Mental Health: request for advice!

I haven’t written for quite a while, particularly about my mental health, and I think it’s about time I change that.

I’ve had a whirlwind of a year. I got my first paid trans activist job, I lived in Berlin twice and now I’m back living in Belfast and I’m working for a fantastic global trans organisation which allows me the freedom to work from home.

But I’m also depressed. Im anxious. I’m an addict. There’s something very wrong with me and I don’t know what it is. For the past year I’ve been throwing myself into work and running away from my problems. This is me trying to face them.

I just finished watching the most recent episode of Crazy Ex Girlfriend, which is a series on Netflix that talks really honestly about mental illness. I think it’s exactly what I needed to see. Just like the protagonist in the series, I spend my life running away from myself and never accepting help, so this me reaching out.

I’m looking for some form of talking therapy that will help me to understand why I use addiction to cope, and I also want to work out who the hell I am. I’ve always struggled with issues of identity, so I want to be able to talk about this and try to “fix” this, for lack of a better word. I’ve tried CBT and various forms of counselling, but I need something more permanent and something that allows me to look at what started my issues. I’m don’t know if psychotherapy is the solution, but I’m considering it. I’m just really concerned that whoever I see will just make it all about me being trans, and I know it’s not that simple. I’m happy with my gender so I don’t want someone messing that up for me.

So: advice! What sort of therapy should I seek, and any advice on getting round the transphobia/lack of education about trans people issue?

Comment below or message me on Facebook 🙂

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Infinite Gender

astroblend

I don’t really know how to explain this, so bear with me…

As a non-binary person, I’ve always known that I am neither male nor female. I suppose some might call this agender, but I don’t feel like I exist without a gender, more that my gender is something different to male/female, like a third gender. I also feel that the more comfortable I have become in my skin since getting top surgery and developing secondary sex characteristics from testosterone, the less I connect with the binary gender system.

I suppose I’ve always seen myself as an effeminite male-presenting person. I’ve always abhorred social constructs around masculinity, such as aggression, lack of control, and inability to communicate openly/emotionally. However, it is these exact characteristics that are most present in me when I try to explain my gender identity on a binary spectrum. I have come to believe that my personal experience of gender is too far outside the capabilities of current language for me to explain accurately. So instead, I will explain it by referring to current terms that we use to to talk about gender, in our binary system.

Imagine you are sitting on an island. Across a stretch of water are two other islands, and all three islands are equidistant from each other. This is how I imagine third gender to be. For the binary system, just take away one island. However, my experience of gender is not something that I do, or am; rather it is something that happens to me. When I envisage gender, it is a like an infinity of stars and darkness, and it is, at once, all the colours and the very absence of colour itself. For me, gender is freedom from the social restrictions that our understanding of ‘gender = sex’ places upon us. Gender is the freedom to both go through a second ‘male’ puberty while also embracing femininity. It is the freedom to be both butch and camp. It is seeing social interactions playing out in front of you like an elaborate interactive theatre experience, one in which you cannot help but take part. It is the embracing of masculinity and femininity at the same time, while also rejecting both.

Gender, for me, is not linear or controlled, it is expansive and explosive, it flows like water through cracks and it tears apart the rigid rules within which we constrain ourselves. It is human nature to classify things, to separate into boxes, to divide and conquer. This is what we have done to gender. With the growing trans activist movement, and increasing awareness of the binary system in which we have classified gender, people are slowly starting to become more aware that gender does not have to be restricted, or controlled. Society is starting to colour outside the lines, and with it, I hope, comes a deeper understanding of gender and the complexity of the human condition.

Children, before they become aware of social norms, are unrestricted by gender, in their expression, in their play, in their interaction. This is how I have always felt. I think, somehow, I never lost my naivety when it comes to gender. I think this is partly because my hearing loss led me to miss out on social cues that would have otherwise altered my behaviour. I have always been the token weirdo in the room. I’ve always been the different one amongst much more ‘normal’ people. Partly, I was drawn to this, drawn to being the one who is different, because it made me feel special. But it also made me feel isolated, and alone. Nowadays, I avoid ‘normality’, instead being drawn to others who refuse to conform to social restrictions. These can be many different acts of defiance – refusal to conform to gender ‘norms’, refusal to behave extroverted in social situations, refusal to engage in ‘socially accepted’ ways of socialising – but each act is, intentionally or unintentionally, a demonstration of freedom from social rules and restrictions.

