DOUBLY DISORDERED

Sometimes you get towed in with an ignition problem only to be told you need a whole new engine. Or something like that. I really shouldn’t use car analogies. I’m not even sure I know how to put air in the tires for the one I’m driving these days.

Last fall, I was admitted to hospital for acute depression. I went in voluntarily but they immediately certified me as involuntary. An unnecessary and highly unappreciated step, as you might imagine. I was already there and I wasn’t going anywhere. But that maneuver by some presumably well-intentioned doctor after a five-minute conversation with me made my eighteen-day stay so much more complicated. To say I was being admitted involuntarily when I’d gone to see my psychiatrist, discussed the decision to admit myself, waited for him to type a supporting letter, then stopped back home to pack for my stay and walked into ER,…well, that was rubbish.

I already knew this wasn’t going to be anything like those sojourns in lovely white mansions with grand porches surrounded by fields of green grass where patients dance about waving butterfly nets. I’d seen that in old movies. That kind of place would’ve made me feel better (as long as I didn’t get tangled in the butterfly nets too often).

No, this would be unpleasant. This would be an ongoing battle to regain my rights…and a writing pad…and my clothes. I could go into extreme detail about everything wrong with the experience. I journaled what I could, first with crayon because it was all I could find, then with one of those stubby mini golf pencils because it’s all they’d offer when I begged, all on scraps of paper—the backs of the menu sheet that accompanied each food tray meal, a torn out magazine page with an abnormally large amount of white space. It’ll make a memoir one day. Or maybe not.

Feeling like I had no control over my environment, I did what I always do when I am overwhelmed. I began to starve myself. I ate and drank nothing during my first day in a holding pen of sorts, the Acute Behavioural Stabilization Unit, where patients are expected to calm down as the heavy locked doors constantly slam while hospital employees use the room as a shortcut corridor from one place in the hospital to another. Zero food, zero sleep.

Once transferred to a “regular” psychiatric unit, I first refused food because it wasn’t vegan. Then, I refused what I deemed as being too high in sugar and fat. Then, what was too discolored to actually be an edible version of the food they said it was. (That’s why the tray came with a coveted sheet of paper listing of what was on it: to clue you in that a mini tray of sliced something was actually zucchini.) The expectation was that all of us had to report to the “dining room”, a sad open area with bright florescent lights, to eat at the same time. That didn’t work for me. I didn’t want to socialize. I didn’t want people seeing what I ate or didn’t eat. As I took my tray to my room, a nurse stopped me and said it was against the rule. My shoulders tensed. Rules. Fine. I left the tray and headed back to my room, stomach empty, the growing gurgles strangely satisfying as a sound of defiance.

As I had a different psychiatrist each day, I had to constantly rehash my cycle downward and explain my food issues. A doctor overrode nurses’ objections to me eating in my room and I faced icy looks from Food Traffic Nurse for the rest of my stay. There was a mouse problem in the unit. Indeed, I saw several during my stay. Cute critters. And smart. Based on my observations, many psychiatric patients are too highly medicated to really care about keeping food on the tray. The dining room surfaces areas were regularly a sticky, crumb-strewn mess.

I still refused to eat most of what was served. A dietician became a daily visitor. Nurses were instructed to do daily calorie counts regarding my intake. Once I was allowed to wear my own clothes and I got passes to leave the hospital, I was permitted to buy my own food—nonfat cottage cheese, nonfat yogurt—and keep it in a locked fridge that I could only access when my assigned nurse was available.

I was a problem patient. Depressed with too many extras. I rapidly lost significant muscle mass just as I did during my previous hospitalization. But this time something different happened. As part of my discharge, they referred me to an eating disorders program. I cried when the dietician asked if I’d be amenable to that. I’d struggled with disordered eating for at least thirty-five years, mentioned it to doctors and, being as I was a guy, nothing ever happened. Finally, an opening!

After an ECG, bloodwork and a two-hour assessment and my diagnosis as being anorexic was official. Add it to my résumé. I cried again. Relief. Even triumph. I’d lived with this for so long on my own, its intensity varying during various periods in my life but it’s presence always there, always taking up so much thought and time each and every day.

