When My Mental Illness Is Bad

When My Mental Illness Is Bad

Mental illness isn’t a solitary, isolated, and vacuum-sealed experience. Mentally ill people, like myself, have friends, family, and peers. We interact with strangers. We can make mistakes and have messy behaviour, just like everyone else. Sometimes, mental illness is bad—or at least it makes us feel that way. When I say mental illness is bad, I don’t mean mental illness is a problem that needs to be fixed, or that mental illness is something immoral that needs to be punished. What I mean is that mental illness and its symptoms can have a negative impact on people. When talking about mental illness, it’s important to be honest without reinforcing stigma. But it’s also just as important not to dismiss or romanticise parts of mental illness. Sometimes, my mental illness is bad, and I end up doing hurtful things to myself and the people around me.

I have bipolar type II, with hypomanic and depressive phases. I also have complex posttraumatic stress disorder (C-PTSD). They’re not “pretty” or “easy” mental illnesses. Along with being complex and individual, they’re messy and difficult to manage.

This is going to be about my personal experience and symptoms. They are bad to me. They make my life harder, and they can be harmful to me and the people around me. I sometimes fear for my life when the symptoms get intense. Please do not take this as reflective of everyone with mental illness. If you can identify with what I say, then that’s okay—but if you’re neurotypical and reading this, remember that I am just one person.

Symptoms that my mental illness is bad

It’s hard to feel human when my mental illness makes me feel like an immoral person. Like what I’m doing and how I’m behaving are wrong, rather than difficult and symptomatic of a deeper problem. Maybe I’m overthinking how much these can affect other people, but I know I’ve lashed out or been incredibly irresponsible with some of these symptoms present.

Anger/irritation

I lash out a lot. When I get frustrated, I can get very impassioned and heated. It’s not nice to be around me. My hypomania often goes from hyper to angry, not happy or over-the-moon as the stereotype can be. Anger is not a bad feeling to have, but it’s very easy for me to disrespect the people around me when I get irritated.

Self-harm

I want to hurt myself. This is not good. Urges or desires to hurt myself are a sure sign that I’m not in a good place.

Lack of sleep

When I’m hypomanic, I don’t feel tired and I don’t feel the need to go to sleep. Not sleeping means that I’m hurting my body. It affects my reaction time, so driving and walking become dangerous. It also changes my routine and schedule. My self-care and work can be severely affected if I’m not resting. It’s irresponsible, mostly.

Delusions of grandeur

I become convinced that I can undertake projects and make plans that are, without a doubt, beyond my capabilities. This ends up wasting my time and resources, while also potentially wasting other people’s time and resources. If I start getting invested in a project or goal that originates from a delusion, I don’t follow through. It doesn’t get completed. I put a strain on my money and friendships.

Hallucinations

These are the scariest. Most of my hallucinations are visual and they set off anxiety. When they’re auditory hallucinations, I’m even more afraid. I hear things that don’t have a source outside my head, even if they sound like they’re external. My behaviour changes significantly, and I can end up lashing out or slipping into paranoid thinking.


These are all signs that my mental health isn’t being managed and maintained well. That’s what I mean when my mental illness is bad: it’s not being treated properly. I’m blessed to be able to have counselling and medication to treat my mental illnesses. But when I get to this severity? I’m in trouble. They can’t be managed by a crisis intervention. I feel just a level below crisis, or like it’s less concentrated and intense than a crisis, when my mental illness is bad like this. But it’s a little too much for me to handle on my own.

How I can improve

Talking about these issues requires self-awareness. Without being aware of my own behaviour, whether it’s from my mental illnesses or not, I can’t make an attempt to manage and improve myself. The mental health community needs to give space for these discussions as well. We need permission to converse about our harmful behaviour without being villainised for experiencing it. Mentally ill people, especially those with mood disorders like mine, have a reason for why they act certain ways. It doesn’t mean they should be given a free pass to continue that behaviour. It means that we need to be aware of the context.

