Tuesday, January 29, 2013

News 1-29-13

 - Sarah Spiers

As stated, I attended the round table on Mental Health and Guns in America. To say that I was rather displeased with the discussion on mental health until later in the deal when the court appointed guardian, Mr. Cross, spoke on behalf of those of us with mental illnesses.

I was 3rd out of 4 to address the round table. This is what I said:

"I'm feeling rather stigmatized right now. I mean, this woman said she's scared of me because I have a mental issue.

My name is Sarah Spiers. I am the founder of St. Dymphna's Mental Health Support Group in St. Joseph. I've been through a lot in my battles against bipolar. I've witnessed others' struggles. Please truly invite the patients' point of view, thoughts and feelings into your considerations.

There are 3 areas that need fixed.

1st, stigma. We face injustice and prejudice constantly. People are scared of us simply because we fight an invisible battle. It's taboo to have a mental illness in America. Remove the stigma and people will seek help for themselves and their children.

2nd, Education and Awareness. Teach kids to love and accept. Teach teachers, law enforcement, professionals and our family how to deal with us. Plant the seeds of education and wisdom so compassion can flourish.

3rd, fix the broken systems. If you want to help us, make it easier and more affordable to see the 3 people we need for medication and therapy.

I challenge you to get help as an unemployed and uninsured person.

Thank you."

When the meeting concluded, Representative Galen Higdon of the 29th District came to me in an abrupt manner and shook my hand. He said I showed courage standing up and saying what I said. We visited a bit and then I visited with Jim Neely for approximately 15 minutes and then Representative Mike Kelley showed his appreciation for my speech. We visited for awhile.

I am currently drafting a letter to Rep. Higdon. He's local. He knows the history. He's former Law Enforcement so I can get their point of view, better enabling me to think of solutions.

Tuesday, January 15, 2013

Sarah's Story

- Sarah Spiers

I have battled mental illness as long as I can remember. Looking back at how I acted and little things I did as a kid would send up red flags. But, in the early '80's nobody thought to look for mental illnesses in children. We were just odd, the black sheep of the family.

Unfortunately, that meant I slipped through an important crack. Early diagnosis. Spot the problem before it becomes a problem.

It wasn't until I was 16 that I was forced to go to the doctor to deal with my anger issues and was diagnosed with depression, which changed to depression with anxiety. I remember thinking that I wasn't crazy so I don't need any crazy pills. Life's hard enough for me at school, all I need is word to get out that I'm taking anti-depressants.

I, as a patient and a sufferer felt the burn of the stigma associated with mental illness. I believed in the theory of crazy people do crazy things, there's something "wrong" with us, etc.

I was put on Paxil. At 16 I should not have been on that drug. It's been shown to lead to increased suicidal behavior in teenagers and young adults. It's no wonder that at 19/20 when I entered a high stress job with a hostile work environment I started developing suicidal thoughts. I didn't think much of them. They did concern my brother, though. I ended up being asked to resign from my position as EMT based on my inability to work with others, among other things. Patients had a problem with me, at least that's what I've been told.

I had to move in with my parents after only 2 months of freedom and independence. I went through a couple of bad relationships. I started cutting. (Cut free for about 8 years now). My life spiraled down. I went insane, at least what I'd call insane, and didn't respond well to the rejections being thrown at me.

I tried to commit suicide 3 times in a short time period. That's how the cutting started.

I hit rock bottom. I wanted to die, but I didn't want to die. I wanted freedom from my brain, my demons, myself.

I sought counseling... on my own. I wasn't going to live my life the way I had the previous 2 years. I wanted to live in peace and harmony. The first step to finding a counselor is to go to your general practitioner and get a referral.

I made the appointment with the Nurse Practitioner. I told her what symptoms I was having and that I was suicidal and I thought that I might have Borderline Personality Disorder. She said:

It sounds like you've read one too many books.

To get insurance to cover the counselor for me I had to call the Employee Assistance Program number and go through their red tape. She asked what was going on. I told her that I had been having suicidal thoughts and that I thought I might have Borderline Personality Disorder. Her response:

Hahaha it sounds like you've been reading too much.

Yeah. Like I wasn't depressed enough, now you make fun of me, right?

All of this when I was 22, the perfect age for bipolar to start seriously affecting life. Did I mention I was a Corrections Officer with access to firearms? It's a good thing I loved my job because I had ample opportunity to off myself in the car.

