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?
Just so we’re all on the same page, my mental health landscape consists of a fairly high general level of anxiety which sometimes spikes into panic attacks and migraines coupled with intermittent major depressive episodes which manifest as hibernation—I go numb, I feel put in stasis, and really all I can do is sleep.
But this is a more nuanced question than it looks like on the surface. The obvious answer is that when I’m too anxious to do anything but panic or too depressed to do anything but sleep that I can’t write. At that point my brain is so broken I can’t even feed myself properly. Any level of emotional or mental effort is just too much and not happening. When things get that bad, it’s mostly just a struggle to keep surviving.
But not every moment is like that. There are the relatively stable periods between the panic attacks and the hibernations, and most of the time I’m living there in the general flatness. Generally I’m a bit anxious and often fending off some unnameable insecurity. So, most of the time the tension is trying to write, trying to create and produce while waiting for that other shoe to drop. The specter of another panic attack or another depressive episode is always looming, and for me it’s a matter of pushing through and living and working and writing in those blessed flat times anyway. If I don’t push myself to do things while I actually have the wherewithal to do things then the looming threat of overwhelming mental illness paralyzes me. And then it sends me into a panic or gives me a migraine. And then I crash into a depression. So, for me, the real problem my mental illness poses to writing is that nothing ever feels safe, it never feels like the right time even when it actually is the right time to write. There will always be times I can’t write, and that knowledge (paradoxically) makes it harder to write when I actually can do it.
What are some specific things you do to manage your illness that you find effective?
By training I’m a social science researcher, and by occupation I’m a data analyst. It may not be surprising, then, that one way I manage my illness is by religiously documenting it. I shit you not, I have a spreadsheet where I track my stress levels, my exercise habits and my dietary habits. I’ve attached a screenshot. Stress, physical activity and diet are all things I’ve tracked long enough to know have a direct impact on my sense of well-being. I’ve recently gone vegan because dairy is a clear trigger for migraines for me, and getting migraines both sucks and creates a tone of anxiety for me, so cutting out cheese (while tragic) actually helps manage anxiety by reducing the likelihood of another migraine. This gets meta, but filling out the spreadsheet every day also makes me take stock of my stress level and makes me accountable to myself to eat properly and get exercise. It’s the element of my self-care regime that actually enables me to keep doing the other parts of my self-care regime.
Not unrelated, I have a similar spreadsheet for writing. I track daily word counts, what project I’m working on, if it’s in submission and where. The sheet aggregates an overall ongoing total of words written that year to date and also calculates monthly average words per day. I do this mostly because I really need to write every day I’m able to write if I can. Writing does marvels for my general well-being—creating something makes me feel productive and engaged and proud of myself. And, like I mentioned before, I tend to get paralyzed when I don’t do something consistently. To reap the benefits of writing as self-care it has to be habitual. If I take a few days off I start down an anxiety spiral where I start convincing myself that my mojo is just GONE and I’ll never be able to write again EVER it’s just OVER and clearly I should give up. But if I just keep writing consistently, and the spreadsheet proves I’ve done so, then I don’t fall down that rabbit hole.
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 take medication. For me, the jury is out on whether or not the drugs are really making the difference or whether the act of taking a pill is such a powerful placebo that my brain tricks itself into coping better. I really crave a strong sense of control and I tend to latch on to doing things to help manage my illness, so even just knowing that I’ve decided to take a pill to help is something that helps already. I’ve been really lucky, also, that any time I’ve been on medication (I was on lithium for awhile because I have a very pervasive family history of bipolar disorder though I don’t have it myself and I’m currently on zoloft) I’ve suffered no side effects. Not having to struggle with the effects of the medication certainly makes that easier. I’m employed full time with health benefits, so medication is accessible and relatively affordable to me.
Therapy, though, is not. My health care plan doesn’t provide coverage for therapy really at all, and I can’t afford to pay out of pocket for it. Therapy has been useful in the past—specifically, I dealt with some really nasty postpartum anxiety issues after I had my kid, and therapy was absolutely essential to getting me to a place where I felt comfortable functioning as a parent. Having a kid after coming from a family with abusive parents while struggling with an anxiety disorder is not fun.
When do you struggle most with self-care? When do you find it easier?
Winter is hard for me. I suspect I have seasonal affective disorder. Doing anything in winter is difficult. Exercise is hard for me because I work all day, and I have an hour long commute both ways. It doesn’t feel like there’s enough hours in the day to work in yoga or running, and it’s especially hard in winter where my option is basically to run outside at 6am in the cold. Also, I’m such an introvert I’m pretty much a recluse, so getting the solitude I need to recharge is a constant struggle.
What kind of relationship do you have to your illness? Does how you think about it change the way you live with it?
It’s a constantly moving target. For years I didn’t even realize I had an anxiety disorder because it manifests in culturally sanctioned ways by and large (like spreadsheets and never missing deadlines). My first major depressive episode was absolutely harrowing. It colored my whole perception of myself—I remember thinking as it passed and I went back to living that everything I thought about myself was wrong. My brain was broken, and it would break again and again and again. It was terrifying; that’s when the mental paralysis started. Writing fiction was actually the only way I found to break myself out of that paralysis. I hadn’t really written before.