If I flip my lid, I need to reflect on that. Why did I react that way? Was it appropriate? How is the rest of my behaviour, in terms of symptoms?

This also means I need to learn how to follow-through with correcting my behaviour and apologising if I do end up hurting someone. I need to be able to have the grace and forgiveness to apologise to myself, too. I need to be able to say to someone, “Hey, it was wrong of me to behave that way, and I sincerely apologise for my behaviour. My mental health has been poor, so I’ll be taking some time to address it and my symptoms—including the rage I directed at you and the irresponsibility of my actions.”

I am one person, and as Kelly Kapoor said so intelligently about managing her one-person department, I am not easy to manage. It’s especially true when my mental health is bad.

My PTSD, Triggers And How I Manage Them

My triggers aren’t limited to my posttraumatic stress disorder. Because I have CPTSD, it’s ahem more complex than PTSD from concrete traumatic events. (This isn’t to say CPTSD is more advanced or whatever; they’re variations, with trauma coming from different events, factors, and points in life.)

As such, I’m triggered by different things, not always associated with trauma.

The thing about triggers is they’re not a guaranteed way to get a reaction. I’m not triggered every time I’m exposed to one of my triggers—which is something people might not understand. I am aware of my triggers, and I am also aware of how well I can manage any possible reactions if I’m exposed to them. Just because slamming doors triggers me doesn’t mean I’m going to have a mental breakdown every time someone slams a door. (I might have in the past, before I started therapy and learning how to manage my mental health.)

Here are the triggers I’m fairly certain are related to my PTSD:

  • loud footsteps
  • slamming doors and cupboards
  • hands moving to my face
  • yelling/loud voices
  • walking near moving trucks or cars

My PTSD triggers need to happen in real life. I need to hear and experience them to be triggered by them—a video game with stomping sounds, or a movie where people yell, won’t trigger traumatic flashbacks and my fight-flee-or-freeze response.

Here are the triggers unrelated to PTSD:

  • corpses
  • death
  • suicide
  • self-harm
  • bodily mutilation, on humans or animals
  • existentialism (I’m not even kidding with this one)

I’m still bouncing around on how I feel about the PTSD diagnosis, but I’ve been diagnosed twice with depression by medical practitioners in different cities, so I’m going to say I have depression. The triggers above are more likely to initiate “bad vibes” and a depressive mood, or make me incredibly upset.

The way I manage my triggers, and when I’m triggered, depends entirely on how I get triggered and what triggered me.

If I’m triggered in a verbal conversation with someone, or by something happening around me, I make a quick note to the people around me (who know about my mental health) that I’m not comfortable with the topic or the environment. My biggest response to my PTSD triggers is to get anxious or angry. I’ll complain about what I hear, because that’s the only way I can tell myself, “This isn’t a precursor to harm. It’s a trivial thing. People can complain about trivial things, things that don’t matter too much.” If you follow me on Twitter, I have occasionally talked about living with people who have heavy footsteps.

The triggers I struggle with more are the images and videos. I feel sick when I see photos of hurt people or animals, especially ones that are like, “Little Benjamin the beagle needs emergency surgery after being attacked, help the crowdsourcing campaign!” followed by a picture of little Benjamin’s hurt body. Just fucking don’t. It’s a graphic image. Content warnings for graphic imagery occur on television, but not on the Internet, and that’s why I need to avoid social media when I have bad mental health.

I could elaborate more on the specifics and individual situations, but it’ll be faster and more efficient to sum up my known triggers, how they influence my mental health, and how I attempt to manage them.


Trigger: loud footsteps, slamming doors and cupboards, yelling/loud voices, walking near moving trucks or cars
Effect: fight, flee, or freeze response; irritability; anxiety
Management: I’m still trying to figure out how to manage this trigger. At the moment, it leads to a bunch of complaining about whatever noises I’m hearing.