I was diagnosed with Bipolar at 24. It then got changed to Bipolar Type 1. Now, in the last few weeks, it's been improved to Bipolar Type 1 - Rapid Cycling - Last episode unspecified. This means I'll get to go from one end of the spectrum to the other weekly rather than on an extended time frame. It is not fun.

With diagnosis comes treatment. For me that means meds and counseling. All was well for about two years when I was only on Lexapro. Then the Lexapro stopped working. I kept taking it for another 4. This began the game of "Find the right anti-depressant" followed by "Find the right mood stabilizer" followed by "Find the right doses." This went on in exhausting length. I was ready to just give up. I couldn't find anything that worked. This is what I get for not seeking a trained psychiatrist. Although, I'm sure we would have had the same problem if I did get to a trained psychiatrist sooner.

I had super highs and super lows. In Feb. 2011 I felt suicidal again and hospitalized myself. My treatment in the ER was atrocious. They put in my chart that I was combative so they could chemically restrain me with Haldol and Ativan. I was asleep when they decided I needed this. They had to wake me up to give me the shots. After a long 9 1/2 hours I found myself at Shawnee Mission Medical Center where I was watched and released with a treatment plan.

That was a few months after I lost my mother. With her, my entire world went black for about 2 years.

In the summer of '12 I was put on Effexor which changed to Effexor XR. I should have known something was wrong when I vomited within 20 minutes of taking it the first time.

Of the "Call your doctor immediately if:" list, I had these symptoms. Rigid muscles, sweating, confusion, fast heartbeats, tremors, agitation, nausea, vomiting, diarrhea, loss of coordination, trouble concentrating, headache, memory problems, confusion, cough. I'm talking my heartbeat was constantly at 130 for 5 days straight. I literally thought I was going to die.

I cut a few cysts out of my head and sought treatment for the wound afterwards. I had been picking scabs to a seriously abnormal degree... so much that I got an infection. I was allergic to the antibiotics so they didn't work. The wound care doctor fixed me up though.

In my records it shows that another doctor had told my doctor that I might need to be committed. This was Sept. 5 this year. The General Practitioner I was seeing decided she couldn't treat my psychiatric problems anymore. I bawled. It took 10 minutes for me to be able to tell my aunt what had happened.

In hindsight, I was depressed and then spiked to a high mania afterwards. I was so depressed and so sick by this medication that I laid in bed 24-7. I slept during the day, I didn't shower or brush my long, thick, coarse hair. It took my aunt 8 hours to undo my hair so it looked somewhat normal again. I did this for probably 6 weeks. I didn't want to do anything. I dropped off of Facebook, I dropped off of the world... into my well of Hell.

Well, being dropped like I was sent me into a tizzy. I got it in my mind that my aunt had somehow played a part in the doctor dropping me as part of a vendetta against me. I wrote 3 "letters" and released a chapter of a real life book to certain people. The first letter was a letter I wrote to the aunt and her daughter. The 2nd letter was a police report putting forth some suspicions and concerns I had about a couple of people. The 3rd letter was really an explanation of my actions.

It was deemed by the Sheriff and Judge that I was unstable, a threat to myself and a threat to others. I was involuntarily committed for 5 days. On the day I get released, someone claiming to be from the sheriff's office called the psych ward that I was on and told them that I was using the phone to make threatening calls. They released me anyway.

While I was in the hospital I was served with 3 ex parte orders. It came out in the ex parte's and court that I had threatened to kill the doctors, their spouses, their children and grandchildren, the staff at their clinic and all the patients I could find.

I just wanted to out some corruption. My aunt and cousin got upset and actually convinced these people that I'm a threat to everyone.

In court, I remember thinking "these people don't know what they're talking about. Seriously, I'm bipolar so that makes me a potential babykiller somehow?" Luckily the judge found in my favor, but not before telling me that my behavior was completely unacceptable and had it been someone else that put the ex parte's up against me he would have granted it for them. Nice. Thanks. Bye. I'm not sticking around to make you any more upset with me.

This whole episode has had its consequences. Some good, like I found my meaning and my purpose in life. Some bad, like it set me back emotionally in ways... but kicked me forward in others.

I've never been able to regain my complete independence. I never will, either, with as bad as this bipolar is. I will literally have to have moderate supervision for my entire life to help make sure I'm not swinging too far one way or the other and that the proper steps are taken accordingly.

