The 13 Reasons Why (It’s Not That Simple)

Disclaimer: I am not a mental health professional. I am not a doctor. I am an individual, sharing thoughts and assertions based entirely on my own experience. My opinions should be taken precisely as opinions, and should not be passed on as fact without further research and verification.

 

There’s been a lot of talk about the Netflix adaptation of Jay Asher’s novel The Thirteen Reasons Why, and not all of it is praise. A very valid dialog has been sparked in the mental illness awareness community in reaction to the show’s popularity as concerns arise about the content. To summarize the narrative, the problem is not that Netflix aired a series about teenage suicide. The problem is that Netflix aired a series about teenage suicide and handled it incorrectly.

It goes a bit like this: 13 Reasons Why…

  • romanticizes suicide as an act of righteous revenge
  • presents suicide as a method by which to provide justice
  • neglects to address very real contributing factors like mental illness, and the immature development of the teenage brain
  • overplays the level of premeditation that precedes the act of suicide
    • e.g. Hannah’s tapes; realistically, the time it takes to do what Hannah did is enough time for the human brain to psych itself out, and start over
  • simplifies the prevention of suicide to “just being nice to people”
  • provides no plot points where help was adequately sought, or provided
  • paints the very dangerous misconception that people who suffer with suicidal thoughts can be “loved back to life”
  • implies that a person is directly responsible for someone else’s suicide
  • suicide can be justified, if its legacy is constructive
  • sexual assault is a death sentence
    • this deserves a whole blog to itself, so I will not delve here

Today, I want to do what others have already done as a reaction to the series, and present thirteen very important truths about suicidal ideation, per my own experience with Depression, and my feelings about the series. Before I do so, I want to talk briefly about my overall reaction to 13 Reasons Why, so a spoiler alert is now in order. To skip, scroll ahead to the list.

I spent the majority of the series feeling very judgmental of the character of Hannah, mostly because I felt as though she wasn’t experiencing anything out of the ordinary for a teenage girl. Not to say I think any of the mistreatment she suffered was defensible, but my knee jerk reaction was to say, “This is survivable. You are belittling legitimate suffering by catastrophizing these minor offenses.” As the episodes progressed, however, I softened toward Hannah. Teenagers experience the world almost entirely in dramatics, because their brains are wired for it. I look back on who I was at sixteen and seventeen and I realize, had I been in Hannah’s shoes, I might have felt almost exactly as hopeless. I do not agree with her decision, but I felt less willing to discredit her suffering. This may have been the only positive lesson I learned while watching 13 Reasons Why: I do not decide if someone else is in pain.

One really poignant moment that I appreciated was Clay’s realization that he could have handled something differently, but there was only one moment within the realization that I felt completely okay with. Clay, reflecting on a night he spent alone in a room with Hannah, recounts Hannah demanding that he leave the room and leave her alone, and in his mind he goes back to that moment and changes his decision. Reliving the memory, he goes back and chooses to refuse, and chooses to tell Hannah he won’t leave her alone, and implores her to help him understand how he can lessen her pain because he loves her, and wants to help. The purity of this hindsight lasts only a few seconds. Unfortunately, it is sandwiched on either side by the suggestion that his original choice to listen and leave the room was one of the factors that inevitably led to Hannah’s suicide. Clay even says, “I killed Hannah Baker.” I wanted to break my television. I wish they had fleshed out the importance of reaching out to someone who is in pain, instead of banking the emotional impact on Hannah asking, “Why didn’t you tell me this when I was alive?” It shouldn’t have been about Clay making the wrong choice; it should have been about the question of what any of us can do to put a hand out to someone who is suffering, even at the expense of our own awkwardness or inadequacy.

Like I said, over time I felt less cold toward Hannah, but I harbored a very real resentment for the way she talked on the tapes, or that she made the tapes at all. She was setting up her own death way too far in advance, in a scripted way that cheapened her story for me. Gallows humor isn’t something a suicidal person has in this much fresh supply if they are suffering enough to be ready to end their lives. The time it would have taken to make thirteen tapes, decorate them, mark and provide a map, make an entire set of copies, address and deliver the copies, and go home when finished is entirely too much time between deciding to go, and going. Suicide is premeditated, but not procrastinated. If you mean it, you find a way to do it. The illness that precedes suicide does not typically leave room for that much artistic expression. Maybe a 45-year-old could have done it, but not a 17-year-old girl.

By the last episode, I was feeling a lot of different things, but I didn’t expect what I felt next. Suicide in movies and television is not new territory. One of my favorite television series, Law & Order: Special Victims Unit, depicts a suicide at least three times a season, and as many methods of suicide as you can think to depict. I’m pretty desensitized to it by now, as I’m sure most people are. Someone overdoses, you show them slumped in a chair with a needle nearby. Someone jumps from a building, you show an overhead shot of their body on the street. Someone hangs themselves, you see their shadow drop against the far wall. It’s all been done. Hannah’s suicide in 13 Reasons Why was foreshadowed a few different times, preparing us for the fact that she would eventually slit her own wrists in a bathtub. What I was not prepared for, and could not have prepared for, was how they filmed the scene.

