This interview project came out of an ongoing conversation with my friend, the writer Mairead Case, and so it feels particularly appropriate to open it with my interview with her. More about the Working project here.
Can you talk a little about the ways in which your illness works as a barrier to writing? What are some of the specific challenges you deal with?
My friend was having a hard time finishing his first book, so to help he started thinking about finishing the manuscript like fixing the sink. When you are fixing the sink you do not say oop, this is so hard! I'll come back in a year. Or geez wait, is this actually a washing machine? Have I been doing dishes in the washing machine? Nope, you just work until the sink is fixed, possibly with a sandwich break or something, and then you move on. You do not dwell.
My illness (I usually say "my depression") either makes me clean obsessively around the sink until I run out of time to fix it right, or it makes me turn off all the lights and cover my face and go to bed. To be clear: yes, I have doubt and anxiety, and sure I've been traumatized and heartbroken, but these are different than my illness, my depression, which just takes all the color.
I can't write when I'm sick, which is how I know it's a sickness because I am a writer. For me it's more complicated than a boundary or a gate, it's a vortex--but does it feel like a barrier to you?
Yeah, like a literal barrier. Sometimes I'm just sad and that's a really different thing for me than being sick. Like, I'm the person who stays up late reading blog posts about human rights violations and polar bears going extinct and crying, but I can still work when I'm sad like that, when I'm heartbroken by the world. When I'm sick there's a wall between me and the world and I know things are better outside it but I stop caring and I stop working. I'm still learning how to be patient with it and patient with myself.
Yup, I hear that. <3
What are some specific things you do to manage your illness that you find effective?
The most helpful thing is framing it as a chronic illness with flare-ups, which it is. It's real. So I don't put myself at risk--I don't miss my meds, I don't work at a desk without light and color, I don't sacrifice sleep or food if I'm in transition--and if I do find myself presenting symptoms there is a list of things to do. (I made an actual diagram, it looks like a use of force continuum with more hearts.)
Another thing I do is try to get in the back door. One component of my depression is obsessive compulsion, which of course can be totally paralyzing if it gets out of hand. I live in a city and I work in public spaces, so I can't let myself get freaky about cleanliness, or complicated daily routines. As if I could anyway. On the flipside, my compulsion makes me a really good teacher, and legal observer, and editor--it's helpful to think of it as a power to be used for good or for evil. Also I journal almost every day, which serves as a sound check, among other things. How do you manage yours? Do you journal too?
Yeah, I do. There are a lot of specific things that are very helpful to me, actually--exercising, cooking healthy food for myself, not drinking, getting enough sleep. All of those things are usually the first to go out the window when the wall goes up. But more recently I've been framing that in my head as a set of choices that I'm making that I have agency over, like "Right now I feel shitty, and I'm gonna do this thing that makes me feel shittier, and it's what I need to do to get through this, but making a different choice is a nice goal for next time." If that makes sense. Instead of "I can't take care of myself because I am a GIANT FUCKUP," "I am choosing not to take care of myself, but I've done better in the past, and I will do better in the future." Which has been weirdly helpful. Do you feel like your relationship to your depression is evolving as you get older?
That does make sense. I've made that choice too sometimes, for friends or work, and especially now that I trust myself on the "I will do better in the future" part, and so I do---I do my job and it's cool, and then I build my reserves back up and everybody's cool, and let's go on. But I never ever skimp on appointments or meds, if only because I know I want my friends to keep any routines that keep them healthy, and I need to practice what I preach. That's my baseline. It's different for different folks.
Thing is though, I think this is being a person who is responsible to the world and who loves her friends and her work--not a fuckup who consistently redeems herself just in the nick of time. This too is a point where I've learned to communicate especially well, in my journal and with close friends. Otherwise they are like "Dude, you've been sitting in your sparkling clean office eating sandwiches for a while now, are you OK? Is it me?" Agency is a really good word for all of this, you're right. When I was younger I wanted to do it all myself, no communication no meds. But no middle ground is generally exhausting, and I can't argue with health. My mom always said, “Listen to your body,” and I’m much better at that now that I’m older.