It is a good thing that I was forced to take a vacation from college for awhile. That stressor on top of everything else would have been a bit too much to carry.

I've picked myself up by the bootstraps, started this support/advocacy group and prospered so far. I leave every Tuesday night with a smile in my heart because I know that one or two hours meant a lot to the people there and I helped them in some way find peace for a little bit.

The Broken System

 -Sarah Spiers

I was interviewed by a St. Joseph News Press reporter yesterday in regards to St. Dymphna's. The question was posed: What systemic failures are there? I really was at a loss for words, because there's so much.

An example of how difficult the mental healthcare system is to navigate, let me tell you a story. A woman with many health issues, including debilitating depression, ends up in the hospital in acute psychological distress. She's diagnosed, treated, watched for a few days, released.

She goes to fill her medicine so she can cope with the outside world and her inner demons. She can't afford them because Medicaid forced her to go by her husband's income, rather than hers, which is 0. She finally gets them, and they don't work. She gets a new prescription and, voila, same problem. She can't get them filled because she's on spend down.

She knows she is destined for the hospital again if something doesn't change. She's said it herself.

And, she's experiencing difficulties in getting disability to approve her claim. She's at a breaking point. She's a strong woman, but strength wears down eventually.

All she needs is the system to work in her favor.

That's just one example of the system failing someone. It's everywhere, at all levels of government, the pharmaceutical companies, the lack of funding for mental healthcare, lack of psychiatrists, therapists and counselors... it's failing everywhere.

We mentally ill, as a whole, need representation. Right now that is up to NAMI, the biggest mental health advocacy group in the U.S. They are doing their part, but if you listen to the media, there is almost no representation on the patient's behalf. Decisions are being made about us and for us without our input.

The systemic problems can be fixed if everyone comes to the table and we actually brainstorm.

Sunday, December 16, 2012

Mental Health Awareness and Education Now and in the Future

Sarah Spiers

Many political issues have arose from the Sandy Hook Elementary Shooting. The one that concerns me the most is the discussion happening about mental illness. There are people going in front of the national media implying that every one of us that suffers from a mental illness should be locked away forever and ever just like in the '50's. It wouldn't surprise me if they wanted to bring lobotomies back.

Instead of being scared of every one of us and clutching your children as we walk by we need awareness and education. Instead of perpetuating the already horrible stigma those of us with mental health issues face daily, educate everyone about mental illness and speak the truth rather than propaganda. Instead of locking all of us away in the mental system that's already overloaded, underfunded and failing - help us get our medicines and therapy.

According to NAMI:
One in four adults - approximately 57.7 million Americans - experience a mental health disorder in a given year. One in 17 lives with a serious mental illness such as schizophrenia, major depression or bipolar disorder and about one in 10 children live with a serious mental or emotional disorder. 

One-half of all lifetime cases of mental illness begin by age 14, three-quarters by age 24.6 Despite effective treatments, there are long delays—sometimes decades—between the first onset of symptoms and when people seek and receive treatment.

Fewer than one-third of adults and one-half of children with a diagnosable mental disorder receive mental health services in a given year.

Twenty-four percent of state prisoners and 21 percent of local jail prisoners have a recent history of a mental health disorder. Seventy percent of youth in juvenile justice systems have at least one mental disorder with at least 20 percent experiencing significant functional impairment from a serious mental illness.

That is a LOT of people, adults and children alike in the US that have a mental illness. Most of us do not commit violent crimes.

As a side note, I'd bet the number of mental health patient "criminals" would decline a significant amount if marijuana would be legalized at least for medicinal purposes.

The system needs to be changed. It is bloody difficult to find appropriate help before it's too late. I am personally dealing with the system myself. I have a new general practitioner, I have a new psychiatric Nurse Practitioner (that I'm unsure about) and I have a new counselor that I love.

People with mental health issues need to know that it is OK to seek help. Unfortunately that doesn't happen because of the stigma we face. Nobody wants the neighbors to think we're crazy. We don't want to have to take pills for the rest of our lives. We don't want people to avoid us because there's "something wrong" with us.

I don't believe anything is "wrong" with me. I was dealt a difficult mental illness (Type I Rapid Cycling Bipolar), but I survive and cope every day without committing violent acts... as do many other people with mental illnesses. To me, bipolar is a part of me like the Marilyn Monroe mole I was born with. It is just a fact of life.