Beginning of Trigger Warning

Every other time I’ve seen suicide depicted with someone slitting their wrists, the violence has been implied. The razor is shown on the skin, but not digging in more than surface damage, if being shown at all before switching the shot to the mandatory blood dripping into the sink. In almost every other example, we only see the final result: a person submerged in a bathtub of red water. In 13 Reasons Why, you are done no such favors. The camera is positioned at the far end of the tub, one long shot, with Hannah lowering herself into the tub directly across from the camera. Extending each of her arms in turn, the camera remains perfectly still as Hannah digs a razor into the flesh of each wrist and pulls the blade down the inside of her forearm, nearly to the crooks. To her credit as an actress, Katherine Langford’s gasps of shock and intense anguish are raw and believable, and stutter convincingly into relief once Hannah manages both cuts without second guessing, and finally sinks into the water to wait.

What disturbed me most while watching this scene was the way my own body reacted to seeing Hannah  willingly mutilate her own. I felt a very intense rush of adrenaline. The same kind of adrenaline the average person probably feels when they watch a video of someone skydiving, or riding a mountain bike downhill at breakneck speed along a dangerously narrow path. It was thrilling, watching someone go through with something I’d only ever fantasized about. It frightened me. It wasn’t until that moment that I really grasped how close I’ve come to ending my own life, despite ‘chickening out’ all those times. Maybe I can spin it in a positive way — call it a mental health breakthrough, maybe — but the consequences of the experience have not been worth it.

I started to have nightmares. I didn’t dream about the characters from the series, or about taking my own life. I dreamed about other people’s suicides, and being forced to witness them. The nightmare I remember most vividly is one that forcibly replayed itself until I was finally able to wake up. I was in a house with Michael Clarke Duncan, who was preparing to take his own life, and he made me watch. I was trapped inside with him. In some of the repetitions of the scenario, I tried to escape the house. In some of the others, I tried to stop him. In the last version before I woke up, I watched him pull the trigger on the shotgun, and watched the back of his head come apart, and watched him slump forward when it was done. I woke up terrified, paralyzed, and haunted by the darkness of my own bedroom. I was too scared to get up and turn on a light. I was too scared to close my eyes and risk going back to sleep. I lay frozen in the dark for several awful minutes before I was able to reach for my phone and text my boyfriend.

The screenshots are a little misleading; details came back to me in the later hours of the morning, but this is the actual exchange we had after I was able to operate my phone with some clarity. Pardon the pineapples — it’s an inside joke**.

13rwtexts

**I started using random emojis as a text message signature, to mess with a coworker. She would ask why there were pineapples, I’d ask “what pineapples?”, and she’d have a fit. I changed the emoji every day until she lost it. It was great.

End of Trigger Warning

I understand now why people are fighting to adjust the content warning on 13 Reasons Why. If I, fully aware of my own struggle with suicidal thoughts, was triggered, I don’t want to spend time inside the head of someone who has never tried to address their impulses. In the end, maybe there is no good or right way to depict suicide in art, but there are things we can do to construct a proactive dialog on the subject, and it begins with people who have experienced suicidal thoughts talking, and other people listening.

So, here is me talking.

