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?
Depression and anxiety are neat little beasts in that either one can ruin me entirely. The former because it's almost impossible to do anything, let alone write, when all I want to do is stay in bed and beg for death; the latter because it is impossible to do anything when my mind constantly races, revisiting and rethinking as many events as it can stand to remember.
Depression is the hardest, though, because the way the disease works on me is by hollowing me out and claiming everything I'd use to fuel my words. The world becomes muted and I feel as if my ability to be creative is trapped beneath an ocean of angry, grey waves.
To switch and abandon metaphors sharply: depression is a fog covering my mental landscape and anxiety is the endless echoes leading me astray through the diaphanous banks.
What are some specific things you do to manage your illness that you find effective?
Very basic and very easy means of relaxation. I'll drink a pot of coffee while reading, for example, and the world will seem a little easier to cope with. Or I'll shut down all of my social media and play video games for the rest of the day. I'm lucky in that I have a supportive environment that allows me to withdraw as much as necessary while I recharge or fight through bad days. I'd even go so far as saying I'm lucky to be unemployed, because that eliminates one of the largest sources of stress people living with mental illness have to deal with.
But then I remember I can't buy a cup of coffee without relying on someone's kindness and I rethink that last bit. Regardless, managing both my depression and anxiety relies on shutting off my head's constant running commentary for as long as I can, by whatever means I can.
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?
I feel like I should make a point, here: regular therapy and my antidepressants are among some of the few reasons why I'm still alive. Before I managed to pull up from the death spiral depression had me in, I was shaking myself apart every day, getting worse and worse as the disease tangled itself in the workings of my head. When I was capable of reaching out, the meds and my Doc were there to pull me out of the hole.
But I recognize that I'm extremely lucky in both of these cases – I managed to get a referral to a therapist who I've been seeing for three years now, and she referred me to a prescribing doctor who got my medication right in two shots. Getting to my appointments and keeping my prescription filled are challenging though, as I can't drive and I don't have any money. Thankfully I've got my mother to help with the former and state insurance to keep the latter flowing.
Again, my luck here can't possibly be overstated. Not many people I talk to who're in a similar boat have had this kind of success with the traditional model.
When do you struggle most with self-care? When do you find it easier?
Days ending in Y, mostly. I lived with clinical depression for five years before getting treatment (and only then because I'd hit rock bottom by way of a suicide attempt) and during that time, the illness succeeded in destroying what little self-worth I'd had as a child of divorce/perpetual social outsider. Hell, the illness used the dissolution of my first relationship as its catalyst, which meant it had plentiful ammo with regards to convincing me that I truly was a useless, terrible monster. So there's a bunch of scar tissue that makes it hard to go about the average machinations of life without tripping up and hating myself for a few hours.
It's easy when I can (and please excuse the phrasing, it's just trapped inside of me thanks to my therapist using it every time we meet) “honor the moment,” so to speak. When my head's constant chatter is at a level I can ignore and I can focus on the tasks at hand, be it reading or using Twitter for weird fiction or goofing off on my 3DS.
What kind of relationship do you have to your illness? Does how you think about it change the way you live with it?
I've always thought of it as war, 'cause I can't stop comparing the bad days to artillery bombardments in which all I can do to keep myself safe is huddle up in the foxhole or trench and wait for the explosions to stop. Even when there's no thumping against the fortress walls, so to speak, I view the depression and anxiety as invaders to be burned out. I think the roots of this come from the fact that when it got really, really bad, the only emotion I felt with any regularity was anger – anger over my life falling apart, anger over losing control over my own head, anger over being near powerless to stop the downward slide.
And yes, thinking of it in terms of a battle makes it a littler easier to function in the day to day reality, because while depression makes me unimaginably tired, I can still muster the energy to fight . But on the flip side, it allows for times where I can't do anything but hate, so much, because of how much time the creeping tangle of illness has stolen from me.
What's most useful for you in terms of support from other people? Is outside support important for you?
The most useful thing I've ever gotten has been a safe place to self-destruct and rebuild. Mental illness hit me when I was young and vulnerable, which is deadly when you're an American teenager a year away from graduating high school. At that age we're told that we need to make decisions that'll affect our lives for years to come and combining that sort of pressure with the slow sinking miasma of depression is a recipe for churning out walking wounded people.
