Bipolar Mixed State: Into the breach

This week has been extremely difficult. I have been in the throes of a bipolar mixed state. This means that I am simultaneously experiencing a depressive and hypomanic episode. This means that I have been dealing with rage and agitation while simultaneously being too exhausted to move. It is like being at war with yourself. Like hypomania, there is no sleep, but unlike hypomania there is no excess of energy. There is no elation. There is no abundance of life. Instead you are morose, sad, and teary.

Battle

Photo courtesy of New Old Stock

I have spent the week trying to tamper the rage and muddle through my responsibilities with the exhaustion. The anger comes in waves. No, a wave is too gentle for what happens. The rage is more like a tsunami. The sheer force and violence picks me up like I am nothing more than a shred of paper. It thrashes me about until I am bruised and battered. My skin raw and bleeding. Anger, like water, fills my nose, mouth, and lungs; it threatens to drown me. I try and scream, but all that comes out is a sigh. I try and fight it, swimming hard against its current, but it’s useless.

The anger suffocates me until, like the natural ebb of the ocean, it leaves my body. I am left exhausted and defeated. Going through the routine of my life after the sheer violence of the rage is like swimming through mud with limbs made of lead. But just as I feel that I have a handle on things, just as land is in sight, the water swells and pulls me back again into its watery violence.

In addition to bouts of uncontrollable rage, I have been battling intrusive thoughts that can be downright terrifying. Please know that these are different than suicidal thoughts. Although I do think things like — that’s a big bus, it wouldn’t be terrible if it hit me by accident and I died. I mean, everyone is plotting against me and would rather that I was dead. They all hate me. They all think I’m a drama queen with this bipolar disorder thing.

But of course no one is actually thinking these things. My brain deforms acts of kindness, acts of indifference, acts of the everyday into something twisted and ugly. The actions of other people are gnarled until they are unrecognizable and I question my sense of reality.

It is hard to focus on work and responsibilities when your life is a battleground and land mines are everywhere. But I persevered, because that is what I do. I survive, despite the way that I feel. I push myself into work, smile, socialize, do what is asked of me. I try even harder to appear normal. All the while I am fighting the rage, paranoia, and exhaustion. I really just want to crawl into bed, pull the covers over my head, and cry.

Drawn and quartered

I thought a Lego man was less grisly depiction of being drawn and quartered.

Perhaps I am so tenacious in this state because I have spent the last 29 years of my life being drawn and quartered. I imagine horses tied to each of my limbs and a mysterious voice yelling for the horses to pull. My limbs rip from my torso as I try and fulfill all of the demands of everyone else, rather than what I need and want.  The voice that commands the horses is constantly criticizing what I am doing and telling me what I should be doing instead, regardless of how I am feeling.

I am sitting on the couch and it asks, “Why aren’t you at the gym?”

“Because I’m tired from fighting my fucking life.” I always start out tougher than I feel. I always feel like I can argue with the voice.

“That’s no excuse,” it snaps. “You could at least be working on your novel or your blog. Isn’t that what you really want to do with your life? Write?”

“Yes, but I’m really fucking tired because this week has been really hard.”

“Hard, you don’t know what hard is. You’re a pampered princess. Do you know what’s hard? Those kids in Africa who have to walk 10 kilometers each way just to get water for their villages. That’s fucking hard.”

“I know, but -”

“You’re just lazy. You’re a useless excuse of a human. You are pathetic. You are worthless.”

And that voice usually convinces me to do something – whether it’s hit the gym, clean the house, work on my blog – even when all I really want to do is curl up and sleep because I have been battling the ghosts that paranoia brings and tampering the rage the swirls inside of me. Even though I have been doing all of these things that take incredible amounts of energy, it pushes me to deplete myself further and further.

But it wasn’t until Friday that I finally told that voice to shut the fuck up. I will write my blog post when I get to it – if I get to it. I will go to the gym next week when I have slept a solid eight hours. I will socialize when I no longer feel like everyone is against me. For now, I will sit on the couch and watch TV. And that’s okay. That’s enough. I’m enough. And surprisingly, the mood lifted just a little. If only for a little while.

Admission: Dispatches from the Psych Ward

[The next few blog entries are going to be about my time spent in the psychiatric hospital. There won’t be any chronological order to them as they are mostly snippets of my time. Some of the things that I talk about in the stories aren’t going to be politically correct and are a reflection of my own state of mind and lack of education in mental health at the time. Please don’t be angry by some of the snap judgments I made].