The education and awareness needs to start at a young age. Anymore parents aren't being parents and they don't have coping skills of their own. Children need to learn how to cope with situations rationally, logically and safely rather than doing the things they see on TV. Children and teenagers can be taught that we're not all scary people and can lead normal lives.

If we can teach the younger generation compassion and understanding we can have a better future. I'd imagine we would have far more mental health professionals entering the field that are more able to help their patients. The stigma (in the long run) would be reduced because the education and awareness instilled into them would be lessened.

Unfortunately, as of now, we're still fighting against 1940's - 70's thoughts on mental healthcare. Lock em all away for life. We're seen as people with lessened or no value... and that's just not true.

Tuesday, December 11, 2012

News and Updates 12-11-12

We had to change our name from Caged Bird because the publishing company would not grant the rights. We are now operating as St. Dymphna's. St. Dymphna is the patron saint of mental illness and nervous ailments. It's a pretty interesting story.

The website is up to speed. Donations have been activated for this name.

We have enough members to go after our Not for profit organization and are in the beginning stages of that.

St. Dymphna's has been born. We've already accomplished more than most groups do, and nobody really knows about us.

Sarah is working on the media kit. Hopefully someone will pick up on the story.

It is indeed a most joyous holiday season.

Thursday, December 6, 2012


Sarah Spiers

Let's start by saying triggers are evil. Anyone who has a mental illness, or cares for someone who suffers needs this word in their vocabulary. The sufferer needs to learn to actually communicate these triggers with those that care about them and avoid the trigger or lessen the effects. Yes, this means the sufferer has to take responsibility (unlike say, Lohan or Spears). Those that care need to take into account the seriousness of the trigger, learn what that person's likely response is going to be, learn to try to avoid the trigger (or at the very least, lessen the effect), and how to handle the person when they're triggered.

Face it, when we are in full trigger mode we are not thinking correctly. Our animal instincts have taken over and we're basically working on hormones, electrons and chemicals. As much as it sucks for the sufferer to give up that bit of independence in our battle with ourselves, occasionally you as a carer are going to have to step in.

Trigger: something that acts like a mechanical trigger in initiating a process or reaction. (Merriam-Webster).

Again, triggers are evil. Generally some outside source sets off a complete psychological disturbance within the person. Triggers can be anything, really. I've known people who would freak out at the smell of Tic-Tacs or seeing a certain type of flower. - These triggers are even more exacerbated (and sometimes weird) if the person is a survivor of some form of abuse.

Many things can trigger a bipolar episode. Some examples:

  •     stress
  •     sleep issues
  •     problems at work/home
  •     isolation (a big issue with me personally)

Read more from David E. Oliver 

Reactions to triggers are awesome!

One frequent response to a trigger is a full on panic attack. 
Breathing becomes difficult. Your heart races. Your adrenaline dumps into your system. Your brain shuts down to everything around you except the memories, thoughts and feelings associated with that trigger and trying to get away from it.

Other responses aren't as "mild."

1. One can easily turn into this: An angry wolverine. A raving beast that even grizzly bears will run away from. A badger the size of a German Shepherd who, when angered, is a whirling dervish of teeth and claws. Believe me, you will always lose the battle against a wolverine. Always. 

OK, you may win if you stab it with Haldol or some other chemical restraint.
In my case, I feel absolutely no pain when I hit this stage of rage (which luckily is rare and takes a strong trigger often associated with my natural protectiveness of others). 

Any police officer, corrections officer or psych ward employee will tell you that the ones that cannot feel pain are the worst to deal with. All you can do is overpower and restrain them (tactic of choice) or hope to talk them down (rarely tried at first).

This demon within me is perhaps the one I am most afraid of because I know I can do serious damage to someone else, not realize I'm doing it, and sadly, not even care at the moment. When this demon comes out, it is seriously like I'm another person, a very scary, if not evil, person, that will not back down when challenged. 

Fortunately the majority of the time this wolverine comes out seems to be when I'm defending someone (including myself), who is the brunt of douchebaggery, abuse, etc... especially if the person is another mentally ill person, Autism, Aspergers Syndrome, Downs Syndrome or simply just slower than the people who think they're the Alpha dogs. I guess I'm just a guardian for the weaker. 

The biggest problem is getting my family to understand that this ravaging demon comes out at the simple mention of my "brother" (I use the term loosely) or he just shows up, leaving me feeling rather bombarded and assaulted in my peaceful castle. (See the first paragraph).
I literally black out. The only thing I can see is him. Nobody else is in the room to me, even if there's 30 other people there. 
Whatever the exact trigger is with him, one could liken the response to being high on PCP and having a blood feud.

