Daily Archives: April 3, 2016

What is your problem?

problem

I thought I’d try something a bit different this week: an audience participation blog entry.

What I’d like you to do is use the comment section to share the biggest problem going on in your life right now. Your comment can be very short or very long…whatever works. It can deal with mental health issues or just plain life.

If you read someone else’s problem and you have a suggestion or want to offer encouragement, please do.

Here we go:

My biggest problem right now is driving and/or riding in a car anxiety. This is preventing me from going to my support group because my husband has another meeting at this time. It also makes my social activities tough because I always need a ride. All of my friends have been very understanding but I feel like such a failure.

I already want to turn down offers to go places this summer because of my fear of riding. This would also affect my husband, which isn’t fair.

A couple of people have suggested CBT. I got a workbook but am not sure it will be a “cure”. Am at my wit’s end with this.

 

Okay, so that is my problem. What is yours?

 

 

 

Depression Sucks

It takes all your motivation away. It leaves you feeling trapped with this horrific feeling of claustrophobia.

Now despite all this I went out for a Sunday drive. We have some really pretty areas around here and it was nice to get out of the house. It might have even helped a teeny tiny bit. Though it took me out of my comfort zone, it was likely a good thing.

Hubby says I should just do things I don’t want to do. I don’t have a feeling of not wanting to do anything. It’s more of I can’t find anything to do. Maybe he’s right who knows.

I’m avoiding sad things as much as I can because I feel like if I were to start crying it would just turn into an endless cascade of tears.

I’m considering giving up weed. Being high every day is starting to be the only way I can feel normal and it’s not keeping the depression at bay the way it used to.  I’ll think about it before I get anymore I guess.


Mur Mur Murrr

I’m sitting here being Annoyed as Fuck™® because I am anxious and it’s making me slightly depressed and they’re feeding each other back and forth. I’m sooooo not impressed. Like, getting the Seroquel sorted means that I’m sleeping well, am starting to get to sleep properly; the change from normal release to extended release takes a bit, with a loving dose of melatonin to boot. I am on the whole feeling more stable and have managed to not murder my kiddos here in the two week Easter holiday (one down, one to go), but still… that anxiety, that depression. I’m hoping that when I’m in next week that we can opt to up the antidepressant and see if that makes a difference.

Really though, I wish the ADHD diagnosis referral would come through. Besides the focus that being medicated would give me, I am led to believe it is super-helpful for anxiety. As it’s been 17 years since I had very very part-time access to ADHD meds compliments of a friend, I never really evaluated it for anxiety help. I was just grateful because the days he’d let me have his meds meant that I was actually able to stay awake through the first period of the day instead of looking like I didn’t give a shit about my classes. Really, the whole deal makes me wish that I was a shadier person with less concept of consequences because if I were, I’d be sorely tempted to go grey market to try and get *something* to help in that regard.

 

But Therapy! Mindfulness!

But what. My BFFFFF says I can outlogic Spock, and I can. If there is a logical reason for me feeling anxious or depressed, I am on it like stink on shit. Unfortunately, 99% of the time it just springs out of nowhere to make my life hell. It’s a big part of why I accept that my brain’s wiring is shot and that medication can make the difference in my life — because it has. I’ll rely on it as long as I humanly can and feel no shame for it.Which isn’t to say anyone is failing if they desire to come off of meds, or therapy helps them — I’m glad there are options out there for people, and am hoping that people in general are rocking the option that gives them the best quality of life.

As it were, my only concern as far as medication is concerned right now is being taken off of something and being put on something else. I worry about losing potential efficacy by hopping around… not that I’ve had hopping yet, just combining things here and there. I don’t even know who I am seeing this time around since Dr. K is going, and what their spin on it is going to be (if they don’t think I’m manic because they don’t understand that Americans talk quickly).

Oh okay, maybe I’m a teensy bit anxious about that, but that’s not actually going to hit me until like, we’re on the way. It’s not like I can do anything about it beforehand, yanno? See, there’s that logic peeping its head up. 🙂

Anyhoos, better out than in, and now it’s out. Hope this finds all of y’all as well as you can be.

