I cried in front of my supervisor for the first time today.
It was bound to happen, with the high levels of stress and responsibility that come with my job. He knew something was up, so he paused in front of my office after staffing. He asked if everything was okay because I’d looked a little down in the meeting that afternoon.
Everything was not okay, but how could I possibly explain? That I don’t belong here. That I am a phony, a fraud. That I am damaged beyond repair and unsuitable for this work. That if he knew the person I truly was, he would have me fired straight away. I felt it happening again: the pressure building in my chest and the tears burning my throat at the prospect of someone discovering my deepest, darkest secret. The precursor to my entire life falling apart.
I told him, unconvincingly, that everything was fine.
We sat in uncomfortable silence for a long moment. I trained my eyes on my shoelaces, unable to look him directly in the face. Part of me wanted to tell him everything, but the rest of me knew that it was impossible.
He caught the hint and let out a soft chuckle. Rising to his feet, he reminded me that I could talk with him about anything bothering me. As soon as he was gone I fled to the restroom, sweating and shaking, trying to make it stop. I thought again about his offer to talk. Did he suspect what I knew to be true? I bent over the toilet bowl and prepared to hurl.
* * * * *
Life has often felt like more than I could handle. I was a sensitive, worried child and cried “at the drop of a hat,” as my mom likes to say. I was twelve years old the first time I thought seriously about killing myself. In high school I got pegged early on as the lonely girl who self-harmed and was routinely called in to see the school counselor. It was a lot of things: family conflict, poor academic performance, interpersonal challenges. Mostly it was an overly emotional response to everyday situations. An inability to cope with stress the way other kids could.
The worst of it came in college. Although initially energized by a fresh start and the free creativity of a music major, that all-too-familiar emotional instability eventually crept back in. I knew things were back to baseline late in my first year when I overheard my roommate whisper to our mutual friend, “I don’t know! She’s like, bipolar, I think,” as explanation for why I had snapped over something trivial and spent the rest of the day alone in my room, sobbing.
By the end of my sophomore year, I was skipping all of my classes except for choir. I lived in a state of deep, unabating sadness punctuated by piercing episodes of anxiety. Tufts of my hair fell out in the shower and I stopped eating regularly. I spent entire afternoons wandering the streets of my small college town in a withdrawn daze, battling the internal demons and picking at my self-injury scabs in the hot sun. The panic came almost nightly – heart thumping, palms sweating, thoughts racing – until I would collapse in a tearful heap on the bed. My unflappable boyfriend would spoon me and stroke my hair for hours, saying everything he could in an attempt to soothe me, but I was perpetually inconsolable. In time, I became too much for him, just as the rest of my social network had disappeared before my eyes.
When it became evident that I would not pass the majority of my semester credits, I moved back home with Mom and Dad over the summer. I felt like a complete failure. I knew no one there, as most of my high school acquaintances had relocated by then. I floated numbly through community college coursework while working an assortment of odd jobs: making ice cream, cleaning houses, and caring for pets, children and adults with disabilities. Filing papers and ordering supplies. Living enveloped in the dark, heavy fog of depression.
I tried every antidote I knew. I eliminated sugar from my diet. I ran a mile for the first time. I tried to make new friends and be more outgoing. I saw therapists at the urging of my parents. Derrence had kind eyes and taught me how to manage my day to avoid the panic attacks. Tony was calm and reassuring when I wept in his small office, but I could only see him for eight sessions, per the community college counseling center policy. Elizabeth told me medication would probably help, since nothing else really had, so my mom’s primary care doctor prescribed Ativan as needed. When that didn’t make enough of a difference, Dr. S added Prozac, shortly followed by trials of Celexa, Lexapro, and Wellbutrin. At first she said I would only need this support until I got “back on track.” In time, it became clear to her that my neurochemical makeup would necessitate medication for the rest of my life. “Some people just need a little help balancing things out, Emily. It’s nothing to be ashamed of.” I didn’t believe her.
Angela was next, because life continued to spiral out of control. Angela tried to teach me how to “ride the wave of negative emotions” on a metaphorical surfboard, but I never did get the hang of it. I frequently called her crying, spun out in a whirlwind of frantic thoughts and feelings. She would try to talk me through the hysteria as I described desperate visions of swerving my car off the highway or darting into traffic at a busy intersection. “Emily, you know I can help you set up a stay in a psychiatric hospital…” The mere mention of this option terrified me as I replayed scenes from Girl, Interrupted in my head. From then on, I learned to only share half the story with Angela so she wouldn’t be ethically obligated to act during a crisis.
The days somehow trudged onward. Behind the plexiglass front desk window at the optometry practice where I worked, I spent the long hours of afternoon receptionist shifts choking back tears and trying to justify my death in Google documents. I wrote for hours. It’s not like anyone would miss me. It’s not as though I’m actually contributing anything meaningful to the world. Maybe some people just aren’t meant to be happy. Maybe life just isn’t for me. I am worthless. I am a failure. I will never get better. I was doing everything they asked of me, but it was not enough to address the immensity of my pain. I could not imagine a reality in which things might ever improve, so I made a plan and tucked it away for the right moment. No one could know.