The Thirteen Reasons Why It’s Not That Simple

  1. Mental illness is real. Suicide almost always walks hand in hand with some kind of preexisting psychological suffering. Neurotypical depression does not usually intensify to the point that the human brain starts to neglect its evolutionary instinct toward self-preservation. I mean to say, the average person survives a bout of depression and comes out the other side, whereas a person for whom depression is ingrained, it isn’t as straightforward. This is why the (predominantly neurotypical) people left behind by suicide are almost always left asking why, because it isn’t that cut and dry. Illness is not simple.
  2. Someone else’s suicide is not your fault*. Obviously the actions of others can contribute to a person’s decision to end their own life, but suicide is not the active choice of anyone but the person who commits the literal act of suicide, which is why Reason 13* will be the most important one on this list.
  3. Suicidal thoughts are often recurring, and start to feel routine. I think there is a common misconception that once someone thinks to commit suicide, that’s when they do it. This isn’t true in the least. There is a very authentic scene in Girl, Interrupted where the character of Susanna Kaysen is telling a boyfriend about the fluidity of suicidal ideation: “Make a stupid remark, kill yourself… miss the train, kill yourself,” or something to that effect. It sounds frivolous, but it’s not off base. Once you’ve been invaded by those kinds of demons, the idea of suicide can become a coping mechanism. It’s comforting to know you’ll always have that way out, just in fucking case. When you consider this, you realize you can’t reduce suicidal ideation to absolute terms.
  4. We often feel there is no safe place to talk. People who don’t live with suicidal thoughts are typically the last people we want to talk to about our suicidal thoughts. We don’t want to be coddled, we don’t want to be interrogated, and worst of all we don’t want to be forcibly hospitalized for trying to find someone to talk to. We understand this will scare you, and so we don’t tell you at all. Unfortunately, that often means we tell no one. On the flip side, if someone you love tries to talk to you about their suicidal thoughts, let them. We wouldn’t come to you if we didn’t think we could trust you, and often you only get that one chance to prove us right or wrong. I understand it’s a lot of pressure, but it’s how it usually plays out.
  5. Choosing to live is not the end of wanting to die. People who live with suicidal thoughts and choose life do not do so lightly, or simply. At least for me, one thing always stops me just before the point of really planning an exit: my parents. Literally only them. My friends would move on, my animals would have homes, a trusted accomplice will destroy my flash drive, and I’d be dead. But my parents? I couldn’t leave them like that. I couldn’t put that on them, no matter how many good reasons I thought I had. So long as they’re both breathing, so the fuck am I. And so, choosing to live is not the absence of wanting to die. It’s just a little from Column A, and a little less from Column B.
  6. Being loved is not enough. Something I hear a lot is, “She was so loved, I don’t understand,” or, “If only I had been there.” Do you hear the two different kinds of blame? Let’s address them together: Not everyone who takes their own life is alone. Not everyone is unappreciated or abused. I talked about mental illness being real, and now I have to mention it again. The mind is sick. It isn’t more or less clear than that. The mind — the organ responsible for the function of every other part of the body — is sick. I have some friends who lost a classmate to suicide. Recently I heard them both say, “Maybe if I had said something.” I’d heard them say it before, and finally I had to weigh in. The thing is, if you’re already down that far, a lifeline isn’t always going to help. Sometimes, it becomes the question of how you can still feel so sick, even surrounded by this much love. It adds a whole new layer of despair. Mental illness needs professional intervention to change course — it isn’t your fault for not sending a well timed text message or making one last surprise visit (unless you happen to pop in right in the moment). It’s not your fault.
  7. You can’t stop living your life to save someone else’s. Likewise, you can’t put your life on hold to save someone else. Be there, be a friend, but when it’s beyond you, admit to it. Bring someone else in. Ask for help. Unless you are a mental health professional, you can’t always be enough. When I was a Bruintown camp counselor, our Advisors taught us to respectfully cut conversations short if they were stopping us from administering our own self care. I’ve carried that lesson with me, and am very grateful to have learned it. I have to live, as much as anyone else, and so do you. If the person you’re talking to is not immediately at risk, be wise enough to say, “I am so grateful that you trust me with this, and I want us to keep talking about it until you feel better, but tonight I have to get some sleep/have to go to work/have to take care of my other responsibilities. When can we talk again soon?” If the sincerity is genuine, it will come through.
  8. We listen when you talk about suicide, and remember what you said when you thought it wouldn’t matter. In 2014, we lost Robin Williams. Though I felt the immediate weight of loss, I realized over time how very authentic that pain was. It’s three years later now, and I still have difficulty watching his movies, and still haven’t started his written biographies. I’ve equated it a few times to losing an uncle — a beloved relative you adore across a distance — and conditions have not improved. In the first few weeks following Robin’s suicide, I made small memorial items for my desk at work, to comfort me. I learned the hard way that not everyone has as much respect for him as I do. More than once a customer sat down at my desk, saw the evidence of my grief, and talked forcibly about what a coward he was. They interrupted completely unrelated conversations to make sure I knew how they felt about another human being’s choice to end his life. I defended him every single time. On one notable occasion, someone (who could easily have gotten me fired) called him a coward, and I snapped, “God forbid anyone you love ever feel as much pain as Robin did, because they won’t be able to ask you for help.” He came back five minutes later to apologize to me, and I hope he remembers the way he felt when he realized he needed to apologize at all. What you say about suicide is remembered by those you say it to, whether you consider the cost of your words or not. Think before you speak. Your friends are listening. Your children are listening. We are listening.
  9. Treatment is not absolute, and a lot of medications have the potential to make it worse. In adolescence, my mother realized I wasn’t completely okay and she took me to see doctors. I remember names like Paxil, Zoloft, Prozac — nothing did precisely what it was meant to, and eventually we threw in the towel. In adulthood, I was given pain killers that made me suicidal, anti-anxieties that made me suicidal, and anti-depressants that made me sleepless and exacerbated a twitch I have in my shoulders and neck. I’ve given up on meds, and am working slowly on finding counseling. My friends are better examples of success stories: N and J we’ll call them, swear by their medication and would be miserable without its assistance. They also both see therapists, to whom they owe a great deal of their sanity and high function. The difference between my experience and my friends’ is a fair example of the spectrum between what works for one person, and what works for someone else. Encourage people to seek treatment, but don’t expect it to fix them, to come easily, or to change them overnight. Medication takes months to adjust your chemical imbalance (if it works at all), side effects can be deadly and frightening, and therapy is a process that lasts years and is a potentially lifelong commitment. Even with treatment, suicidal ideation does not go away. There is no quick fix.
  10. It isn’t as simple as being nice, but be nice. One of the things people criticize 13RW for is the overly simplistic message that not being nice to someone drives them to suicide, or that the opposite practice prevents it. There is a scene where Clay says to another character, “I killed a girl because I was afraid to love her,” to which the second character responds, “You can’t love someone back to life.” The camera focuses on Clay’s face as he tearfully replies, “You can try.” This is a beautifully vulnerable narrative, but it tells too simple a story. Being kind is, of course, important, but it isn’t that black and white. You can’t always be nice, first of all, and you can’t live with the idea that every time you’re rude in a moment of weakness, you could be driving someone to suicide later on. Likewise, being kind to someone isn’t a Band-Aid for mental illness or years of whatever trauma leads to thoughts of suicide. Kindness can heal, but it isn’t all it takes. Be kind, but don’t forget how much more there is to the human experience that also plays a role in how someone experiences being human.
  11. It’s not an easy way out. Suicide is not a simple decision, by any means. You don’t wake up on Monday morning and kill yourself Monday night. You wake up at age sixteen and suffer for thirty years before it finally consumes you. We are aware of what we are leaving behind. We are aware of what we stand to lose, and who we stand to hurt. Even the most nihilist of us knows we leave behind a legacy we can’t control, despite the muddy message sent by narratives like 13RW. I’m an Atheist. I believe this is our only life, and I believe we only die, and we’re gone. Despite that liberating clarity, wishing I were dead is never simple, and death does not feel like the easy way out. The world I leave behind will still turn, and even if I don’t know about it when I’m dead, I know about it now, and the complexity of the human brain has a poor time reconciling the two ideas. Apart from the logistics of the act, and the weight of knowing what you’ll do to the world you leave behind you, people seem to forget that the human body wants to live. Self-preservation is a powerful (sometimes fucking toxic) drive, and a suicidal person has to find a way to break through it to the other side before suicide even begins to feel like a real way out.
  12. We want to be noticed. When people say “they just want attention”, I don’t think they know precisely how correct they are. We live in a world where we are told we are supposed to be asking for help, but we are punished when we do, or don’t know how. Trust and believe, thought is invested in the method of suicide, and if we mean it, we usually pull it off. Granted, things can go wrong, or people come home and stop us, or maybe you even panic halfway through and stop yourself. But for those of us who self-harm and let ourselves get caught, it’s because we let. ourselves. get. caught. So notice us. Take us seriously. Try. The human body wants to live; it’s the human mind that takes convincing.
  13. Suicide is a choice. I think this is the most important thing to accept. I read somewhere recently, a writer was imploring the reader stop saying “committed suicide” and start saying “killed themselves”, because that’s what it is. It’s self-murder. While we should respect and believe in the suffering of those who take their own lives, it is dangerous to reduce them completely to victimhood. People who commit suicide (see, it’s difficult, isn’t it?) are not all the same person — some were legitimate victims of abuse, mental illness, or some other trauma — in the end, however, they choose to die. We have to remember that part. Suicide is a choice made by an individual, and in the end, we cannot deny them that final agency. It is correct to be sad for them, or perhaps even feel sorry for them, but it is not correct to remove all responsibility from the part of the dead. The people in Hannah Baker’s life made choices that contributed to Hannah’s personal decision to end her own life; it does not mean they killed her, it means they made choices that influenced Hannah’s last choice.