Help maybe. A new motor perhaps.

I’ve been going to weekly courses and meetings for five months now. No change in my behaviour. I still restrict food and occasionally binge. I still over-exercise. I still spend an inordinate amount of my time thinking about what will and won’t be my next snack or meal. I wonder if, after all this time, thoughts and habits are too entrenched. I’ve created a warped version of a safe, controlled environment for myself.

For now, it’s a victory that medical professionals have identified another male as having an eating disorder. I’m convinced this is still woefully underreported amongst men and, particularly, with gay men. Eating disorders can look different for men, with the obsessions over protein and muscle gain. I witness the same guys at the gym going to extremes with their bodies and talking to strangers ad nauseam about tuna and oatmeal consumption as they log hours doing dumbbell curls and stealing glances of themselves in the mirrors. Is it healthy? Can they stop?

For now the focus is more confined: Can I?

 

THE FACE OF DEPRESSION

I hear it so often when a person who has experienced depression commits suicide. People are surprised.

He seemed to be doing better.

She was laughing more.

Look at the most recent photos. He looked so happy.

But depression isn’t something you can always detect on the surface like a rash or a broken arm. Shouldn’t all of us know by now that a Facebook/Instagram life is often nothing like the real thing? A tasty looking pizza pic is just that. And I haven’t had difficulty forcing a smile for the camera since those obligatory family photos of my adolescence. If anything, social media has only made us more practiced at faking it.

I recall the shock over Robin Williams’ death. Someone with such a frantic energy and the facility to make people laugh,…how could he? (I suspect he was bipolar.) Same thing when Chester Bennington, the lead singer of Linkin Park, took his life. The media posted pictures of him shortly before his death. I refused to look, but I surmised they were smiley images. How could there be such a mismatch between what’s inside and a broad smile or a robust laugh?

If we don’t dig, we don’t see. Public persona can hide the private agony. After all, we’ve been socialized to hide it. Stop being a downer, man.

The weekend before I was admitted to hospital in September, I went on a fifty-mile bike ride. I took in magnificent ocean and mountain views north of Vancouver. I appreciated my natural surroundings. Maybe I was even trying to pedal away dark feelings. To be sure, getting outside had been an ordeal. It took me two hours to get my socks on. The shock over Chester Bennington’s death gave me the wherewithal to snap pictures as I lay in bed, feeling utterly hopeless and helpless. Most shots didn’t have much in me in view. I didn’t have the energy to do any sort of posing or to even look and see if I was in frame. It was plenty just lifting the phone and pressing the button. Later, I deleted dozens of pics and was left with a few that honestly show how things were in the absence of a social media log-in.

This is depression. This is what it looks like when putting on a front gives way. This is the eve of my downfall. Things only got worse. The bike ride provided a reprieve; it didn’t fix anything.

If you know someone who has experienced clinical depression, all I can say is don’t make assumptions. Don’t read a hell of a lot into the thought, He looks good. People get good at covering up. In my experience, it’s rare for a person to continue to ask, “How are you?” and want anything more than the rote “Fine”. The question is synonymous with Hello.

It has to feel safe for someone to open up, not just once but on a continuing basis. It’s too easy for a person with depression to internalize things with What’s wrong with me? and Nobody cares. The default is, This is my burden. I go it alone. It’s ridiculously easy to fake fine. We’ve been socialized that way. It’s what’s expected. So there should be no surprise that someone’s depression goes unnoticed. There may be a period of genuine remission, but a resurgence is entirely possible, as with most afflictions.

Even when blurred by depression, a person’s suicide is his or her own action. I don’t believe in casting blame. That’s why it’s also referred to as taking one’s own life. The personal agency is at the heart of it. But people can do better with the check-ins for loved ones known to have mood disorders. Go beyond the how-are-you. Add, “No, really,…how are you?” Or name it. “Where are you at in terms of depression?” “What’s your mood been like?” “How well do you think you’re handling things?” These more specific questions venture beyond the hello. They show you care. You are prepared to talk about more than the warming weather, the slumping Blue Jays and how a gay skater won “Dancing with the Stars”.