What is your relationship to more traditional models of managing illness, like therapy and/or medication? Do you find them effective? Is accessing them an issue for you?
When I started puberty I got so sick. I really just stopped wanting to be. I went ghost. I lost way too much weight and my face went blank, and my handwriting got pin-sized, and then my family (myself included, plus two of my high school teachers) saved my life. One day some people brought me to a ward and we had a healthy talk together and I decided that I--and of course I am not everybody, but personally speaking I would not get better if I lived there even for a bit. I would feel so lonely. And so I said no to that kind of therapy. But I do take medication, and I do see a therapist. My family’s care, and the agency I had in that situation despite being so sick—I needed both of those to get better. Fifteen-year-story short, yes I do have issues with the health care system in this country, but rejecting it at the cost of my health would be nuts.
Today, thanks to experience and my therapist, I take medicine that works really well for me. It can take a while to figure it out, for example at first my medication felt like there was a blanket inside my head, it made me not want to have sex, and also it stopped me from dreaming, and crying at movies. So: nope. That's not life anymore than ghosting was, for me. (It's funny--one of the tics I have as a reviewer is saying "this made me cry" instead of "this part was powerful because of XYZ," and really what I'm saying is "this book is so good it made me feel at home in my body.")
After puberty I did go off medication once, to see if maybe this wasn't a chronic illness, and eventually I felt myself getting sick again. So I went back to my diagram, which I made with the help of my therapist when I was sixteen, and eventually, I went back on medication. My point is that depression is manageable for me, but just like anything else you have to be present. I'd imagine I'll stay on medication for the rest of my life, paying careful attention if I'm pregnant, and when I go through menopause.
I am a daily runner and I consider that part of my management routine too, kind of like how Chris Mullin went gym rat to overcome his alcohol abuse. (Obvious differences being I just run forty-five minutes along the railroad tracks in a band shirt, and I am not an alcoholic. But it helps me check in and stay up in similar ways.) I get acupuncture when I can afford it because it makes me feel like I swallowed six buckets of light. If I need a Rocky moment before leaving the apartment I listen Daft Punk's "Make Love," or Brian Eno's "The True Wheel," or New Order. I know you are a music person too… is there any music you especially do or don't listen to, to stay up?
New Order! Totally New Order. Stuff with sad lyrics and lots of dancing. I like LCD Soundsystem for that too. And yeah, acupuncture is so good. When I lived in Portland you could get it at this community place for ten dollars, which is probably the only thing I miss about Portland.
LCD Soundsystem, yes those albums are perfect for those times. For making-soup times too. Oh and Cookie Mueller! Ask Dr. Mueller counts as pop songs.
When do you struggle most with self-care? When do you find it easier?
I struggle in the average ways--like, let's say I'm a mountain climber and ten years ago I broke my leg and had to have a plate and pins put into it. I worked hard in PT and got it strong again. Most of the time it's good as new, and I remember to stretch and so I don't even think about my injury. But sometimes, if I'm climbing an especially tall mountain or it's really freaking cold or I'm worried about my friend instead, I don't stretch like I should and it starts to throb. That's when I struggle, because I'd rather just be climbing the mountain like I know I can… what I mean is, when I am neck-deep in work self-care can be frustrating because I'd rather be writing, or in the classroom or my community, but that doesn't mean I don't do it. I do it--like Phranc I'm sticking around.
What kind of relationship do you have to your illness? Does how you think about it change the way you live with it?
A good one, today and forwards from here. If it was anything short of that I personally would not talk about it on the Internet! We all have bad days but I'm done with the ghost-ones. The nice thing about those is you can see them coming from a long ways away.
That's really interesting to me, because the opposite is true for me--I get sick around the same times each year, usually, but otherwise it comes out of nowhere. But I've heard other people describe it as a thing they can actually see or smell or hear from a distance.