I don’t want to live my entire life in the shadow of my desire to end it. From where I sit today, I don’t feel hope that I will ever stop having moments of ideation, and maybe that’s okay. Maybe I can use it. Maybe I can allow it to inspire me, as odd as that sounds. I spoke earlier of Robin Williams, and my thoughts on that could take up an entire blog by themselves. The short version is that Robin, in the saddest turn of events possible, has become my rock against the tide of wishing I were dead. That Robin’s choice is beyond my control has given me a greater feeling of control over my own choices, and now I live because Robin no longer can. I have to live now, because Robin felt he could not. There is nothing to glorify in losing someone to suicide, but we can choose the shape of that person’s legacy, as far as how it affects us personally. I choose to carry Robin’s memory with me as a token of strength, to do what I will always wish he would have — could have — done instead.

When I started drafting this blog, I went to the American Foundation for Suicide Prevention website and signed up for their newsletter. Now I can go to events in my area and contribute my labor, time, and experience to improving the lives of those who struggle as I have struggled. I encourage you to do the same, whether you have dealt with your own thoughts of suicide, know someone who does, have lost someone to suicide, or hope never to experience the loss at all.

The one thing we can always do, is try. The one gift we can always give without running out, is love. The one thing we can always do to change the world, is act.

“You can do no great things, only small things, with great amounts of love.”

Thank you.

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Bookshelf: Shiver by Maggie Stiefvater

I am an author. I don’t know yet whether I fit into any one genre, but my largest project is about werewolves. Many seasoned authors have issued the keen advice, “To write in your genre, you must read in your genre.” This is a practice observed not only for the purpose of knowing your competition, but to learn from your competition. In the spirit of this advice, I headed to my local Bookman’s Entertainment Exchange to find some examples of lycanthropy in fiction. Specifically, examples of lycanthropy that are not erotica, camp, or otherwise too stylized to fit into the niche I’m hoping to fill in the market. Unfortunately, that is incredibly difficult, which is one of my deepest motivations for finishing the story. I want to prove there is an alternative to the stereotypical werewolf fiction.

Per a GoodReads suggestion list, I picked up Shiver by Maggie Stiefvater. At first, I was hopeful. The story of the Wolves of Mercy Falls begins curiously enough, with the story of the main character, Grace, and a childhood run-in with the wolves that inhabit the woods near her family’s home. Grace goes on to harbor a fascination with the wolves, waiting every summer for the heat to dissipate into the crisp cold of fall, for it was only in winter that the wolves returned. Meanwhile, our second narrator, Sam, shows us the story through his own eyes, as one of the wolves. Just as Grace has watched the wolves, Sam has watched Grace. Now, in the encroaching winter of Grace’s seventeenth year, the two have finally come together after an unfortunate accident that brings Sam back to his human skin, despite the wintry cold. With Sam’s secret revealed and now kept tightly between them, the two rapidly develop a romantic connection. Their singular focus then becomes to beat the clock on Sam’s curse, before winter takes him back. To further complicate their love affair, a local boy has gone missing and is believed to have been taken by the wolves. Together, Grace and Sam must move quickly against the snowfall and find the rogue new wolf before time runs out, or before he reveals himself to the humans of Mercy Falls.