It all changed again with my kid. Partly because of the post-partum anxiety, and also partly because there’s an extremely high likelihood that my kid will have mental health issues down the line. Both me and her father do, and it’s highly prevalent in both of our families. So it was important to me to create for her right from the outset a family space where we talked about mental health honestly and openly and without stigma. It was also important to me to create a space where, unlike in my natal family, there was an expectation that people actively engaged with and managed their mental health to the degree they can. Which meant I had to work through the feelings of shame I had about my mental health issues and that I had to really manage and engage with it in order to parent the way I want to parent.
I try not to feel antagonistic towards my mental illness. I’ve come to a point where it’s not me and it—it’s my brain. It just is. There’s a lot of acceptance in it, and I’ve lived with it long enough to know that the bad times will come, and then eventually they will abate. It’s just how my life is. And that has to be ok, because it’s not going to change. All I can do is manage it and live in it.
What's most useful for you in terms of support from other people? Is outside support important for you?
I use my partners as check points. I’m not always able to tell if the anxiety is taking over. Mostly outside support is useful for anxiety—it does nothing for depression. My depressions are just utter blankness, and nothing anyone says or does penetrates them. But for anxiety, sometimes I need to articulate a fear or a thought to someone else and have them tell me if it seems realistic or not.
You also have a full-time job and a family--how do you negotiate the balance between self-care and writing and working and parenting?
Oh, god, it’s always so precarious. I’m the breadwinner for my family, so I have to work and be good enough at my job that I don’t get fired. Parenting well is extremely important for me, so I have to devote the time and effort to my kid that she deserves and be fully engaged while doing it. That’s like 80% of my time and energy right there just those two things.
Like I mentioned before, writing is a form of self-care, and as I also mentioned, I have an hour long commute to work both ways. I write on the bus. Usually I edit on the way in to work and I write new content on the way home. I can’t write at home—my partners would make space if I asked, but if my kid is awake I want to play with her and if my kid is asleep I’ve usually already run out of energy to do anything more than play a videogame or watch a movie. If I don’t write on the bus I basically don’t write at all. For that reason, I rarely write on the weekends.
The real work of making all of this work is that I have to be very reflective and self aware—the spreadsheet helps—and I have to advocate. At work, I have to fiercely protect my work-life balance. At home, I have to make sure I get my alone time (usually going to bed really early and reading alone). I take the bus in even when my partner can give me a ride because otherwise I won’t write and I’ll get anxious about it. It’s all just very intentionally and very carefully managed. But it’s hard. It’s really hard to do all of this and to do it well, and I will say that mercifully me being a recluse makes it perfectly fine that working and writing and parenting and managing my mental health leave virtually no space for a social life.
How do depression and anxiety intersect with gender identity for you? (Or do they?)
They totally do. Me coming out as trans* was a whole process fraught with depression and anxiety. Being genderqueer means no one ever gets your pronouns right and you’re constantly misgendered. I’m polyamorous and my partners all date but I don’t, largely because I really don’t do well with going out with someone new and having to explain my gender identity and having it get questioned. Like a lot of trans* people, I struggle with body dysphoria periodically, which makes me both depressed and anxious.
And since parenting is a general weak point for me in terms of mental health, the way my gender identity intersects with that is not always pleasant. People question whether or not my gender identity will somehow harm my kid, and while it clearly won’t the anxious part of my brain is always like but what if it does. I was pregnant and gave birth, but I’m not a woman, and I’m not a mother. But of course everyone calls me one, and it’s a constant grind to correct everyone or to grin and bear it and not correct everyone.
Do depression and anxiety intersect with class for you? In what ways?
I grew up poor in a family rife with mental health issues which went unchecked in part due to issue of access due to class. So there’s that—I’m not poor anymore, but I still have a poor person’s sense of when to ask for medical help which is basically don’t do it unless you’re dying. I tend to wait too long and let my anxiety and depression get too severe before seeking outside help to cope with it. I also push myself way too hard. Like, I’m anxious, but I absolutely have to go to work even though I was up all night crying for no reason because I can’t afford not to go in. Growing up poor means your poorness lingers even if you are living a middle class life. And growing up poor means there’s no safety net. There’s no way to ever slow down or to trust that there’s someone to catch you and let you rest. It means I will keep working even when I can’t feed myself because I don’t feel I have a choice not to. Which, in the long run, contributes to fatigue and overwhelm and all these things that further prolong that wretched bout of anxiety or depression.
B R Sanders lives and works in Denver, CO, with their family and two cats, where they spend a whole lot of time writing character-driven fantasy. Their work explores sexuality, gender, and resistance set against a rich and fully realized fantasy backdrop. They studied Psychology, Law and Society, and Religion at Oberlin College, and earned a Ph.D. in the Personality and Social Contexts Area of the University of Michigan – Ann Arbor’s Psychology Department. When they are not knee-deep in words, they are crunching spreadsheets as a K-12 Education data analyst.