<3

Mur Mur Murrr

I’m sitting here being Annoyed as Fuck™® because I am anxious and it’s making me slightly depressed and they’re feeding each other back and forth. I’m sooooo not impressed. Like, getting the Seroquel sorted means that I’m sleeping well, am starting to get to sleep properly; the change from normal release to extended release takes a bit, with a loving dose of melatonin to boot. I am on the whole feeling more stable and have managed to not murder my kiddos here in the two week Easter holiday (one down, one to go), but still… that anxiety, that depression. I’m hoping that when I’m in next week that we can opt to up the antidepressant and see if that makes a difference.

Really though, I wish the ADHD diagnosis referral would come through. Besides the focus that being medicated would give me, I am led to believe it is super-helpful for anxiety. As it’s been 17 years since I had very very part-time access to ADHD meds compliments of a friend, I never really evaluated it for anxiety help. I was just grateful because the days he’d let me have his meds meant that I was actually able to stay awake through the first period of the day instead of looking like I didn’t give a shit about my classes. Really, the whole deal makes me wish that I was a shadier person with less concept of consequences because if I were, I’d be sorely tempted to go grey market to try and get *something* to help in that regard.

 

But Therapy! Mindfulness!

But what. My BFFFFF says I can outlogic Spock, and I can. If there is a logical reason for me feeling anxious or depressed, I am on it like stink on shit. Unfortunately, 99% of the time it just springs out of nowhere to make my life hell. It’s a big part of why I accept that my brain’s wiring is shot and that medication can make the difference in my life — because it has. I’ll rely on it as long as I humanly can and feel no shame for it.Which isn’t to say anyone is failing if they desire to come off of meds, or therapy helps them — I’m glad there are options out there for people, and am hoping that people in general are rocking the option that gives them the best quality of life.

As it were, my only concern as far as medication is concerned right now is being taken off of something and being put on something else. I worry about losing potential efficacy by hopping around… not that I’ve had hopping yet, just combining things here and there. I don’t even know who I am seeing this time around since Dr. K is going, and what their spin on it is going to be (if they don’t think I’m manic because they don’t understand that Americans talk quickly).

Oh okay, maybe I’m a teensy bit anxious about that, but that’s not actually going to hit me until like, we’re on the way. It’s not like I can do anything about it beforehand, yanno? See, there’s that logic peeping its head up. 🙂

Anyhoos, better out than in, and now it’s out. Hope this finds all of y’all as well as you can be.

<3

Mur Mur Murrr

I’m sitting here being Annoyed as Fuck™® because I am anxious and it’s making me slightly depressed and they’re feeding each other back and forth. I’m sooooo not impressed. Like, getting the Seroquel sorted means that I’m sleeping well, am starting to get to sleep properly; the change from normal release to extended release takes a bit, with a loving dose of melatonin to boot. I am on the whole feeling more stable and have managed to not murder my kiddos here in the two week Easter holiday (one down, one to go), but still… that anxiety, that depression. I’m hoping that when I’m in next week that we can opt to up the antidepressant and see if that makes a difference.

Really though, I wish the ADHD diagnosis referral would come through. Besides the focus that being medicated would give me, I am led to believe it is super-helpful for anxiety. As it’s been 17 years since I had very very part-time access to ADHD meds compliments of a friend, I never really evaluated it for anxiety help. I was just grateful because the days he’d let me have his meds meant that I was actually able to stay awake through the first period of the day instead of looking like I didn’t give a shit about my classes. Really, the whole deal makes me wish that I was a shadier person with less concept of consequences because if I were, I’d be sorely tempted to go grey market to try and get *something* to help in that regard.

 

But Therapy! Mindfulness!

But what. My BFFFFF says I can outlogic Spock, and I can. If there is a logical reason for me feeling anxious or depressed, I am on it like stink on shit. Unfortunately, 99% of the time it just springs out of nowhere to make my life hell. It’s a big part of why I accept that my brain’s wiring is shot and that medication can make the difference in my life — because it has. I’ll rely on it as long as I humanly can and feel no shame for it.Which isn’t to say anyone is failing if they desire to come off of meds, or therapy helps them — I’m glad there are options out there for people, and am hoping that people in general are rocking the option that gives them the best quality of life.