I think that we place too many constraints on ourselves in order to control our lives. I have always embraced the chaos, not because I always chose to, but because it is how I cope with life. I think of it as the difference between being an addict, or being a control-freak. They’re both reactions to the same thing – the sense of panic that we feel whenever we realise how insignificant our lives really are – but one is self-constructive, while the other is self-destructive. And in writing this, I realise that, in my explanation of this, I have done exactly that which I claim to resist, the human drive to classify and divide. So perhaps it’s all far more complicated than I have explained here, but essentially, gender is everything. I don’t think that gender is also nothing, but perhaps I’m wrong. I’ve never felt gender as an absence of feeling, but as the coming together of all experiences and emotions at the same time. Gender makes me feel full to bursting, and it’s a great feeling. Or maybe this is just what life feels like when you feel good in yourself. Who knows?

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Nothing About Us Without Us

Today, TENI – Transgender Equality Network of Ireland announced their new CEO. He is a white cisgender man. While there is no doubt that his CV is impressive, I am personally incredibly disappointed that the board of TENI have appointed Stephen O’Hare. I’m incredibly upset that the only trans organisation in Ireland that receives funding is being led by a cis man. Trans people experience unemployment at 3x the rate of the general population (1) and perpetrators of transphobic violence are more than 2x likely to be cis men (2). I believe that the trans community should be led by a trans person. To have a cis man representing the Irish trans community at the highest political, economic and social levels sends out the message that we cannot be trusted to lead our own communities in our own fights for rights, equality and acceptance.

I will be attending TENI’s General Assembly on Saturday 7th October from 3-5pm at the Chocolate Factory in Dublin to put some really hard question to the TENI board. ___________________

(1) https://www.theguardian.com/society/2016/dec/08/transgender-survey-suicide-poverty-unemployment-mental-health

(2) http://www.independent.co.uk/news/uk/home-news/transphobic-hate-crime-statistics-violence-transgender-uk-police-a7159026.html

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Gender Fluidity 

Transitioning is a complex journey. Questions are asked, self-identity is challenged, sexuality can change, and all this is ongoing.

When I first thought about my gender properly, I began to identify as a genderqueer woman.  At the time, my only frame of reference was My Transsexual Summer on Channel 4, and despite the inclusion of Fox Fisher on it, the show was presented as journeys of binary gender transition. By the time I had tried on my first binder, I had begun to think of myself as transmasculine. I even briefly identified as a trans guy, but I was never comfortable with that definition. Finally I came to the realisation that my gender is non-binary. How I understand my non-binary identity is now the aspect of my transition that changes the most.

When I finally hit on the non-binary ‘label’, I knew that my understanding of my gender was not yet complete, merely that I had found a parameter within which to define my gender identity. I told myself that a deeper understanding would manifest itself with time. At the time, I was struggling with more immediate issues relating to my medical transition. One of the biggest questions at that time was whether or not to start taking testosterone (T). I knew that if I did take T, that I might medically transition to a point of regret, but in the end I decided that the risk was worth it. 

I’ve now been on varying doses of T for approximately 18 months. Overall, I am enjoying the changes – much more than I thought I would, actually. However, the closer I get to “passing” as male, the more aware I become of my increasingly tentative connection to the queer female community, and this scares me. The confusing thing is that I don’t want to be seen as female. But as non-binary identities don’t really have a specific place yet in these overwhelmingly binary spaces, it’s hard to know where I want to fit in. I constantly battle with having to choose between the gay/bi male community and the gay/bi female community. 

This internal struggle makes me question my gender in different spaces. On the whole, my interaction within these binary spaces leads me to ask myself if I am genderfluid. On reflection, it’s a label that I am becoming more comfortable with identifying with the longer I ponder it. It’s possible that my expression in these spaces is more relevant than my identity, but the further I get into my transition, the more these elements overlap. In gay/bi male spaces, I identify more closely with femininity/femmeness, whereas in gay/bi female spaces, it’s in my masculinity that I feel most comfortable. 

For this reason, I still identify closely with the butch female/non-binary community, and I have begun to identify more closely with the femme male/non-binary community. It’s only in queer spaces that I genuinely feel comfortable enough to express both parts of my identity without fear of being perceived as the ‘wrong’ gender (i.e. female in male spaces, male in female spaces). Therefore, it would seem that it is binary gender which forces me into this identity of gender-fluidity. 

As an openly non-binary person, I am aware that I cannot ever fit into these binary communities, yet the world in which we live is structured around binary gender! The easiest way for me to navigate this world is to find a way of ‘fitting in’, and for me, that means identifying as genderfluid. I still express my gender freely in queer spaces, which allows me to feel at home in my gender identity. Due to the rarity of such spaces, I tend to immerse myself in those communities that I do discover, which has lead some well-meaning heterosexual cisgender people to encourage me to try to “fit into the real world” better. My response to these people is this: I am fitting in as best as I can. This world was not designed for people like me. This is why I spend all my time and energy trying to change it when I can. Some people say I do so much for the non-binary trans community through my activism. But the truth is that I do it first and foremost for myself. I don’t want to feel like an outsider in my own home. 