2. Triggers can leave us completely incapacitated, crying, enduring the pain, thoughts and/or memories that are waging an assault on us - leaving us looking something like this:

Depending on the state of mind we were already in, a full on depression caused by whatever trigger can last days or weeks. Personally, when I hit a serious depression I can be laid up for 2 weeks easy, sleeping at least 16 hours, often 20 hours a day. I honestly think that this is not only a recuperation device, but a way of "avoiding the pain," or letting the mind and heart heal itself a little bit so I can survive. That being said, recuperation after a week or two of this is slow, agonizing and frankly, quite annoying. I'll go deeper into the depression aspect in a later blog.

3. Even worse than just a laid up depression, many  find themselves self-harming. Some people with no clue what it's like to be in our shoes call it "self-mutilation," which fits, but makes us feel worse for doing it. Again I'll go further into detail about Self Injury in a later blog.

The important thing about self injury is (pay attention) it is the step BEFORE suicide attempts.

As a cutter, I can tell you that cutting prevented several suicide attempts (though I do have 3 attempts on me). As difficult as it is to wrap your head around if you are not a self injurer, it works. Yes it's highly dysfunctional, yes it's bad... but damn it, it works. It calms you down enough to maybe be able to sleep the suicidal phase off, or even makes you forget about committing suicide for awhile. The bad thing is, since it does work, it's addicting, like alcohol, heroin, or crack, and just as difficult to stop. Self medicating is called self medicating for a reason, it works; it takes the pain away, even if only for a few minutes, and that's a few minutes we can have relative peace inside our chaotic minds.

4. Well, you're not going to like this one, but triggers can be so harsh the sufferer simply cannot handle the pain and torment within their soul and chooses to remove themselves from this mortal world. Suicidal episodes tend to develop over a long period of time, with explicit warning signs. These warning signs should NOT be lightly taken as a life really is at risk, whether you as a carer can handle the thought of it or not.

Being A Responsibly Mentally Ill Person

Being A Responsibly Mentally Ill Person
Sarah Spiers

I'll put it right here in print - this blog is about those with the ability to control themselves. Not the people that are so far gone they need extensive hands-on care most of the time (and that's with the meds).

One of my biggest pet peeves is the stigma associated with mental illness. This, to me, is because of the many, many people who have say, bipolar or borderline, that do not take responsibility for their own actions. Trust me, I fall off of this wagon myself.

Then there's the caregivers that are essentially enablers and excuse makers. Media doesn't help matters either.
Example: http://www.msnbc.msn.com/id/40691150/ns/us_news-crime_and_courts/40689405

    "He didn't want anyone to get hurt but himself," Rebecca Duke said of the man she loved. She called him a "gentle giant."

    "The economy and the world just got the better of him," she said.

    Police said the attack wasn't some spur of the moment idea. At his mobile home in the woods, they found Dec. 14 circled on a calendar. And police said he had at least 25 more rounds of ammunition in his pocket. 

    In 2000, he was convicted for waiting in the woods for ex-wife with a rifle, wearing a mask and a bulletproof vest. She confronted him and then tried to leave in a vehicle, and Duke shot the tires. His second wife, Rebecca, said the incident was a misunderstanding and that he went to his ex-wife's house because the ex-wife "wouldn't leave them alone."

    Evans said Duke had been diagnosed by several doctors as bipolar, but didn't have enough money to buy the needed medication. "He was clearly in need of help," Evans said.

    He and Rebecca had married in 1999, just before his prison sentence. She said Wednesday that Duke faithfully took his medication for his bipolar disorder, but that he was under a lot of stress.

    "My testament: Some people (the government sponsored media) will say I was evil, a monster (V) ... no ... I was just born poor in a country where the Wealthy manipulate, use, abuse, and economically enslave 95 percent of the population. Rich Republicans, Rich Democrats ... same-same ... rich ... they take turns fleecing us ... our few dollars ... pyramiding the wealth for themselves."

I would like to take this opportunity to call shenanigans. Being a severe bipolar myself, the articles associated with this guy infuriate me beyond imagining. There's another quote from the widow. Essentially she stated that he had moved to a quiet neighborhood (the video looked like a standalone singlewide) and was trying to get better.