As it were, my only concern as far as medication is concerned right now is being taken off of something and being put on something else. I worry about losing potential efficacy by hopping around… not that I’ve had hopping yet, just combining things here and there. I don’t even know who I am seeing this time around since Dr. K is going, and what their spin on it is going to be (if they don’t think I’m manic because they don’t understand that Americans talk quickly).

Oh okay, maybe I’m a teensy bit anxious about that, but that’s not actually going to hit me until like, we’re on the way. It’s not like I can do anything about it beforehand, yanno? See, there’s that logic peeping its head up. :)

Anyhoos, better out than in, and now it’s out. Hope this finds all of y’all as well as you can be.

<3

Unloved Daughters: 4 Tips to Make Self-Compassion Easier

A brilliant, informative and instructional article for all of us, daughters with unloving mothers. May we find love, may we find strength. May we find the strength to love ourselves. Namaste. 

https://www.psychologytoday.com/blog/tech-support/201603/unloved-daughters-4-tips-make-self-compassion-easier?utm_source=FacebookPost&utm_medium=FBPost&utm_campaign=FBPost#sidr-mainUnloved Daughters: 4 Tips to Make Self-Compassion Easier
1. Spend some time with a photograph of yourself when you were little. 

 
Posted Mar 24, 2016

Children whose parents are unloving, hypercritical, disparaging, or authoritarian often become adults who struggle with self-criticism. What is self-criticism? It’s the mental habit of attributing bad outcomes or situations—failing a test, not getting a job offer, having a relationship unravel—not to a series of causes and effects but to generalized, fixed characteristics about yourself.
Self-criticism sounds like this:
“I got a bad grade because I am dumb and worthless and that’s not going to change.”
“I’ll never get a decent job because they’ll see through me and realize I’m a dud.”

“He left me because there’s nothing good or lovable about me. Who can blame him?”

Secure people understand failure and challenge differently and actually use their self-criticism to troubleshoot, asking questions about what they might have done differently and how they could change in the future. This just isn’t true of the insecurely attached child. (From here on, I will refer only to daughters but this applies equally to sons.)

As studies show, self-criticism is the result of a child’s internalizing the harsh and abusive verbal assessments of, usually, a mother, but sometimes from a father. It also grows from the messages conveyed by both actions and inactions (hostile encounters or withheld comfort or support). Unloved daughters with verbally aggressive mothers often report—and I can attest to this from my own experience—that shutting off the tape-loop of self-criticism in your head is surprisingly difficult, even with a therapist’s help. Among the legacies unloving mothers bequeath is the unhealthy default setting of self-blame when life goes south, made worse by the fact that insecurely attached daughters have trouble regulating negative emotions.
It’s been suggested by many, including myself, that self-compassion is a successful strategy for those trying to recover from childhood and who need help stilling that critical voice. Additionally, self-compassion has been shown in studies to bolster resilience from failure and to support self-improvement.
What is self-compassion exactly? Just as compassion involves feeling for the plight of others, and extending caring and understanding to them, self-compassion directs caring toward the self in the same way. According to Dr. Kristen D. Neff, self-compassion requires that you see your pain in the larger context of humanity’s experiences—and as a part of them. It necessitates that you treat yourself with the same lovingkindness your compassionate self would offer to others. (This understanding is drawn from Buddhism, as you probably know.)
What’s important is that self-compassion isn’t anything like self-pity because self-pity focuses on the self as separate from others, and promotes a “poor me” point-of-view that paints the self as worse off than anyone else. It is more self-involved and selfish than not.
Neff describes self-compassion as having three parts, which I’ll paraphrase:
extending kindness and understanding to yourself, rather than judgmental criticism;
seeing your experience as part of the larger human experience; and

keeping yourself aware of your painful feelings without over-identifying with them.

The problem, though, is that all three of these steps are hard for unloved daughters to begin with. Why? The first relies on self-love, which is usually in short supply; the myth that all mothers are loving isolates the daughter and she’s likely not to believe that her problems are like those of other people, as the second step suggests; and finally, most insecurely attached people have trouble managing their negative feelings so the third step is very difficult indeed.