“Do you think you need to be admitted into the hospital?” My therapist asked me. I was at my weekly session in the outpatient treatment centre attached to the hospital. I had left work on my lunch break and drove across the city to make it to this appointment. Frankly, I was more concerned about getting back to work on time than I was about getting help.

“Of course I don’t need to be admitted into the hospital,” I scoffed at her. Although I had been battling with my mental illness for about four years, this was the first time anyone had suggested that I go into the hospital. I didn’t belong in the hospital. I wasn’t that crazy. I’d had some suicidal thoughts here and there, but surely these didn’t warrant being institutionalized, right? Besides, the hospital was for bad cases. You know, the one’s who were seeing the devil or thinking they were the reincarnation of Jesus. I was just depressed. I didn’t need to be locked up with the loonies.

“But you just admitted to having suicidal thoughts…”

She had me there.

This had been my first mistake; admitting to her that I was thinking about suicide. Sometimes I speak without thinking of the ramifications and in this case, talking about killing myself during a session was a major faux pas. You see, when psychiatric professionals hear the S-word, they immediately go into action mode. I guess I looked like enough of a mess that I might actually act on my suicidal thoughts. That was my second mistake. I didn’t look as put together as I normally did. Frankly, I had been too damn tired to put on makeup. It had been days since I slept and I was losing touch with reality. So putting on eyeliner was the least of my concerns. Besides, the therapist had seen the fresh self-harm wounds from a mile away. Therapists are perceptive like that. My attempt at camouflaging them with bandages and bracelets was futile.

Although, i had already learned that the hard way at work. A female coworker had had called attention to the cuts on my arms and wrists.

“What are you trying to do? Kill yourself or something?” She asked, laughing hysterically as if she had just made the funniest joke in the world.

Imagine I had actually responded honestly?

“Yes, actually. Every night, instead of sleeping, I cut myself because the anxiety I have is so intense that I feel like I  may actually explode. The cuts act as release valve on the pressure I feel. And you know what? While I’m cutting, I’m actually thinking about ways to kill myself that would be the least inconvenient for everyone. Wanna hear what I’ve come up with? The best way to commit suicide is to take all of my medication with a mickey of vodka. What do you think?”

But because I’m depressed and frankly don’t have that sort of personality, I simply ducked my head and vacated the scene for the washroom before bursting into tears.

“I can’t go into the hospital,” I said to my therapist. “I have to get back to work. They can’t function without me.”

“Do you really think that?”

In response, I burst into tears. In my mind everything was dire, end-of-the-world serious. And so yes, I did actually think that if I didn’t return to work the world would, in fact, stop rotating on its axis.

One Flew Over the Cuckoo's Nest“Marisa, I’m going to see if there’s a bed available for you today.” She handed me a tissue as she got up from her desk. She was a blur of grey hair and beige clothing as I watched her leave the office.

The familiar prickle of anxiety was forming in my hands and feet. Unable to sit still any longer, I got up and began pacing in her office. All I could think of was One Flew Over the Cuckoo’s Nest with Jack Nicholson. Images flashed through my mind of Nicholson convulsing on the table as he received ECT. Do they even do that anymore? Would they do it on me? Or what if they just injected me with a whole bunch of medication and I was just one of those zombie patients doing the sedation shuffle across the ward? I could almost hear the raving lunatics screaming in the night, begging for help.

“You’re lucky,” my therapist said as she came back into the room breaking me from my imaginings. “A bed just became available.”

I laughed out loud. Lucky? How the fuck was I lucky? I was going to be institutionalized. 

Later, when I would be hospitalized for a second time, I would realize that I really was lucky that day. Psychiatric beds are hard to come by and my second hospitalization included a week-long stay in emergency because there were no beds. The psychiatric ward is bad, but staying in ER for a week before you are transferred is even worse.

“Do I have to go?” I asked, tearing at the tissue in my hands. My stomach was a tight knot and I felt like I could puke at any moment.

“Well, I can’t force you into the hospital, but I strongly recommend it,” she said gently. “We’re able to make more dramatic medication changes when you’re hospitalized and hopefully get you sleeping. Wouldn’t that be good?”

I shrugged. “What about work?”

“You’re not going back to work,” she spoke more sternly this time. “You’re sick, Marisa.”

A different person would have protested and fought, but I have been conditioned to obey authority figures and defer to their professional opinions. If my therapist thought I should be in the hospital, I should be in the hospital. Despite my reservations and fears about the whole thing, there wasn’t any arguing to be done.