Trigger: hands moving to my face
Effect: knee-jerk reaction to get the hell away from you; fight, flee, or freeze response; accelerated heart rate; flashbacks; anxiety
Management: I snap or explain the situation to the person who triggered me.

Trigger: corpses, death
Effect: anxiety; suicidal urges; upset stomach; symptoms of grief (crying, loss of appetite, sadness, etc.); hopelessness
Management: I’m usually triggered by images of this one, but occasionally written or heard can trigger me; so getting away from the pictures helps, along with distracting myself with puzzles and other cognitive engagement (like games!).

Trigger: self-harm, bodily mutilation, suicide
Effect: urge to hurt myself; upset stomach; crying; suicidal ideation, urges, or rumination
Management: I’m only triggered by visuals of this trigger, and I manage it with deep breathing, distracting myself with puzzles and games (cognitive engagement), meditating, and doing “body scan” exercises to remind myself of compassionate touch/perspective on my skin, instead of pain.

Trigger: existentialism
Effect: suicidal ideation, urges, or rumination; anxiety; hopelessness
Management: I end and avoid conversations or discussions rooted in existentialism. Considering my purpose on the planet, or wondering the meaning of my life, is a sure-fire way to make my mental illness difficult to manage.


My intensive short-term therapy last year ended up being the best place for me to learn how to manage my mental health when my mental illnesses are triggered. I left out some of the more situation-specific triggers that can worsen my mental health, but on the whole, this post is fairly exhaustive of my life. Not every trigger has the same reaction and the same way of dealing with it. I’ve spent at least a year now trying to figure out the best solutions to navigate my mental illness without reinforcing harmful behaviours.

It’s been hard.

My PTSD And Motivation

This is part of a series where I talk about my complex posttraumatic stress disorder. The first post outlines my C-PTSD/PTSD.

The majority of motivation lies in the thought, “I am able and want to achieve this.” We’re motivated to do something because we think we can get there, and ultimately we want to get there. There is an inherent desire spurring us to do whatever goal we’ve set for ourselves. We want to go to college, so we’re motivated to do what it takes to get there. We want to have a published book. We want to get the job. We want something and we see the means to the end goal, or we at least discover them on our way to the goal.

Having PTSD makes this a little difficult. I struggle with desire and capability.

I find it hard to set a goal and reach it, shown by my track record and trail of unfinished projects, because my PTSD fills me with fear and insecurity. My PTSD developed over a time of instability, and this affected my ability to set goals and maintain progress toward them. I grew up without knowing when something will get upended. I became highly alert of the possibility that things would change. In short, I was always on the lookout for the next interruption and disruption.

This pattern of seeking disruption stalks me. I’m a mile ahead of my goals and their means. I’m a mile ahead of doing Step 1. I process to a hypothetical Step 100 and essentially create disruptions for myself by looking at setbacks and obstacles between 1 and 100.

This is why I cried when I finished a complete rewrite of my novel.

Now, I’m there again, processing from Step 1 to 100 for the revision of that same novel. I’m trying to stay motivated to see Step 1 through to completion. I write to-do lists. I make checklists. I break my goals down into specific, measurable, attainable, realistic, timely, small goals. “Revise THE PILGRIMAGE” becomes multiple steps of revision, with a checkbox beside them and an end point. I’m still on Step 1, which is a read-through and note-taking. I’m struggling to stay motivated. I’m jumping past Step 1, trying to rationalise and strategise how to make my way through the next steps… when I’m not there yet.

My motivation turns into tactics for the big picture journey, rather than the small goals I set up. The “traumatic” and “stress” aspects show in motivation and goal setting. The trauma comes back, and the past occurrences and similarities show themselves. The stress comes back and soaks through all the rational efforts.

Dissociation and low self-esteem are also factors that inhibit my ability to stay motivated, even with end goals and actionable steps to reach them. My PTSD also features manic episodes, and they’re a form of elated dissociation. I’m untouchable in mania, just like I’m untouchable in dissociation; but with mania I have power on the world, whereas with dissociation I have invisibility and disconnect from it.

