mental health

The Start of Something Old

I didn’t even realize that I wasn’t doing that well until I decided I wanted to post a blog and started thinking about what I would say, but River can tell I don’t feel well.  A few minutes ago, she lay down on top of me and wouldn’t stop giving me kisses.  I know that sentence sounds awkward, but I googled the past tense of lie down and that’s what Writer’s Digest told me it was. My 7th grade English teacher, Mrs. Shope, would know, but she wasn’t available to ask and I wouldn’t want to bother her about such things.

I don’t feel like writing anything today.  I don’t feel like getting out of bed.  So I’m writing this from my bed in hopes that maybe it will help someone else feel a little less alone.  I’m not depressed yet, exactly, but I know that’s the direction I’m headed.  I don’t feel sad or hopeless or helpless yet, but I have barely left my room since Wednesday afternoon, all I want to do is binge watch Homeland and be left alone, I haven’t showered since Wednesday morning (gross, I know, but I’m just trying to be honest and I imagine I’m not the only person in that particular boat right now), and I feel apathetic again.  I wrote something yesterday to post on a bad day, but it wasn’t super long or anything and it doesn’t feel appropriate for how I’m feeling today.  I’m saving it for a self-loathing sort of day and today is just a blah sort of day.  I also shared a thing I wrote for the Peace Corps about my service, but that’s all I’ve really done besides binge watching Homeland in the past two days.

Part of Bipolar Disorder is the hypomania and the mania, where I’m irritable and agitated, everything feels awesome and totally doable/in my power, I feel like I don’t need sleep,  I hear voices and music, I feel like there are bugs crawling all over me, I see bugs and shadows out of the corners of my eyes, I spend a lot of money, I take risks and act out of character, I talk really fast, I can’t stop moving, I have racing thoughts, I have so many ideas I can’t keep them straight, or I start new big projects to name just parts of what can happen while hypomanic or manic.  The other part is the crippling depression that can get so bad that I feel completely hopeless and helpless and don’t want to live anymore.

This is how that starts.  And this is how it will continue for a while until it gets to the bad part or until my medication is changed.  Sometimes it just stays like this for a really long time, sometimes months, and I don’t get to the deep dark bad part, but this part is bad too since I don’t feel like doing anything or seeing anyone and it can last so long if left untreated.  I was supposed to meet up with a friend on Thursday and a different friend yesterday, but they both had to cancel and I was honestly so relieved.  (Sorry/Thanks ladies!) I see my psychiatrist on Tuesday, but I’ve otherwise been doing okay, so he may want me to ride this out and see where it goes.

I’ll do something different today from the past two days.  I’m going to get up, take a shower, get dressed, and go see a movie with my parents, our friends, and River.  In the Intensive Outpatient Program we called it Opposite Action- acting opposite to how you feel like acting.  It’s usually a pretty helpful tool for me.  It doesn’t always work right away, but it’s a good way to gauge when you’re feeling better because you’ll start to notice you’re enjoying things again, which you can’t notice if you aren’t trying any of the things that usually bring you joy or pleasure.  I’m not particularly enjoying things right now.  I’m really just watching Homeland because it’s something to do besides just lie in my bed and I started it and I’m on Season 4 and I feel like I have to finish it.  That happens with me and TV shows.  If I start them I feel like I have to finish them, for the most part.  Book series, too, except sometimes I hold out on reading the last book because I don’t want the series to be over.

So that’s a little update on me.  I hope this lets up soon and it’s possible that it will.  I would normally have just written this type of stuff in my journal, but people seem to be really responsive to the posts I make on here about my mental health and I’ve gotten some feedback that some of my blog posts have been really helpful to people, so you may be hearing from me more frequently than you have been.