Or, ya know, some shit like that.

Let’s take a note from Stewie Griffin‘s book and do what he likes to call a “Compliment Sandwich”: First, I will talk about something I liked about the story, then I will talk about where I believe it could have used improvement, and then I will end on something positive.

I did like the new spin on lycanthropy, which was a spin I had not yet seen. The idea that the change is triggered, not by the full moon, but by the cold, was very interesting to me. Within the story, Stiefvater goes on to explain the different layers of this rule she’s invented for her wolves, and I find it holds water. Stiefvater builds palpable suspense and tension in the moments that she describes Sam’s struggle against the cold, and ultimately his struggle to remain himself, in his own skin. Despite the story being told mainly from Grace’s point of view, I found Sam’s voice to be the more compelling and genuinely conflicted of the two. The stress of warding off a change he can neither compel or resist comes across easily in the narrative. Overall, Sam’s mind was a pleasant place to be, and my preferred window through which to watch the story unfold.

The list of my grievances is quite a bit longer than that of my praises. I find I have some of the same complaints about Shiver that I had (and still have) about Twilight, in that first and foremost, good ideas were laid by the wayside in order to spend time on angst. Several times I felt as though worthwhile ideas were given very little development, despite how simple it would have been to focus on them even temporarily. Screen time, so to speak, was dedicated in large part to teenagers fumbling through feelings instead of to actual action. Similarly, no time was spent developing characters’ digestion of their environment. Grace went quickly from discovering Sam was a werewolf to being completely comfortable with it, literally within the space of ten seconds. A valuable opportunity to explore Grace’s mind was sacrificed in order to advance the love story instead of her character. This same sacrifice is made with another character’s secrets later in the story, but constitutes a spoiler.

The term “wish fulfillment” is used frequently when criticizing Twilight, and there are moments in Shiver that the same accusation stands, particularly toward the end. What teenage girl who feels as though she does not fit in would turn down the chance to take part in an overly dramatic love affair with a supernatural boy? Who among us that did not experience true love in high school does not use her imagination to fill in the blanks? A great deal of us, surely, and for those of us who write, it comes out in the narrative. As much as I resent this trend in popular fiction, I resent even more the new trope of the female protagonist always being a book reading, homework loving, bad parent having Mary Sue with no remarkable features or talents, whose worth is communicated only in the aforementioned prerequisites for Young Adult front women. Sam loves Grace for no reason. None at all. I understand that apple doesn’t fall far from the teenaged tree, but if what you want is for me to be drawn in by something special, it needs to be – well, fuck – special.

Furthermore, in the real potential that was lost in fluff are fleeting moments of action that I think, maybe, were meant to lure me into a sequel. If that’s what it was, then there were better ways to do it. What was the point of Shelby? Is she coming back? What about Beck’s newbies? Do they have a point? The only person I want to see come back in the sequel is Olivia. Her little moment toward the end of the story was truly poignant for me. I hope to see her again.

Despite my disagreements with the narrative, obviously I never stopped reading. I wanted to know what was going to happen next, at all times. The dialog felt natural in almost every scene, and Steifvater worked a comedic edge into the dialog that felt very natural. Whenever Isabel spoke, for instance, I heard her in my head as clearly as bell, and more than once laughed aloud at her effortless cheek. Like I said before, I enjoyed the inside of Sam’s head, and its quirk for writing song lyrics to describe his experiences, even if the lyrics were completely typical and groan worthy. As much as I criticize the angst, a great deal of it was well written, if what she wanted us to focus on was the angst and not the story. I will be picking up Linger in the near future in order to finish the story, and I hope the next chapter(s) will be more solid, and less fluffy.

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Goal: Don’t Kill Self…

…before Trump is out of office.

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Wellbutrin, 28 Days Later

It’s been four weeks on Wellbutrin, which is where you ought to start noticing improvement, or the absence of. I stopped taking Ativan because it was making me suicidal. Passing that comment along to my primary care physician prompted her to refer me to a social worker, who is supposed to be helping me find a psychiatrist, but I feel like she’s leaving most of the work to me. She literally sent me a list I had Googled for myself the day before. Half of the doctors on the list aren’t even psychiatrists, they’re neurologists who double majored in Psychiatry. I’m trying to stay encouraged to find and work with a psych, but honestly I’m feeling pretty turned off of the whole experience.

I feel as though I’ve experienced some improvement on the medication front. Sleeping is still a toil, but I’m experimenting with sleep aids. Right now I’m trying melatonin in 5mg tabs, which do seem to help a bit, but I wish I were falling asleep faster. I may take one and a half tonight and try a 7.5mg dose and see where it takes me. Word of Warning: Melatonin and alcohol affect everyone differently. Some people experience increased insomnia, some experience a more intense drowsiness than with melatonin alone and have trouble waking the next day, and then there are people like me who have a glass of wine too close to a dose and have horrifying nightmares about watching Michael Clarke Duncan commit suicide via shotgun. I had to turn the lights on for a while after I woke up from that one.

