Single-Malt Workohol

Despair is a heavy burden, and I bear its weight by working out.

I am not diagnosed with depression or anxiety, but there are days when I wonder whether I should be. Hints of how I deal with anxiety are scattered throughout my writing, but depression is a rarer visitor. I’ve avoided any real accounting of my depressive symptoms of episodes because of one peculiar fact: they’ve been incredibly useful to me.

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Single-Malt Workohol
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Disability Misery

I’m multiply disabled, by whichever model you use. I am on disability assistance and I live in Canada where I even have access to healthcare. Given all this, you might think that the fact that I still have disability related depression, that I am proof that disability really is misery. That the medical model is right.

I want to make this really easy to understand.

I’m not miserable because I’m in pain.

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Disability Misery

When Depression and ADHD Collide

Ever since I discovered and wrote about the importance of treating ADHD if one also has depression, I have found myself thinking a lot about why this is the case. I’ve floated hypotheses that it has to do with regulating brain chemistry, since both conditions can be caused my imbalances and it is not unreasonable to think that the two might interact in some way.

I was lying in bed, my mind racing and thinking about the dozens of different things that my mind seems to decide must be thought about as I desperately attempt to fall asleep, that I began to think about the many ways that the two mental illnesses present in terms of symptoms. The more I thought about it, the more I realized the myriad of ways that the two reinforce one another. Continue reading “When Depression and ADHD Collide”

When Depression and ADHD Collide

When Society Echoes your Troll Brain

CN: Discussion of Ableism, Mental Health, and Suicide

If you suffer from Anxiety or Depression, or have friends and family who do, you may be familiar with the concept of troll brain. It is the thought manifestations of your disorders: lies your own brain tells you in order to prey on your fears and insecurities. Part of learning to cope with anxiety and depression is learning to recognize those thoughts that are lies, which are your brain trolling you, and separating them from your real thoughts. It’s not easy, especially since your brain obviously knows you better than anyone else. It’s the manifestation of all of your fears. That you are worthless. That no one loves you.

But what happens when society reinforces the same ideas as your troll brain? What happens when the message you are given everywhere you look reminds you that the vast majority of society agrees with the lies your brain tells you. This is the reality for many disabled people. In some cases it is a contributory cause of their depression and anxiety.

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When Society Echoes your Troll Brain

The Cruelty of Hope

People say a lot of things about hope.  It’s an endless positive, the core of vital optimism that prevents people from descending into despair.  People claim it’s audacious to be hopeful, a bold statement of the inevitability of future improvement.  Heroes are powered by hope, defined by hope, sustained through their darkest moments by hope.  Hope is what we offer each other when we are wounded or scared: This isn’t forever.  Things will get better.  You can get through.

Hope is dangerous.

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The Cruelty of Hope

It’s All in Your Head:

The false dichotomy between physical and mental illness

It used to be thought that different illnesses were the result of demons and evil spirits. In the bible for example there are instances of epilepsy that are treated as demonic possession. As physical explanations were found for different disorders, the supernatural explanations were abandoned in favor of scientific ones.When it comes to mental health disorders however, physical explanations are harder to grasp and find. Not because they don’t exist, but rather because a lot of brain related research is either not possible with our current technology, or must be undertaken with great care for ethical reasons.  As a result, our society has created a separation between physical illnesses and mental ones.

On some levels, this separation make sense. When we think of physical illness or disability, we think of some physically embodiment. Take Crohn’s for example: with the right equipment one can point to the inflammation and ulcers in my intestines as an explanation of why I am feeling the way I am feeling. With mental illness, however, a lot of times we are dealing with something a bit more intangible: emotions and thoughts.

This separation is a false one however, that actually creates a lot of misunderstanding and harm. Because we see mental illness as dealing with something intangible like emotion, there is a social perception that mental illness isn’t real. That it is “all in your head”.

The truth is that mental illness is as much a physical thing as any other illness or disability. The brain is as much a part of the body as a leg or intestines. Depression, anxiety, and other such conditions may manifest themselves in part as emotions and thoughts, but those are expressed symptoms of underlying conditions in the same way that pain is an expression of inflammation or injury.