So I thought it might be useful to use Neff’s shorter scale—“How I Typically Act Toward Myself in Difficult Times”—to assess your skill set when it comes to self-compassion. You should answer on a scale from 1 to 5, with 1 being Almost Never and 5 being Almost Always. You don’t have to score this but can just pay attention to what your answers are. (If you do want to score it, please look at the bottom of the post.)
_____1. When I fail at something important to me I become consumed by feelings of inadequacy.
_____2. I try to be understanding and patient towards those aspects of my personality I don’t like.
_____3. When something painful happens I try to take a balanced view of the situation.
_____4. When I’m feeling down, I tend to feel like most other people are probably happier than I am.
_____5. I try to see my failings as part of the human condition.
_____6. When I’m going through a very hard time, I give myself the caring and tenderness I need.
_____7. When something upsets me I try to keep my emotions in balance.
_____8. When I fail at something that’s important to me, I tend to feel alone in my failure
_____9. When I’m feeling down I tend to obsess and fixate on everything that’s wrong.
_____10. When I feel inadequate in some way, I try to remind myself that feelings of inadequacy are shared by most people.
_____11. I’m disapproving and judgmental about my own flaws and inadequacies.
_____12. I’m intolerant and impatient towards those aspects of my personality I don’t like.
How did you make out? My older self did better than my younger self might have but it’s still clear to me that my self-compassion is—how shall I put this—not precisely a dominant trait. I remain impatient with parts of myself, for example, and I don’t excuse my flaws because most people have them. 
So, since research shows that self-compassion really does help people deal with challenging times and stops rumination—another thing most unloved daughters suffer from—how do we build our capacity so we can use it to still the critical voice? Here are a few anecdotal layperson tips, slightly aided by science but informed by experience, which may be of help on the road to self-compassion. As you do these, be sure to use “cool” processing, which has you recalling why you felt as you did, not what you felt. This is important because thinking about what just has you relive the painful moment.
1. Get a photograph of yourself when you were little and spend time with it.
Look at that child (you) and see her as a stranger might. What’s cute and appealing about her? Talk to that little girl and give her some comfort. And while you’re there, ask yourself why anyone would ever think that child was anything less than adorable
2. Focus on one thing you love about you.
It can be a characteristic—the way you smile at people or put them at ease—or a talent or ability, but it should be something you are proud of. Think about the critical voice and how it ignores your positive qualities. Writing about yourself in this way is also helpful.
3. Make self-compassion a goal.
You can work up to being self-compassionate as you would set any other goal, such as saving money, cleaning out your closets, or finding a new job. Keep notes on the progress you’re making by not reverting to that self-critical point of view, and treat yourself to something you like when you succeed. Yes, it’s called positive reinforcement.
4. Ask yourself: Will I show myself compassion?
Studies show that, contrary to popular belief, affirmations don’t motivate as well as questions. Write the question down and pin it up where you can see it. Remind yourself that this is a step-by-step process and that baby steps are fine. It’s getting to self-compassion that matters.
The science suggests that self-compassion may be a useful strategy for regulating our emotions and stilling that internal critical voice. It may simply be that some of us have to work on being compassionate when we look in the mirror before we can make it work for us.
To get your self-compassion score, reverse score the negative items (1,4, 8, 9,11,12,) by making 1=5, 2=4,3=3, 4=2, 5=1), then add, and compute the mean.
Neff, Kristen D.,”The Development and Validation of A Scale to Measure Self-Compassion,” Self and Identity (2003),2, 223-250.

Neff, Kristen D., Ya-Ping Hsieh, and Kullaya Dejitterat, “Self-Compassion, Achievement Gals, and Coping with Academic Failure,” Self and Identity (2005), 4, 263-287.
Breines, Juliana and Serena Chen. “Self-Compassion Increases Self-Improvement Motivation,” Personality and Social Psychology Bulletin, published online 29 May 2012 DOI: 10.1177/0146167212445599
Raes, F., Pommier, E., Neff,K. D., & Van Gucht, D. (2011). Constructionand factorial validation of a short form of the Self-Compassion Scale.Clinical Psychology & Psychotherapy. 18, 250-255.
Kross, Ethan, Ozlem Ayduk, and Water Mischel, “When Asking ‘Why’ Doesn’t Hurt: Distinguishing Rumination from Reflective Processing of Negative Emotions ,” Psychological Science (2005), vol. 16, no.9, 709-715.