Some of my personal symptoms of Depression have also changed just a tad as well, or at least it feels like I’m headed in that direction. I went through a phase where I didn’t want to ride my bike to work. I couldn’t bring myself to commit to it, so I kept carpooling with a coworker. The last couple weeks, however, I’ve been riding in per usual, and feeling less triggered by the experience. Since my accident last summer, riding has been a touchy activity. Some days I’m fine, and other days I have to pull over and focus on breathing just because a car whooshed past me too quickly and set me off. I feel like that has changed, and may continue to get better. For my birthday weekend last Friday, I went out all night with my other bicycle friends, and felt great and confident the whole time. Good signs.

Speaking of my birthday weekend, that’s a great example of me going out and doing something social and taxing without trying to find ways to get out of it by faking illness or conflicting commitments. I planned it, coordinated, executed, and enjoyed. That is a gigantic accomplishment for me.

Here are some other things I’d like to see change before I report back to my doctor to discuss upping my dose and keeping my prescription open:

  • The will to get up and clean my apartment.
  • The will to keep on top of regular habits like laundry, cleaning the litter box, and dusting out my PC.
  • To enjoy reading again.
  • Longer bike rides, confidently.
  • Regular physical activity, of the cardio persuasion.
  • Less frivolous spending. This doesn’t sound symptomatic of Depression, but for me it is.
  • The courage to hunt, apply for, and maybe get a new, better job.

 

So that’s where I am. I go back to my doctor in June, so I have just over four more weeks to really feel out this Wellbutrin situation.

Wish me luck.

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Wellbutrin, Day One

A Brief History

I have struggled with capital-D Depression nearly my whole life. During my childhood, my mother tried to take me to child psychologists. It didn’t take. As a teenager, a second attempt was made, and we tried pharmaceutical therapy as well. From Zoloft to Prozac to Paxil, nothing seemed to change things for the better. So, I gave up.

By age eighteen I was habitually using methamphetamines, and all the clouds cleared away. I reflect fondly upon that part of my life, and I realized at some point in my later twenties that I was self-medicating with amphetamines. My mental illness was in remission, because of my drug addiction. Obviously, going back to meth wasn’t an option, but it gave me a real insight into the validity of my claim to mental illness.

Meth withdrawal saw my mental illness roaring back to life and making up for lost time. Between ages twenty and nearly twenty-four, I was a nightmare. It was a very dark time in my life, and that anyone who knew me then still loves me now is a miracle. By my mid-twenties, I was working hard to understand and manage my symptoms. I had a steady job, I was getting out and making friends, and I was trying to write again. Most remarkably, I quit smoking in 2012 and subsequently succeeded in losing nearly sixty pounds all on my own steam. In late 2012 I was feeling like I was on top of my game, and I packed my suitcases and moved across the country to be with my current boyfriend, a former friend for whom I developed feelings during our 1600 mile separation.

I thought I’d been through the worst, but my relationship with Daniel threw my illness right back into hyper drive. Daniel is my polar opposite, emotionally. He doesn’t worry. He doesn’t fret. He doesn’t flip. Nothing is urgent. Everything is fine. Why are you freaking out? Calm down, Chey. It’s not a big deal.

It drove me literally insane to be paired with someone for whom life just was, instead of representing a constant obstacle between one’s self and one’s happiness. I don’t know how Daniel has survived it for four years and counting, or how he continues to survive it while I work to understand, manage, and conquer what ails me. He is a blessing and a curse, and I hope we’re worth it for each other.

The Present Day

Two of my best friends also live with mental illness. The key difference between them and me is that they have had access to professional care from nearly day one, and have been medicated and treated consistently for the better parts of their lives. They are therefore very pushy about the benefit of professional help, and routinely lose their patience with my excuses for not seeing psychologists or taking pills. To be perfectly honest, I don’t want a therapist. I don’t want to spend money and time on it, I don’t want to go through seventeen people before I find someone I don’t think is garbage, and there is some stuff I really don’t care to share with a paid professional. On the other side of things, I don’t want to fix with pills. I don’t want the solution to my problems to be drugs. There has to be something in me that’s strong enough to survive myself.

In 2015 I opted for the Mirena IUD. Side effects are typically minimal, as Mirena’s influence on your body is localized to your uterus. But, because every body and every mind is different, my experience was characterized by weight gain, a spike in the severity of my illness, and a detrimental shift in my ability to rest or be active. I didn’t notice. I assumed it was all on me. I was lazy, sick, and tired and I was doing all of this to myself. By the time I scheduled my salpingectomy in early 2017, Daniel and my friend Natasha took it upon themselves to encourage me to do away with my IUD, despite the relief it gave me from my menstrual cycle. It took the two of them gently ambushing me with examples of how much worse I’ve been for the last two years, and Natasha showing me photographic proof of my weight gain, for me to finally realize Mirena and I needed to part ways. It has been bittersweet, but much should change for the better.

Although mental health and proper sleep and activity are important, it was the weight gain that upset me the most, once I realize the extent. In a previous blog I addressed the subject of my weight gain. I hovered between 200 and 205 pounds before early 2015, and when I wrote the blog I estimated my weight gain to be twenty pounds, tops, putting me at 220ish pounds. I made this estimation based on how well my size sixteens still fit, how well I could still suck in my gut, and the fact that my boyfriend didn’t seem to have anything to say about the change in my body. I’m not saying he’s the type to comment on a woman’s weight gain, but I’ve always encouraged him to be candid if he thinks something is wrong with me.