Moreover, it ignores the fact that all perceptions are “in our head”. If you consider pain, for example, while our bodies processes the injury causing the pain at the point of injury, the actual experience that we call pain is processed in our brains. This doesn’t mean pain doesn’t exist. In fact, we know that pain not only exists, but it is necessary for our survival. We know this because of individuals with CIP (congenital insensitivity to pain), a condition where people cannot feel physical pain. People with CIP need to consistently measure their body temperature and be very careful because it is possible for them to injure themselves, like break a bone, without realizing it.

Every tactile experience, every visual one, every auditory one is processed “in our heads”. If you say that mental illness isn’t real because it is “in your head” you are essentially saying that every experience we have isn’t real. Our whole lives are lived in our heads.

There are physical symptoms of mental illness as well. Many people who have depression experience joint pain, as well as fatigue. Anxiety can cause your blood pressure to spike, can cause chest pains, nausea, acid reflux, and a whole host of other symptoms. There is absolutely a physical component, so treating it as if it is something separate ignores important aspects of mental illness.

Moreover, treating mental illness as separate from physical illness or disability, ignores the fact that physical disabilities and illnesses often occur in conjunction with certain mental illnesses. Specifically, many people with disabilities have more risk factors for depression, anxiety, and PTSD. This can be the result of the imposed social isolation that many people with disabilities experience, or in some cases may be a result of their illness. For example, Crohn’s Disease, in addition to the pain and physical symptoms that can increase the risk of depression, the inflammation of the intestines can also lead to a lower absorption of Vitamin D which can result in depression.

Because physical and mental illness are treated as separate, those of us with disabilities are not given adequate access to mental health care. In an ideal world, every person with a chronic illness or disability would be given access to a mental health professional who would manage their mental health in conjunction with their physical health. The connection between the two would also make it easier to argue for social contact as an accessibility need.

The way the world is set up now, people with different types of disabilities experience social isolation as a matter of course. This can be as a result of symptoms, or often as a result of insufficient accessibility. Because mental health and physical health are seen as separate, the idea that disabled people are prevented from being able to socialize effectively due to barriers such as transportation or even just on-site accessibility, is not seen as a big deal. Government officials see closing down programs and businesses that encourage and enable disabled people to socialize as risk free. People feel the need to vandalize playparks that are set up to be accessible to disabled children.

The false dichotomy is actively harmful to all disabled people. It enables people to ignore the needs of the mentally and the physically ill. It is meant to divide and shame. It is meant to pit us in false competition with one another, in the hopes that it will distract us from the systemic ableism that is so ingrained in our society.

It’s All in Your Head:

HOW ADHD SHAMING ALMOST KILLED ME

TW: Discussion of Depression and Suicidal Ideation, descriptions of self-harm.

Just getting diagnosed with ADHD was a struggle. I remember the doctor I was seeing at the time giving me a lecture about drug seeking behaviour. When I pointed out that there were easier ways to get drugs than trying to get an appointment with a psychiatrist she relented but asked me why I wanted to be diagnosed if I wasn’t in school anymore.

The cultural perception of ADHD is that it is just a matter of too much energy. You hear all sorts of people extolling the virtues of good old fashioned exercise, or warning people about the dangers of giving children drugs similar to amphetamines. No one takes the time to think about how medications work. This is evident when they start talking about Ritalin or Concerta being the sit down and shut up drug.

ADHD changes the way you think. Not what you think, but rather how you think. It falls into the category of brain conditions that are considered neurodivergent.  It also has a high rate of comorbidity with autism. It’s not just “undisciplined” or “lazy” kids who need more exercise, it causes structural changes in the brain and can even impact how you react to different medications.

Most people however still have a hard time believing that the condition even exists.

Continue reading “HOW ADHD SHAMING ALMOST KILLED ME”

HOW ADHD SHAMING ALMOST KILLED ME

From the Ashes

Four years ago today, my house burnt down. I still remember the call. I was home sick, staying with Alyssa at her place near campus, when my roommate called me. At first I thought it was all part of some elaborate joke, before she started telling me that the roof had caved in, and that firefighters were still there trying to put it out.