What Being Institutionalized As A Trans Person Made Me Realize

Back in the days just before I started testosterone, I used to say, “If HRT were to start causing problems with my bipolar disorder, there’s no question – I’d stop the hormones.”

I swore, over and over again, that I would never sacrifice my sanity for my transition. But this is not what I said in the psych ward, when the psychiatrist asked me, “Would you be willing to stop testosterone?”

Repeatedly, day after day, doctors would ask me about stopping HRT and my answer was the same every time.

“That’s not an option.”

My self of six months ago would have been aghast if he knew I was refusing to stop HRT despite being institutionalized.

But it wasn’t six months before. It was present day.

Present day, under a 5150 – wishing I weren’t alive, hearing voices that told me I was better off dead, and drinking more than my fair share to cope with both – the Sam that had hair on the back of his hands where there wasn’t any before, the Sam that was losing his curvy shape by the day, the Sam that looked in the mirror and felt whole for the first time, went against medical advice and insisted that they find another way to help him.

And I think that if you aren’t trans – and maybe even if you are – you might think that’s absolutely crazy.

But in my mind, I would’ve rather struggled to find medications that allowed my transness and bipolar to coexist than give up on my transition for the indefinite future, losing any hope of being in a body and inhabiting a self that felt right.

It would’ve been trading one kind of anguish for another. Which, to me, didn’t feel like a real solution at all.

For the cisgender medical providers around me though, they couldn’t wrap their heads around why I would refuse to stop HRT.

They couldn’t comprehend why I was willing to sit in an institution for however long it took to find a medication regimen that stabilized my bipolar disorder without denying me my transition.

And I say this not because I’m taking pride in being stubborn, but because cisgender people in general don’t know or understand the lengths trans people go to – the sacrifices we make, the trauma we endure – just to be who we are.

Cisgender people don’t understand that even in spaces that are supposed to be “safe,” trans people are subjected to harm that cis people will never endure.

I didn’t expect my hospitalization to be one in which my transness was understood, but I was blown away by just how little support there really was available to me.

If we aren’t suffering at the hands of someone else, we’re suffering the emotional trauma of being trans in a system that does not yet know how to affirm us, help us, or treat us.

In my case, there wasn’t a single doctor that could tell me if I would be allowed to continue on testosterone – because there’s simply not enough research around treating mentally ill trans people.

I had to sit in a psych ward, my mind eating itself alive, waiting helplessly to see if it was lithium that would win this fight or if I would be denied hormones because it was considered too risky to continue.

I had to wait, day after day, knowing that the hospital could take my hormones away at any time.

Thankfully, it was lithium that won out, this time.

But I quickly learned that even the best psychiatrists struggle to know what to do with transgender patients.

And when you’re locked in the psych ward, being treated like a medical mystery is not reassuring when your life and your transition are on the line.

This doesn’t even begin to capture the utter incompetence I experienced in the hospital, from staff members who did not know how to talk about trans people to the rampant misgendering despite my files clearly being marked “FEMALE TO MALE.”

I went there to heal but instead, panicked doctors and nurses encouraged me to stop HRT, they unapologetically misgendered me despite being repeatedly called on to do better, and a facility that assured me it was trans-competent turned out to be more invalidating of my gender than any mental health facility I’d ever been in before.

I was supposed to be a patient. But I was forced into the role of advocate and educator, at a time when I barely had the energy to care for myself, let alone teach an entire (rotating) staff how to treat transgender people.

In the San Francisco Bay Area, of all places, in a psych ward where suicide attempt survivors and suicidal trans people – of which there are many – will be going to receive care and begin their healing.

In a hotbed of insensitivity, cluelessness, and even violence.

It begs the question: For a community that is in dire need of mental health support, where do we go when we’re in crisis?

For me, I had no choice but to go to the ER when my breakdown happened. And I fear for other trans people who are similarly left without viable options, and are subjected to transphobia that wears them down during a time when they should be healing.

And I fear for the number of mentally ill trans folks that were denied hormones before they were ever given a chance to find an alternative.

I was released from the hospital yesterday, now very stable on both lithium and testosterone.

But I’m alarmed by the number of professionals that told me stopping HRT was my only solution, the amount of transphobic microaggressions I experienced in a hospital of all places, the number of battles I had to fight in a place I should’ve been cared for.

