Mental Illness (In Parts)
Please know: This essay discusses depression, self harm, and suicidal ideation. Take care of yourself and feel free to skip this one. Bold text is taken from the Patient Health Questionnaire-9, a tool used to screen for, diagnose, and monitor depression.
Over the last 2 weeks, how often have you been bothered by any of the following problems? (use a checkmark to indicate your answer)
Feeling bad about yourself or that you are a failure or have let yourself or your family down
Not at all__
Several days__
More than half the days__
Nearly every day__
I didn’t seek help for my mental health for a long time because I was afraid. For more than a year, I knew I needed help. I feared for my life and safety. But I was afraid of being locked away in a psychiatric facility. Maybe worse, I was afraid that I would be told that there was nothing wrong with me, I was just bad at dealing with life. I was afraid that my parents would feel sad and overwhelmed that their “good” daughter was not as good as they thought she was. I was afraid my friends would distance themselves from me. I was afraid my boyfriend would be afraid of me.
Before I went to the doctor, I had tried, unsuccessfully, to manage my mental health myself. I ate healthy: chopping kale, roasting sweet potatoes, simmering black beans. I ran 30 minutes every morning. I wrote lists of things I was grateful for (“living in a beautiful space and being able to be outside in nature so easily”). I wrote lists of things I liked about myself (“even when you’re tired, you always listen to and communicate with your friends, especially when they’re in trouble/sad/stressed”). I recorded my daily health habits and emotions to try to recognize patterns (“neutral, happy, worried,” the next day, “happy, motivated, sad”). I still have these notebooks, now eight years old, lists scribbled sporadically throughout their pages. Some days, “what I am grateful for” was simply forgiveness from others. Other days, “what I am grateful for” was left blank.
Even when these efforts became daily habits, it was not enough. Despite my lists and smiling at myself in the mirror and my meal-prepping, my brain felt disconnected from my body. I still collapsed in tears. I still self harmed. Each room in my apartment had a purpose: In the living room, I would slam my head against the concrete floor to try to give myself brain damage. In the kitchen, I would slap and scratch my legs until they were hot and red or break glasses to carve valleys and crevices in my arms. In the bathroom, I would cry. I can still feel the cool tiles on my legs and the hard curve of the tub pressing into my back as I collapsed in snot and tears.
Over the last 2 weeks, how often have you been bothered by any of the following problems? (use a checkmark to indicate your answer)
Thoughts that you would be better off dead, or of hurting yourself
Not at all__
Several days__
More than half the days__
Nearly every day__
Things that have kept me alive, in no particular order:
My love for complete strangers1
My dog
[Name redacted]
[Name redacted]
[Name redacted]
Escitalopram
My unbridled desire to be deeply loved in the future
Over the last 2 weeks, how often have you been bothered by any of the following problems? (use a checkmark to indicate your answer)
Feeling down, depressed, or hopeless
Not at all__
Several days__
More than half the days__
Nearly every day__
In October 2016, I texted my mom and said that I needed help and was afraid of hurting myself. So the week Trump was elected, I was flying home to Montana to go to the office of the Physician’s Assistant (PA) I’d been going to since childhood. I was unemployed and on my parents health insurance, so I took about a month off to attempt to get control of my brain.
First, the PA had me do some blood tests.
“Some patients just don’t get enough vitamin D, especially those of us who live so far north,” she told me. “Their issues just totally go away when they start taking vitamin D.”
“Oh,” I said.
“You know, Senator Tester really likes PAs, because his childhood doctor was a PA,” she told me. “He’s always very supportive of us.”
“Nice,” I responded, smiling politely.
I walked to another building on the hospital campus to have my blood drawn, then walked back to the PA’s office. The tests revealed I indeed was vitamin D deficient, so she told me to start taking twice the daily recommended amount, at least for the time being.
Then she handed me a small pile of forms. I sat on a blue chair with metal legs that looked like I was an elementary school student, and propped the forms on the edge of the L-shaped counter as the PA left the room. The forms asked me about my weekly habits, emotions, and thoughts. I don’t remember exactly what they said, but I remember feeling like they didn’t fully capture what was going on in my brain. She came back in, and quickly tallied my responses. I was diagnosed with major depression disorder (moderate) and generalized anxiety disorder (mild). The PA prescribed me an SSRI called Escitalopram. She said she liked this medication for patients like me because it should take effect quickly, within one to two weeks.
