A Brief Taxonomy of My Mental Illness
I’ve been having a bad few days re: my mental illness struggles and I thought it might help me process all the stuff I deal with if I wrote it all down and shared it. At the very least it’ll give the people reading it a more detailed look inside what I personally mean when I throw around various mental health terms.
A note for anybody struggling: Everybody’s symptoms and struggle are different, and it’s a very human habit to find reasons that you’re not “really” depressed, or “really” traumatized, or “really” transgender. My symptoms are mine, yours are your own, and if you’re agonizing over whether or not something you have “counts” as one of the below categories—it probably does.
So: here we go.
You may know that incidents of extreme stress and trauma, if unaddressed in the moment, can lead to Post-Traumatic Stress Disorder, the primary symptoms of which are oversensitive threat detection and involuntary full-memory flashbacks.
What you may not know is that chronic periods of elevated stress, even without a single defining traumatic incident, can have a very similar effect on the brain. We call it Complex PTSD, and it functions in mostly the same way, except that the flashbacks are less rooted in concrete memories and more in the feelings that defined those periods. Thanks to my abusive childhood and the sexual assault I went through in college, I have both! Which is very, very fun.
Living with PTSD is like walking a minefield. I’ve gotten a handle on a lot of my particular triggers—mostly things to do with parental and/or sexual abuse, who could have guessed—but there are always weird things that crop up that just so happen to resonate with one or more of my various traumas. I can be walking down the street, smell a particular smell, and then suddenly feel under threat and victimized in a more real way than anyone without PTSD can possibly imagine. Even hearing my very awesome roommates rummaging around in the kitchen sends me back to my childhood fears, no matter how much I know intellectually that I’m not in danger.
Incidentally, when we talk about the need for trigger warnings in art, this is what we mean. It’s not about being offended—it’s about literally having your PTSD triggered without warning, which is a hellish experience that serves neither the art nor the audience. In fact, I often gravitate towards triggering art, both as audience and creator—explorations of parental and/or sexual violence can be hugely cathartic for me, when framed right. But when I’m not ready, it throws me out of the experience and ruins my day.
And it’s not even like I expect to go through life without being triggered. I’m constantly getting triggered. I’d just like the world to do its best, given how hard life is for me and other PTSD sufferers.
Anyway, the next entry in this nightmare list is:
This is the one I’m most used to and probably the one that, at this point, impacts my day-to-day the least. Which isn’t to say that I still don’t get anxiety attacks before and during high-stress social interaction—which, for me, look like tightness of breath, claustrophobia, fear sweats, and an unshakeable sense of impending doom. It’s just that I’ve been dealing with it so long that I’ve learned to just plow through. Which isn’t always the best choice, because plowing through relies on the adrenaline produced by the anxiety itself, and that’s ultimately just begging for a massive crash, one that leaves me vulnerable to:
This is probably one of the most misunderstood mental illnesses. It’s not being sad all the time, at least not for me. It’s more a sense of pervasive, sour numbness. Depression kills my interest and enthusiasm for life and for myself. Things that bring me joy often don’t, and my failure to cheer myself up often leaves me even more depressed. Depression is also a massive energy drain for me, one that makes living my life difficult on all levels. And the fatalism of my anxiety is still present, but the fact that I’m unquestionably doomed isn’t terrifying as much as it is a sick sort of comfort when I’m depressed. Which is a perfect transition to:
When neurotypical people try to talk about the suicidally depressed, they tend to assume that we’re all delusional, irrationally certain that everybody hates us and that the world will be better off without us in it. But that’s not always how it works.
A lot of suicidal people experience their ideation as strictly intrusive thoughts—an unshakeable, involuntary fixation on their own deaths that has no real relation to their intrinsic sense of self. That’s not really me either.
My mind sees suicide as an escape hatch from the high-stress moments of anxiety and PTSD as well as the empty future of depression. Whenever I start to experience overwhelming negative emotion or sensation, my brain will very helpfully pitch suicide as the solution. And I’d be lying if I said that knowing I can give up and end my own life at any time isn’t comforting sometimes.
I want to want to live. I am committed to trying to live as long as I can. But I want to die, earnestly and deeply, often. Because part of me has always known that killing myself will always be—if not easier, simpler—than the uphill climb of finding real quality of life despite my enormous pile of issues, the most pressing of which is currently:
The narrative around dysphoria in cis circles is unrealistic and melodramatic. Some trans people do feel stereotypically trapped in their bodies, in constant existential pain that makes their transness impossible for them to ignore. But a lot of us, including me, experience dysphoria as a simple but pervasive discomfort, one we’ve learned to ignore and treat like the white noise of our lives. When I was a little kid, I desperately longed for a “female” body, but I grew up and got very good at forgetting about that for years at a time.