That makes sense to me too. We should make you some clappers, so you can scare it off seasonally like when Vicky Robinson went camping in The Parent Trap and was worried about cougars. (Only yours would actually work!)
Oh man, that sounds good. You’re supposed to blow a whistle, too. My friend actually did get followed by a cougar in the woods once, and it turned out okay, but I don’t know if there’s a metaphor there. What's most useful for you in terms of support from other people? Is outside support important for you?
Well, sure. When I feel like E.T. I phone home. My sister saved my life times two, once because of her advice and love and twice because I love her too. I want to take care of her too. So specific outside support is important from her, and from a few close dears, but beyond that circle not really--unless I'm being a friend or an ally, and in that case I listen a lot too. Or, unless I'm journaling, or re-reading old journals, which absolutely feels like outside support as well. Reading is outside support too, especially your own words.
I like thinking about the first letter in Dodie Bellamy and Sam D'Allesandro's (heartbreaking!) book Real: The Letters of Mina Harker and Sam D'Allesandro. Mina says she wants her words to "sparkle but it's difficult when living in a body that's contemplating the Void. Everything is gnarled--gargoyles poke from the armrests of my antique sofa." She feels like she's turning into a baby so asks her partner Kevin if he'll take care of her. He says no, he's not capable of that "but I could move in with him and he would see me every day and night until I grew up again." Mina says that's true love. I don't relate to feeling like a baby but yes, especially when you're sick you do need someone to see you regularly. That is part of love for sure. Holding the physical space.
Has anybody (friends, books, songs--anybody) ever said anything to you that really stood out as good self-care advice? Or is outside support not helpful to you these days?
You, actually. Describing it as a chronic illness, with flare-ups--I mean, it's really obvious once you look at it that way, but that was a little lightbulb for me. I used to think of it as a shitty roommate. But a roommate you can still kick out, technically, and getting sick is more like—we don’t beat ourselves up for not being able to work when we have the flu, right? So thinking of it as being sick is more helpful for me now.
And Kate Bornstein's book Hello, Cruel World, which we have talked about. The whole idea that as long as you're not being a shit to other people, what matters most is keeping yourself alive, and whatever you need to do to stay there is okay. I'm not great at talking to people but I do have a lot of amazing people in my life and knowing they're there helps. And I'm good at talking to myself. I've been living with this for twenty years now and I get exhausted by it, for sure, but I can still tell myself, "You did this the last time. You can do it now." I have a little inner therapist who used to be a total bitch but she's getting better at her job the older I get. Do you do that, too?
Awesome, I’m glad. I felt the same when my sister said it to me. About the inner therapist slash wise neighbor (who kind of reminds me of Raoul in your book!): yes, same, and I like her as well. She first piped up when I was young and had someone tell me it will always be like this, which I mean... geez. If it was always like that then I would not be here now. But then she spoke up and said "Yes, but it won't always FEEL like this," and that was incredibly helpful. Lately I am excited to get older and keep doing what I'm doing, which is rad and lucky.
One thing you said that's helped me is being no-bones about how time alone is important. I spend a lot of time alone too, and sometimes I forget not to feel guilty about it, because so much of my life is in community (as is yours), or that being alone doesn't mean being lonely. I would've felt alone on that ward but not here, drinking coffee at my bright red desk.
You're also a freelancer--how do you negotiate the balance between self-care and writing for love and writing for work?
I always write for love, there's no other way. I operate on a strict budget, I know when my money comes and goes. Even when I wrote ad copy for green socks, that was money I needed for a roof, meals, and meds so it was for love too.
Mairead Case (@maireadcase) is a writer, editor, and teacher. An MFA-W candidate at the School of the Art Institute of Chicago and graduate of the 2013 Summer Writing Program at Naropa, Mairead is Youth Services Assistant at the Poetry Foundation Library; a manuscript editor; and a columnist at Bookslut.