I haven’t written since June 15th. I wrote then about my disability and the effect it has on my life. I didn’t write about how that tour ended in mental health disaster, but it did. Five weeks on the road proved too much: I collapsed in the gorgeous Black Hills of South Dakota and had to return home, again through the assistance of my wife. I didn’t write about how a short vacation with friends in Colorado was ended because of a series of meltdowns. I haven’t written about the tumultuous 2.5-day train ride where I had to disembark two hours in and was stuck, suicidal, in a hotel in West Virginia for two days. I haven’t written about the disaster of a trip to Rocky Mountain National Park with my father, where I cut the trip short due to flashbacks of the abuse I suffered at the hands of my family when I was younger, to which my father made feeble and misguided attempt at an apology.
I haven’t written about any of these things because I have been exhausted by my inability to enjoy life this past summer. I haven’t been able to hear the click-clack of typing because it feels like nails in my eardrum. I haven’t had the energy to do anything but sit inside. Even watching TV or reading has been quite sporadic, as the sensory input from these things has derailed all comfort they have given me in the past. I’ve stared at walls, out windows, taken long spells laying down in my bed, and doing an awful lot of reflection about my dark companion, my disability.
I must say, 25 years of journaling, a decade of mindfulness training and years of graduate work, research, and practice of psychotherapy have trained me to reflect quite well. It’s a skill I advise anyone to develop as it leads to some important insight that can improve your life. In fact, it’s been 3 years since I was in the Ph.D. program and 2 years since I left the field of behavioral health altogether. I’ve learned more in the ensuing time than the many years I was working and researching the field.
The psychology-related fields enjoy surrounding mental health with boundaries, which they call diagnosis. It wasn’t long into my training when I came to the conclusion that diagnosis in mental health was complete and utter bullshit due to the subjectivity of the person making the diagnosis. In other words, mental health is not like physical health: In the physical realm, a doctor would look in a patient’s ear, see a red, inflamed eardrum and say, “Well, you have an ear infection. Here are some antibiotics, take them properly and it will go away.” And lo and behold it does. Mental health is different. “Well, you are depressed, take this Prozac and it will go away.” Then it doesn’t. “Hmmm… well, you are still depressed. Take this Zoloft and it will go away.” You have diarrhea for two weeks, the depression is still there. “Oh, hmmm… take this Lexapro in addition to the Prozac, and here’s some Xanax to take that edge off…” and on and on and on it goes.
The reasons psychiatrists keep cycling is because the mental health fields want to say the concerns their patients come in with are “this or that”. Oh, you’re depressed. Oh, you have PTSD. Oh, you have some neurological disorders. A “this or that” view naturally limits treatment. If someone is being treated for depression and they have a neurological disorder affecting their social dimension being left untreated then the person is never going to heal from the depression.
Mental health defies boundaries every step along the way. So many diagnoses have similar signs to others, so many are intermingled with other concerns like addictions, trauma, and neurological differences. It is never “this or that”, it is always a combination of things. Some of these things are very complex and reach deep into the subconscious. If the whole person is not being treated they will never heal.
The profession is not moving away from the medical model anytime soon. In fact, with the publication of the DSM V (the book that tells you how to diagnose people in psychology), it would seem the field is doubling down. As a person who struggles with mental health, it is up to me to recognize the problem and do what is necessary to obtain the holistic treatment my mind and body needs. I’m privileged: I have years of schooling and practice to recognize the things I need to advocate for. Most people in my psychiatrist’s waiting room do not have the tools I have, and therefore they are being left behind (and don’t even get me started on how unethical the VA is in this regard). Even though this knowledge isn’t easy to obtain sometimes, it is important for me to add simply changing one’s mindset from looking at mental health as one singular concern to looking at as a web, with each strong and sticky strand comprising one element of what’s causing the anguish. Depression, trauma, neurological stuff, anxiety, adverse early child memories, physical pain, all of these things are strands in the web. We can’t just go after one strand, we must address them all.
This summer, I watched countless sunrises and sunsets from the windows of my house. I viewed countless pictures of peoples’ outdoor adventures from the confines of my phone. I stared at walls, floors, and ceilings. During all the staring, all the seemingly mindless moments where I was focused on my pain, I was actually working. I was being productive and reflexive, and as a result I feel a spark of hope for the next few months. While I haven’t been hiking (and my body feels the results of this inactivity), I have been working harder than ever inside my head. And yeah, it’s exhausting. My hope is the result of this work will be hanging out with my friends again, enjoying my tours, going on road trips without crippling anxiety, and being able to enjoy all the amazing cities I visit and play in.
Thanks to my friends for sticking with me through this journey. I know I’m largely incommunicado, and I appreciate the patience over the past several years. Here’s to hoping the sun sets on my depression, even for a little, and I can enjoy the cool fall nights of relief.