Now, I hadn’t been weighing myself for years. I don’t really believe in it. But, when I ditched the Mirena and decided I needed to get back on track, I started using My Fitness Pal again to get an idea of how I was eating. The thing about My Fitness Pal is it really only works if you tell it how much you weigh. Otherwise, its predictions about your progress have no basis in fact. So, I asked a coworker to bring me her scale from home so we could keep it at the office. Word of advice: Don’t bring a scale to the office. It makes everyone insufferable.

When I stepped on the scale, I nearly wept. The actual damage? 243

To be clear, when I was at my heaviest I was 260 pounds, and I lost sixty of that in a year. How I gained thirty-five pounds back in two years and couldn’t see it for what it was, I have no idea. Seriously, where on my body am I hiding it?? I am devastated, and thoroughly confused.

So, What Am I Gonna Do About It?

With the combination of weight gain, depression, generalized anxiety, and life altering insomnia breaking my body and my spirit, I finally decided I needed to reach out to my doctor for help. Because all of my complaints cooperate mutually to ruin my life, I asked if there wasn’t something we might be able to do to address all of my issues at once, instead of prescribing me several different pills I don’t want and won’t remember to take.

I made the biggest fuss about the weight gain, appealing to my doctor for a depression/anxiety/insomnia solution that wouldn’t put me further into the red. Understanding my concern about anti-depressants and weight gain, my doctor recommended Wellbutrin, which is more notorious for weight loss than gain. Obviously, I was thrilled.

As with most anti-depressants, it takes up to six weeks to really see the changes Wellbutrin promises. In an effort to give me relief right away and during the interim, my doctor also prescribed a 90 day supply of Ativan for sleep. Technically you can take Ativan up to three times a day as needed for anxiety, but my intention is to limit it to bedtime. I really, really, really need to sleep. We all know sleep is important, but what we don’t think about enough is how much impact sleep has over the rest of our lives. A tired body is not a healthy body, and a healthy body is not a productive one. Even if I am eating right, for instance, if my body is not rested, it will not burn fat. Furthermore a tired body is a tired mind, and a tired mind does not manage its defects gracefully. Worst of all, my insomnia has gotten to a point over the last couple years to where I wake up almost hourly, and sometimes leave my bed entirely because I’m restless and in pain. During these nightly wanderings through my apartment, I sleep eat. Daniel has told me a few times that when he sleeps over, he has witnessed me standing in the kitchen with the lights off, eating over the sink without appearing to really notice him. Putting the dots together, it’s clear the pattern of behavior that has led to my current misery.

Ch-ch-ch-change

Last night I took my first dose of Ativan for sleep, like I’m about to do in about fifteen minutes for tonight’s rest. I plan only to use Ativan to sleep on Sunday through Thursday. I sleep in on the weekends anyway, and I don’t want to make Ativan something I can’t do without. The idea is to be able to give it up after the prescription runs out, so I may not even take it on nights that I’m especially tired. Right now, for instance, I’m feeling pretty groggy, so I may rethink Ativan for tonight.

Yesterday, I woke up knowing I’d slept. There was no evidence to suggest I’d left my bed, and my neck and head were killing me from being in the same position all night. Because Wellbutrin can sometimes cause sleeplessness (or sleepiness, depending on you), I elected to take it in the morning before leaving for work. I felt fine until about halfway during the way, at which time I had to sleep during my lunch hour just to keep going. I had coffee at 2PM, which is typically a huge no-no for me, and I still feel groggy now. I think the lesson to be learned here is that a sudden change takes a toll on me. I’m going to give Ativan a week to show me it can level out. If not, I may call my doctor and ask if she wants to adjust my dose, or consider another drug. It is worth mentioning that I also experienced some feelings of depression today, but that they did coincide with some legitimate negative experiences I’ve been having at work, so I’ll dog ear that and see if it becomes a pattern. One risk with Ativan is depression or suicidal ideation, so both of those are things I need to monitor.

I am hopeful about Wellbutrin. I hope it can help me find and maintain some peace. I want to be calm, rested, and vibrant. If I can achieve good rest and keep an even keel, I believe I can get back to the person who lost all of that weight, who loved riding her bike, and who felt no desire to seek solace in food.

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“The BMI is Bullshit,” said the grumpy Amazon before deftly crushing the skull of her enemy.

For those of you who don’t know, the Body Mass Index (BMI) is a scale that uses only your height and weight to generate a score. Essentially this score is your body’s health grade. It does not factor frame, weight distribution, age, sex, muscle mass, or lifestyle. Your value is reduced to the ratio of how much you weigh versus how tall you are. That’s it. You can Google it; there are a billion different calculators available online, and they’re all fueled by the same overly simplistic pack of lies.

If you’ve never heard of it, I’m surprised. The BMI gets pulled into a lot of otherwise enlightened conversations about weight loss, body image, and physical fitness in general, which instantly lose their credibility as far as I’m concerned.

First slide, please.

