13 Weeks

     I've been wanting to publish this blog post for a long time. The hardest part was finding the time and motivation to sit down and write. It's been weeks since I wrapped up my first draft, though, and I still haven't hit that button that says "save and publish." I'm not sure why. Maybe it's because I'm nervous; being vulnerable is still hard, even all these blog posts later. Maybe it's because I'm a perfectionist who always feels there's something more to be fine-tuned in my work. May is Mental Health Awareness Month, though, and I feel that posting this during that time means something to me. So, seeing as it's May 31, I'm quickly running out of time. Just like with my two books, I've come to the point in creation of a written work where I have to share it with the world as is, even if that state is far from perfection. 

     Mental health is something near and dear to my heart, because it's something near to my everyday life. Mental illness is not my friend, but it's my constant companion. I was born with mental illness, and I'll die with it. That doesn't mean the years between need to be lived as a resigned slave, though, or that I can't live days where I almost forget about the illnesses I have. I'll have great times and terrible ones and everything in between. (Which, even if my emotions might carry more extremes than some people's, this isn't too different from everyone's lives!) My life has been a constant fight against mental and physical health issues. Each year I think I can't take much more, and every time God shows me that I can and I will withstand whatever comes my way. The pattern these past 16 years has been much the same: when one thing gets better, another gets worse. When I get a good month, the worse one that follows is even more horrible. When I find people, friends, or places that I begin to feel at home in, my health always tears me away from them.

     For the past 13 weeks, my health has taken me from school and put me in various hospitalization programs. For 10 weeks, I was in a partial hospitalization program. From 8-2:30 each day, I was at Rogers Memorial Health. I spent my days doing CBT, exposures, interoceptives, and all sorts of things I'd love to further explain in a future blog post. For now, I'll just give a short description of CBT, the kind of therapy Rogers operates on. CBT stands for cognitive behavioral therapy, and since Rogers uses a form of this therapy called ERP (exposure response prevention), it involves performing exposures. Exposures are based on things you're terrified of. You work with a therapist trained to perform CBT to find things that cause you anxiety, interfere with your daily life, or your mental illness makes frightening due to distorted thoughts. Then, you perform that action over and over, all the time recording what your anxiety is as you begin and end each trial (one trial is one performance of the fearful activity, while five trials make up an exposure). While doing this, you're supposed to avoid coping skills (such as rationalizing the fear, telling yourself you're not in any real danger, etc.) and instead make the situation as bad as possible. (For example, let's say your fear was your family dying in a car crash. To make the exposure as effective as possible, you might tell yourself that you're unsure where your family members are and that it's storming badly outside; you might even run through what life would be like without them, or imagine the pain they would be in if they were injured.) The goal is that with enough repetition, the situation won't be as terrifying, and it therefore won't interrupt your daily activities when you imagine or encounter those fears. Rogers also takes some fears and creates more extreme exposures that probably won't apply to real life situations (for example, if you had contamination fears, they might have you eat off of a toilet seat); however, their reasoning behind this is that if you've gone to extremes, even if you regress a bit after treatment ends, you'll still be able to function more normally. Finally, interoceptives are activities that are supposed to mimic the effects of a panic attack so that people who get them can learn to work through them in a safe environment. Some interoceptives are breathing through a coffee stirrer, having yourself breathe as fast and deeply as possible, holding your breath, frantically shaking your head, running up and down stairs, and being spun around in a chair. 

     If you're anything like me, you're probably reading this and thinking something along the lines of Wow, okay, that's definitely not legal. Or safe. Or humane. Should we call the authorities or something? To that, my response is that I was you. To be honest, I still am you a lot of the time. When I first heard about CBT, I was in the third grade. The therapy was mentioned when my family was first needing to find more serious treatments for my mental health. As I heard about CBT, and later read about it, I kind of just sat there in frozen disgust and declared, "Nope!" anytime the therapy was mentioned. I "managed" for the next seven or so years. (When you grow up with mental health issues, "managing" is sometimes a keyword for "feeling absolutely miserable more often than not.") Last year, my mom and I heard of Rogers Memorial Health; the program had just opened up a new branch in Nashville, and it was a revolutionary program to us! However, with the emphasis of their treatment on OCD, we were wary. My OCD has always impacted my life—sometimes more than I realize—but it has never been nearly as bad as it was when I was in the third and fourth grade. Back then, it was debilitating. Every bit of every day was consumed by my OCD. So, all these years later, I felt that the program had come years too late. 

     Most of my life, my mental health has declined (spare my first couple of years of life and my fifth grade to sixth grade years). Sometimes it declines faster than other times, though. While some times I can feel myself slipping down a slight slope, the past few years have been a full-speed tumble down a hill. My parents brought up Rogers again last February, and for the sake of honesty, I was very uncertain. I'd been sent away from so, so many professionals. I'd sought help from so many places only to leave them worse than I'd entered them. Once I realized Rogers was inevitable, I asked if we could wait until summer for the sake of school. One thing that my mom said to me was that she wouldn't wait to get me treatment if I had a broken bone, needed my tonsils removed, etc. The first time I heard this, I stopped. I actually, physically stopped what I was doing. I talk about advocation for mental health so much. I try my best to educate others on mental health conditions and their effects. However, I wanted to delay my own treatment due to school. I don't think that was wrong, as I go to a very competitive and fairly fast-paced school. As well, when you have chronic illnesses, you can't take a break from life every time you aren't feeling well. If you did so, you would never leave your house; you learn to deal with things that wouldn't be manageable under normal circumstances. Finally, mental health often takes longer to aid than physical health. Whereas I would have gotten a cast and been back at school in a day if I'd broken a bone, most mental illnesses take months to improve even a bit, and even once things improve, they're often not perfect. Maintaining mental health to the best of your abilities is a lifelong process that takes a lot of time and dedication, and we live in a world that is used to quick fixes. 

