise).
I’ve spent several years receiving counseling and this has been tremendously helpful in working through numerous areas of struggle – but has also proven incapable of handling the areas that the medication addresses. I’ve tried and continued to try exercise – but in spite of the research indicating that exercise improves one’s emotional well-being, I find the effect to be negligible on me.4Exercise should be amongst the first lines of treatment for mental illness, I am simply stating that it does not seem to work for all people in all situations. I continue to make behavioral changes – establishing routines to provide consistency to my day and modifying my diet to be more healthy. These certainly help, but would be hopelessly insufficient if not for the medications which provide the bulk of my treatment.
Physician, Heal Thyself
I’ve always been gifted (at least I think so) in problem solving. Not so much abstract problems as concrete problems. This has been most evident in my ability to solve problems in IT infrastructure areas that have been quite complex.5Not that I am unlimited in any way, there are many within the IT profession who are much more competent, knowledgeable, and intelligent than I. As a pastor this also is an area I think I am gifted in – an ability to provide biblical and psychological insight and direction.
Yet, I identify deeply with Dr. Gregory House of the TV show House in that while I am almost always able to untangle other’s problems, to see into the depths of their issues, to pull out underlying motives and illnesses – I find myself utterly incapable of healing myself. For me House was more than entertainment, it was a cathartically healing experience.
Here was House who could explain to others why they were interacting in such and such a manner in a given relationship and help them rectify some issue they were struggling with, and yet himself was unable to be the sort of person he was able to help others to be.
I like to think of Saint Paul in a similar manner as he writes to the Corinthians stating, “So to keep me from becoming conceited because of the surpassing greatness of the revelations, a thorn was given me in the flesh, a messenger of Satan to harass me, to keep me from becoming conceited. Three times I pleaded with the Lord about this, that it should leave me. But he said to me, ‘My grace is sufficient for you, for my power is made perfect in weakness.’ Therefore I will boast all the more gladly of my weaknesses, so that the power of Christ may rest upon me. For the sake of Christ, then, I am content with weaknesses, insults, hardships, persecutions, and calamities. For when I am weak, then I am strong.” (2 Corinthians 12:7-10, ESV)
Unlike Saint Paul, while I have a “thorn in the flesh” and have accepted that apart from a divine gift from God that it is a lifetime thorn, I am not (just being honest) at the point where I am “content with weaknesses, insults, hardships, persecutions, and calamities.”
I want to allow the Lord to work in my life – however He wishes – but I will not pretend to have accomplished or even to approach the work of grace which God performed in Paul’s life.
I accept that I am who I am and that I will live with this incapacity for the rest of my life6As I noted previously, apart from a divine work of God.. It is important for me to accept this – otherwise I spend all my time struggling against it and have no time or energy for anything else, and I do believe God has else for me to do.
At the same time, I do not believe in a complete abandonment of hope. I continue to read, to study, to receive counsel, to take medications, to hope that a better, fuller answer will come…But I also trust that God, in His mercy, has provided me with enough…Certainly He has provided me with a script for when I am angry with Him in the Book of Job and demonstrated His ability to handle my pain and wrath through His patience with His servant Job.7Though unlike Job, I do not think I am actually righteous, other than currently positionally righteous in Christ Jesus.
Some may wonder why I share, why I post about these struggles. The reasons are several and intertwined. I don’t believe in spending all our time gazing at our navels (introspecting) and at some juncture I give up on trying to untangle all the exact reasons behind my motivations, but I can state that these are sometimes my motivations…and obviously, some I hope (and oftentimes know) are more my motivations than others:
- Nobody told me that other people struggled like this. Since childhood I thought I was alone or normal. I was afraid to talk about what I was experiencing, I feared judgment, I feared not being understood. Oftentimes people didn’t understand. I want others, especially children and teenagers, to know that they are not alone and that there is help and hope. I think the fact that there is help and hope can only be expressed sometimes by also demonstrating how hopeless and helpless we become. Saying, “It will get better” to someone is oftentimes trite unless that person knows you have experienced the pain they are experiencing.
- I want to diminish the stigma associated with mental illness. Folks with mental illness are in disguise all around us – not b/c they don’t want to say what is going on inside of them, but b/c they are afraid – afraid they’ll lose their friends, their jobs, the respect of others. I want to demonstrate (a) that being mentally ill doesn’t mean we are dangerous or irresponsible, (b) that disclosing our mental illness does not have to limit what we can do with our lives, and (c) to the mentally ill that oftentimes people are more understanding than you would expect when you do share.
- I want to communicate that I am ill and that this limits my abilities to be there for you – especially when the illness is at it’s worse. I don’t want people to think that I don’t like them or care about them b/c I disappear, seem distant, or whatever it might be. The truth is I’m struggling with a deep illness on the inside and my energies are drained by it. You aren’t the problem – I am – and I want to make that clear. If I’m worn out after spending a short period of time with you, it is very frequently my problem. You are not exhausting, I am exhausted. You are not draining, I am being drained from the inside. I try to do this in person as well, to be honest about where I am at and what I am capable of – but sometimes I can’t even pick up a phone to converse…and at those times, I don’t want folks to feel like I don’t care about them…b/c I do.