For goodness sake, after asking an open-ended question, allow the person to have the time to respond. I’ve found that talk of mood disorders makes so many people skittish. A minute or two and it’s back to pulling out phones and photographing pizza. Do that and the chance your friend will open up in the future is significantly minimized. This kind of conversation makes a person feel extremely vulnerable. You’ve lost their trust. They can’t be brutally open only to be shut down halfway.

Ask. Then listen. Acknowledge. No advice necessary.

That’s all.

EXPANDING MY HORIZONS

A few catchy titles on display at Ada's Technical Books & Café

Okay, so this post doesn't have anything to do with being gay or dealing with mental health issues. But then, the main reason I keep a blog is to have a forum for writing and to get feedback from readers either in the comments section or, as is more often the case, on Twitter. Writing can feel like a lonely, even foolish endeavor. What's it all for? Self-doubt often creeps in. I have several--six, I believe--first draft novel manuscripts awaiting revision, but trying to get an agent or an editor can seem far away and next to impossible.

So, yes, I blog.

And lately, I've started to think about essays and other articles I can pitch to newspapers and magazines. Getting a shorter piece published, helps refuel when my confidence as a writer sags. Last October, UNESCO designated Seattle as a "creative city", specifically a City of Literature. Interesting. I had just gotten out of hospital, so I could only file that piece of information in the back of my brain. I just wasn't ready. In March, I began preparing a trip to Seattle that would be entirely focused on literary destinations. Then, over the Easter weekend, I drove down and crammed in twenty-seven places and events in order to decide which ones should be included in the ultimate literary travel vacation.

Returning on the  ferry from Bainbridge Island to Seattle 

After writing the article, I submitted it to The Globe and Mail, arguably Canada's most respected newspaper and today the article has been published. A bit of short-term validation. I'm thrilled and honored as this is my first travel piece.

In case you're interested, here's the link:

https://www.theglobeandmail.com/life/article-seattle-by-the-book/


Now I've got to come up with another pitch...

LIVING "LITE"

May is Mental Health Awareness Month, or at least it is here. It’s probably a lot of other things. That time for May flowers, dotted with four “Caturdays” and whatever else people throw into the Twitterverse and sticks. But mental health concerns me far more than random cat photos or even the fact that May 10 is Clean Up Your Room Day. Periodically, I’ve shared some of my mental health challenges and I plan on two or three related posts this month.

Back in October, I acknowledged spending eighteen days in the psych ward of my local hospital. It was my second stay in four years, something I swore I’d never repeat. Unfortunately, I was suicidal after falling into a deep depression. I have been diagnosed as being bipolar II, meaning I have periods of depression and episodes of mania, but my mania is low-grade. That end of the diagnosis is never a worry. I like that part. I’m super productive then. I multi-task up to five things at once…and get them done! I think all my ideas are out-of-the-ballpark homeruns. And even if most of them aren’t, it’s amazing what a boost of confidence can do. Ah, mania. Not my problem area.

Alas, depression. I’d managed well after going off meds for thirteen months before hitting rock bottom again. Yes, I’d been foolish. I don’t like meds. For anything. I never take antibiotics; I won’t even swallow a vitamin tablet. I’ve apparently inherited a stubborn, I-will-handle-this-on-my-own tendency from my father. And he’s a doctor. Some say doctors make the worst patients but I’m a case for doctors’ kids being even worse.

For now I accept medication even though I recently read my file and my psychiatrist still contends I’m resistant. (The fact that I happen to forget once or twice (or more) each week is not intentional, I swear. I’m told forgetfulness can be part of depression.) We’ve been tinkering with my medications for the past seven months. Feels like we’re seasoning soup. Little of this, little of that. Stir. Too much, too little. A pinch less, a tad more. Stir again.