“But what will I tell work?” I asked, always worrying about how I was going to disappoint someone. “I have shifts this week.”

“Your’e going to call them and tell them that you’re going to be admitted to the hospital for an illness. But you don’t have disclose what.”

So I called my mom who then called work to explain the situation. And when I was released from the hospital, I never went back for fear of embarrassment. I don’t even think I collected my last pay cheque. At least I never had to see the bitch who made fun of my self-harm scars again.

To be honest, I don’t really remember how the next few hours proceeded. My parents showed up to the hospital with a bag packed with my things and before I knew what was happening I was being herded into the psychiatric ward.

As they buzzed me into the ward, I was hit with the sharp smell of antiseptic and sickness. There’s something about the way that sick people smell that makes me nauseous. But the psychiatric ward had the added scent of greasy hair and unshowered bodies. I understood what it was like to be depressed and unable to shower, but in that moment I swore I wouldn’t become like one of those people. I vowed that I would shower every day. That was, until I realized how inconvenient it was to shower on the psych ward.

Taking a shower was a multiple step process. First, you had to get the attention of the nurses at the nurse’s station. Then you had to ask if you could take a shower because one of them had to be on duty outside of the shower room. If no one was available, you’d have to come back later. If someone was available you would then have to go through the process of collecting your shower products. Once you were in the shower, you would be interrupted every few minutes by a nurse asking if you were okay.

Eventually, it became easier just to not shower. Besides, who’s seeing you except your psychiatrist and your family who came to visit? And as I would learn, looking disheveled got you taken more seriously by your psychiatrist than looking clean and shiny.

After being admitted into the ward, I was escorted to my room. I cried as I walked down the long hallway, clutching my pillow at my chest. I glanced into one of the rooms as we walked by and saw a woman sobbing into her hands on the side of the bed. I couldn’t believe my mental illness has gotten me here. I know my therapist thought this was the best place for me, but surely it wasn’t. This had to be a mistake.

Crazy Cat LadyFinally, we stopped outside of one of the rooms. As I entered, I was horrified to see that I would have a roommate. The curtain that divided the room was pulled back to reveal a sleeping woman in her 80s. She looked like Eleanor Abernathy, a.k.a. the “Crazy Cat Lady,” from The Simpson’s.

I had never shared a room with anyone, let alone a complete stranger. What if she had a psychotic break in the middle of the night and tried to kill me in my sleep? Or what if she screamed in the night? She was the personification of what every crazy person ever looked like.

Seeing the fear register on my face, my mom said, “Well, at least she doesn’t look chatty.”

And she was right. “Eleanor” wasn’t chatty because she had some how lost the ability to speak. She had extreme dementia and her family had dumped her here when they couldn’t handle her any longer. Her meals were brought to her room, but she barely ate. She was on so much medication to manage her dementia that she spent most of her time sleeping. The strangest thing she did was pee with the door open and the light on. Once in a while she would scream in the night, but I couldn’t possibly begrudge her that because I felt so terrible for her. I never once saw her family visit.

The nurse ran through the rules of the ward and then searched my bag for contraband (i.e. things that I could possibly use to kill myself with, which included my tweezers in my makeup bag. For some reason, makeup seemed like a good thing to bring to the psych ward). They also confiscated my purse and they would have kept my cellphone and charger had I not hidden them in my pocket.

Then the moment came when my parents had to leave. The nurse left us alone in the room and I started to cry again. Some words were whispered about this being the best thing for me and how they would come and visit every night. I wouldn’t be in here very long.

And then they left. Leaving me alone with my snoring roommate and my fear.

Working with a mental illness

High stress workplaces and overworked employees aren’t anything new when it comes to North America. However, recently The Atlantic reported on a working paper from Harvard and Stanford Business Schools that investigated the impact that job stress had on the health and mortality of American workers.

“The paper found that health problems stemming from job stress, like hypertension, cardiovascular disease, and decreased mental health, can lead to fatal conditions that wind up killing about 120,000 people each year – making work-related stressors and the maladies they cause, more deadly than diabetes, Alzheimer’s, or influenza.”

It’s incredible that 120,000 Americans are dying each year because of workplace stress. It’s not particularly surprising when we think of our climate of work and our glorification of busy. If you’re not busy, you’re worthless! We base our value on how many things we are able to achieve in a day. If we’re not exhausted and exasperated at the end of the day, then our day wasn’t worth anything. If we can’t complain about how tired and busy we are, our lives don’t matter.