The fire had started at our neighbours’, and then to our building. After hours of fighting a fire that ended up consuming three houses, they finally had to bulldoze the building to the ground. I lost everything.

In many ways I was lucky: I had a place to stay, I had a couple days’ worth of clothes as well as my laptop and charger from spending the weekdays at Alyssa’s. The university gave me a quick emergency grant and so I was able to buy some more clothing and replace the school books I had lost.

I had tenant insurance which helped me get a new apartment. In the meantime I had to make an inventory of everything that I had lost along with its approximate value.

Imagine that for a moment; losing everything. Imagine all the sentimental items you have, the photographs, your favourite book. There are things that can never be replaced that are gone forever. Just a few months earlier, my parents had taken the family to Poland to celebrate their 25 wedding anniversary. While there my aunt, who is an artist, gave me one of her paintings. I dragged it with us across Europe and back home. It hung on my wall for such a short time before it was lost forever. On the same trip my parents showed that they were becoming more accepting of my career as a writer by giving me a quill set. I had never even had the chance to use them.

I lost books that I had had autographed by favourite authors. Each of those had a story that went with it, like how I got to see Margaret Atwood talk about starting the Writer’s Union on someone’s front lawn. She said such nice things to me when we spoke and she signed my book. Or like Charles De Lint, who when my ex told him that I was a big fan brought a signed copy of his limited edition Yellow Dog. Those are keepsakes that cannot easily be replaced.

My yearbooks were all lost, as were the various awards I had won. Gone was the biology prize. Gone the various debating awards.

How do you put a price on all this?

In other ways however, I wasn’t lucky. Because of health related concerns and bureaucracy, I knew that in the next several months I would have to stop accepting aid for my parents. I had to save the majority of the check that eventually came in to pay for tuition for the next year. One doesn’t realize how much the various possession we accumulate over time add up until you suddenly have to replace them all at once. For years afterwards, even to this day, I have found myself missing some item, some tool, which I had had previously and been unable to replace.

A loss such as that, followed by years of poverty, can mean difficulty for a long time. Most of our furniture we found on dorm move out day, when people tossed the things they couldn’t bring with them. I don’t have a lot of clothing, and most of what I do have comes from Value Village.

The loss of my home sent me into a reawakening of my Crohn’s flares. Instead of getting better like I had been previously, I started getting worse again. I spiralled into depression which took me a long time to figure out. I absorbed the shock of the loss and became instantly numb, except that as time passed I couldn’t quite get feeling back. Numbness becomes oppressive after a while. You yearn desperately to feel again, but you almost can’t remember how. You laugh, but you don’t really feel joy. Tears fall from your eyes and you cannot stop them, but you don’t understand, because you don’t feel sad.

I wonder sometimes if I had been there, if I had seen with my own eyes, if it would have bestowed some form of closure, some acceptance of what happened. Even years later it sometimes feels like I just picked up and left everything. The fire ended up on Youtube, but it is still not the same. It is hard to believe that everything is just gone like that, and even four years later it doesn’t seem entirely real. I don’t know that I ever really grieved. There was never any time. There was always something more pressing. Maybe this is me grieving. And maybe someday I will be able to rise from the ashes, reborn.

From the Ashes

Worth Less

In my fights for women’s rights, I have been startled to see how often the issue had an important element of disability activism. Take abortion rights and access to birth control.  I am under consideration for being included in drug trials. My participation includes the need not to become pregnant.  In order to ensure this, it is important that I have access to birth control. This means that doctors or pharmacists who choose not to make birth control readily available don’t just take away my rights as a person to make my own medical decisions; they are actively putting my health at risk. In the event that I do get pregnant, having safe and easy access to abortion services is necessary. As long as I am not in remission, being pregnant is a serious risk to my survival.