- Sometimes emotions are just bursting out of me. I learned at a young age (for reasons I don’t entirely understand) that emotional expression was not okay. I still do not communicate with strong emotional expressions except on rare occasions – and so the spoken or written word is one of the few ways I have to express strong emotions.8Haha, and yes, I do write many of these in private journals! You don’t see the darkest my life, but you do see the gist.
- Sometimes I want to know someone cares. Skillet has a song entitled “Would It Matter” that includes the following, “If I wasn’t here tomorrow / Would anybody care / If my time was up I wanna know / You were happy I was there / If I wasn’t here tomorrow / Would anyone lose sleep / If I wasn’t hard and hollow / Then maybe you would miss me.” This is at the bottom of my totem pole, b/c I know people care and I also know that my worth does not come from others’ perceptions of me but from God’s imparting of value to each of us as His human creations. But, I have to be honest and admit that yes, someone I want to know someone cares.9Okay, that a lot of people care.
What Can You Do?
When I share these sorts of feelings, how do you handle them? What am I asking from you? When others share these things with you, what are they asking of you? Great question! I’m so glad you asked.
Oftentimes we just need to share. To let out some of the silent scream that dwells within us. To let someone else know that we are in pain – even though our physical body may look whole and healthy – that there is something in us which is agonizing as deeply as any mortal wound can cut.
Oftentimes I just need permission. Permission to hurt. Permission to heal. Permission to throw away the formalities of civility. We don’t expect polite banter from the person who is crippled with pain in a hospital bed, and sometimes I need the expectations of polite banter removed as well…b/c I can’t do it.
I know this is hard – but for myself and for others – I think one of the most important things is offering oneself without demanding it be received. We have a hard time doing that. When we offer ourselves we want to be validated that we can help, that we are needed, that we are wanted…and usually we can help, we are needed, we are wanted – just not in the ways we might think.
Let those who are hurting know you are there and available for them, but that you are secure in your own identity and don’t need them to need you / want you in order to feel whole and alive. I know this may sound a bit crazy, but I think it is a huge part of developing healthy self-esteem – knowing your value apart from what you can do for others. You are inherently valuable.
Where Am I At?
I’ve actually been doing really well up until the past week or two. Between working only one job and adding wellbutrin to my cocktail of medications I’ve experienced a significant stability in my emotional state. I still don’t experience a lot of positive/good emotions, but I’m not experiencing the severe dips that I used to.
But this past week or two I’ve taken a plunge back into the depths. What happened? Well, I am stable but when something happens that affects anyone deeply, it still affects me deeply. Being on anti-depressants doesn’t mean one can’t still be depressed. A situation in my life rocked me deeply and threw me into the pit. I’m still feeling its effects and it may continue to impact me for weeks or months to come…but it is situational – and almost all situations change, given time.
This is why we don’t prescribe anti-depressants when someone in the family dies. The sadness and grief one feels are a natural part of the mourning process and as the situation is removed in time from us, our mourning naturally (should) taper off.
My Body is a Cage
Lets close with one of my favorite songs by Arcade Fire, “My Body is a Cage”:
My body is a cage that keeps me / From dancing with the one I love / But my mind holds the key
I’m standing on a stage / Of fear and self-doubt / It’s a hollow play / But they’ll clap anyway
Body body is a cage that keeps me / From dancing with the one I love / But my mind holds the key
You’re standing next to me / My mind holds the key
I’m living in an age / That calls darkness light / Though my language is dead / Still the shapes fill my head
I’m living in an age / Whose name I don’t know / Though the fear keeps me moving / Still my heart beats so slow
My body is a cage that keeps me / From dancing with the one I love / But my mind holds the key
You’re standing next to me / My mind holds the key / My body is a
My body is a cage / We take what we’re given / Just because you’ve forgotten / That don’t mean you’re forgiven
I’m living in an age / That screams my name at night / But when I get to the doorway / There’s no one in sight
I’m living in an age / That laughs / When I’m dancing / With the one I love / But my mind holds the key
You’re standing next to me / My mind holds the key
Set my spirit free / Set my spirit free / Set my body free / Set my body free
|↑1||I still have to take multiple naps each day.|
|↑2||I tend to consume large amounts of food, especially candy, chocolate, and ice cream when depressed to counter emotions.|
|↑3||Where the pain is so severe I would be essentially immobile.|
|↑4||Exercise should be amongst the first lines of treatment for mental illness, I am simply stating that it does not seem to work for all people in all situations.|
|↑5||Not that I am unlimited in any way, there are many within the IT profession who are much more competent, knowledgeable, and intelligent than I.|
|↑6||As I noted previously, apart from a divine work of God.|
|↑7||Though unlike Job, I do not think I am actually righteous, other than currently positionally righteous in Christ Jesus.|
|↑8||Haha, and yes, I do write many of these in private journals! You don’t see the darkest my life, but you do see the gist.|
|↑9||Okay, that a lot of people care.|