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Hypomania + Insomnia

For the longest time, I have thought that the depression I experience is not unipolar, but bipolar. I discussed this with my psychiatrist at the GIC, who said that my ‘manic’ episodes are not severe enough to warrant a ‘diagnosis’ as bipolar. Although I understand that my manic periods don’t result in hospitalisation or psychosis, they still affect me such that aspects of my life drastically change due to the extreme highs and lows.

Once I started to take Venlafaxine I noticed that I needed to sleep less, I was more agitated and I had a lot more energy. I started Venlafaxine not long before I started taking testosterone, so I struggle to discern from which substance the changes in my physical and mental health came. Recently, a good friend of mine just started taking Venlafaxine too, and talking to her about how it makes her feel has made it clearer in my mind what Venlafaxine is doing to my mind/body/brain.

Before I ever started to take anti-depressants, my mental health went from really low points in winter, to really high points in summer. As time went on, the length of time between the highs and lows became shorter and shorter, until I was swinging from one to the other sometimes several times in a day. It was exhausting. It’s only from talking to my friend that I’ve realised that these extreme “mood swings” (for lack of a better word) have become less intense, less repetitive, more spaced out. However, it appears that although the really deep, dark lows have become much less intense, the highs have become far more concentrated than I have experienced them before.

It used to be that when I was ‘manic’, I would become super sociable, I would sleep less and yet somehow be more energetic. This time, however, I’m not just sleeping less, I’m barely sleeping at all. Whenever I do sleep, it is a half-waking sleep from which I awake feeling irritated, agitated and full of nervous energy. I don’t need to eat, and if I didn’t force myself to have at least one meal a day, I would simply go without. Hunger exists, but it’s like a long-forgotten sock left underneath a dusty sofa. It does not drive me or call to me, but simply hides away, easily forgotten. I cannot switch off fully, but being unable to switch off, I cannot be fully switched on either, existing instead in a fuzzy haze of insomnia, hypomania and exhaustion.

The strangest thing is that it does not scare me. I am aware that the crash will come (and with a really high-high, there follows a REALLY low-low), but somehow I feel that on Venlafaxine it won’t be able to touch me like it has done before. I am, however, concerned. I know that lack of sleep can bring on hypomania, and that hypomania brings with it insomnia, so it’s like a cat chasing it’s tail – the circle goes on repeating itself. The last time this happened to me, I experienced insomnia and hypomania with severe depression. This time, I don’t feel depressed, just vaguely aware that the depression is there, but it’s trapped beneath the surface – by, I think, Venlafaxine. The solution for my insomnia the last time was low-dose sleeping pills, prescribed for only 10 days, to regulate my sleeping pattern enough that I could eventually fall asleep more ‘naturally’.

Maybe I’m putting to much store by the anti-depressant medication that I take, but after doing some research into it, it appears that Venlafaxine can indirectly cause hypomania due to the side effect of insomnia. It’s worth mentioning that I have been through quite a lot in the last 2 months between looking for work and lots of things going on in my personal life. It has been a tough couple of months, with a lot of stress and anxiety, so it’s not really surprising that I worked myself up so much that I am currently unable to sleep for longer than 2/3 hours at a time. I also did some research into why hypomania/insomnia and bipolar disorder are so interdependent, and supposedly people who are bipolar have a sensitive body clock, which is easily affected by irregular circadian rhythms. Where I live, the sun only sets for about 5 hours in the summer. Sleeping without blackout curtains means that I get no sleep at all.

I don’t have an immediate solution to my current insomnia predicament. Currently I have been awake for 24 hours – my head feels fuzzy, my body is agitated and full of nervous energy – yet I do not feel sleepy at all. I intend on staying awake until at least 10/11pm tonight and then I will attempt to fall asleep at a regular hour (i.e. before midnight). Hopefully I will be so exhausted that I will actually sleep through the night, and deeply.

Posted in Anti-Depressant Medication, Mental Health | 2 Comments

Daily challenges of living with depression 

A friend of mine recently reminded me of an aspect of depression that is often overlooked: that the lack of motivation to do things can affect not only your ability to participate in social activities, but every element of your life, including eating.

People who don’t really understand depression often offer advice such as “if you ate healthier food you would feel better” or “if you could just get a regular sleeping and eating schedule, everything would start to improve.” While I don’t disagree with the content of the statements – certainly routine and consuming healthy food has been demonstrated to prove overall health – they’re not particularly useful pieces of advice for a depressed person. The thing is that eating healthy food involves one of two things: making it yourself at home cheaply; or buying expensive pre-made food at high-end supermarkets. As most people can’t afford the second option, eating healthily means making it at home. 