When I first started taking it, I felt almost instantly different. It’s hard to describe how my emotions were for those years prior to medication: I could feel anger growing in me. It felt uncontrollable; my reactions were urgent, strong, and confusing. But suddenly, my nervous system felt calm, almost stunted. I went an entire week without crying or urges to hurt myself. It felt unnatural. I was used to emotions that felt physical – of aggression, anger, sadness, paranoia, jealousy, exhaustion. Was this what I was supposed to feel like?
About a year and a half after I started taking medication to manage my mental health, in May 2018, my best friend of seven years (now, thirteen years) was visiting and we took an online quiz that was supposed to bring us closer. She never told me what it was for, she just started asking me questions and I answered. Near the end, the quiz asked us to tell each other one thing we admired about the other. She said she was inspired by how openly I talk about my mental health issues. She told me that after I had shared in a group chat that I talked to my doctor and started taking medication for depression and anxiety, our other friend decided to seek help for his mental health as well. He told her I was one of the main reasons he decided to seek help. I was in shock.
Over the last 2 weeks, how often have you been bothered by any of the following problems? (use a checkmark to indicate your answer)
Trouble falling or staying asleep, or sleeping too much
Not at all__
Several days__
More than half the days__
Nearly every day__
In January 2018, I began a Google doc reflecting on my journey with my mental health. I edited it late at night in May, June, July, and August of 2018, then again in January 2019, June 2019, and April 2020. It’s not quite a journal; I was writing reflections on my mental health more than chronicling day to day experiences.
This essay is an edited compilation of these reflections. This is an abbreviated (1,011 words) version of the full (3,102 words) document.
Every time I edited it, my perspectives on my mental illness – and how I had hurt myself and others – transformed. I would read my past self saying she would never forgive herself. Things she hated about herself and her mental illness. Fears she had about dating, love, friendship, the future.
My mental health has shifted immensely since I first sought treatment 8 years ago. I have not self-harmed or felt suicidal in years. I feel more in control of my emotions than I once did. Yet some things have not changed. In 2019, I wrote something that, save a few details, I could have written today:
It has been a rough transition to 2019. I am struggling to feel invested in my classes. I don’t know if it’s because I struggle to understand them or because of my loneliness and mental health and feeling agitated like I shouldn’t be here. It’s also because I don’t really have strong friendships here. I have a few people, well, two, that I try to talk to regularly. I have sex with boring people who like me and interesting people who don’t like me.
I feel zapped and alone. I am on social media too often. Trying to talk to close friends, friends that aren’t here, to distract myself. Sometimes I just scroll through the same feed, seeing the same thing, over and over again, not even really looking. My eyes get glossy but I just keep postponing whatever I need to do — shower, walk Hank, get to class — so I end up rushing and stressed and disgusted with myself.
Perhaps what has changed the most is my ability to talk about my mental health with others, something that was once a mere hope for the future. The last entry I added to the Google doc was April 14, 2020. I wrote one sentence: “I hope one day I can share these thoughts with someone I love and they will still love me, and maybe even hug me.”
This is still my hope. I hope to share all 3,102 words with a future partner, so they know me more deeply, and know what past struggles impact my ability to show and receive love. I hope to share it with close friends, maybe one or two, who I want to know what happened in those dark years of crisis. I want to talk about mental health and illness, because when I was at my lowest, I wish I had heard more people talk about theirs.
The day before I finished editing this post, several friends gave me a card. I’d cancelled plans the day before because of my mental health, and sent them a long text explaining what was going on. In the card, one wrote: “These are trying moments but know you are in community and I hope you feel or begin to feel comfortable sharing. Actually, I truly admire how you’ve been vulnerable in these moments of creating community.” To be loved is to be seen, in moments of anguish and vulnerability and joy and everything in between. I hope one day I can share my thoughts with someone I love and they will still love me, and maybe even hug me.
For many months in my early 20s I contemplated killing myself while driving by either swerving into oncoming traffic on the highway or off a bridge, but was too afraid of hurting someone else to go through with it.
As always, Abaki beautifully reflects on topics so many of us are afraid to share publicly. Grateful for the work she is doing to change narratives by sharing hers🩷
Using the PHQ-9 as the essay's structure - that's a real move. Letting the clinical instrument frame the story instead of fighting it.
I want to ask you something: what do you like creating? Not for work, not for anyone else - the thing you'd do even if nobody saw it.