     Going to Rogers was difficult. It was (and is) really, really hard. I was finally enjoying school a bit more when I had to leave yet again. I became isolated from my peers. I had to give up the few, precious activities I had left, such a playing and learning instruments. I had to prioritize treatment (which is every weekday from 8 to 2:30, is located about 40-60 minutes from home, and comes with about 2 hours of homework every night of the week) while still completing all my schoolwork. Due to my low weight, I was put in the eating disorder program at Rogers instead of the OCD one. It took the staff a couple of weeks to get to know me and my story and confirm that my weight loss was actually due to medication side effects, not an eating disorder. Even once that happened, since I'm in the ED program, I still have to abide by the same rules as the other patients.

    My time at Rogers has been one of the worst times of my life, but it's also shown me so much. It's shown me another level of strength I didn't know I had. It's shown me another level of perseverance I didn't know I possessed. I've shared a bit about my experiences with weight restoration. It's one of the worst things I have ever had to do. It is more painful than I could ever describe. It has been a year-and-a-half long process that has been of misery, tears, and setbacks; just the sheer length of my weight restoration journey (due to inaccurate medical information, and being hypermetabolic) has meant I've been worn thin by the process. (No pun intended, though I'll admit I did smirk when I caught this phrase during editing!) It has pushed me to my limits and then some. It has been full of people underestimating how excruciatingly painful it is, physically and mentally, to spend your entire day eating. This has been my life every day for so long now. With help from Rogers, though, the pain is paying off. A few weeks ago, I officially found out that I'm weight restored. My activity level is being able to be increased, and my meal plan is slowly decreasing. It's been a slow process. It's been a terrible one. It's worth it, though. Life isn't meant to be lived sedentary so that you can't do any of the activities you enjoy. Life isn't meant to be lived constantly twisting and turning in chairs, baths, and even plush couches, because there's nothing to prevent your bones from digging into the surfaces. Life isn't meant to be lived constantly trying to regain feeling in your fingers, toes, and hips, because you can't feel them for most of the winter. Life isn't meant to be lived where you're so weak you can hardly hold your schoolbooks. Life isn't meant to be lived with brittle hair and nails and painfully dry skin. You shouldn't have to resort to the children's section, because even the smallest teenage and adult clothes swallow you whole. Life was miserable when I was dangerously underweight, and even though the path to becoming healthy hasn't been easy, I don't have a single doubt that my life is so much better because of it. 

     The same goes for my treatment for OCD, clinical depression, GAD, and tics. When I first went to Rogers, things got a lot worse in all these categories, and for the sake of honesty, they stayed worse for quite a while before improving. Mainly, my depression and anxiety were terrible, and that's coming from someone who has lived with those disorders for years. I felt upset and isolated. I spent almost every afternoon for weeks and weeks in tears because of how much I hated treatment, how upset I was at the increasing severity of my already debilitating conditions, and agitated that I had to leave my school and peers for treatment when I wanted to wait until summer. I've spent years trying to alleviate the strain of mental illness. I've done everything: therapy, numerous medications and dozens of doses, seen many specialists, and done all the things that can sometimes alleviate mental health issues a bit (like exercising when I was healthier, making myself do the things my depression makes me want to avoid, etc.). It's upsetting to not know what it's like to be healthy. It's discouraging when specialists send you away with nowhere to go because they don't know what else to try. It's isolating when people don't understand what it's like to live with mental illness, or they underestimate it. That's all I knew, and it made me wary of sacrificing so much when I wasn't convinced it would help at all. Treatment has helped, though. I'm not cured. I don't feel miraculously better. I see small improvements every day, though, and I'm trying to enjoy each and every one of them. 

     On week eleven, my treatment was finally downgraded. Whereas I was in a partial hospitalization program (PHP) for 10 weeks, May 15 was my first day in an intensive outpatient program (IOP). This means I now only attend Rogers from 11-2 every day. This change is exciting, but it's also nerve-racking. Changes have always been hard for me, even when they're really good ones. I just keep trying to tell myself that this is perfect practice for the real world (as I so affectionately refer to life outside of hospital walls). With any luck, I'll be out of Rogers in 4-6 weeks from that May 15 date. The rest of the summer will be dedicated to finishing up the school year and getting ready for the one ahead. I'll still have therapy every week, of course. My mental illnesses aren't the kind that are typically cured in the way many people associate the word with (where the afflicted never suffers from the illness again). Life will be more normal, though, and more manageable. I've been just getting by for the past 16 years, and that's not something I should have to deal with for the duration of my life. My family's hopes were that this investment of a few months at Rogers would reap a lifetime of benefits. I can't attest to that, of course (I'm not even through with treatment yet!), but I can say that I've seen improvement thanks to the supportive and skilled team at Rogers and the support from my family and friends (the other kids I've met at Rogers have been absolute lifesavers these past 13 weeks). For that, I'm thankful. 

     Most people can never understand the mental and physical toll mental illness takes on a person, and that's hard to come to terms with. I want to help bridge the gap, though. That's why I've used this blog to share some of my story, even though it terrifies me to do so. Knowledge leads to understanding, and understanding leads to sympathy, and sympathy leads to less suffering for those who are already in so much pain.