2020 Diaries: Mental Health in Confinement

Earlier this week, I wrote about fleeing Paris in an attempt to stave off depression before I killed myself.

Oof, we started deep. What did I tell you about my unending intensity?

But that is the truth. I was struggling with growing thoughts of suicide and, well, it’s not the first time. I was scared, and so was my husband. Even my mom, who I mostly try to keep a smile for, kept calling to ask if I was okay.

I use the word “depression” widely. I have indeed struggled with what the psychs call “major depressive disorder” since I was about 11. I was also diagnosed bipolar at one point, though that diagnosis was rescinded in favor of “borderline personality traits compounded by trauma.” Fun.

The definition of “major depressive disorder” from the Mayo Clinic.

At two points in my life – including during confinement – I started to hear faint voices, though what the difference is between the overactive imagination of a life-long storyteller, and the start of something much more serious, I do not know.

I even had the pleasure of being hospitalized for a month back in 2012, when the faint voices weren’t all that faint, and my then-boyfriend had to take a four-hour bus ride to keep me from killing myself one especially hard night. (Thank you S.)

In my defense, I was months out from having been held hostage by a man who tried to rape and kill me with a machete which, as trauma is wont to do, set off a chain reaction of events that I can’t talk about because it involves someone I love very much, who does not want those things made public.

Misunderstandings of Mental Illness

I haven’t particularly wanted to be a mental health warrior, because I am scared it will mean people won’t want to work with me, or hang with me, or love me.

I am doubly scared that as soon as someone hears bogeyman words like “voices in my head” or “borderline,” that everything I say will be invalidated, written off as crazy talk.

But here we are. 

I did write a little bit about trauma in those dark days of 2012. I had a website I never really told anyone about, where the pain pouring out of me found a place to land and the lack of an audience made it feel safer. 

Somehow one of my students found that website. 

One day after class, that person slipped an envelope onto my desk. Inside was a three-page letter telling me that they’d found my blog on a night they themselves had planned to kill themselves, and that they didn’t, because of what I wrote.

To receive something like that … it’s beyond words, even for a writer. 

But eventually, the fear of what would happen if I kept writing about these things overcame me, so I stopped.

Since then, I have thought often about that letter, stored in a box somewhere in my mom’s attic. I wish I could say I thought of it with pride, to have had that impact on someone. But mostly I have thought of it in shame, knowing that I let fear silence me.

But I can’t stay silent anymore. I deserve more. They deserve more.

True mental health warriors have done extraordinary things to bring awareness (thank you), but there is still so much misunderstanding out there that makes life harder for people who live that struggle.

I was reminded of that when I saw someone I know from Paris write on social media about how “selfish” it was for me to go to the south during confinement, and reducing my entire health struggle, in their words, to someone “who couldn’t handle staying in their apartment.”

I want to thank that person, because their comment brings to light two of the most widely-held misconceptions used to stigmatize mental illness.

First, the assumption that taking care of ourselves is selfish. 

I won’t even bother getting into the fact that, in consultation with my doctor, we carefully considered the social implications of traveling and deduced that we could actually keep our fellow citizens safer by retreating to an isolated house in the country where we’ve had contact with all of 5 people in over two weeks, with masks on our part, plastic coverings on theirs, and a fair amount of distance between us.

(For the sake of clarity, the reason we didn’t rent a place in the forests near Paris is because after about 30 hours of research, we didn’t find a single place that would accept all three pets.)

What I will bother with is this: I’m pretty confident that if I’d posted that we had fled Paris to seek treatment for, say, cancer, or to help take care of an older relative, I wouldn’t be accused of being selfish.

But saving my own life from mental illness? Unacceptable.

To call someone in the midst of a life-threatening mental health crisis selfish is to say that you don’t believe in their sickness (as if illness is about what others believe).

It’s hard for some people to believe in mental illness the way they would, say, cancer, because they live under the false idea that it is not physical, or that we have more control over it than you would any other disease.

They don’t realize that depression can be diagnosed through bloodwork; that illnesses ranging from depression to schizophrenia are increasingly thought to be controlled by the immune system; and that cortisol, the hormone released by PTSD, can create debilitating inflammation and cause auto-immune diseases like Lupus.

