Mental Illness and The Hopelessness of Poverty

One of the worst things in this country about being poor and suffering a chronic mental illness, other than the shame, is the complete lack of resources for everyday stability. Programs that specialize in rehabilitating the mentally ill are expensive or non-existent. Generally speaking, existing treatment programs tend to be intertwined with substance abuse, so if someone’s just so dysfunctional they can no longer care for themselves, or purposely start inviting risks in a passive-aggressive, “I don’t want to kill myself, but I don’t to be alive,” sort of manner, there is nowhere for them to go at all.

Unless you’re in crisis, and even oftentimes when you’re in crisis, competition for low-income resources is fierce. I schedule out months ahead with my doctor, and in an emergency situation it is difficult to get hold of her. Even if I call every day to see if there are any cancellations, I might still go a month without seeing her. Not to mention that I would have to take off work at a moment’s notice, which doesn’t really work for employers. But neither does not being able to get out of bed in the morning. Or calling in sick because you’re having an anxiety attack. Or quitting your job on a manic and poorly thought-out impulse. So I need my medication, and I go when they say they have an opening, whether that means pissing off my boss or even losing my job, depending on the circumstances surrounding the crisis.

It’s part of the reason the mentally ill, particularly bipolar people, suffer from chronic instability. It’s part of the reason I suffer from chronic instability. It’s the reason I haven’t been able to get stable: because the things I need aren’t easily or readily available. At the end of September, I put my name on the waiting list for an in-patient and addiction counseling program. It was supposed to be a month. But I’m still waiting, a month and a half later, to even hear a start date. So it’ll still probably be at least a week, when I was in crisis two months ago.

Two months is a long time to keep it together without the help you really need. Two months is also a long time for someone notorious for wild mood swings and absolute changes of heart. I’ve struggled through each day and failed way too many times. But I’ve also reached out for help, and turned my reflections inward, and started trying to address some of my inner demons. So, in some ways, I’ve made a little bit of progress, and the darkest veils of the depression have started to lift.

With that has come major changes, such as finally quitting the job that was sucking my soul. Not in the way I wanted to, either, in any way, shape, or form. This one wasn’t done on a manic impulse: it was done after years of a dysfunctional relationship and at the urging of the people who actually care about me. Still, even though I’ve felt better and freer and more hopeful than I have in a long time, I regret the way things played out. I have these very confused feelings about my former boss. We had a close relationship, but one that was very totally power imbalanced. Where I thought of her as mentor and a mother figure, she thought of me as a friend, and overall, an employee. And let’s just say that I very much disagree with the way she treats her employees. Not to mention other complicated relationships in the work environment, like working with my rapist. The entire situation was just unhealthy and wrong for me.

I should have left months ago, but due to some misguided sense of loyalty and affection and desperation (I haven’t historically been good at maintaining employment), I stayed and put up with a lot of questionable things. And when you’re putting up with a lot of questionable things, you tend to get depressed, and bitter, and hopeless. And when you feel hopeless, it’s hard to make changes in your life, or even to fulfill its basic tasks. But there came a breaking point- the point at which I was accused of trying to steal hours and screw her over- that I just couldn’t take it anymore. And then I lost my tongue and vented about it all on Facebook (and maybe embellished a bit), and a dear old enemy who has it out for me jumped at the opportunity for my undoing.

Which was actually a relief, that left me feeling immediately better. One major life obstacle down. A fresh start, at a job that doesn’t have three years of back story on me, sounds delightful. I’ve also been reaching out to various bipolar advocacy groups, which has led me to realize that I’m not in this struggle alone. I have all this inner dialogue of self-loathing for my signs and symptoms, which I deprecatingly view as personal weakness. I deal with this constant bully on the inside, that tells me I’m a failure for being poor and a failure for not being able to keep the house and a failure for being emotionally distant when I’m depressed and recklessly impulsive when I’m manic. But I’m not the only one who has a sporadic work history. I’m not the only one who gets hopelessly behind on housework. I’m not the only one who is at times so despondent I can’t be an effective mate or mother. And I’m not the only one who has a hedonistic and colorful and slightly egotistical storybook of manic adventures.

Realizing that this a problem that millions of others face, and many have learned to overcome, gives me a little more faith in myself. Maybe I don’t have to give in to the whispers of self-hatred any longer. Maybe I can stop telling myself I’m worthless because my brain is broken. Maybe it’s time to re-frame it, in a logical perspective, as a problem to be solved rather than a war over worthiness. Maybe it’s time to detach myself from this notion that my flaws are a result of my inherent lack of virtue and value, and are instead a common experience for people with the same chemical imbalances as I. Time to stop being bipolar, and time to become a person who suffers from bipolar instead.