How can I stay motivated when I’m not here, or when I am but I’m filled with wishful thinking? How can I stay motivated when my brain is wired to find every possible setback? How can I stay motivated when I’m too occupied with navigating fears? How can I stay motivated when there are 99 steps between my current state and the end goal, and I have zero idea what I might need to face with each step? How can I stay motivated when my brain and body have only been used to strategise my mortality?

It’s hard to rewire myself. All the motivational quotes, lists of achievements, goal setting, and reassurance in the world won’t help me if my mind can’t believe them; or if my mind is unable to use those to its advantage; or if I have a counterpoint to each one. There’s nothing my brain wants to do aside from continue its current patterns. After all, it’s spent most of my formative years and life doing that, and it’s seen the results: I’m still alive.

At this point, I think the only way I can really be motivated to do anything is remind myself that I’m hard to destroy. Is that the key? Do I need to rewire my brain to one of confidence in order to be motivated? Do I need to be confident in my existence before I can be motivated in my projects? We’ll see. For the time being, I’m… well, as I write this, I’m stuck in dissociation and can’t even feel my fingers as I type. But for the time being, until I’m managing my PTSD better, I’m going to focus on completing my checklists and ignoring the future.

My PTSD

I first started seeking help for my mental health in 2011 when I said to my parents, “I think I have depression.” My father then revealed to me that he has depression (something he has been successfully managing since 2013!) and mental illness is frequent in our family.

A year ago, in February of 2016, I saw my third therapist: a trauma counsellor with a focus on spirituality, psychosomatic medicine, and cognitive behaviour therapy. She was a fantastic fit. I can’t stress enough how therapy is most successful if you have a therapist who actually helps you.

I had seen two other therapists who specialised in treating depression, and though I could have gone on antidepressants (I fully support them!), I didn’t feel right. I didn’t feel like I was being treated the way I should have. I didn’t feel like depression was the end of my mental health struggles. I felt like there was more that I needed to figure out.

During the standard first meeting with my most recent therapist, she instructed me to get comfortable. In retrospect, when she saw me assume the Lotus Position in my socked feet, she knew exactly how to approach my treatment. I remember having doubts about how successful our work would be, and she challenged that. While sitting on the couch, I told her in detail about my life and the experiences that mattered to me. She told me I have posttraumatic stress disorder (PTSD) and that it might be complex posttraumatic stress disorder (C-PTSD). She told me how a traumatic life, specifically childhood, can lead to PTSD in adulthood.

Everything clicked for me. It made sense: I wasn’t just depressed. I was traumatised over decades. I developed PTSD.

Often, I feel like saying I have PTSD is a sham. I’m not a military vet, I didn’t grow up in a war-torn country, and I haven’t experienced sexual assault. There are so many “poster child” representations of PTSD that feel more valid to me than my own—hence why complex-posttraumatic stress disorder (C-PTSD) has been proposed. I grew up and experienced more frequent trauma, on average, than people my age.

But I still have PTSD. I say PTSD for simplicity’s sake, though it’s really C-PTSD. I haven’t found much difference between the two for me personally, but I know others have a different experience with PTSD and C-PTSD.

So that’s why I’m writing this post: to share my experiences with my mental illness.

My PTSD and experience with it mean that I am…

  • prone to violent anger.
  • prone to psychotic episodes, where I can’t discern reality from imagination, dreams, hallucinations, or delusions.
  • unable to regulate emotions, particularly strong emotions.
  • afraid of developing dependency on substances like alcohol and strong painkillers.
  • terrible at sleeping normally.
  • terrible at remembering things without having a record of them.
  • dissociating frequently from my body, to the point where I can wake up, go through an entire day, and not remember what happened by the time I’m in bed again.
  • triggered when events, sounds, and images are similar to the traumas I’ve experienced.
  • unpredictable and a lot to handle emotionally and mentally, especially for myself.
  • comorbidly suffering from depression and anxiety.
  • struggling with grief.
  • suicidal and ideating suicide more often than not.
  • controlling, with very specific preferences.

