hillarygayle: (Elrond Serious)
Most of the people who read this already know me. You already know I'm in the fight against mental health stigma up to my eyeballs. Primarily I'm in it for [livejournal.com profile] asqmh , but I've had many friends & family affected by emotional & mental health disorders in my life. My maternal Granny had bipolar disorder with schizophrenic patterns during manic phases. I've had 2 uncles deal with severe depression and another who dealt with a tremendous substance abuse problem when I was in high school. One of my very good friends, Tashina, is getting her DNP in mental health nursing practice while I'm getting mine in acute nursing practice. So I'm all in, and I have been for quite some time.

I have told people & told them, a thousand times to tons of different people: if you need a medication for depression or anxiety or paranoia or ANYTHING--there is no reason to feel ashamed or embarrassed of that. I have also shouted to the sky how that doesn't make a person dangerous or someone you should be wary of. I have reblogged & tweeted & Facebooked the statistics that support the true facts: people with mental health disorders are actually more IN danger than they are a danger to OTHERS. I have encouraged others who "came out" with their own mental health disorders or even just mental health struggles! I've been very open about my own ADD and my choice to medicate for that.

Well now it's my turn again. Yesterday I got a prescription for bedtime clonazepam at my ADD checkup, & I took the first one last night. I slept better than I have in ages, & easily woke up at 6am to pack Ganon's school lunch. I know I'm not REQUIRED to explain why I am taking it, but I think sharing my situation & how this helps might be helpful to someone else for their own situation.

Grad school is stressful. This is a thing everyone is aware of. :) "It is known, khaleesi." Since I started school last year, I learned exactly HOW stressful. I am in a very high pressure program, and if I might be a bit critical, the continual communication difficulties between professors & students in this particular program has added to that. There's a constant fear that we'll miss something because it wasn't communicated clearly, and there are extremely high expectations of us with very little in the way of specific guidance. Since this time last year I have taken many steps to decrease my stress. I cut my hours at my job, then I went to weekends. Then I cut my hours again. Finally, when the work environment became too much stress on its own, I quit my job. This summer I chose to hire someone to come and clean the house every other week as a way of helping me manage the stress of clutter in the house. I got a lot of things accomplished in the house during the break, as well, knowing that those things would make my life easier in this coming academic year. I started making lists of things I accomplished during the day. I understand stress, & I know how to manage it for myself.

But no matter how good I am at dealing with stress, no matter how many compensation mechanisms I develop & how many things I do to alleviate some of it, there's one that has always nagged me, and it's gotten worse with graduate school. My brain doesn't turn off in the evening. In fact, it ramps up. The most stressful part of the day for me is the evening, when I should be winding down. It's when I start thinking about all the things I still need to do, but it's a bad time for that because you can't DO much about anything in the evening. Fretting about running by the bank, making a shopping list, deciding I need to read one more chapter--all that stuff is either much harder or impossible in the evening. Even making my "accomplished" lists isn't totally helpful, because each thing I accomplish makes me think of something else I have yet to do.

That failure to wind down leaves me in bed every night, looking at my iPhone, making lists, thinking about all the things I need to get done tomorrow. I'll lie there & think about things I read that day. I'll think about when I begin clinicals, or berate myself for forgetting to do my 30 minutes of activity. I cannot switch off until midnight or 1am, and I'm not sleeping well after that either, because I wake up exhausted in the morning. I'll sleep until 10am if I can. I came to realize I couldn't afford crappy sleep: it made it near impossible to get up & get Ganon's lunch ready. If I slept until 10am, I was wasting several hours of empty, quiet house time that were perfect for studying & taking tests & thinking graduate school thoughts.

So yesterday I asked for a prescription of something that could help me turn my brain off at night, and I was given a prescription for clonazepam. It's a tiny little dose that Q declared "adorable," but it's the first anxiolytic I have ever taken in my life. Taking it felt a bit like the first time I took methylphenidate: a bit of apprehension, some curiosity, & a healthy dose of resentment that I needed it at all.

This morning I woke up at 6am, completely rested & ready to get it started. Made Ganon's lunch, drank some coffee, came to my "study cave" in the basement & immediately knocked out 4 case studies for the directed study class. Because my brain got some SLEEP & didn't just stay half-awake all night thinking about what it should've done. It made me wonder why I'd pushed against it so hard--why I had done literally every other thing I could think of before I tried this. And I came to a conclusion which made me feel like I needed to write this.