So, that said, I had two things going for me: the first was a few friends who, no matter how many times I kept shaking myself apart, were always around to help talk me through the process of piecing things back together. In the end, it wasn't enough, but I survived some terrible days because of their support. Second, and perhaps most importantly, I had a home where I could do the aforementioned piecing together. My mother – Jesus, my mother's why I lived to see therapy and medication work. She didn't kick me out, she didn't pressure me to find help, she didn't do anything but let me exist as I tried to work through the depression by myself.
And for her child that's most like her in stubborn temperament, that was the best thing she could've done. All that said, outside support was and is incredibly important to me.
How do you negotiate the balance between self-care and work for money and writing for love?
Honestly? I don't. Only recently have I gotten paid for my writing and even then, it was only one job. I'm experimenting with Patreon, but that's still in nascent stages. Writing for love is what I've always done, though most of the time it feels more like a compulsion than it does a passion. I get itchy if I don't make some sort of effort to be creative, which is how my Twitter account happened (and pitching to The Toast, and launching a Patreon project, and answering the call for an interview like this, etc., etc., etc.)
My recovery has been organic, in that over the years I've slowly started to reclaim my ability to live in a piecemeal fashion. So there's no real balance to speak of, only routines and territories I'm taking back from the tangle in my head and trying to integrate into the main body of my life.
What kinds of things help you with establishing those routines and learning to stick with them? (I am asking for selfish reasons, because this is one of the things I am really trying to get better at.)
Repetition. Constant repetition. Since the early days of my illness I've always tried to at least force a basic structure onto my life, i.e. wake up, take my meds, shower, get dressed, drink coffee and read bad fiction for a few hours, etc, etc. I'll have bad days and missteps, times where I forget to take my antidepressants until five in the evening or where I'll stay in bed past noon while staring at the ceiling, but backslides happen. They're a sign you've been making progress, that all of the fighting hasn't been wasted effort.
More directly, it's a matter of forgetting that you didn't follow through on all of your routines yesterday and remember that you've got another attempt in front of you. I do this very easily because my memory may as well be Swiss cheese for all of the consistency of form it has. But regardless, you try, over and over again, and be kind to yourself if you spend those hours in bed.
The entire thing reminds me of something my therapist and I talk about, which is there's a difference between knowing something and believing it. Which is to say, I know I'm not actually a horrific monster, but to believe that is worlds apart. It takes time and effort and constant repetition to internalize both habits and beliefs. So give yourself that time. I know that in my case, after years of living under the guillotine of depression, it's finally my time to give.
Does being a trans woman intersect with living with depression and anxiety for you? In what ways?
Oh, God, yes. First of all, the dysphoria I feel with regards to my body is regularly magnified by both. I'll be having an okay day, then start hyper focusing and worrying over a part of my overall features, and then it's three hours of a black hole later. Coming to terms with being trans was both a huge weight off of my shoulders and an additional war to wage, because my uneasy feelings regarding my gender suddenly found a focal point, i.e. “well no wonder you never felt comfortable presenting as a man, you're a woman” which then gets shifted to “fuck, you're terrible at presenting as a woman.”
Second, just existing is once again a task of tremendous effort. Whereas before I was just worried with getting through the day without wanting to die, now I fret over the rapid growth of my beard, how terrible I feel in all of my clothes that are made for a man's body, consternation with how short my hair currently is, etc., etc. It's very much another front in the battle of recovering my self-worth after the illnesses stole it from me. And even that's not the end of it, because while getting my house in order is all well and good, I still have to leave it and confront a world where women like me are seen as oddities at best, y'know?
That said, it's remarkably freeing to finally see a pretty girl in the mirror and feel happy because of it.
Aw, geez, that made me really happy, too.
Red Mills (@redfivetwo) is a writer from New England who spends time sending dispatches concerning life at odd angles from the frozen wastes of her home. Her work is entirely internet based and can be found by poking at her Twitter account (or by poking her on Twitter, whatever's clever.)
More about the Working interview series here.