Like all mental disorders and illnesses, it’s impossible for me to separate myself from mine. I have PTSD, and I expect the rest of my life will be a journey of coping, surviving, and managing my mental illness. I have lots of resources and good methods for working through it, but I’m always struggling.

Therapy Diary: Mindfulness

Blue and white paint splattered and dripping down a black wall.

When I was in therapy last year, my counsellor told me that the goal for our sessions would be creating mindfulness. There were a number of ways we worked through being aware of my body and my emotions. Because my PTSD is very dissociative, it means there’s a mind-emotion-body disconnect. I often feel “outside” of myself in varying ways. Sometimes I am a floating balloon being held by my body. Sometimes I am a suitcase being dragged. Dissociation is a beast in itself and I wrote a short blog post on it a few months ago. This post acts as a bit of a follow-up.

Along with the exercises we did, such as identifying where an emotion existed in the body and describing it (anger being in my throat, or despair being in my belly—that kind of thing), I use or have used these tools to become more aware and mindful of my entire existence:

  • journalling
  • yoga
  • meditation
  • tarot reading

I don’t journal as much as I used to while I was in therapy. I think this is because I’ve gotten better at being mindful/aware/in-tune/etc. Journalling was a very explicit way of creating awareness of my emotions and my body, and the relationship between the two.

These days, I lean toward yoga, meditation, and tarot reading. The yoga helps with my mind-body connection, with a focus on my body and how it connects within itself. The meditation points me toward the relationship between my mind and body while emphasising my emotions, feelings, and thoughts.

Tarot reading is a new one, though. I grasp onto symbols and metaphors, and that’s all tarot is. I don’t use a classic tarot deck, with Major Arcana and whatnot. Instead, I use regular 52-card playing cards with numbers and suits. There’s an additional layer of abstraction with these cards. The symbols and metaphors come from interpretation of the numbers and the suits. Instead of seeing a moon or a sun, I have to consider my own intuition and understanding for the numbers and suits.

When it comes to the tarot reading, I do a combination of reading cards for in-depth interpretation of a single card, or I do a self-reading with a 3- or 4-card spread. Some spreads require a question to answer, and others are assessment or guidance spreads. I don’t read the cards for prophecy or fortune-telling. I read them so there’s somewhere I can project my worries, concerns, desires, and intuitions.

On the whole, creating mindfulness has been the key to lessening my dissociative states—whether by frequency or intensity. I have been plagued by a constant disconnect between my mind and body because connecting the two was dangerous during my traumatic childhood. There’s been a lot of learning, trial and error, and patience involved. I have to constantly work in order to hinder the PTSD from dictating my life, but I’m finding ways that let me progress.

I’m Not Doing Great

This is a spontaneous blog post.

But I’m not doing the greatest lately. I’d say since my rabbit died. PTSD makes events like death, loss of other forms, and stress a whole heap harder. This hasn’t been my first grief and mourning. That’s probably what makes it hard. My sadness has been compounded.

And I am one of little faith. It’s hard for me to hear the phrases, “They’re in a better place now,” and feel comfort. I struggle to be a spiritual person, despite the fact that I know it helps me. Not religion–never religion. But spirituality… I need it. And I haven’t been able to practise it in any way.

I’m trying to find places to lay blame. Sources where I can say, “Yes, if I stop this, it’ll stop the flow of horrible lethargy.” But the thing is, there are no sources outside of my head. It’s all in my head. It’s all going on in the mush in my skull. My boyfriend is on anti-depressants and thinks they would benefit me.

I don’t think anti-depressants would help me.

The ball-and-chain isn’t just the lethargy. It’s a long metal linkage of trauma, paranoia, hallucinations, forgetfulness, depression, and lethargy.