But when you’re this far down the rabbit hole, that’s hard to do. There are so many critical parts in treating and controlling this illness. And that means acknowledging certain facts in life, things that other people don’t have to worry about in quite the same way. Like knowing that the slightest thing can make me lose my mind, and I should thereby be careful with all I do: my diet, my sleep, my medications. I went without one of my prescriptions for five days last week, and got slightly suicidal. I shouldn’t drink, at all, because when I’m depressed, I over-indulge to numb the pain, and when I’m manic, I over-indulge to live life to its fullest. And even when I’m stable and doing well, being the slightest bit off in mood can send me on a depressive tail spin when combined with drinking. So I need to just not do it. But that’s hard, because drinking was always social and silly and fun when I was younger. And who wants to admit that they have a drinking problem, and give up those social, silly, fun times?

Getting all these things under control takes time and stability and structure. I need certain things to get myself under control- establishing a regular sleep schedule, nurturing my body out of its malnourished state, sticking consistently to my meds without missing days on a semi-regular business. I need in-depth counseling on how to better deal with my moods always shifting, and I need to explore the wounds that leave me dysfunctional and impaired.

But like I said, two months is a long-time. I’m going stir-crazy here, because the depressive fever has broken and I’m no longer in crisis. And when you start feeling better after a depressive episode, you start thinking that maybe you can actually do it on your own. The tiny bits of progress you’ve accomplished start to make you overly ambitious. And you start to question the downsides of the plan, like, do I really want to miss Thanksgiving and Christmas and New Year’s with my family? How can I afford another three thousand dollars in medical debt when I already need to declare bankruptcy for debt I already have? And what about working? I want to start looking for another job, but I have no idea when I’ll be able to start, and that leaves me feeling completely impotent. My children need new clothes and Christmas presents, but how can I afford those without working?

So now I have to fight the impulse to give up on treatment in this misguided impression that I’m better. I’m not better yet. I still don’t sleep regularly or eat regularly. I forget to fill my medications on time. I’m still all too tempted to drink. My successes can only be measured in the tiniest of degrees, and I still need the help I needed a month and a half ago. If I try to invest myself back into life without fully addressing my issues, I’ll just crack and end up in crisis again.

It’s a perpetual struggle, and if I didn’t have sources of support like Ian and my mother, I’d probably never get past it. Because I’m rational and self-aware, I realize I need to get my problems under control. Because I’m emotional and impulsive, I realize that I’m not always the best judge of my own capabilities. I don’t know what I would do if I didn’t have trusted loved ones to encourage me in the right direction- if I didn’t have their careful suggestions to keep me on track. Here I am, feeling all cocky because I’ve actually had a few good days, and now I think I can do it all. Which isn’t true. My brain is still broken. I’m still not healthy. And I never will be unless I take the time and energy required to address my problems in depth.

So I still need help, and I can’t go on yet. If I didn’t have people who love me and know me well, I’d probably jump the gun and just try to start over again. And fail, because I’m not ready. But it’s hard to patient, and it’s hard to be honest with yourself when you struggle with being different and broken in important ways. It’s hard to live in a society that stigmatizes and misunderstands mental illness: that equates bad brain chemistry with moral and spiritual deficiency. It’s hard to go on for years like this because I don’t have the money to pay for expensive treatment programs. It’s hard to watch society pay lip service to these problems without ever actually doing anything to solve them. And it’s hard to keep myself afloat while dealing with all these factors.

But stay afloat I must, because, as I’ve said before: what other choice is there. I know things can get better, as long as I don’t give up. As long as I push myself through the struggle every day. As long as I remember how very much I love my husband and my children, and how that feels and helps sustain me in the face of absolute misery.

And maybe, just maybe, if I can get it together, I can actually do something with my life. I can become the advocate and activist I want to be. I can write the book I’ve been planning for years. I don’t want to be another wasted life, because I could never develop my potential. I’m just so tired of dealing with the obstacles, and the culture we live in doesn’t make it any easier. We have to better. We have to make help available to the people who so desperately need it. And we need more people to be brave enough to share their stories.

If you have a place where you chronicle your struggles with mental illness or substance abuse issues, I would love for you to share it in the comments. We need to support each other. We need to network with each other. It’s at least a basic first step we can take while trying to get things figured out for a better future.

(PS: if you can possibly help me with my own struggle to pay for my treatment program, I have a GoFundMe here. My pleas thus far have been ineffective, but I guess it’s still worth putting out there.)

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