I figured if I complied with the meds, everything else would go back to the way it was. That’s what I’d done last time. Discharged from hospital on Friday, back at work on Monday. It wasn’t a choice. I hadn’t accrued enough sick leave from that employer. But a strong Protestant work ethic played a factor, too. (Sorry, other worthy religions. Somehow Protestants, particularly Calvinists, laid claim to hard work. Seems silly these days,…although I’m a huge fan of Calvin & Hobbes. That’s all I know about Calvinism.) I worked until everything fell apart all over again. Perhaps with an exponent tagged on the end.

Right now, I’d say my life is fairly manageable. That’s great until I think about how it’s a “lite” version of life. My plate has little on it. Maybe a couple of celery stalks and a dab of cottage cheese. Manageable and bland. I have not returned to my job as a school principal and that comes with a mix of emotions that I try to repress. I learned long ago as a teacher that I may be proud of what I do, but I’m not indispensable. Someone can take over. I’ve been doing my best ostrich-in-the-sand routine, not asking who is in for me. Somehow it’s better not knowing. What if the person drags down momentum? What if he/she exceeds anything I ever did? Yep, ostriches are my new favorite animal.

This past month, my status officially changed from “away on sick leave” to being on long-term disability (LTD). I cried when I got the news. In part, it was a relief. I’d been led to believe that, since my case involved mental health, there was a higher level of scrutiny than with typical physical disability cases. That not only incensed me but got me spinning with anxiety. My file was extensive and my doctors’ letters were unequivocal. It was suggested that there might be something akin to an interview just to make sure I wasn’t a fraud. (As if I’d fake the hospitalizations and everything else I go through.) But then, as I navigated the process, I was also advised that my case was a “slam dunk”. Gee, thanks. That felt like too much the other way. For now, LTD—incidentally, a 1970s, Jeffrey Osborne-fronted band with an awesome song I play when jogging—is my status and will be reviewed every few months (which makes me anxious just thinking about). Again, life is manageable in its current state. I realize that, as my leave extends, the chance of returning to work becomes less. Not sure how I feel about that in the long run; for now, I feel safe.

Of course, there are corollaries that come with being on leave. I have a hard time seeing school-aged children in public. Guilt and shame rise up. I’m reminded of where I used to be and what shaped a big part of my identity. I was a beloved teacher and then a principal that kids and parents adored. (Teachers were always harder to read.) One of the challenges in where I live is that there is an elementary school by the park across from me. It’s a beautiful new white building, accented with bright colors, impossible to miss whenever I look out my tenth floor window. I see kids going to school, backpacks strapped on, walking hand in hand with their parent; I hear the bells during the day and the squeals that rise during every recess and lunch. If I’m home, there is no escaping the school timetable. I’m supposed to be in that setting. I’m supposed to be working. I’m having to let go of that notion.

My week continues to feel full even if, mercifully, it just has a lot fewer people in it. I stick to a strict writing schedule seven days a week, hitting my first café as their first customer when the doors open at six in the morning. I exercise to the point of extremes six days a week. I read avidly. I’m having another go at learning French. And, four days a week, I attend support groups, psychiatric sessions and other meetings related to mental illness. I tell myself being active and being invested in my own wellness will make a difference.

I am fortunate that I don’t fit some stereotype of being curled up in bed, hidden by covers and a pillow. There are people in my support groups like that. (It’s a weird feeling going to a support group and not feeling worthy, not feeling depressed enough!) I am thankful that writing gives me purpose. I make myself write even if it may not produce anything worthwhile on a particular day or week. The fact that I have a compulsive need to exercise has created its own problems, but I believe it’s also saved me from sinking too low. I am one example of a person who deals with depression. (I like to say “deals with” instead of the more negative, victim-tinged “struggles with” or the neutral “experiences”. It feels like I have a more active role in facing the challenges before me.) I am fortunate that I can live off LTD when others scrimp on welfare. I have no family or friends here to help me so I’ve managed to reach out to formal supports. I teeter frequently but, for now, I am coping. I write this as one window into depression. There are, no doubt, many more.