Hamster wheelI have been on sick-leave for the past 5 months and have stepped off of that hamster wheel of stress, Only now have I been able to look critically at my work self. I already knew I was a perfectionist workaholic (I take after my dad in that regard). But, I hadn’t realized that I had been conditioned to say yes to everything and respond to additional work with a smile and can-do attitude because I was told that’s what team players do. That’s what hard workers do. That’s what people who get promoted do.

But it’s not.

That’s what doormats do.

That’s what people who cannot establish boundaries do.

Now that I have established distance from work, I recognize that it wasn’t just unmanageable workloads and difficult colleagues that caused my latest relapse (although they were major players). It was my inability to ask for help and not establishing boundaries with colleagues that really made me sick. If I had the strength to tell my boss sooner that I was floundering under the weight of my workload instead of trying to do it all, maybe I wouldn’t have relapsed. Now I can see that the workplace may create stress, but only I have the power to stop these situations from impacting my mental health.

WorkingThis week I will be returning to work. It will be a gradual return that will take about 8 weeks until I return full-time. To say that I’m nervous is an understatement. I am terrified that being thrust back into the pressure cooker will completely destroy me this time around. All of these realizations that I have had about my role in my own sickness are great, but will I actually be able to say no? Will it be possible for me to do my job without making myself sick? I run through hypothetical scenarios with my therapist and in those moments I can say: “No, I have too much to do. If you want me to complete that task then you will need to take something off my plate.” But when it comes down to it, will I actually do it?

I hope so and I’m going to try my hardest.

Whether you have a mental illness or not, boundaries are critical in maintaining good mental health as the Harvard and Stanford paper illustrates. However, as someone with a mental illness, I must recognize my limitations and work around them. I have to understand that asking for help isn’t a sign of weakness, but a sign of strength. My ability to say no will not only benefit my health and future, but it will also benefit my employer.

Wish me luck!

Surviving the holidays with a mental illness

Keep CalmThis post was supposed to offer self-care and survival tips for the holidays, but then I realized that I have none. I’m still struggling to find strategies to cope when my world is moving at warp speed and my chest feels like it’s about to explode, so who am I to offer solutions?

I read other mental health articles about how to survive the holiday season with a mental illness and I could just rattle off their information, but that seems disingenuous.

When I started the sharing my mental health story, I promised myself that I was going to be extremely candid about what has happened and what is happening in my life. I never wanted to give my readers the impression that I have everything figured out because the reality is, I don’t. Not even close.

So this is more like my, what’s making me stress out this holiday season post.

For most people, going home for the holidays is already stressful with travelling, pushy relatives, over eating, and over spending. But for someone struggling with their mental health, the holidays are laden with triggers that you try and avoid, but they’re hidden like landmines. They’re unseen and unsuspected, until it’s too late and you’re blown to pieces.

In the lottery of parents and inlaws, I have sort of hit the jackpot. Horrible parenting stories are are a dime a dozen and even more common is the trope of the out-law in-laws. I’m extremely lucky to have none of that. I know I am well loved by both sets. My husband and I are also lucky because we have hometown friends that we still get together with. Despite our luck, we still feel the pressure, self-inflicted for the most part, of balancing our time. It’s like a dance of when to stay where and for how long and when to see which friend without our families feeling jilted. We are continually caught in a cycle of trying to please everyone and ensure no one feels neglected or slighted. Except this year, on top of the usual balancing act, I need to carve out enough time for me to stay sane. And I don’t mean that in a flip, hyperbolic way. Finding time and space for me is integral to my recovery.

Depression ball and chainI, and everyone around me, needs to recognize that I am not functioning at 100 per cent. My moods are like a roller coaster and I’m just along for the ride. I’ve been off work since October  and despite the reprieve, I still have that shell shocked feeling of being over stressed. I still bolt upright in the middle of the night, sweating and panting, wondering what I have forgotten to do. I’m on a new medication regimen and it has caused major agitation that is sometimes unmanageable. My anger is sometimes so intense that I feel like my body may spontaneously combust. When the rage is at its apex, I’m afraid of even opening my mouth for fear of what might come out. This is why I haven’t been at work. This type of behaviour often leads to unemployment sooner rather than later.

Beyond the terrifying anger, my ability to perform day-to-day tasks has decreased dramatically. I get tired and frustrated very easily. A simple task, like grocery shopping, has become the bane of my existence. Not only do I have to interact with people in a confined space, but I become exasperated when our store runs out of products. A few weeks ago, I almost had a meltdown in the middle of the store because I couldn’t I was cooking french onion soup and our store didn’t have gruyere cheese. If it hadn’t been for my husband offering to check the store across the street, I would have deserted the cart and fled the store in tears. This is my reality – I have meltdowns (pardon the pun) over cheese.