Someone on Twitter described their dysphoria as an itchy shirt they’d been wearing so long they forgot what being comfortable felt like, and that was the big lightbulb moment for me. But once I accepted my transness, all the dysphoria I’d shoved down over 24 years came roaring back up.
Actually describing the sensations of dysphoria to people who have never experienced it is really, really difficult. The closest I can come is saying that you don’t feel like yourself on a fundamental level. If that’s hard to digest because you always feel like yourself…congrats, I guess. If it’s hard to digest because you never really feel like yourself, you may want to look into that.
It’s a lot easier to describe gender euphoria, which is how the feeling of being correctly gendered and validated in an identity that you may not even know you have. It’s elation, relief—it’s how I imagine the Grinch felt when his heart grew three sizes that day. It felt fantastic the first time it happened (when I asked myself “am I a girl,” and some part of me answered yes), and it felt even better as I started to get used to it, as the feeling became less of a high and more of a sense of deep rightness that I didn’t know I was living without all this time.
I’ve started transitioning socially, but I still present very boy. And when a cashier or a waiter calls me “sir”—reflexively, with no ill intent whatsoever—this wave of discomfort hits me so hard that all the joy in me dies in my throat and all I want to do is claw my way out of my skin. That’s dysphoria. And in my lifelong quest to ignore it, I developed some toxic coping mechanisms that have since metastasized into their own issues. Such as:
If you know me, you’ve probably seen me zone out or get lost in my own head. In college, I developed a reputation for nearly walking into traffic.
For me, dissociation functions as turtling up—I fall away from my body into my own looping, incoherent thoughts. Someone on Tumblr described it as “brain static” and I think that’s perfect. It’s this distance from reality, this feeling of not-really-here, not-really-me, no matter how hard I try to come back to reality. It’s very difficult to describe.
Dissociation is also one of my primary PTSD defense mechanisms. For a long time, sudden triggers would send me into full-on dissociative episodes. A movie would just be trucking along—Baz Luhrmann’s “Romeo + Juliet,” for instance—and suddenly a scene would trigger me—Romeo taking the ecstasy, in this case—and something in me would shift. First, a blood sugar crash, then obsessive, racing thoughts about the trigger itself. Next, queasiness and shortage of breath. Then flashing vision and dizziness, then cold sweat, and, finally, a full-on blackout.
As much as that’s been awful for me, it was a particularly bad dissociative episode that finally got me into therapy. When your body just quits and sends you collapsing face-first into the bathroom floor, you start listening to it.
When I was a kid, going to sleep meant actually listening to my internal monologue of self-loathing. So I avoided sleep by any means possible.
My sleep schedule is pretty close to normal now, but there are still nights where I inexplicably just can’t sleep, no matter how tired I am, what supplements I take, or how long I lie there in the dark. I probably don’t have to explain why this is a living hell.
This is the most straightforward. I turned to weed in college to numb out my pain and maintain functionality and it quickly became a habit. I’ve gone through periods of alcoholism, bulimia, binge-eating, self-starving, punching walls—basically anything that could give me the endorphin rush and illusion of control I needed to keep ignoring my problems. My weed addiction is basically the last one standing, which is for the best—it takes the least toll on my brain and my body. I would very much like to be able to function sober, but weed is very effective spot relief for dysphoria and PTSD (at least for me) and being high is fundamentally dissociative in a way that makes that nightmare feel normal and fun. So it’s here to stay for the time being, at least until I’m more thoroughly transitioned and financially stable.
And that’s pretty much the roundup! But before I go, I want to present a quick example of how these things work in tandem:
Last night, I couldn’t sleep. My insomnia opened the door for my suicidal ideation to run rampant. Eventually I got hungry and frustrated and got food, but resisted a full-on binge. When I finished eating, I smoked a bowl to try to ease myself down into unconsciousness. But as I tried to relax, I found out that someone I knew had been attacked for being trans (I don’t want to go into it more here because it’s so graphic, but you can and should find her GoFundMe here), which was deeply anxiety- and dysphoria-producing and aggravated my suicidal ideation even more. My first instinct was to self-trigger my PTSD, which is one of my self-harm practices. I managed to resist the urge by smoking more and putting on an episode of Joy of Painting, but I was dissociating too hard to actually pay attention. So I turned the lights off and let my brain freak out for a long time as Bob Ross’s soothing voice nattered away in the background. Eventually (no idea when), I passed out.
If you’re neurotypical, I hope this was educational for you in some way. If you got something out of this, please head over to my Patreon via the sidebar. My issues make employment very tricky and anything you give will go a long way towards supporting me and my work.
For me, writing this has been a really nice reminder that I’m carrying an enormous amount of psychological weight and that my inability to function sometimes is in no way an indictment of the effort I’m putting in or my value as a human being. I hope that, if you’re struggling, this helps you validate yourself in the same way.
Stay as safe as you can,