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PCV, Peace Corps

My Peace Corps Story

I recently learned that there is a RPCV (Returned Peace Corps Volunteer) Portal on the Peace Corps website and that there is a place for Returned Volunteers to share their stories about what service was like for them.  This is what I wrote:

My name is Catherine, I’m from Asheville, North Carolina, and I arrived in South Africa to serve in the Peace Corps as an education volunteer on July 4, 2013.  My story is not the typical Peace Corps story as I did not complete all twenty-seven months of my service.  In fact, I only completed five months of service before I was medically evacuated and seven months of service total before I was medically separated from the Peace Corps.  I would describe how I felt when I arrived in South Africa as furiously happy.  I had never felt more alive or more passionate in my life.  I was finally living my dream of helping other people and truly making a difference.  I didn’t feel homesick, but I did feel something else that I still can’t quite put my finger on and have never felt since.  Everything was new and different.  There was no one I had known for any length of time with me.  I was completely and totally out of my comfort zone.  I had traveled to Kenya by myself once before, but it was only for two weeks.  Knowing that I would be in South Africa for twenty-seven months made this feeling entirely different.  I imagine there aren’t a ton of people outside of Peace Corps Volunteers and RPCVs who understand the feeling of being thousands of miles away from home with no access to your family, support system, or existing friends and knowing that you have to adapt and make new friends and create a new support system.

I was mentally ill before the Peace Corps, but I was stable on a medication regimen I had been on for a while.  I had suffered from depression and anxiety for over a decade by the time I left for service with it sometimes being under control and sometimes being at the forefront of my life.  I became depressed not too long after arriving in country, maybe a month later.  I expressed suicidal thoughts to a close PCV friend who was adamant that I contact the PCMO, but at the time I refused.  They were nothing I hadn’t dealt with successfully a hundred times before and I was terrified I would be sent home.  Some days I would do ok, but other days I was so depressed that getting out of bed felt like a monumental chore.  During PST it wasn’t as bad, but once I got to permanent site, the depression set in like a black dog laying on my chest.

My favorite memory of Peace Corps happened during PST.  I decided to go on a walk through my village one day and I ran into some children playing in the street.  They asked what I was doing and I explained that I was going on a walk.  They asked if they could come with me and I told them that it would be great if they wanted to come.  A few children quickly became four which quickly became six which, by the middle of our walk, became something like twelve children walking through the streets of my village with me with all of us singing and dancing, primarily to the Sepedi version of “Head, Shoulders, Knees, and Toes.”  The experience was pure joy.  The children were so happy to be playing, singing, dancing, and laughing with me and I was so grateful to them for sharing their time with me and making me feel like I belonged in their home.  My host family during PST was equally amazing, laughing with me, letting me help cook, making me delicious fat cakes, and treating me like a real member of the family.

I don’t really have any proudest achievement from serving in the Peace Corps because I didn’t really achieve anything while I was there aside from lasting five months before finally caving and going home.  I helped partially set up a library in my school, but it was with books the previous PCV had gotten donated.  I was supposed to start helping the ladies that ran a bakery in my village, but I got pulled into Pretoria by medical before that could happen.  I guess the thing I’m most proud of is that I gained the trust of many of my students and helped them to understand that there are adults out there who care about them and won’t just use them to get chores done.  In my village, I saw a lot of children (and women) being treated very poorly and it was very frustrating to me.  I wasn’t always the most kind or the best friend I could be to my fellow PCVs (I think the mental illness had a lot to do with that), but I worked hard to treat people I encountered in my village well.  The children knew that they could talk to me about anything and I would treat them with respect and I am very proud of that fact.  In return, I was honest with them and did my best to describe my experience of depression to them.