Similarly, my atheism and skepticism is brought into sharp focus by my struggles with medical conditions. Responding to religious and anti-science pundits is a daily act for those of us who are disabled. We face woo on a personal level, with it directed directly at us from friends, family members, and authority figures. Even non-atheists are harmed by the lack of secular services available to help those in need within our community.

Disability activism highlights the importance of intersectionality since it can be the result as well as the cause of discrimination and marginalization. Many people who fall within the category of being trans, queer, women, people of colour, and so forth live with the very real risk of physical harm and abuse, and as a result are at risk for anxiety, ptsd, depression, and physical impairment resulting from violence.

If we define disability as a physical or mental barrier from successfully and/or comfortable navigating our society, then race, gender, sexual and gender orientation, can all be seen as being disabilities. Perhaps disability activism should be then seen as changing the world in such a way as to make the whole world more accessible to people of all genders, orientations, races, religions or lack thereof, and physical and mental ability. Where potentially other social justice concerns differ from disability is that in the case of the former, the barriers are almost universally external, whereas in the case of the latter there do exist internal barriers as well, which may be further strengthened by the external.

Our society has such a negative attitude towards disability however, that even people that fall into the socially accepted definition of that category struggle against being labeled as such. “I’m sick, but I’m not… you know… disabled.” It is hard to make the argument that disability is in any way a positive. Disability is painful, whether mental or physical. It makes your life harder. It can make it difficult to live a life that is socially deemed as worthwhile or productive.  The personal aspects of disability won’t change, but what can change are the external barriers that exist in our societies. By changing our concept of normalcy from “white cis straight able bodied male who is financially secure” we can begin to change how our society handles differences.

Take mobility impairment for example. Most of our architecture and infrastructure is predicated on the assumption that people can walk. As a result, most buildings, sidewalks, and so forth are difficult to navigate for those of us for whom mobility is an issue. Where mobility disability is taken into account, it is usually in such a way as to be out of the way. Elevators are the most common solution, but of course elevators break down, are not consistently implemented, and in the event of an emergency such as fire, they are inaccessible.  Imagine if we had a paradigm shift and instead based our architecture on the idea that a percentage of the population is not mobile? What if we replaced all stairwells with ramps? True, ramps take up more space then stairwells as they have to have lower incline then staircases do, but such a change would not negatively impact anyone. In fact, it would be beneficial to more than just the wheelchair bound. Parents with strollers, for example, would have a much easier time navigating, as would anyone who relies on wheel-based carriers. There would be a lower incidence of injury as falling down a ramp is less physically intense then falling down stairs.

Our culture’s obsession with ranking relative value and worthiness is at the heart of many instances of oppression; white is more valuable than not-white, male is more valuable than female, cis is more valuable than trans, so forth and so forth. We do this with every aspect of our culture: someone who becomes a janitor or a blue collar worker is seen as less valuable then someone who majors in business. In fact blue collar or no collar work is seen as the domain of “stupid***” people, and anyone who is “stupid” is inherently less valuable.

People with disabilities struggle with the concept of worthiness, or more specifically worthlessness, in particular. Our culture values productivity above many other things and the definitions of productivity can be limiting. When you exist in a body that forces you to spend entire days in bed for no other reason than because the pain you feel makes it too exhausting to get up, it can be difficult to feel like you have worth. When you see your friends and family members have to rearrange their lives around you, you get caught thinking over and over again, is it worth it? You feel like a burden. You feel worthless since by conventional standards you are not a productive member of society.

By the standards of our current society, we are worthless, and we are introduced to this idea every day.  We hear about how people who rely on disability support payments are lazy. Every time someone talks about how they were “useless” because they spent the day in bed or at home, it is like a hot needle of shame shoved in our hearts. It is a reminder that as far as the majority of society is concerned, we are worthless.

Casual ableism is so prevalent in our society that in many ways what many would consider the most benign of insults, are actually terms most often used to marginalize people with disabilities. That’s so lame, dumb, stupid, idiotic, retarded*,  he’s so blind, slow, crazy, such a spaz, all these phrases and more have lost in the social memory the association with disability. And yet, that association exists. Imagine being a non-verbal child who knows that the designation for their impairment is used as a synonym for lacking in intelligence? Why is the opposite of cool or awesome a word that means having mobility impairment?