They don’t understand that PTSD is a constant activation of what’s called the “sympathetic nervous system,” that makes it physically impossible to relax. Ever. Or what the consequences are.

So what are the consequences? Constant physical pain, nightmares, anxiety, anger, panic attacks, to name a few. Like cancer, PTSD only gets worse if it goes untreated.

Of course, there’s also the whole phenomenon of women being expected to care for others, but being called “selfish” when we prioritize our own care. Though in the name of focus, I’ll leave that one off the table.

PTSD symptoms, as explained on PsychCentral.

The second mistake I’m grateful this person brought to light, all too common, I’m afraid, is reducing illness to what’s visible.

When you look at me, you can see that I live in a fairly nice apartment. In Paris! I travel. I eat well. I have pets, friends, and family. 

Let’s not discount that. Let’s never discount the privilege of financial security and a support network.

I was not being sarcastic when I said earlier that I had the pleasure – albeit a painful one – of being hospitalized. It was a true privilege to receive the kind of life-saving treatment that remains financially (and physically) inaccessible to most people in the United States, and the world.

But when you live with mental illness, particularly when it’s an effect of trauma, you carry wounds that most people can’t see. 

Unlike my husband, who was shot during the terrorist attack at the Bataclan, I can’t point to a scar on my leg to prove that I’ve been hurt.

You must choose to believe me when I say: I am a victim.

And we all know how believing women goes in this world.

(Thank you Freud and Aristotle, and white philosophy bros everywhere.)

A ground-breaking work by Bettina F. Aptheker, who wrote about how her father – a revered historian and labor activist – sexually abused her throughout her childhood.

Medical experts now understand that mental illness is often the result of trauma. What I have found in myself and the people I’ve known, either personally or through various trauma rehab groups, is that much of that trauma is unspeakable.

The worst trauma inflicted on us as women, emotionally and physically, is often by the men we are closest to, and to speak about it publicly can risk the bonds that are most important to us. 

It’s one thing to talk about that stranger who attacked me with a machete. It is quite another to say, “this person I loved, who was meant to protect me, has hurt me.”

I know from my own experience, and from what I’ve learned from others, that for every trauma someone discusses publicly, there is a world of it they keep quiet to protect others, or to protect ourselves.

I Believe You

I’ve seen a fair number of stories about the mental health crisis triggered by both the pandemic and confinement.

It’s easy, I think, to show compassion to the idea of that crisis, but I believe it is just as easy, when confronted by someone who is living it, to invalidate their pain as simply that of someone who isn’t tough, or grateful, or selfless enough.

I did not become sick because I couldn’t handle living in my apartment for two months.

I am someone who became sick because of trauma. I live with a chronic illness, and confinement took away the things by which I can manage that illness, like access to a doctor and exercise.

Most critically, confinement took away my access to nature. Although many westerners, myself included, too often discredit the link between health and nature, the Japanese have a word just for that: shinrin-yoku.

“Forest bathing,” as it translates, is the Japanese tradition of escaping into nature to heal. Even under normal circumstances, medical studies show that spending too much time indoors, or outdoors in cities without greenery, increases the stress hormone associated with PTSD.

(One last thank you, to my friend Bridget, for bringing this to my attention.)

The health benefits of “forest bathing” is documented by Dr. Qing Li, an immunologist at the Nippon Medical School and visiting fellow at the Stanford University School of Medicine, who has studied shinrinyoku.

So when I say that confinement made me crazy, I mean that confinement prohibited my access to these therapies, without which my manageable illness becomes life-threatening.

And I suspect that when other people talk about their mental health suffering because of confinement, they mean something similar. I do not believe that they – or I – are simply too weak to handle staying indoors.

I hope that by telling this story, I can do a couple things.

I hope that I can help even one person be more compassionate to those of us who fight this type of disease.

Even more, I hope that if you struggle, you will know you are not alone.

I see you.

I believe you.

And I hope that you’ll believe me, too.

Additional reading

An Unquiet Mind: A Memoir of Moods and Madness, by Dr. Kay Redfield Jamison, who both treats and lives with bipolar disorder.

The Center Cannot Hold: My Journey Through Madness, by Dr. Elyn R. Saks, who used her experience with schizophrenia to become a leading psychiatrist, lawyer, and professor.

© Veronica Cassidy, 2020.

Leave a Reply