I’d go back to therapy, but it was offered through my school. And I’m no longer in school. I don’t think I have the funds to seek out additional therapy–and let’s be real here, I don’t want to have to unpack two decades of crap again to someone who might not be helpful.

I’m trying to remember the things I learned from therapy. I’m trying to remember the things that helped me. I’m trying to remember that I have the tools to get better. I’m trying to remember. I’m trying to remember how it feels to be a person again. I’m trying to feel okay again.

Therapy Diary: Dissociation

Blue and white paint splattered and dripping down a black wall.

My dissociation manifests in a few different ways and feelings, and I can compare it with a bunch of metaphors. But it all boils down to a single feeling—of rather, lack of feeling.

My dissociation means I’m not part of reality. I’m not fully in the world I’m interacting in. My body is doing one thing, but my consciousness is distanced.

Sometimes my dissociation is heavy and sometimes it’s light. I’ve described it as half of my existence floating behind me like a helium balloon; or half of my existence being dragged like a suitcase with a broken wheel.

You’d think that being dissociated is easy to notice. But I only notice the way it feels—the heaviness or lightness or distance or closeness—once I know I’m dissociated.

So the disconnect is something that shows up as irritation or lethargy. It’s only after a bit of wondering, “Why am I reacting like this?” that it dawns on me: “Oh… I’m not all here.”

And then what? What do I do once I realise my consciousness isn’t within me?

I try meditating for a few minutes. I try doing a vinyasa or two. I try lighting a scented candle. I try taking a warm shower or a cold shower. I try reading a book. I try playing a video game.

But none of those are fool-proof, sure-fire ways to reassociate with the world. They’re only baby steps.

It’s almost impossible to eliminate the dissociation the day it happens, or even the day after. Sometimes it lasts for a few days. I’ll power through it, but there are days I just can’t. I need to sleep and let myself succumb to another reality (the surreal of dreams).

My therapist told me that it takes time to feel safe enough to “come back” after being dissociated. So I don’t push progress or obligation on it.

Mental Illness and Writing

Mental illness and writing do not go hand-in-hand.

But then again, mental illness doesn’t particularly go hand-in-hand with anything productive.

It hits hard against writing and creative work, however. There are so many thoughts and so much subjectivity that it’s hard to separate from your mental illness. There is also so much production necessary in creative work. And when you’re in bed, depressed, or having a panic attack from your PTSD, it’s nearly impossible to receive anything, let alone produce anything.

A quick list of the things I suffer from:

  • PTSD (as described by my recent counsellor)
  • Depression (as described by my doctor and my previous therapists)
  • Disordered eating (as discovered by lots of googling and common sense)
  • Body and gender dysphoria

So life is difficult. Everything is difficult. Words are difficult and washing my face is difficult. And yes, I say suffer, because fuck do I suffer.

As writers, we’ve heard of and experienced writing burnout. We hustle so hard until we reach a certain point and need to stop. We know there’s something wrong, and we know that continuing at our current pace will spell certain disasters for us.

Having mental illness means I have a reduced capacity for tasks, whether they’re mundane or creative or whatever. Not every day is the same, of course—some days, my mental illness sits and doesn’t bother me. Other days, though, I lie in bed without the energy or desire to brush my teeth, wash my face, or eat something.

When I’m being told constantly that “writers write” and I need to “write every day” and I don’t have the capacity for it? I kinda feel like shit. I already feel guilty for not being able to do things “normally.” Hygiene and eating are such simple tasks, but they can become difficult when my mental illness flares up. Adding writing to that? Adding any kind of creative art to the list of things I need to do? I can’t handle it.

If you have a mental disorder or suffer from a chronic illness, you don’t need to write every day. You don’t need to hustle until you burn out from writing. You can be slow and write small amounts. 5K days aren’t always feasible. Write 100 words if you can. Hug yourself for not writing today if you can’t.

I know I can’t write every day, because 1) I’m a busy student; and 2) I have mental illness and need to prioritise other tasks than writing.