I had originally assembled interviews from different individuals for a single article about attending school while living with a mental illness; the responses I got were so beautifully thoughtful that I couldn’t bear to divide them into sound bites and quotes. This is the second of that series; the first was The OCD Was My Part-Time Job: Living With & Healing From Obsessive-Compulsive Disorder. Thank you so much, JSA, for sharing your story here with us.
JSA Lowe can be found on Twitter, Facebook, and her website, Lycanthropia.net. She is a PhD student in creative writing and literature; her most recent chapbook of poetry, Cherry-emily, is forthcoming in September from dancing girl press.
My first depressive episode was actually my sophomore year of college, pretty typically. I can’t remember the name of the writer who notes that affective disorders rip through dormitories like an epidemic in students’ first and second years of college, but she’s right—a great number of us present with our first symptoms around that age. I’d had phobias and anxiety symptoms my entire life, as well as an on-again off-again eating disorder, but when I turned 18, depression hit me like a wet dull sledgehammer. My English professor even went so far as to ask my mother what was wrong; I brooded, turned anhedonic, wrote bleak journal entries, stopped talking to anyone. I wasn’t conscious at that time of any hypomanic or manic symptoms, just the overwhelming gray gray friendless depression.
Of course, while I still lived at home with my parents, I used the household structure and routine to prop myself up, and graduated from community college with a 4.0 and a scholarship.
But at 19, when I moved away from home and started at a four-year-college, which happened to be located in a cold and snowy climate (seasonal changes have always been a part of my mood swings), I hit the wall, and my grades took an immediate slump. I dropped out after one semester, having earned Cs and Ds for the first time in my life, stunned by the betrayal of my brain.
After that experience I felt crazy, by which I mean, profoundly destabilized and unable to take care of relatively simple everyday tasks, much less more complex intellection like reading and writing. I also started having my first borderline symptoms that year, though it would be 20+ more years before I admitted that they existed, primarily because I was so up-in-arms about BPD as a politicized misogynistic wastebasket/junk diagnosis. While I think it was, has been, and probably will continue to be those things, it also eventually became necessary for my survival to admit that I had life-obstructing symptoms and to try to get help for those—and that help was DBT, for me (Dialectical Behavioral Therapy). Marsha Linehan’s approach is destigmatizing and statistically effective; I believe it saved my life. But at that time DBT didn’t exist, so I didn’t practice it until much, much later.
My twenties saw me dropping out of first that college, then another. The pattern was that I would recover over the summer, enroll in the fall, and drop out after the first semester. Finally I gave up and became a waitress, gardener, bookstore clerk. I had no insurance, couldn’t afford treatment, and so remained depressed. My symptoms progressed with every go-around, and increasingly the dull gray pain became more the screaming crying self-destructive variety. So that was the first impact of my mental health on education: I couldn’t stay enrolled. I could barely stay employed, and lived well below the poverty line.
Finally I wound up as a “returning student” or “mature student” (though I was pretty immature) at a very nurturing women’s college, who generously gave me scholarship money and (more importantly) therapy and support. I persistently refused medication, because I was stubbornly determined I would cure myself through reading Jung or Kierkegaard (insert eye-roll) and the available medication in the ’80s and early ’90s wasn’t really that helpful to me anyway. Because my symptoms were all depressive, no one diagnosed me as bipolar, but “dysthymic,” so I would be offered Elavil, as well as Prozac and Zoloft (which had just become available and did nothing for me—they were like chewing Tic Tacs). Despite being unmedicated and constantly flailing about, I finally got my BA (summa cum laude, amazingly), a full nine years after entering college. I had two psychiatric hospitalizations for anorexia/depression/BPD stuff, but I graduated. After that, I felt more confident in attempting graduate work—though that has had its own challenges.
I would just add that one advantage of all this has been that I can spot signs of mental interestingness in my own students like a drug-sniffing dog; I usually teach first-years and sophomores and can tell immediately when they’re having affective-disorder type problems. What I hope is that my own suffering has some value, that it has made me useful. Thanks to having been through all this myself, I know when to reach out, and can offering assistance in finding resources, and can listen without judgment. Once I had a student suffer a full-scale psychotic break in my classroom. I stayed with them for hours while we waited for the ambulance. After that, they would always seek me out when their medication wasn’t working, because they knew I wouldn’t be scared or judgmental.
[How did you approach dealing with academia while also dealing with bipolar disorder? What were some specific challenges that you faced, school-wise?]
One of my primary obstacles has been that when my mood tanks, I gravitate (as we all do) toward isolation. It’s hard for me to go to class, hard for me to speak up in seminars (especially when a chorus of mental voices is going to follow everything I say with scathing contemptuous criticism of how stupid I am), hard even to get out of bed and get dressed. Through dint of DBT training I eventually mastered a bizarre reverse psychology where my cued behavior (depressed => stay in bed) has been rewired (depressed => get up and look for a bra and jeans). My very first DBT therapist used to say, practically (she had been a basketball coach), “You don’t have to WANT to do it, you just have to DO it.” So I work in a cognitive-behavioral way with my brain, reminding it that we don’t have to WANT to go to school/the library/the grocery store/the world, we just have to get dressed and GO. I can also call my therapist for on-the-spot coaching, which is a great benefit offered by DBT. Since I teach undergrads, my personal rule is I can’t take more absences than they are allowed, so I save absences for only the worst days. And I know I’ll always feel better once I’m in front of a group of students. Teaching is a natural environment for me, one in which I make sense; and it cheers me to be around my students, who are so funny and bright.