But it isn’t always like this, these are only the most difficult days. Most of the time, I just want to be alone and quiet. My current situation allows me to have a lot of time by myself.  My husband leaves to school during the day and comes home only for lunch and dinner. This leaves me alone to go for a walk, write, maybe run an errand or two, workout, and watch A LOT of daytime TV.

Other than my husband, therapist, and doctor,  I don’t really talk to that many people and that’s fine by me. Right now, in person social interactions are exhausting. For every one day that I socialize, it’s like I need two days to recuperate. So what am I going to do over the holidays? How do you explain that to people without their feelings getting hurt?

You're not a burden

Image source: Emm’s positivity blog.

It’s not that I don’t love my friends and family because I do. They’re everything to me. But, despite my physical body being strong and healthy, I’m unwell. I haven’t been around people in a constant way in three months and that makes me incredibly nervous. I’ve learned now that when I start to emotionally unravel at the seams, I have to crawl into bed with a book and be quiet for an hour or two before I feel like myself again. But that’s hard to do during in the middle of Christmas dinner or New Year’s Eve festivities. My two best friends have had major life events happen – one recently got engaged and another just bought a house – how do I explain to them that getting together to have a glass of wine or a coffee can seem daunting? How do I explain to my sister that Christmas shopping for mom and dad seems terrifying? How do I tell my in laws that despite the fact that I love their company and am so happy they are letting us stay with them throughout the holidays, I just really need to be alone right now? How do I say to my mom, please just don’t ask questions about my mental health or work because I just can’t handle that conversation?

There’s not a single mental health blog out there offering tips for these holiday problems and that’s because no one can answer these questions for me, not even my therapist. She and I have, undoubtedly, come up with coping strategies but how do I deal with hurt feelings?  It’s not that I don’t want to stay with my in-laws or have that glass of wine or go shopping, it’s just that simply getting out of bed in the morning can sometimes be difficult.

I need a wide berth by people right now, but I think it’s difficult for people to recognize this when you’re physically healthy. I look the same and may appear functional, but it’s important to remember that I’m not. I’m raw, on edge, and my brain is broken.

How do you survive the holidays when you’re struggling with your mental health?

If you need help coping, here are some of the articles that I read:

Pregnancy & mental health; or how one psychiatrist told me I shouldn’t have kids

When I participated in an inpatient program, I met a woman whose family had a doctor perform a full hysterectomy on her when she was eighteen (she was now in her late fifties) because of her bipolar disorder. Her family and doctor both believed that she would be an unfit parent and they didn’t want to risk her having a child that could also develop the disorder. I was terrified by this story. This woman had not only endured a debilitating mental illness, but she had to endure it when compulsory sterilization was a reality for those in psychiatric hospitals.

quotes-1109Fast-forward to 2012, a Massachusetts woman with bipolar disorder and schizophrenia was forced to have an abortion and be sterilized. In 2013, an Italian-born woman had her baby forcibly removed by ceasarean and taken into child services by the UK government because of her mental illness.

As a woman who is married and still deciding whether or not I want to have children, the stigma toward pregnancy, motherhood, and mental health is concerning. But until two years ago, these were just stories I had heard or read about. Then I had my own, although much less traumatic, experience.

It was December (I remember because it was my birthday) and I had a consultation with a new psychiatrist. Like I said in a previous post, I’ve never met a psychiatrist I liked and I was certain this was going to be just another name on my list. I never thought it would probably be among the worst psychiatrist visits in my life.

As I sat in the waiting room, I knew who was waiting for me. It was undoubtedly going to be a man (they’re always men). He was going to have glasses (they always have glasses). He was going to be slightly disheveled (they’re always disheveled). He was going to ask me questions about my history that I feel guilty and embarrassed about. I was going to cry. He’d ask me why and I’d incoherently try and explain myself through my tears. It would be awful, but then it would be over.

You might be wondering, why is a psychiatric assessment so terrible? It’s because it’s not just just a doctor glancing at that mole on your shoulder. You’re sharing your most personal and more often your most shameful experiences.

Facepalm

When it’s so embarrassing, you need a double facepalm.

