My Break Down Year

A year ago I was hospitalized because of a bout of acute psychosis. It changed everything for me. And, a year out, I'm ready to share a bit of my story in hopes it might remind you to lift, pull, flop

I’ve spent a good bit of my professional life working in mental health, and all of my educational life studying it, and still the detached curiosity I had as I began to catalog the possible explanations for the mental break I was experiencing shocked me. Hallucinations, delusions, missing time, missing memories, made up memories. All of it real, none of it real. The world spinning but only for me. It was a heartstopping symptomatology I couldn’t look away from. A lifetime of training taking over as I realized I’d lost the strings of myself. I couldn’t stop crying - sometimes sobbing - but the crying part of me felt completely divorced from the thinking part of me. The soft animal of me keening in pain, while my intellect watched with horrified curiosity taking note.

I was having a full blown panic attack while I categorized my symptoms. The two felt utterly unconnected. 

A schizo affective disorder would fit the symptoms to a certain degree. I was a little old for that to be just manifesting, but it was possible. Bipolar disorder stressed enough could create the kind of hallucinations and delusions I’d been told I’d been having, but I didn’t have most of the common symptoms. A psychotic disorder was possible. Less likely but not impossible was a delusional disorder pushed to the brink. Major depressive disorder would explain some of the symptoms, but the visual hallucinations would be exceedingly rare. A dissociative personality disorder could be at play, but, again, it would be uncommon to have no acute symptoms manifest before my late thirties.

Possible diagnosis after possible diagnosis - the boxes checked and unchecked - cycled over and over for hours as I made my way home. 

I was driving. I shouldn’t have been, given the panic attack I’d been moving in and out of for the last few hours. Given that I’d lost touch with what was real and not real. Given I was - in the most literal possible sense - experiencing what could only be thought of as an old school nervous breakdown.

It was weirdly okay, though.

I wasn’t inside my body - that pained and panicking body -  in a way that mattered. I was separate - separated. The body and soul and psyche in exceptional pain and crisis while the intellect was very calmly doing the thing I had no choice but to do - drive, hour after hour, southeast. 

Home.

Well, not home, but hometown.

I ended up at a mental health facility holding a clear plastic bag that was heavier than I expected. Inside was a hoodie with no strings, shoes with no laces, and enough tee shirts, leggings, and shorts to stay awhile. They took my toiletries for inspection. They took the razor and electric toothbrush. I would be given a less dangerous one. It was between three and four in the morning, probably. I wasn’t sure. Time had gone wobbly on me. My mom and I were the only people in the intake space outside of the receptionist who greeted us like it wasn’t the middle of the night, like I wasn’t watching myself interact with her with the same head cocked curiosity I’d watched endless patients with, like I hadn’t irreversibly shattered.

She was so normal. It felt like something from a before I’d left behind for an after I could not even begin to imagine.

Everything - including my phone and books - were taken and placed into a locker. Heavy. Industrial. It locked immediately upon closing with a massive clunk that felt final. My body jumped a bit, my heartbeat raced, and my mind wondered if it was really that loud or if all of this was yet another hallucination.

Real had become difficult in a way I’d also couldn’t even begin to imagine.

My locker was Number 10. My basketball number. The key was behind the desk. I could not hold the key - I could not be trusted with anything so pointed and sure - but my mom or a staff member could open it for me if I needed anything.

The only thing in there I would’ve been allowed was the hoodie. I didn’t need it though. Everyone said it was cold in there, but I hadn’t stopped sweating since I’d started my drive home. A cold and clammy sweat that sat heavy on my skin.

My mom’s stuff went in a separate locker. Her shoes had laces. She had to lock them in the locker with her purse (it had a strap) and keys (pointed and sure). She kept her phone. I couldn’t touch it. I didn’t want to, but the gentle reminder it was off limits as we were escorted into an office for an intake interview was humbling.

My mom’s socks were very white. I knew they weren’t new, but they were the kind of white my socks only are right out of the package. I couldn’t look away. It felt important that her socks were so white. I don’t know why, but it felt absolutely essential that her socks were white and mine only ever were before I touched them.

I was hard on things. 

I realized then I was crying again. Not sobbing, exactly, but a steady stream of tears such that the shoulders of my tee shirt were damp from unconscious wiping. I was sniffling consistently, but my breath wasn’t hiccuping. 

It was the kind of crying one does not as they are breaking, but in the aftermath, in the knowing one is now deeply broken.

I had never sat on the other side of the desk in a psych hospital before. The room was bare - most are. A heavy desk bolted to the floor, chairs heavy enough to make throwing them a true challenge, a phone within reach of the staff but not me. The walls were bare but for two signs. One detailing my rights as a patient and the second reminding me that hurting hospital staff was a crime they would prosecute.

I sat in front of the desk, my mom sat next to it, her hands gripping her phone, her legs crossed tight, the top foot bouncing slightly. Her white sock flashing in the harsh lighting of the space.

I was told intake took an hour. I felt like I sat there for my next three lifetimes learning and unlearning the making of myself.