I’m outraged for my community, and the trauma they’ll endure in psychiatric facilities that are supposed to be for healing – not for harm.

There’s a glaring deficit in research, treatment, and care of transgender people, especially those with mental illness.

Until we acknowledge this, transgender people will continue to be failed by the mental health system – and will continue to end their lives instead of getting help. And facilities like the one where I stayed aren’t just responsible for doing better. They’re complicit in this epidemic of lost trans lives.

“Don’t transition” is not a solution. “Don’t be in crisis” is not a solution.

Transgender people with mental illness need and deserve better.


What Being Institutionalized As A Trans Person Made Me Realize

Back in the days just before I started testosterone, I used to say, “If HRT were to start causing problems with my bipolar disorder, there’s no question – I’d stop the hormones.”

I swore, over and over again, that I would never sacrifice my sanity for my transition. But this is not what I said in the psych ward, when the psychiatrist asked me, “Would you be willing to stop testosterone?”

Repeatedly, day after day, doctors would ask me about stopping HRT and my answer was the same every time.

“That’s not an option.”

My self of six months ago would have been aghast if he knew I was refusing to stop HRT despite being institutionalized.

But it wasn’t six months before. It was present day.

Present day, under a 5150 – wishing I weren’t alive, hearing voices that told me I was better off dead, and drinking more than my fair share to cope with both – the Sam that had hair on the back of his hands where there wasn’t any before, the Sam that was losing his curvy shape by the day, the Sam that looked in the mirror and felt whole for the first time, went against medical advice and insisted that they find another way to help him.

And I think that if you aren’t trans – and maybe even if you are – you might think that’s absolutely crazy.

But in my mind, I would’ve rather struggled to find medications that allowed my transness and bipolar to coexist than give up on my transition for the indefinite future, losing any hope of being in a body and inhabiting a self that felt right.

It would’ve been trading one kind of anguish for another. Which, to me, didn’t feel like a real solution at all.

For the cisgender medical providers around me though, they couldn’t wrap their heads around why I would refuse to stop HRT.

They couldn’t comprehend why I was willing to sit in an institution for however long it took to find a medication regimen that stabilized my bipolar disorder without denying me my transition.

And I say this not because I’m taking pride in being stubborn, but because cisgender people in general don’t know or understand the lengths trans people go to – the sacrifices we make, the trauma we endure – just to be who we are.

Cisgender people don’t understand that even in spaces that are supposed to be “safe,” trans people are subjected to harm that cis people will never endure.

I didn’t expect my hospitalization to be one in which my transness was understood, but I was blown away by just how little support there really was available to me.

If we aren’t suffering at the hands of someone else, we’re suffering the emotional trauma of being trans in a system that does not yet know how to affirm us, help us, or treat us.

In my case, there wasn’t a single doctor that could tell me if I would be allowed to continue on testosterone – because there’s simply not enough research around treating mentally ill trans people.

I had to sit in a psych ward, my mind eating itself alive, waiting helplessly to see if it was lithium that would win this fight or if I would be denied hormones because it was considered too risky to continue.

I had to wait, day after day, knowing that the hospital could take my hormones away at any time.

Thankfully, it was lithium that won out, this time.

But I quickly learned that even the best psychiatrists struggle to know what to do with transgender patients.

And when you’re locked in the psych ward, being treated like a medical mystery is not reassuring when your life and your transition are on the line.

This doesn’t even begin to capture the utter incompetence I experienced in the hospital, from staff members who did not know how to talk about trans people to the rampant misgendering despite my files clearly being marked “FEMALE TO MALE.”

I went there to heal but instead, panicked doctors and nurses encouraged me to stop HRT, they unapologetically misgendered me despite being repeatedly called on to do better, and a facility that assured me it was trans-competent turned out to be more invalidating of my gender than any mental health facility I’d ever been in before.

I was supposed to be a patient. But I was forced into the role of advocate and educator, at a time when I barely had the energy to care for myself, let alone teach an entire (rotating) staff how to treat transgender people.

In the San Francisco Bay Area, of all places, in a psych ward where suicide attempt survivors and suicidal trans people – of which there are many – will be going to receive care and begin their healing.

