So You've Just Been Diagnosed - Welcome

Dear newly-diagnosed friend,

Welcome.  You've begun a journey into the unknown, and there are friends here already. We welcome you. I welcome you.

Some doctor has just told you that you have a mental illness. I've been where you are. It's a scary place, isn't it? You see depictions in the media of us all the time, us - you never thought you'd be one of "us," did you? Us - that group of psychos you see on television and in the movies, in the newspapers.

Let me guess at what you might be seeing. You see the wild-eyed girl pacing up and down the halls mumbling to herself, having sex with everything in sight, spending too much money on things she doesn't need or even want. You see the woman who at 50 has a house full of things, full - full to where the seams may split and the contents of her cluttered life fall out like so many secrets. You see the unshaven, dirty, smelly man.  You see the woman who has lost all joy in life and sits day after day after week after week in her room, looking at her bed, wondering if these hands are actually hers. You see the man who believes he can fly, saying it's not right man, it's not right, it's not right. You see the white straitjackets with their silver buckles and the orderlies in scrubs who control the keys. You see a padded room with four white walls.

That's not who we are though, and the media does us a huge disservice by painting mentally ill people with such an emotionally-charged brush.

Mental illness does not look like what it does in the movies - not all the time. I'm not going to pretend to you that there won't be times that it looks frightening. There will be times where you say hey, I need to sit back and relax - I'm wound up too tight. There will be times where you slip and you need a safety net to catch you. There might even be times that your brain plays tricks on you that you are not prepared for and you might wind up in a hospital for a few days, remembering who you really are.

Mostly what mental illness looks like is someone you know. It could be a coworker, or a student at school, or a family member - but it's all around you, and it's people living their lives. They work. They have joy. They have families. They have sadness. They're big stars, sometimes - they're the elderly lady who you see at the post-office other times. They're your cousins, or your children, or your parents. They're often exceptionally creative - maybe you are creative too. They're often very expressive - and maybe you're worried about not being expressive anymore.

When I was diagnosed I was very worried about several things. Here were my top questions.

• Will I be a good mother? (I have two children, and was diagnosed when they were 3 and 5)
• Will my friends still love me?
• Will I still be able to write if I take medicine?
• Will the medicine make me crazier?
• Am I going to live a long life?
• Can I really be happy?
• Will everyone know I'm crazy?
• Will I be able to hold a job?
• Will I wind up in a mental hospital forever?

Some of the questions you have will only be answered with time.  It's not a bad idea to write down some of the questions you have and to discuss them with a therapist. You're going to need a toolbox and a therapist is going to need to go in your toolbox.

(For me, the answers were yes, I'm a good mother. My friends love me, and not only that, having the window of bipolar to explain some behaviors I'd had at times in the past was illuminating. They were able to see that, before I got myself under control, some of the erratic-ness was illness and not me. It made my real friendships stronger.  I am still able to write, in fact I'm more focused and clearer, a better writer. Some medicines did make me crazier, and I worked with my doctor to adjust them and get on the right medications when I needed them most. I'm not sure if I'm going to live a long life, but if I don't - it's not going to be because mental illness went untreated and got the best of me. And I'm happy - I'm happy every day. I'm not happy all day every day, I'm sure, like anyone else I have ups and downs and like myself I sometimes have very high ups and very low downs. But the balance of my life is bliss. I have jobs. I have been hospitalized, but short term - ten days.)

What mental illness looks like isn't what the media says it is. It's really just about management. You can absolutely do this. You can absolutely get your illness under control. Like diabetes, you're going to need to treat it in some way for the rest of your life, but that's not something that should deter you from doing it. All you need is some planning and a tool box.  What should go in your tool box?

• Social support system - you need a safety net of friends and family you trust. Even if it's just two people, you need someone to reality check you. You may need to have someone you've enlisted to take your credit card away, like I do, if you should start having instability. You might need to have someone you can call if you feel like hurting yourself. You might need to have someone who you can talk to in the middle of the night if you have nightmares. Social support systems are critical.
• A therapist - you need a therapist. I don't care if you think therapy is crap, it's really important to have that person who listens objectively and will give it to you straight. For me, it has to be a CBT (cognitive-behavioral therapist) because I don't do the touchy-feely-therapy crap. I just want to talk straight, and find solutions. You might want the touchy-feely though - you're going to have to try out different therapists and find one who works with you well.
• A psychiatrist - your psychiatrist is your medication manager. You will need to meet with her frequently until you get your medicines straight. After you're on a regimen of medicine that helps you feel stable, you will likely meet with her less often.
• Medication - it's not the bane of your existence. It's your helper. It's your re-balancer. You have a mental illness. That means there are chemicals that are not properly balanced in your brain. Your chemical composition needs a little help, and even if you're one of the lucky ones who doesn't need medicine for the rest of your life, you need to know it's there. You need to know that if you are in crisis, that medication is there and it will work with you to restore you to your former glory. The medicine you need will be largely dependent on your symptoms and on your doctor - make sure to speak up and work with your doctor. Talk about all side effects, talk about how you are truly feeling.
• Truth - you cannot lie. It's important to tell people really, truly, honestly what's up. If you're used to lying and saying, "I'm fine," all the time when someone asks how you're doing, you should get out of that habit right away. Just tell the truth, if the doctor says how are you, you can say, "You know, I feel very anxious at night." You can say, "This medicine gives me a baboon's butt red rash all over my legs."  You can say, "I'm feeling happy.... maybe too happy, is that a thing?"
• Time - give yourself the gift of time. Nobody conquers a disease right away. Things take time. You'll be frustrated, you'll get upset, you'll rail against the machine. But you're going to make it - you just have to be patient and you have to give yourself time to adapt, time to learn yourself, time to heal.
• Coping mechanisms - these will vary, and are a huge topic on their own, but think about things you love that make you happy and use them to help yourself heal. Art, poetry, writing, dance, music, knitting, running - you think about what you love. Then do it.

It's all very overwhelming and daunting, I know, but you're at the beginning of a journey. When you are starting, it's okay if you feel like you don't know what the end is going to look like. I don't either - but I know what it's not going to look like. It's not going to look like darkness forever. It's not going to look like the end of you - it's going to look like you as you've never seen yourself before. If you've just been diagnosed, chances are you've been wearing the veil of illness for a long time, a specter on your forehead. When you see yourself without your illness in the way, you may not recognize yourself. 

But you're beautiful! And you're possibly even more beautiful than you've ever given yourself credit for.

So welcome to the club. Feel free to ask questions, get to know others, and you're quickly going to realize that the media's wrong. Mental illness isn't "that crazy person" - it's just part of us. You, me. We're all right.

You're going to be all right.

- Jen