Treatment began four hours later. I hadn’t really slept. I was given the chance, I could’ve started the next day after sleeping, but I didn’t want to wait. I didn’t trust my intellect. Twenty-four hours was a lot of time to convince myself I was fine.

I wasn’t fine. I wasn’t in the same stratosphere as fine. But had never stopped me from thinking I was before. I needed help. Immediately. And I knew I couldn’t be trusted to get it if I didn’t start now.

I was hospitalized for fourteen days and in intensive outpatient treatment for an additional month. I was diagnosed with cPTSD, a generalized anxiety disorder, recurring episodes of stress-induced psychosis, and other flotsam and jetsam that had me understanding vaguely my dissociation - the splitting of myself - was a trauma response, an unconscious coping mechanism essential in childhood but so often relied upon the past that it became my default. I learned that for the 18 months before my breakdown I’d been in a downward spiral with my symptoms getting progressively worse and worse as I kept pushing myself harder and harder. I learned that reintegrating my consciousness would mostly consist of me learning what it meant to be inside a body I had never really been inside of and that Tolstoy had gotten it backwards when he wrote, “All happy families are alike; each unhappy family is unhappy in its own way.” At least when extrapolated down to the individual.

One by one I learned the story of my fellow patients and they learned mine. Story after story, heartbreak after heartbreak, the sameness of our unhappiness - no matter the cause  - was the theme that held.

All happy people are happy in their own way, but each unhappy person is alike.

I moved to a less intensive program after those initial six weeks, but cycled in and out of crisis and levels of treatment over the next seven months as we figured out which meds worked at what dosage and which didn’t work or worked but made me think living was a mediocre idea at best. There were times when I felt better than I had felt in memory, and moments of such despair it seemed that my living was making the world worse for everyone who had ever and would ever exist. 

As all this was happening I tried to have a life and failed so much more than I succeeded. I let people down. I let myself down. I hurt people. I hurt myself. I learned what had happened and what hadn’t. I lost friends. I lost time. And no matter what I did, no matter how hard I tried, I couldn’t keep my socks clean.

It took months, and a lot of tinkering, but the meds got figured out. Then came the realization that I was okay without the antipsychotics as long as I stayed on my other meds and took care of myself in a rational way. I didn’t have psychosis, not the pervasive kind. I had unresolved trauma, an insatiable desire to be liked and included, and a uniquely powerful skill at disassociation. A bad combination for anyone, and especially bad when stressed to breaking. But, it turns out, dealing with your shit, even after it has dealt with you, still works if you mean it. 

I meant it.

---

There is this incredibly weird thing that happens when you start really healing from trauma, especially after you have an acute incident after a prolonged period of being disordered. You get sick a lot. Not like the weird body rebelling sick that happens from prolonged stress I’d been dealing with unknowingly for almost two years. But normal, run of the mill, sick. Colds. The flu. Stomach bugs. It’s like your immune system has a hard reset as it learns to operate outside of the fight or flight response. 

So, after we finally got the med thing figured out and I was feeling what I hoped for normal for the first time in a long time, I started to get sick. Often. Vertigo. A Cold. A stomach bug. Two different strands of the flu. A couple months of what felt like a week on, week off schedule of illness as my body learned to do all the things a body does without being under constant stress.

It was miserable. I was miserable. And not just because of the sickness, not even mostly because of the sickness. It was time that got me. I have never been particularly good at the human being parts of life. I am a natural at reaching, at striving, at changing, at moving. But, being? Being is hard. I am much better at becoming.

The thing physical sickness does better than just about anything I can think of is force you into being. Being in your body. Being still. Being present. Simply being, without the reaching, without the striving, without the changing, without the moving. 

A human merely being.

I felt so stuck as I watched the world roll past me. It was so frustrating to miss things I desperately wanted to attend, to be unable to do things I’d done before, to not have language to understand and explain what was happening when language, story had always been my true north. 

I did not know what to do, so I just kept doing the work my therapist asked of me. It didn’t feel like much. Some days it didn’t feel like anything. But, it was all I had - learning how to be - so I became.

---

The first book I remember reading on my own was Shel Silverstein’s The Missing Piece Meets the Big O. I was in the living room of my childhood home sitting on the floor with my back resting against the couch. No one else was awake. I can’t remember if I was up late or early - I was notorious for both - but I was alone and only a lamp was on. I remember the warm glow as I settled down on the floor with a book that felt so big to me at the time. I’d picked it out myself at the library. One in a small stack. It happened to be at the top. I’ll never not be grateful for that little bit of kismet.

I laid the book on the ground in front of me and began to read.

For the uninitiated, The Missing Piece Meets the Big O tells the story of a triangular slice of a circle looking for the place where it fits. It is a long and fraught journey. Sometimes it is too big, sometimes too little, sometimes too sharp… always not quite right. It can be really lonely and hard, trying to find the place where you fit and you feel stuck. One day a Big O rolls past and the missing piece stops him and they have this interaction.

“I think you are the one i have been waiting for,” said the missing piece, “Maybe I am your missing piece.”