You see, I know why I pushed back so hard, why I tried everything else. It's the stigma. No matter how much I told other people "It's perfectly fine for you to need this" and "This isn't a failing on your part, it's chemistry," I didn't believe that for myself. I pushed because I thought if I could just push a little harder I wouldn't need it. If I could just suck it up a little more, I could fight the stress down on my own. That's ridiculous. I am carrying more than I've ever carried in my life. Trying everything else doesn't mean I now "deserve" this, either; that's another thing a lot of people do. I'm glad I tried all those things, because they do help on their own; their effect will enhance the good nights' sleep & help even more, but they weren't hoops I HAD to jump through before I admitted the need for some nice chemical help.

I guess defying one stigma doesn't necessarily translate to comfortably defying another. I feel the same feeling as when I first got into body positivism. I had to train myself to weed the fatphobia out of my thoughts then. I had to pretend to be perfectly okay with wearing sleeveless things until I actually WAS okay with it. It wasn't a conscious thought, but I think I figured since I have come so far in conquering fat stigma, that I should be fine & dandy with mental health stigma. It wasn't true. I had to defy that one from square one, as well.

I'm putting all this out here in case it helps someone else. If you're thinking about an anti-depressant or an anxiolytic or even not thinking of anything specific, just thinking that you don't like the way things are going & you need SOMETHING, don't let the stigma stop you. I will be right here with my nice bottle of clonazepam & my good night's sleep, giving stress & depression & anxiety & mental health stigma the finger, & doing whatever else I can to help you get what you need.
hillarygayle: (PP Molly kicks ass)
Lot of talk out there about suicide right now, thanks to Robin Williams. I'm horribly sad that such a bright, amazing, and by most accounts kind & generous person died this way. That he felt there was no way out but to opt out of living, after having given SO MUCH to so many people. I am grateful it's started a conversation about mental health, depression, & suicide.

But WOW, for the first time in my life, I think I understand why some people use the term "armchair activist" in a pejorative way. I have always been favorably inclined to the very young, very vocal people shouting about their particular pet issue on Tumblr & Twitter. If nothing else, they're raising awareness, & many of them are not only doing that. Many of them are involved in wider movements to address the issue they feel strongly about. I've used the phrase "Tumblr Aunt" to describe my fondness for all the social justice warriors raising awareness of so many important issues, & I'm grateful to them for doing it.

Please understand as you read the rest of this: this was written by someone who knows & understands what it's like to prevent a suicide, but not someone who has ever had suicidal thoughts. I cannot speak to that, & would not take the mic from those who have been in that dark place.

But right now I feel like an old lady out on the porch wanting to yell at these kids to get off my lawn. I have to wonder how many people retweeting the suicide hotlines & saying "You're loved & needed in this world" have truly participated in suicide prevention? Do they understand what it takes to actually prevent a deeply, chronically depressed person from killing themselves?

I do. You see, I understand on a visceral level what it's like to prevent a suicide. I have done it several times that I'm aware of, and I KNOW there are times I've done it when I wasn't aware. I have also dealt with the aftermath of suicide attempts in my career as a critical care nurse.

What it takes to prevent a suicide isn't a hotline or a pithy captioned photo on Facebook or a blanket reassurance on Twitter that this person loves all 3,000 followers on their Twitter list & doesn't want them to die. What it takes is a deep, continuous relationship with a suicidal person, and that's one hell of a lot less comfortable than the previous options. A suicide hotline is a tourniquet. It stops the hemorrhage in the short term & it may prevent that suicide from happening TONIGHT. A person who is depressed & has become suicidal, though, rarely stops at once. They're going to go there again. Many times, depending on life situations, mental health maintenance access, and other influences. Preventing suicide requires an ongoing commitment from you as the person dedicated to preventing it.

I'm almost not sure suicide can be decreased in a general, mass population way. There are many diseases that CAN be decreased just through awareness of risk factors, such as we've seen happen with lung cancer. Unlike lung cancer, however, suicide is not caused by the same thing in every person. The triggers are incredibly personal, and the situations are extremely specific to each person at risk for suicide. Unlike many diseases faced by public health advocates, I'm convinced suicide prevention has to happen on a very personal, one-on-one way. It has to be about the day-to-day presence of a reassuring, supportive person or group of people who affirm the worth of the suicidal person.

Edited to add: It's been pointed out to me that a lot of folks may assume I'm lumping online relationships in with the blanket RTs & captioned photos. That's absolutely not the case. If you're the kind of friend who lives across the country & carries on a long-distance friendship with someone via technology (many of my friends & I call it "living in each others' pockets), that's a relationship. I'm not discounting that because you're not sharing the same air as someone. I'm also not not knocking actual conversations that start with the blanket tweets & witty pictures.

There are many things we need to do to ensure better mental & emotional health care in this society. We have to erase the stigma of emotional & mental disorders. We have to ensure access to mental health care providers to EVERYONE. And to really prevent suicide, we have to BE the networks & relationships for those people with depression & other mental health disorders.


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