My permanent host family was great, but I don’t think they were quite sure what to do with the depressed and confused American girl who showed up on their doorstep and wanted to be left alone all the time.  All I wanted to do was be alone in my house binge watching Breaking Bad or talking to my American family and friends.  I feel very badly about not becoming more involved with my host family and I feel as though I disappointed them or let them down somehow by not being well enough to fully integrate the way their previous Peace Corps Volunteer had.  I think it’s worth noting at some point during this story that, by Peace Corps standards, I was sexually assaulted twice during my stay in South Africa with a third event that was questionable but undoubtedly uncomfortable.  One time a stranger grabbed my butt, one time a stranger grabbed my hand and kissed it repeatedly while asking me to marry him and wouldn’t let me take my hand away, and one time the Vice Principal of my school did something during a handshake that meant something very dirty and inappropriate.  The PCV who had previously been at my site had been male and, to my knowledge, was not exposed to the sexual harassment and assaults that I was while visiting another PCV in his village, in my community, and in my school.  Peace Corps service as a young female is very different than Peace Corps service as a male or as an older woman.  Or at least it was in South Africa.

The same friend who tried to get me to call the PCMO back in August or September finally convinced me that I really needed to and on October 20, 2013, I called the Peace Corps Medical Office to explain to them that I was terribly depressed and having suicidal ideation and that it had been going on for a few months.  Peace Corps Medical told me to pack a bag and make my way to Pretoria that very day, which was good because I had been missing school and going in late because I just couldn’t face leaving my little house. While there were many wonderful and beautiful moments of Peace Corps service, the truth is that every PCV I talked to before I left for Peace Corps service was right when they told me it would be a huge roller coaster ride.  Anyway, getting to the Peace Corps Headquarters was a trial in and of itself because I couldn’t get the taxi I had paid to take me there to take me there even though it was only a few blocks away.  I eventually got there but my appointment with the psychologist had to be pushed to the next day.

I stayed in Pretoria for a month, seeing the psychologist very frequently and eventually seeing a psychiatrist who changed my medication from Celexa, an antidepressant which was obviously no longer working, to Cymbalta, a different antidepressant that I had never tried before.  Over the course of the next week or two, I became incredibly irritable.  I was staying at a hostel with other PCVs who very kindly kept inviting me to go do things with them, but all I wanted to do was binge read books on my Nook all night and sleep for part of the day.  They were all trying to be nice to me and I was largely a jerk back if memory serves correctly.  I was hypomanic, but I didn’t know it.  Eventually, I found out a large group of children was going to be coming to the hostel.  I knew I wouldn’t be able to handle being around them in my state and requested that the Peace Corps move me somewhere else to stay.  They agreed that I could move to a bed and breakfast with one other PCV.

That day I swam and laughed and socialized with the owners of the B&B for hours.  They were lovely hosts and I found everything they had to say so interesting.  That night, I started three new “30 day challenges,” took a shower at 3AM, sang and danced around my room, and only slept for an hour before waking up feeling wide awake for my medical appointment with Peace Corps that morning.  I couldn’t stop moving or talking.  When I arrived at Peace Corps Headquarters, I found out my appointment had been moved to that afternoon, which was bad because I already knew by then that I was manic, which meant that my diagnosis had changed from Major Depressive Disorder to Bipolar Disorder.  I took Ativan (which was prescribed to me to use as needed) to try to calm myself down, but I could not physically stop moving or talking.  The other people I saw that day could hardly get a word in edgewise and I really hope they know and understand that I wasn’t myself at all that day.

I saw the PCMO that afternoon and he agreed that I was manic, which led to a whole string of phone calls to headquarters in Washington, D.C. and my parents back in Asheville, NC to decide what would be the best treatment option for me.  I was told that I could go to an inpatient unit in Washington, D.C. or go back to my home of record to see my Primary Care Physician.  I earned my M.A.Ed. in School Counseling and my B.S. in Psychology before leaving for the Peace Corps, so I knew that I could not be forced to go inpatient as I was not a danger to myself or other people and I said as much to the PCMO.  I spent the next two nights at the PCMO’s house while Peace Corps drove a friend to my house to gather some of my things.  I was not allowed to go pack them myself and I was not allowed to go say goodbye to my host family.  Those are the only ways in which I feel the Peace Corps handled the situation poorly.  Otherwise, they were very on top of things and took excellent care of me.  A PCMO from a different country flew in to South Africa with one of their PCVs and she volunteered or was asked (I’m not entirely sure) to escort me back to my home in Asheville, NC.  At the time I was a little resentful of having a babysitter, but in retrospect it was good to not be all alone in a foreign country while having my first manic episode.