“But I am not missing a piece,” said the Big O. “There is no place you would fit.”

“That’s too bad,” said the missing piece. “I was hoping that perhaps I could roll with you…”

“You cannot roll with me,” said the Big O. “But perhaps you can roll by yourself.”

“By myself? A missing piece cannot roll by itself.”

“Have you ever tried?” asked the Big O.

“But I have sharp corners,” said the missing piece. “I am not made for rolling.”

“Corners wear off,” said the Big O, “and shapes change.”

The Big O rolls away, leaving the missing piece alone again. For a long time the missing piece just stayed where it was. Then, slowly, the missing piece lifted itself up, pulled themselves onto their tip and flopped over once, then twice, then again and again and again. Lift. Pull. Flop. Lift. Pull. Flop. Lift. Pull. Flop. Until its shape started to change. It’s corners rounded and suddenly it was bumping then bouncing, and finally it was rolling. The last page of the book is seared into my memory, a Big O and a Little O rolling together.

Lift. Pull. Flop.

Throughout the first ten months of treatment I struggled to read fiction the way I had before. I couldn’t fall into a story. I couldn’t get lost in the feelings of a book. I could read endless non-fiction, but the stories I most love I couldn’t get into, get lost in, the way I had for my entire life to this point. There was a block, a thirty-minute time limit, before I found myself reaching for another book or task or my phone. Anything, really, but losing myself in a book. I also struggled to write in ways I never had before. I couldn’t go there. I didn’t understand why, but I couldn’t get to the place where my words hide. There was suddenly a wall between me and my creativity. I could put words on paper some days, but they were empty, and even those empty words were a struggle.

At first I ignored my inability to do what I most loved even as I healed. I blamed the psychosis, then the brain fog, then the meds, then coming off the meds, then settling into a new way of being, and then being sick, and then, and then… until there was nothing left to blame but the actual culprit: a heartstopping, throat closing, blood chilling fear of being myself.

The truth of me is I have spent my entire life living for the approval and acceptance of other people. From birth I was indoctrinated into a religion that taught me I was born irredeemably broken. Who I was innately wasn’t enough and I was never going to be enough - that I was only lovable because someone else had made me so and for that I was indebted and must live my life the way the church said was correct. More, if I choose not to be who the church told me to be I would spend eternity burning alive or worse. It did not matter how I felt about myself. It was the least important person in the equation. All that mattered was what God thought of me and that was mediated by his followers' judgments of me. 

Approval, acceptance, meant being a good person - and not spending literal eternity in excruciating never ending pain.

Also, just constitutionally, I want to like you and I want you to like me. Unlike most reality show contestants, I did come here to make friends. I was bullied hard as a kid. No matter what I did, no matter how I contorted myself, I was never able to fit into a mold my peers, teachers, pastors found acceptable. I couldn’t figure out what was wrong with me and no matter how hard I tried it was never enough. Acceptance, approval, felt like an unsolvable equation. And then, accidentally, I was given a solution. The school I went to was religious and taught a literal seven day creation in science class. We were talking about it at Sunday school one day and a member of my small group was complaining she had to learn evolution as a valid theory. My Sunday school rolled her eyes and broke into the conversation, “Just give them what they want. You don’t have to believe it to say it. Get the grade and go on.”

So, I started just giving people what they wanted. I didn’t have to be it to present it, not really. I learned how to get approval and go on. I did it so much I stopped realizing I was doing it. I did it so much I no longer knew who I was outside of a reflection of what others wanted me to be. I did it so much I didn’t know how to do anything else.

It is a strange realization, to be on the backend of your thirties and understand you have never let yourself be wholly you, to let it be real for you the way you have broken yourself into acceptable pieces for so much of your life there is real concern you’ll never be able to piece yourself back together, to fear both the best and worst parts of you are fabrications made in service of being the least objectionable version of yourself. 

It is a terrifying realization, to be on the backend of your thirties and understand you are going to have to become now. To look down at the velveteen rabbit tattooed on your bicep and for the first time truly understand what the rocking horse meant when he said, “You become. It takes a long time. That's why it doesn't happen often to people who break easily, or have sharp edges, or who have to be carefully kept. Generally, by the time you are Real, most of your hair has been loved off, and your eyes drop out and you get loose in the joints and very shabby. But these things don't matter at all, because once you are Real you can't be ugly, except to people who don't understand.”

Lift. Pull. Flop.

There is nothing romantic about healing, about becoming. It is a slog. A boring, repetitive, plodding nonlinear march towards yourself. A march I have been on for the last year and will be on for the rest of my life. 

I am doing better today than I have in as long as I can remember. I also know who I am better today than I ever have. And still I am learning and growing. I can write now, though. And read. I understand a little better who I am, what I believe, and how I want to live my life.

I’m not scared of being myself anymore. I am becoming,

And sure, I might not be rolling yet, or even bouncing, but I am bumping along. And, after the year I had, that is a beautiful place to be.

I guess what I am trying to say is my socks may never be as clean as other people’s socks… and that might just be okay.