If you are bipolar, isolating yourself does not mean you are trying to get better. If he was indeed trying to get better, he would have found http://www.needymeds.org/ just like I did... and like hundreds if not thousands of others do every day.

The economy excuse as a trigger for what this guy did and had the intentions of doing is poor at best. His actions this December were premeditated, and not the first time he acted in a violent fashion. He did time for the first one. I can understand if it is before he was diagnosed with anything. I'll give him that much wiggle room, however, either Duke or a person close to him should have seen the warning signs that the medicine was not working or that he was experiencing warped thinking at a worse interval and he probably needed psychiatric intervention.

Clay knew the violent demon was rising up inside of him when he began to make the plans to have a shootout at that school. He knew he was bipolar. He knew he could have gone to any hospital and had himself confined on the grounds his medications were ineffective and he felt he was a threat to others or himself. He knew good and well what he was thinking and feeling was irrational and illogical and that his actions could have deadly consequences, and could have been planning for people other than himself to die.

This was a completely avoidable episode. Clay should have taken RESPONSIBILITY for his own care. I have issues with the public mental health system in America (essentially they're far too underfunded to be able to deal with the massive patient population), but he should have used it at the beginning, when he was still completely cognizant of what he was experiencing.

There is a fine line between caring and enabling; being blinded by a personal relationship and being observant of the one you love; being responsibly mentally ill and being irresponsibly mentally ill.

Another useless excuse for a mental health sufferer who refused to take responsibility for his own mental health is Seung-Hui Cho - the Virginia Tech Shooter. To this day my heart still goes out for the victims, their friends, and their families.

Cho had opportunities to take responsibility for what was going on inside his head. He methodically refused to do so.

    The records chronicle two telephone conversations and one in-person visit between Cho and mental health professionals at the Cook Counseling Center, the university's student mental health services provider, in the winter of 2005, the only instances in which the student ever interacted with the center, according to authorities.  

    Cho denied having any homicidal or suicidal thoughts, according to documents. 

    Conrad wrote that she provided Cho with emergency numbers should he begin to have "suicidal or homicidal thoughts" over winter break.

    In the records from his initial telephone conversation, another triage counselor checked off "Troubled: Further contact within 2 weeks" under the portion of the form that rates the severity of the patient's disposition. 

And that's just the first of a 3 page article.

Cho had immediate help and refused to own up to the demons. He was given further opportunity to own up with the emergency numbers. He refused. He also refused to go to a meeting with a counselor. Cho has no excuse whatsoever.

Responsible lunatics, like myself, fight ourselves to be one step ahead of ourselves. Being mentally ill is a responsibility. I choose to fight it every day.

I have to analyze every mood, every swing of the pendulum, every thought to make sure I am not headed down a dangerous path.

It's almost like a chivalric fight in its own right. Sir Gawain fought his inner demons and seduction to keep himself pure. William Marshal became the only man of his time to believe in loyalties, what it was to be a noble knight, to take responsibility for his actions, to keep his emotions in check.

It is indeed like my chivalric quest to attain the Holy Grail, to have the perfect soul despite the stormy waters, to be the perfect woman where it counts - the soul which stays forever young, not the skin which wrinkles and sags.

I have failed before, and I will fail again. It happens. Life happens. I'm just smart enough and responsible enough to know exactly what measures can be taken and when to take them.

I'll admit, I'm willing to commit myself to the psych unit when I need it. I've done it before. It is a difficult decision to make and that has something to do with me being absolutely stubborn about wanting to fight the battle myself. I don't always have the grasp of a "wise general knows when to retreat and when to call for reinforcements." But I fight on anyway, even when it gets to the point where I am expressing myself like this:

    Battle weary is an understatement. Having to keep guard over yourself, monitor and police your thoughts, emotions, actions, mostly thoughts, every second of every day of your life, having already done that for 26 years, looking down the barrel at 45 more if the whole life expectancy thing holds true. Which it probably won’t. Your life is lived in a combat mode that does not end. Ever. Even if you are surrounded by friends and those who “love” you. Even If you’re alone with that one special person you trust enough to let you see you at your sobbing, snotting, teary, vomit-filled weakest. You. Have. To. Exert. All. Of. Your. Energy. To. Keep. Yourself. Alive. And. Somewhat. Sane. Each time you hit the depression, not knowing if this is the one that’s going to claim you, or if you’ll pull through it only to know for certain you will be in the same place once again.