This casual ableism is prevalent in many social justice communities as well.  Often, little to no thought is given on how a given subject, action, and what not affects the disabled. Marches are organized without thought on how this limits participation by those who have difficulty with walking. Having sign language interpreters is the exception and not the rule. The activist behaviours most accessible to people with disabilities, the creation of online petitions, writing, Facebook posts, is given the dubious label of slacktivism. This term is given without consideration of how for some, these may be the only outlets for social change available to them.  Many in the community see nothing wrong with comparing religious belief to mental illness.

Within the feminist community, when calling out the gas-lighting behaviour that associates the word crazy with women, little to no thought is given to the inherent trouble with using crazy as a pejorative. What about women with bipolar disorder, depression, anxiety, ptsd? Is it ok to call them crazy since in some ways they are? Is it ok in that case to disregard what they have to say as unimportant, lacking in reason or merit?

When these concerns are brought up the thoughts are often dismissed as unimportant or at best thought exercises. When prominent atheist activists like Miri of Brute Reason have brought up the negative impact on atheists with mental disabilities to compare religion to one, the matter sparked some debate but no pressure existed to enforce a change of behaviour. The culprits had no fear of continuing their actions, even where they had previously done so to accommodate other social justice concerns.

In other cases where concerns over ableism or inaccessibility were brought up, they were met with hostility and immediate dismissal.

When members of the community are dismissed or forced out from their positions due to their illness, we do not see the same level of public outcry as if someone were let go for reporting harassment, or forced out due to their race, beliefs, or gender expression. The marginalization or discrimination against people with disabilities doesn’t cause scandals. It is as most a blip on the radar evoking the half-hearted response of “that sucks”.

Disability concerns are an after-thought at most, if that. When it comes to activism, disability doesn’t have the sex appeal of issues such as sexual orientation, gender, and race**.  When you are someone who struggles with disability and particularly with raising awareness of the issues as they exist within our communities, this dismissal creates a feeling of resentment. This is particularly the case when an inability to raise awareness on such issues means a continuation of the devastating impacts of living with these disabilities.

When a known member of the community struggled with potential homelessness as a result of their disability and inability to get the support they needed, the response was half-hearted at best despite the money being asked for being less than outrageous. Raising it took a long time, putting pressure on the person in question as homelessness loomed. This occurred around the same time that the response to an unknown preacher losing his job due to a publicity stunt involving atheism raised in the tens of thousands in a matter of days.

We as a community need to respond to the call to arms to support our own members. Members whose everyday struggles are a lived manifestation of the need for atheist and feminist activism; our members whose struggles are intimately intertwined with the professed concerns of this social movement. It is time to examine our own ableism. It is time to let wounded voices have a chance to speak. It is time to show the morality we claim of ourselves. A response to arms means more than just bringing awareness to a necessary social issue; it can quite literally save lives. I call on all those who call themselves humanists, intersecitionalists, to shut up and listen.

 

*I include the word “retard” here as a strengthening example, with full knowledge that it is becoming less socially considered to be benign.
**It is worth mentioning that when it comes to social justice, race concerns are dismissed more frequently than many of the others and is lacking in representation among our community concerns.
*** My use of the term stupid in this case is to illustrate how the term is used as a pejorative against people who have different types of intelligence. It was included with an assumption that I would continue on to explain how the term affects people with cognitive disabilities, but in the end chose not to include those paragraphs.

Worth Less

YSI Excerpt: Disability and Mental Health

When struggling with pain, constant fatigue, nausea, malnutrition, loneliness, and a variety of other symptoms, it is not hard to believe that it is common for people dealing with chronic illness and disability to be vulnerable to depression. Whether this is because at times everything becomes overwhelming, due to circumstances influenced or worsened by your condition, or because of deficiency in necessary vitamins and chemicals, it doesn’t ultimately matter. The result is the same: depression.