Three weeks after my 22nd birthday, the time came to enact my plan. Looking back it seems impulsive, but on that particular Thursday it felt as though years and years of buildup were all pointing to that moment. I wanted out, once and for all. On the way home from work, I pulled into a Walmart parking lot and took an overdose of pills.
Gagging on the chalky lump at the back of my throat, I panicked and dialed my best (and only) friend. He came and got me safely to his apartment, then eventually coaxed me into going to the hospital “just to get checked out.” I was sure it would be over quickly, but as the nurse led me by the hand through the locked entrance of the psych emergency department, I learned that I was in for much more than I had bargained.
That night is mostly a blur now, but several things stand out in my memory. Being asked to strip naked and be searched by a tech followed by a quiet ambulance transfer to the medical hospital. The five doses of saccharine charcoal and the sour taste of vomit in my mouth. IVs and catheters. Sweating, shaking, and losing touch with reality, and the crescendo of a shrill ringing in my ears. The terror of being held down against the bed, of being told to calm down and get myself together. Safety precautions: the grid of bars over my window, the “sitter” at my bedside, security officers, plastic silverware, and a lack of privacy at all times. The task of calling out sick to work, devising a fake stomach bug so my manager wouldn’t ask any questions. The dread and shame of seeing my parents for the first time. I stayed in the hospital for five days over an extra-long St. Patty’s Day weekend. When I was reevaluated on Monday, I knew exactly what the social worker needed to hear in order to move forward with discharge.
After I was released, I still wished I was dead, and now had the added trauma of hospitalization which gave me nightmares for months afterwards. I felt conflicted. Based on the reactions of family and hospital staff, it seemed that people would rather I stay silent about how awful I was feeling. At the same time, I wanted more than anything to talk openly with someone about what was going on without the threat of judgment or involuntary commitment.
Things continued in a negative trend. Back at school there was an incident during which campus police escorted me out of a lecture hall full of classmates when someone dropped a tip that I had expressed a desire to harm myself. A few months later, Angela let me know that she couldn’t see me anymore because I was so challenging to work with. She believed I might have borderline personality disorder, and since this was out of her scope of practice she referred me to DBT group with Christy. My new psychiatrist forced me onto different, stronger combinations of medications (adding Geodon, then Abilify) by threatening to call the police if I refused to sign her treatment plan. The mood stabilizers made me gain weight and feel nauseated all the time, but somehow life kept moving forward.
Near the end of my undergraduate coursework, I had the idea to pursue a master’s degree in social work. I held onto a furtive hope that I might be able to vindicate myself from all this psychiatric mistreatment and prevent others from going through what I did to get help. To my astonishment, I was accepted into the MSW program to which I applied, despite a substandard transcript and no concrete plan for my future.
Having finally achieved something entirely for myself, I decided it was time to take ownership of my recovery. The summer before I started classes, I intentionally tapered off all my meds, carefully and secretly. I threw myself into graduate school with full force, making up for all the years of underachievement and missed opportunity. Miraculously, I thrived! For the first time, I learned that I was not alone on my journey. I discovered that all the best healers have been through things – whether it be personal experience with the child welfare system, homelessness, or addictions – which draw them to this work. A lot of us were the “different” kids who served in-school suspensions or required the regular intervention of a counselor. These connections with other survivors are what ultimately gave me new reasons to keep going. They drowned out the voices in my head telling me that nothing mattered and that I didn’t deserve to live. They gave me hope.
I graduated last May, was named Student of the Year, and landed an incredible job shortly thereafter. I am now living the dream I never knew was inside me.
* * * * *
Back in the bathroom stall at work, I roll up my sleeves and trace the thin, pale scars on my forearms. I doubt anyone even notices them anymore. I unlock the door and step into the fluorescent light. I splash water on my face as I clean myself up and lean in close to examine my reflection. She has bloodshot eyes, but this girl in the mirror will pass for a professional.
I turn on my heel and march back to my supervisor’s office. He invites me in and I start to explain. I don’t share all the details, but I tell him what I know for sure:
I have come to understand that there is something different about me, some quality that makes it harder to cope. I feel the sensation of things more deeply than most. When I am content, I fly higher and laugh louder. When confronted with adversity, my body is swiftly wracked with insurmountable heartache and fear. And when I fall into that negative tailspin of emotions, I am more likely than others to act impulsively and hurt myself.
Framing it as strength is more helpful than viewing it as illness, because I have come to believe that these struggles will always be part of my life. Call it bipolar, or borderline, or the up-down spirit of the tortured artist – I am tired of living on someone else’s terms. I know now that these experiences make me the person I am today. They are not events of which I should feel ashamed or attempt to hide from others. Instead, they are gifts which allow me to empathize and connect deeply with the people I serve. I am truly privileged to have a second chance at life. I am fortunate to come to work each day with an opportunity to alleviate even the smallest bit of human suffering and to advocate for broader social change.
It occurs to me in this moment that I am not an imposter. I was meant to be here.
The tears fall, and I let them. It feels so liberating to finally speak my truth.
Mad in America hosts blogs by a diverse group of writers. These posts are designed to serve as a public forum for a discussion—broadly speaking—of psychiatry and its treatments. The opinions expressed are the writers’ own.