This is me in very early 2013, just before St. Patrick’s Day. This is the outfit I wore to a friend’s wedding, because I’m an ass. Anyway, at the time of this photo I weighed anywhere between 200 and 205, depending on the day and where I was in my menstrual cycle. I had just lost 55-60 pounds over the course of the preceding year, and was still adhering to the diet that got me there. I was eating only lean meats, and had cut out nearly all added sugar, salt, fat, and general junk. I look pretty good, don’t I? Slim, shapely, healthy.

2013_205lbs

According to the BMI, I was at a score of 29.4, classified as “overweight”. Take a long look at my body in this picture, look me in the face, and tell me I was still fat. Go ahead. I’ll wait.

Next slide.

In this photograph, taken this year, I’m probably hovering at about 220 after two years of hormonal birth control and the subsequent depression and increased appetite that followed and, nevertheless, persisted. Again, take a good look at my body. Do I look thick? Yes. Fat? A little. Form an opinion quietly, then let’s continue.

2017_220lbs

Now let’s ask the BMI: 31.6

I have officially entered the “Obesity” category of the BMI. This score is being rendered to a vegan body that cycles to and from work everyday, does not drink soda, eat candy, or add creamer to coffee. If I were to describe that body to someone before showing a picture of it, they may even envision a smaller person, but surely never an obese one. I may not spend everyday loving myself, but I am never so foolish that I would believe someone who looked at my body and said, “You’re obese.” I’m a size eighteen today. Get real.

Now, for the sake of argument, I’m going to give the BMI one more weight to judge. I’m going to give it the weight I was in 2007, just before my family and I moved back to Iowa together. My weight then was 180, a full twenty pounds smaller than I was in the first picture posted here. The score for 180 pounds at my height is 25.8, which begins the assigned spectrum for “Overweight”.

To put that in perspective, 180 was my steady weight while I was addicted to methamphetamines.

Yes. Even at the skinniest I’d been in my adult life so far (and to this date, even), the BMI would have ruled me overweight. My friends routinely told me I was “wasting away”, but to hear the BMI tell it, I still was not working hard enough.

Unfortunately, I have no pictures from that time that are not severely Photoshopped, because I spent literal hours at a time manipulating pictures until they were more Pop Art than photographs. Remember the plaid skinny pants from my previous blog? Those were comfortable on me then, and they barely clear my ass now.

But, hey, come on. Surely that isn’t so extreme, right? Come on, let’s keep putting numbers in until we get me right in the median of the “Healthy” zone, shall we?

175…

165…

155…

Not until I tried 145 did I reach the middle of the “Healthy Weight” spectrum for the BMI scale. Now, if you will, let’s review my 200-205 pound body.

2015_205lbs

In case anyone is confused, this is a proportioned body for a wide set woman who stands nearly six feet tall and does not yet have muscle mass. This body wears a size 15 pant, cycles ten miles without difficulty, lifts and tosses 50 pounds repeatedly without strain, and shits everyday like fucking clockwork. This is a healthy, operational body capable of great things. But according to the BMI, it is overweight, and by definition unhealthy.

Now subtract sixty fucking pounds. Yeah.

Here is a gallery of women who claim to be 5’10” with an hourglass figure who weigh in at 140 pounds. If you do your best to focus only on women with wide frames like mine, you’ll notice they’re muscular. So, apparently that’s the line. It hurts my head to do the weight math forwards and backwards to try and figure it out, but you get my drift. The women with average or smaller frames obviously thicken out the smaller you go, but for a woman like me, whose rib cage is 38″ around no matter what? Yeah, no. I just tried to measure how far apart the points of my pelvis are, and it’s like eighteen or twenty inches. Sometimes a bitch just big.

The point is, and will always be, that you can’t reduce a person to numbers. I am a 5’10” woman with a bulky skeleton and an hourglass figure. At 200 pounds I was comfortable enough in my skin to drop another ten pounds and turn my focus to strength training and muscle gain. In the end, I probably would have bottomed out at a lean 175 pounds with musculature. For the record, that puts my BMI at 25.1, which is still classified as overweight.

Numbers don’t lie, but presented incorrectly they are wickedly deceptive.

Know your body. Trust your body. When you feel lean, strong, healthy, and vibrant, THAT is your perfect score. Not some fucking math problem you can find online.

 

 

 

Update: Please refer to this new blog, for an amendment to my current weight.

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Video Updates: Mirena Crash

The after-removal bleeding reached a point that it was having a miserable effect on my day to day life, so I condensed the experience to a couple videos for ease. Enclosed here.

 

 

And part two, because my phone cut me off and made me delete things for space.

 

 

I made those videos on Tuesday, and it is now Sunday. I ended up taking my last dose on Thursday evening, just before noticing I’d developed a miserable bacterial rash on my abdomen, presumably because my immune system backed down against the pills. The pills worked, however, because the bleeding quite suddenly became perfectly manageable. I haven’t taken anymore and the bleeding is still normalized. I am incredibly grateful and relieved to be able to use my Diva Cup again without misery.

As the Crash continues, I am sleepless, moody, and weak. I went out for St. Paddy’s and my ankles still kill from all the walking, and it couldn’t have been more than a few miles in total.

Moral of the story thus far: Mirena Crash is real, and one must be prepared to take steps to cope with it until it passes. So far I’ve been bleeding and symptomatic for twelve days straight. Sigh.

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