With all the concern about managing your apparently more serious chronic symptoms, it can be tempting to simply ignore the mental health concerns. It makes sense that you are depressed. Who wouldn’t be if they lived like you? You already have all these other drugs, do you really mean anti-depressants. It’s not like you are going to hurt yourself, you don’t have the energy. And even if you did, would anyone care? You would stop being a burden. No one would have to worry about you anymore. It would stop the pain…

Just like that the depression becomes severe and cause for concern. At the worst moments during a flare, you might be stuck indoors for long periods of time alone. You might be in a hospital bed, your only human interaction the occasional visitor and the nurses, not to mention the person who comes to take your blood every morning. Regardless of whether you see a lot of people or not, you are stuck in one place for a long time. Imagine having to spend your entire day in a small, somewhat uncomfortable bed.  The only time you get up is to go to the bathroom, and to do that you have to push an IV pole that is attached to your arm.

Even if you aren’t hospitalized, the exhaustion can create the same results at home. After a while it starts to drain you even further. Your life starts to stretch out before you, and endless miasma of pain and boredom. You don’t even have the energy to watch TV. You just want to lie in bed, and wish you could get up the energy to have a shower.

What can further complicate the situation is that symptoms of many chronic conditions and depression overlap: fatigue, difficulty falling asleep, lack of energy, pain, and so forth. It can be difficult to tell when you are dealing with one thing or another. Are you unable to get motivated because your Crohn’s kept you up all night, or because your depression is making it hard to care about anything? Is the exhaustion mental or physical? Is my joint pain a physical response to inflammation or to psychological pain? Moreover, sometimes physical pain can cause the psychological pain. It all intertwines until it is almost impossible to tell.

Despite the frequent connection between disabilities, illnesses, and anxiety/depressive disorders, the medical community still has a hard time understanding the correlation. Frequently depression, anxiety, or any psychological diagnosis is treated very negatively. Even if you have a documented disorder that you are getting treated for, a diagnosis of any psychological condition could mean a decrease in the quality of care. Suddenly, every trip to the doctor or ER becomes suspect. Some doctors will wonder if you are faking your symptoms in order to score drugs, while others will assume you are over reacting or confusing mental symptoms with physical ones. It creates a situation where there is an incentive for people with chronic conditions not to seek help for their related psychological conditions.

I have seen this manifest personally. The usual procedure when I come into the hospital is to be given an anti-nausea agent and pain meds. Regardless of whether they think I need to be admitted or not, the usual assumption is that if the pain is bad enough for me to feel the need to come in, then controlling the pain is a concern. On one such occasion, I noticed a slight change in how I was treated. Usually there is an effort to reduce my pain symptoms as quickly as possible. This time around, it seemed that there was a hesitancy to do anything about it. I was offered some anti-nausea medication, but not once was there even a mention of anything to do about the pain.

When the doctor came in to see me, the first questions were not about why I was there, but clarifications about my last visit to the hospital being labeled “psychiatric”. I was confused, having never come to the hospital for anything mental health related.  I wracked my brain for every time I had been to the hospital in the last few months: visit with my gastroenterologist, visit with my rheumatologist, weight management clinic…. Bingo. It seems that the clinic that my GI had sent me to to see about getting help in losing weight with the difficulty of Crohn’s and arthritis, registered as a psychiatric visit on my hospital file.  In combination with my medication for anxiety and ADHD, they has assumed that I had come in to be treated for something else. The pallor of having sought help for a mental health problem changed how they viewed my physical health. I never was offered anything for pain, and I was sent home without any satisfactory aid for what was wrong with me. For the first time I was given the answer that it was “just Crohn’s”. A condition that had such a profound impact on my life was suddenly seen as no big deal because of one tick on my chart that might suggest that I also had depression. That the Crohn’s might be the cause of the depression was never considered. That a person can have two things wrong with them and have them be equally valid and serious was never considered. No clearly, despite the fact that I had a documented condition, depression, anxiety, or any other form of mental health disorder had to mean that the pain was all in my head.

YSI Excerpt: Disability and Mental Health