This involves a fairly uncomplicated, but task-laden process that takes time, energy and effort:

  • Decide what to cook – either by looking up recipes or memory of familiarised recipes.
  • Write down or remember ingredients for recipe. As a trip to the shop requires a lot of effort, this will also often requires including everything else that you have run out of on the list too.
  • Work up the motivation to actually go to the shop.
  • Go to the shop to get food. Depending on circumstance this can involve making decisions about what to buy or not buy based on: what is within budget; what you can manage to carry if going by foot or bicycle; how strong your will is to avoid buying junk food or easy-to-make food.
  • Get home and unpack the food. 
  • Work up the energy to actually cook something.
  • Cook the food and eat it.
  • Clean up the kitchen afterwards or shove everything in the dishwasher if you can afford the electricity.

I know this reads like a #firstworldproblems list, but the reality is that, for me, this was the step-by-step process I had to go through in my head in order to make food. Sometimes just thinking about it all would overwhelm me so much that I wouldn’t be able to leave the house.

Over time, I found ways around this. I would use the days or hours when I was full of energy to cook massive portions of one-pot dishes that were cheap and simple to make, and then freeze the excess for the bad days. Sometimes the bad periods would last longer than my food supply and I would go through weeks of eating porridge and stewed beans until I had another good day. I’m fortunate that I love cooking. I can’t imagine how I would have coped if I hated cooking. I relied on recipes with lots of beans, tinned tomatoes and root vegetable, which are cheap to buy in Northern Ireland. I would spend maximum £20 per week on food, sometimes as little as £5 when I was really broke.

Having little money can massively impact on mental wellbeing. The constant worry about running out of money, having to count every single penny spent, becomes exhausting. Add this to the anxiety and/or depression already experienced and it becomes almost impossible to escape worry, despair and/or hopelessness.

It’s crucial to understand that tackling severe or non-functioning depression requires a comprehensive approach that takes into account all aspects of an individual’s life. When I was signing on (getting social welfare benefits), I received monthly payments of £220 from the housing benefit office and £245 for unemployment benefit – £465 in total. My monthly outgoings included £275 for rent, £20 mobile phone bill, £18 for TV licence & internet and £15-40 for electricity and gas (depending on season). This would leave me with £110 in winter months to pay for public transport, food, and any emergency expenses that came up. I know it’s not dire poverty, but it also isn’t enough money to live on without constantly worrying about running out. It’s not living, it’s struggling. 

There has been so much effort put into challenging social attitudes towards depression and anxiety, but little has been done to address the social inequalities that reinforce the systemic discrimination towards people living with severe mental health issues. It’s time to start thinking about the bigger picture and how we can begin to challenge these imbalances. 

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One thing at a time

There are days, sometimes weeks, when I feel fantastic. Then there are days, sometimes weeks and months when I feel pretty crappy. On the crappy days, my mantra becomes “one thing at a time”. When my depression was really bad, it was the only thing that got me out of bed. It was my mother who taught me about this. When I was in my first year of university, back in 2009, I would struggle with getting out of bed. My mum’s advice was to just do “one thing at a time”. She also suggested having little rewards to work towards to motivate myself to do the things that needed doing. When I couldn’t get out of bed, my reward was Crunchy Nut Cornflakes – if I managed to get out of bed, I would have a bowl of it for breakfast. I ate crunchy nut for breakfast that whole academic year.

Nowadays, when my depression tries to drag me into despair and hopelessness, paired with despondency and an inability to motivate myself to do anything other than lie on my bed and play Spider Solitaire on my phone, I remind myself of this advice. “One thing at a time”. For this to work, it requires not so much total focus on the task at hand, but more of a passive awareness that I may only manage to do this one thing, without any further pressure on myself to complete another task. Only by taking pressure off myself to do anything more than a single task, will I manage to motivate myself. Often, this is paired in my mind with a small push such as “if I manage to make the bed, then I might walk to the shop to get an ice cream”. Although the reward in itself is also a task (which would have completely defeated me a few years ago), now I am able to work the energy up to take a walk to the shop to get the ice cream. 

For those who haven’t lived with depression, it can seem a ridiculously simple thing to be defeated by. Unable to find the energy to walk to the shop? #firstworldproblems. Part of me feels the guilt of this mindset. After all, I’m lucky that I live in a country where it’s safe to take a random walk to the shop, and that I can afford such luxuries as ice cream. I’m aware of this, but knowledge of this only serves to make me feel more worthless, compounding my depression and making it even harder to work up the energy to leave the house.

As I lie on my still unmade bed, contemplating the simple task of getting out of bed and making it look tidy, I realise that writing this blog post is simply an avoidance tactic to delay getting out of bed. Perhaps, when I’ve posted it, I’ll make myself a coffee. One thing at a time, followed by a reward. Maybe, once I’ve had my coffee, I might have the energy to make my bed. 

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