The OCD symptoms can make studying/writing difficult, and always have. OCD for me is just as much an obstruction as the mood disorder, and they’re interdependent — when I’m hypomanic, the OCD gets worse. My concentration will take the wrong focus, and in a parody of a procrastinating graduate student I can spend six hours perfecting the paragraph breaks on a blog post, or obsessively curating the files on my laptop/Google Drive. It’s a dysphoric feeling; unfortunately, the more euphoric hypergraphia that also goes along with being on the manic end of the spectrum almost never gets channelled into writing long research papers (alas! I’ve always envied Kay Redfield Jamison on that front).
Timing’s also crucial. Fortunately for me, I usually start the fall semester in a relatively undepressed mood (though often irritable from summer hypomania), and I try to establish rapport with my instructors quickly. That way when my mood plummets in November, if not sooner, they’ll have seen some of my work, been suitably impressed, and will be more likely to grant some leeway. The spring semester is the opposite—I usually crawl through January and February, and March, April, and May see a rush of fevered activity, which again (thank you mania) may have almost nothing to do with assigned material. Spring is when I invariably decide to write a novel! in two weeks! and then go to the library at midnight and carry out forty books! on exciting topics like wilderness survival and building your own house! etc., etc. But those are the gross (big) swings; there are dozens of smaller micro-moodswings and (best of all) mixed states during the academic year itself.
I have often asked for incompletes. These can be useful because I can prioritize my own teaching during the semester (grading papers and handing in final grades for 50-70 students) and get past the exhaustion of interacting with people five days a week, and then transition into a summer or winter break where interaction takes a backseat and I can fall into the silence and concentration of longer writing projects. I still need a lot of therapeutic coaching to get through them. Having a looming writing deadline, like being on my period or going through a breakup, can be a cue that pushes me over the edge of dysphoria into serious suicidality.
I’ve tried to find graduate programs in sunny places, after a very difficult two years in England and three in Boston. Thus I did my last degree in Arizona and am now in Texas. Sunshine helps! And sometimes you just need that tiny ledge so you can stand up on it.
And finally, my cat is a lifesaver. She’s totally an Emotional Support Animal. She should wear a little vest or something, with a handle. She knows when I feel badly, and stays close.
[What was the best thing you did for yourself, mental health-wise, in college/graduate school?]
The first is that, as soon as I arrive onto a new campus, I get in touch IMMEDIATELY with their counseling center/psychiatric clinic/whatever they have, and find out what kinds of services are available, what kinds of referrals I might need to go into the community for treatment. Because I have a 25-year mental health history, campus resources are never going to be enough—most counseling centers offer a set number of appointments, for example—but I need to touch base and make the connection, and set up a [psychiatrist/therapist] combo as soon as I can. I’ve just accepted this now, the way I have being on medication the rest of my life: I am never not going to need a DBT therapist and a psychiatrist.
The second best thing only happened recently, in my first year as a PhD student. I was arranging for some academic accommodations for an undergrad student of mine, through our university’s center for students with disabilities, and it dawned on me suddenly, yet slowly, my brain becoming aware of a familiar yet oddly new idea, that I had been giving my students accommodations and advocating for them for decades, but it had never once occurred to me that I too could and should ask for and receive accommodations. It was a stunning moment. Since I went on disability (SSDI) in 2006, and my most recent hospitalization was in 2009, I was pretty sure I would qualify. So I called and made an appointment, and have to “refresh” my accommodations every 6 months, but it’s one of the smartest things I ever did. I even got a small scholarship this year, for disabled students.
It’s almost impossible for me to think of my invisible disability as “real,” not least because I get near constant feedback from the world that it doesn’t exist and I am basically—I love this one—crazy for thinking I’m crazy. (“Crazy” is a very positive term to me, that I’ve reclaimed, à la “bitch” or “dyke.”) And in fact not all of my professors have been able to wrap their heads around what a disability accommodation means, particularly the older ones, who tend to panic and yell at me (this has happened). No one has ever asked point-blank what my actual disability is, but I generally volunteer that it’s “neurological” and I take medication for it and see a doctor every two weeks; and I think that’s all they need to know. In explaining specific requests I have to be patient and persistent, and clear about exactly what I need (even though it’s written on the form): sometimes I may have extra absences, sometimes I may need additional time to complete work, sometimes my concentration and attention and memory are poor and this doesn’t mean I am not doing the reading/writing, but only that I am struggling with it. Then they usually calm down somewhat. It’s still awkward, especially in small classes where other graduate students may sometimes wonder why I’m the only one not handing in a paper, e.g. But awkward is a small price to pay for not being facedown on the bathroom floor hoping to die.
[Say you’re sitting in front of your 20-year-old (or whatever age you choose) self, sharing a cup of tea. What advice would you give her?]
A more intimate version of what I say to my own students. If she’s 19 and it’s her first depression, she’s refusing to drink any liquid. So I’d offer her a cup of tap water and a box of tissues and get down on the floor with her and put my hand on hers and say levelly:
This is not your fault.
You didn’t do anything wrong.
And you can’t get out of this by pulling yourself up by your bootstraps (which to you anyway just means “Yell at yourself meanly until you cry and try to hurt yourself”).
You can only get yourself out of this with drugs and therapy. I know you have no money. But you need to find a good therapist and learn to validate your feelings while rewiring them; and you need to get on a mood stabilizer NOW. The longer you put it off, the sicker you will be in your 20s and 30s. Every time you have an episode you are inscribing it more deeply into your brain and making it more likely the next one will kindle. Don’t be a snob about medication. When they prescribe lithium for you at 22, don’t be scared, take it. Don’t be so hung up on the label of “I’m not bipolar, those people are crazy!” Honey, you ARE crazy. When they say you might be borderline, don’t throw Kate Millett at them. Go to group, see what it’s about.
And try to remember that if you overdose, you are not going to get to have the awesome sex you will have in your forties.