In a hotbed of insensitivity, cluelessness, and even violence.

It begs the question: For a community that is in dire need of mental health support, where do we go when we’re in crisis?

For me, I had no choice but to go to the ER when my breakdown happened. And I fear for other trans people who are similarly left without viable options, and are subjected to transphobia that wears them down during a time when they should be healing.

And I fear for the number of mentally ill trans folks that were denied hormones before they were ever given a chance to find an alternative.

I was released from the hospital yesterday, now very stable on both lithium and testosterone.

But I’m alarmed by the number of professionals that told me stopping HRT was my only solution, the amount of transphobic microaggressions I experienced in a hospital of all places, the number of battles I had to fight in a place I should’ve been cared for.

I’m outraged for my community, and the trauma they’ll endure in psychiatric facilities that are supposed to be for healing – not for harm.

There’s a glaring deficit in research, treatment, and care of transgender people, especially those with mental illness.

Until we acknowledge this, transgender people will continue to be failed by the mental health system – and will continue to end their lives instead of getting help. And facilities like the one where I stayed aren’t just responsible for doing better. They’re complicit in this epidemic of lost trans lives.

“Don’t transition” is not a solution. “Don’t be in crisis” is not a solution.

Transgender people with mental illness need and deserve better.


What Being Institutionalized As A Trans Person Made Me Realize

Back in the days just before I started testosterone, I used to say, “If HRT were to start causing problems with my bipolar disorder, there’s no question – I’d stop the hormones.”

I swore, over and over again, that I would never sacrifice my sanity for my transition. But this is not what I said in the psych ward, when the psychiatrist asked me, “Would you be willing to stop testosterone?”

Repeatedly, day after day, doctors would ask me about stopping HRT and my answer was the same every time.

“That’s not an option.”

My self of six months ago would have been aghast if he knew I was refusing to stop HRT despite being institutionalized.

But it wasn’t six months before. It was present day.

Present day, under a 5150 – wishing I weren’t alive, hearing voices that told me I was better off dead, and drinking more than my fair share to cope with both – the Sam that had hair on the back of his hands where there wasn’t any before, the Sam that was losing his curvy shape by the day, the Sam that looked in the mirror and felt whole for the first time, went against medical advice and insisted that they find another way to help him.

And I think that if you aren’t trans – and maybe even if you are – you might think that’s absolutely crazy.

But in my mind, I would’ve rather struggled to find medications that allowed my transness and bipolar to coexist than give up on my transition for the indefinite future, losing any hope of being in a body and inhabiting a self that felt right.

It would’ve been trading one kind of anguish for another. Which, to me, didn’t feel like a real solution at all.

For the cisgender medical providers around me though, they couldn’t wrap their heads around why I would refuse to stop HRT.

They couldn’t comprehend why I was willing to sit in an institution for however long it took to find a medication regimen that stabilized my bipolar disorder without denying me my transition.

And I say this not because I’m taking pride in being stubborn, but because cisgender people in general don’t know or understand the lengths trans people go to – the sacrifices we make, the trauma we endure – just to be who we are.

Cisgender people don’t understand that even in spaces that are supposed to be “safe,” trans people are subjected to harm that cis people will never endure.

I didn’t expect my hospitalization to be one in which my transness was understood, but I was blown away by just how little support there really was available to me.

If we aren’t suffering at the hands of someone else, we’re suffering the emotional trauma of being trans in a system that does not yet know how to affirm us, help us, or treat us.

In my case, there wasn’t a single doctor that could tell me if I would be allowed to continue on testosterone – because there’s simply not enough research around treating mentally ill trans people.

I had to sit in a psych ward, my mind eating itself alive, waiting helplessly to see if it was lithium that would win this fight or if I would be denied hormones because it was considered too risky to continue.

I had to wait, day after day, knowing that the hospital could take my hormones away at any time.

Thankfully, it was lithium that won out, this time.

But I quickly learned that even the best psychiatrists struggle to know what to do with transgender patients.

And when you’re locked in the psych ward, being treated like a medical mystery is not reassuring when your life and your transition are on the line.

This doesn’t even begin to capture the utter incompetence I experienced in the hospital, from staff members who did not know how to talk about trans people to the rampant misgendering despite my files clearly being marked “FEMALE TO MALE.”

