Quick overview

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Monday, January 18, 2016

(My) Chronic and Mental illness story - #LISMentalHealth

(My) Chronic and Mental illness story – it’s hard to separate the two
Posting as part of LIS Mental Health Week 2016
About My Illnesses
I’ve written about how diabetes has affected my professional life on Letters to a Young Librarian, but I wanted to go a bit further for #lismentalhealth week.

I have diabetes. As a result, I have to constantly monitor my body, and this includes more than just using my glucometer to check my blood sugar. It’s also important for me to remember that the body includes emotional reactions, and oh hey even happy stress can raise blood sugar. This self-monitoring goes on constantly. Even when I wake up at night. Even when I’m teaching a class or leading a meeting. Even when TSA is doing explosives tests on me at the airport because of my insulin pump. And still, I’ll sometimes miscalculate or forget something. It is frustrating and scary and embarrassing and exhausting.

I also have a thyroid disorder. Actually, I have two: the right lobe of my thyroid gland was removed 20 years ago, the left lobe of my thyroid gland has Hashimoto’s. I have less control over adjusting my own meds with this condition, which has its pluses and minuses. But even well-controlled, it has ongoing risks including brain fog and even scarier stuff.

Recently, I’ve also been diagnosed with depression. Maybe. Or it could be Seasonal Affective Disorder. (Although it seems to have expanded beyond seasonal at this point.) Or maybe Generalized Anxiety Disorder. My therapist and GP aren’t really sure. Fortunately, whatever it is, Lexapro (escitalopram) seems to be doing the trick. It’s taken a very long while to get here though. And by here, I mean: I can acknowledge that my brain was no longer working the way I wanted it to; I can acknowledge that yoga, exercise, sleep, meditation, crocheting, cognitive behavioral therapy, and all the other self-care things I do aren’t enough on their own; and, perhaps most importantly,  I can acknowledge that this condition doesn’t make me less human, less worthy of respect and care.
Also, I have ovaries. They don't really cause problems, but they do have the same hormone release action that the rest of the endocrine system has. Among other things, my ovaries and my menstrual cycle  remind me that it's unreasonable to expect that people will come in and work with the same high level of energy and engagement every day, not even fully abled people. We all go through up and down periods. (pun unavoidable)

About My Illnesses at Work
One of my coworkers will sometimes come into my office and say “Good morning! I’ll come back later.” That’s because she can tell just by looking at me that I’m having a Bad Day. She also knows that she can’t fix my Bad Days. She knows that I’m not mad at her. She knows that I don’t want to be fussed over or coddled. She also knows that whatever work thing she needs from me is going to get a better response when my brain/body are in better condition, so she comes back later. (If it’s a simple hypo / low blood sugar moment, I’ll call her 15 minutes later and follow up. If it’s hour six of a sticky high blood sugar, I’m probably going to be nauseous for the rest of the day and tomorrow will be better.) To me, her way of responding is the ideal.

Other coworkers will come into my office and, even after I warn them that they might be better off waiting a bit, they will want an immediate response. In addition to ignoring my  boundaries, which is kind of uncool, I’m usually less helpful here than I’d otherwise be. To me, this is sub-optimal.

However, sometimes I’m the jerk. Remember at the beginning where I talk about always needing to self-monitor? That means I have less mental processing space available to monitor the reactions of other people than I would like. If I’m feeling especially stressed, I will not only not pick up on social cues, I may react in an inappropriately hostile way to things that aren’t worth the argument. (Sorry, coworkers past, present and future.) This is an explanation, not an excuse – if I’m being a jerk, people have the right to call me on it. However, thanks to cognitive behavioral therapy and meditation, I’ve learned to monitor my emotions similarly to how I monitor my blood sugars. This has helped me recognize when I’m in a mood-state where I’m liable to let my inner jerk out in public. I’m not perfect, but I have gotten much better at this in practice.

Adding Mental Health Care to the Mix
During my adult life, I thought I had my medical stuff pretty well under control. Then I took a tenure track job at an academic library. At first, things were fine, but one of the conditions of employment was getting a second master’s degree – it’s actually one of the things that attracted me to this job. While I enjoyed the program (TESL), towards the end I got very, very tired. Like mini-blackouts while walking across campus or sitting in class tired. Also, big surprise, I got pretty cranky. But then I graduated and things seemed to be getting better. Trouble was, I also started hearing my coworkers say negative things about me at work. And by negative, I don’t mean “I disagree with your idea” or “when you interrupt me it makes me feel bad.” Those statements would be completely legit. I mean things like “you’re a horrible person and I don’t know why anything thinks you should be here.” So, that was stressful. On the positive side, that’s what prompted me to finally see a therapist.
As I mentioned earlier, the things I learned from the therapist were really helpful. We talked about how it’s totally normal for people with diabetes to get really cranky if we don’t get enough sleep. We talked about meditation and she suggested I take up crocheting as a way of soothing anxiety. She suggested I get my Vitamin D level tested (very low! I was also anemic. It explained a lot.) She also suggested I get a happy light for the seasonal affective disorder– it did nothing. But thanks to her help I made it through another Minnesota winter and in spring things looked better.

In fact, the next academic year started out really well. I felt strong enough to take on a stressful leadership position and had an ambitious research agenda. Unfortunately, even though I was using all the things I’d learned from my therapist, the following spring wasn’t the release it usually is. I recovered a bit over the summer, thanks to sunlight and daily yoga and meditation, but in retrospect I can see that the seasonal affective disorder had turned into year-round depression. So when this fall started and I started to spiral down again…. I was already near the bottom.

I’ve learned to restrain my inner jerk, so I got no indications from my coworkers that they could even tell that I was struggling. I think that might be because restraining the jerk in some ways means internalizing the jerk: by the time I started antidepressants, I was having daily fantasies about self-mutilation and suicide. It’s been a very long time since I’ve had those urges and I knew it was a dangerous sign. (I guess I’m coming out as a former cutter on here too. Oh well.) Fortunately, thanks to years of seeing people with depression speak out on twitter, I felt only the smallest twinge of shame at the thought of going on meds. I’m also extremely fortunate to have a close friend who’s a pharmacist. When I told her I was concerned about possible side effects with my other meds, she made an extensive list of options and things I should be aware of with each. (I am loved. If nothing else, this experience has taught me that.)
Pulling It All Together
I wish mental illness wasn’t so stigmatized – in a perfect world, I would have started this mental health journey decades ago. But, finally, I’m on medication and using the things I've learned in therapy. I feel more alert and happier than I’ve been in a very long time. I’m well enough that the happy light does actually help on those gray mornings when it seems like waking up is impossible. I’m making the choice to reduce my emotional involvement and overtime at work and let myself heal, because I picked up some bad eating habits in the last couple of years that I need to focus my energy on right now. And my plan for doing that without it turning into another form of pushing myself too hard? Structured journaling.  

Like I said, I’m feeling much better than I have in a long while. I wanted to share my experiences to encourage others who might be looking for a sign that it’s time to reach out to a doctor or a therapist. You don’t have to be public about it, like I’ve been, but if you’re looking for a sign - this is it. We work in a service industry where we're always expected to care for others (in my library "for the students" is a rallying cry). It's ok to take care of yourself too.

I also wanted to share my experiences with people who haven't had to deal with issues like this. People who care, but aren't really sure what it all means or how to be supportive. My only real suggestion is, if someone has trusted you enough to share this sort of thing with you, let them know that you care about them, that you trust they're doing the best they can, and that you appreciate how hard they're trying. Life is hard enough. We don't need to make it harder for each other.