Imagine the most embarrassing moment of your entire life. Maybe it was that time you farted during your sixth grade presentation or that day in tenth grade when you walked around with your skirt tucked into your tights ALL DAY. Whatever it is, imagine that moment and remember the fear of judgement, the embarrassment, and the shame you felt. Now imagine retelling every mortifying moment to a stranger on the bus.

And you’re not just retelling the story to a passive audience, your listener is asking questions. What did the fart smell like? What did you have for lunch that day? Have you ever farted in public before then? Does your family have a history of public farting?

These questions make you relive not only the embarrassing moment itself, but all of the moments that led up to the incident. Now you regret eating beans at lunch because you should have known better. Your family has always whispered about your Uncle Frank’s 1965 broccoli incident.

And as he asks the questions and you answer, he takes notes. Endless notes. You try and peer over his clipboard to see what he’s scratching, but you can’t see. He holds it close to his chest. And with those notes, he makes files – files that you are never privy to – even when you ask (trust me, I’ve asked).

That’s what makes the process of retelling your history to one psychiatrist excruciating.

When my name was finally called, I followed him into the office that now felt claustrophobic with the two of us inside. I quickly launched into the gory details of my illness. (It’s like ripping off a bandaid – do it quick and the pain lasts only a second).

We sit silently for a moment as I dig through my purse looking for a tissue (it’s not a psychiatrist visit without some tears!). Just as I find an errant tissue, he inhales and asks, “Are you thinking of becoming pregnant?”

I pause, momentarily stunned by the question. I’d seen a lot of psychiatrists, but none of them had ever asked this before. After a moment, I reply. “Not any time soon.”

“You know it’s dangerous to become pregnant while on these medications,” he replies, ignoring my response as he makes more notes on his clipboard.

“Yes, I know the risks involved.” My back is up, I’m feeling defensive. “But I’m not thinking of getting pregnant soon.”

“Good, because it’s dangerous and not just for you. We don’t know the risks of medication use on the foetus. It could cause birth defects and other issues. It’s not 100% but there’s still a risk. You need to know all of this before you become pregnant.”

“Yes, I’ve spoken to my doctor about it before. But since I’m not planning on getting pregnant any time soon, we figured we could revisit the issue when I’m making that decision. I don’t even know if I want kids anyway.”

He looks up at me, cocks his head to the side and adjusts his glasses before looking back down at his clipboard. “You know that your disorder is genetic.”

I nod, feeling my cheeks flush. He interprets my silence as misunderstanding. (I forgot to mention that psychiatrist’s are always condescending too).

“That means that it’s passed down,” he speaks slowly, emphasizing every syllable, “through the family…”

“I know what genetic means,” I spit through my teeth. There’s nothing worse than people thinking that you’re stupid.
“So you know that there’s a possibility that your child could turn out like you.”

10712840_10100467498047785_6912168116314759968_n

Wonder Woman perfectly encapsulates my outrage

I stare at him aghast, floored by the words coming out of his mouth. Apparently he thinks I’m some kind of monster that shouldn’t procreate! Would it be so terrible if I had a kid and they had bipolar disorder? I wouldn’t wish my disease on my kid, but my life isn’t horrible. And I imagine that if my child did have a mental illness, I’d have the tools to help them cope.

I suddenly tried to imagine my life without children. Where once it seemed like a choice, now it seemed like it was something being forcibly taken away from me. Anyone who knows me knows that I hate being told what to do and this doctor was suggesting that I shouldn’t have children.

For the first time in my life, I desperately wanted children. I wanted a hoard of them. I wanted to raise them to be healthy and happy and then I wanted to thrust their beautiful cherub faces at him as proof, see they’re fine! I can be a mother!

I was so angry, and hurt, and completely shocked by his implications that I don’t even remember how the appointment ended. All I can remember is leaving the hospital with tears streaming down my face, thinking, it’s my birthday. He ruined my birthday.

It’s been two years since that appointment and I have shared this story repeatedly to illustrate the pervading stigma and fear that exists towards those with a mental illness. My experience is no where near as traumatic as someone who was given a forced hysterectomy or a forced abortion through the collusion of families, friends, and doctors. But I tell this story to illustrate the point that medical professionals are still deeply uneducated when it comes to discussing mental health and parenthood. These comments came from a man who is supposedly educated in the field. This is a man treating a vulnerable population. This is a man who is using his authority to spread fear and misinformation.

Although my husband and I still haven’t decided if and/or when we’ll have children, the hurt and anger of this encounter linger. Some days, when I see my friends with their babies, I think “I could do that. I could be a mom one day.” And then I hear his voice, “but they could turn out like you…”