I went there to heal but instead, panicked doctors and nurses encouraged me to stop HRT, they unapologetically misgendered me despite being repeatedly called on to do better, and a facility that assured me it was trans-competent turned out to be more invalidating of my gender than any mental health facility I’d ever been in before.

I was supposed to be a patient. But I was forced into the role of advocate and educator, at a time when I barely had the energy to care for myself, let alone teach an entire (rotating) staff how to treat transgender people.

In the San Francisco Bay Area, of all places, in a psych ward where suicide attempt survivors and suicidal trans people – of which there are many – will be going to receive care and begin their healing.

In a hotbed of insensitivity, cluelessness, and even violence.

It begs the question: For a community that is in dire need of mental health support, where do we go when we’re in crisis?

For me, I had no choice but to go to the ER when my breakdown happened. And I fear for other trans people who are similarly left without viable options, and are subjected to transphobia that wears them down during a time when they should be healing.

And I fear for the number of mentally ill trans folks that were denied hormones before they were ever given a chance to find an alternative.

I was released from the hospital yesterday, now very stable on both lithium and testosterone.

But I’m alarmed by the number of professionals that told me stopping HRT was my only solution, the amount of transphobic microaggressions I experienced in a hospital of all places, the number of battles I had to fight in a place I should’ve been cared for.

I’m outraged for my community, and the trauma they’ll endure in psychiatric facilities that are supposed to be for healing – not for harm.

There’s a glaring deficit in research, treatment, and care of transgender people, especially those with mental illness.

Until we acknowledge this, transgender people will continue to be failed by the mental health system – and will continue to end their lives instead of getting help. And facilities like the one where I stayed aren’t just responsible for doing better. They’re complicit in this epidemic of lost trans lives.

“Don’t transition” is not a solution. “Don’t be in crisis” is not a solution.

Transgender people with mental illness need and deserve better.


Lithium and Depression Woes

What the actual fuck.

I noticed for awhile I wasn’t getting nausea with my a.m. lithium. It was a nice nine day respite. Today, though. Wow. I feel like I could hurl pea soup. I should eat. I can’t be arsed. Beef jerky is food, right? I had a piece of that. Stupid lithium, what do you need, a four course meal to avoid the nausea?

I get homicidal when shrinks and various other cockweasels insist lithium does not cause nausea. For some of us, it does. Also, extreme thirst, and we all know you drink toilet water for lithium thirst. (Inside joke.)

My head also hurts in spite of Tylenol. I figure between my meds and bad genetics, I’m gonna have some sort of fatal organ failure, what the fuck, take another pill and another until it works.

The problem is, it’s too sunny out. Which makes my burgundy curtains seem way too bright. And it makes my head hurt. But when it is gray and gloomy I feel even worse. I am a conundrum.

I had a four thing goal list to do before I bring my kid home today. My give a damn is busted. Stupid splat exhaustion.

I however have kicked my ass and bullied myself into accomplishing two things on the list. I vacuumed the  hallway and her room, put down new rugs (ya know, new means, from a yard sale). I changed her bedding. Now I can’t bring myself to face the plethora of other shit that needs done or even the last two things on my list. Maybe later. Maybe when my head doesn’t feel like a puppetmaster is behind my eyes, using the muscles like marionette strings.

I keep trying to point out all the good things. Forget the bad things. It’s not helping. I know I shouldn’t feel this way. Things aren’t that bad. Yet my brain is covered in this gauzy fog of darkness where not even winning the lottery would change a thing. Hell, at this point, I’d be too tired to go through the rigamarole of cashing the damn thing in.

One last thing…

If you’re gonna stalk my blog, er, I mean, FOLLOW…Drop me a comment once in awhile. Just let me know you’re reading. Tell me I am a twonk. Ask me what hair ferrets are. Just speak up on occasion. I’m needy that way.

Actually…the biggest compliment I have ever received in my life was a few weeks ago when I needed the campaign to get the car licensed…And an anonymous reader who follows but does not comment…Donated and said it was worth the money if I just keep writing.

Yeah, nothing has ever meant more to me than to have my writing wanted and encouraged.

So, yeah…Needy me.