After arriving back home in Asheville, I saw my primary care physician who referred me to an Intensive Outpatient Program for people with Mood Disorders.  I was in the program for probably four months and went to group therapy three hours a day for three days a week.  It was in this program that my therapist and doctor suggested I get a dog for emotional support, which I happily did.  River, an Airedale Terrier, gave me a reason to get out of bed when I couldn’t fathom moving an inch and gave me a reason to keep going when all I wanted to do was give up and die.  For two and a half years, I cycled between mania, depression, and mixed episodes frequently and viciously.  I thought I would never get a break from the illness, but I finally did when a friend of mine and I decided to visit the UK for two and a half weeks in September of 2015.  The first morning I woke up in London, I felt like myself for the first time since my first month in South Africa.  This mental stability would last for some months, but unfortunately I developed a blood clot on the flight back home and had a pulmonary embolism a few days after arriving and was therefore mostly bedridden for several months due to the pain in my leg.  When the pain in my leg finally started to abate, I started having symptoms of mania again but the psychiatric nurse practitioner I was seeing insisted that I was just anxious.  I ended up in the hospital for a week a couple of months later after behaving out of character, acting recklessly, and spending money like it was going out of style.  When I got out of the hospital, I began a different Intensive Outpatient Program at the hospital where I’d been most recently treated and my doctors, therapists, and I decided that it would be a good idea to train my dog as a psychiatric service dog.

Because of my illness, I have not had a career path post Peace Corps.  Since I developed my illness while serving in the Peace Corps, my medical expenses related to my Bipolar Diagnosis are covered by the Department of Labor and I receive a monthly stipend as I am unable to work.  I have compiled over 50,000 words worth of my journals and blog entries and hope to turn it into a memoir to help other people with my illness.  Writing is helpful for me and it’s something I can do without leaving my bed on the days I feel super depressed.  I’ve also written three (as yet unpublished and unillustrated) children’s books about my service dog, River.  It is my hope that I can find a way to make a small difference in someone’s life, since I wasn’t able to spend the full 27 months in the Peace Corps and make a difference that way.  I was medically evacuated about five months from the date I arrived in South Africa and I was medically separated about two months after that.

Serving in the Peace Corps is beautiful and wonderful and strange and hard and the most fun and most difficult thing anyone could choose to do with twenty-seven months of their life.  Or at least, I assume so, only having spent five months of my own life doing it.  Other Americans should join the Peace Corps because it is an experience unlike any other and has the potential to bring so much joy (along with the frustration, of course).  If someone is interested in making a difference in someone else’s life or in learning about another culture or in learning another language, there is no way as immersive and as rewarding as serving in the United States Peace Corps.

Adventure, PCV, Peace Corps

Parenting Yourself in Isolation- A Self-Care Workshop for Peace Corps Volunteers

 

 

Parenting Yourself in Isolation: A Peace Corps Self-Care Workshop

My Peace Corps blog posts often still get the most traffic even though they were written a few years ago now, so I thought I would share these documents via my blog in case anyone in the Peace Corps runs across them and wishes to use them.  The last elective I took to earn my M.A.Ed. in School Counseling was a class about Parenting Education.  For our main project, we were required to create a workshop for parents.  Since I would be leaving two weeks after graduation to serve in the Peace Corps in South Africa, my professor very kindly allowed me to create a different kind of workshop for Peace Corps Volunteers.  I call it Parenting Yourself In Isolation: A Workshop on Self-Care for Peace Corps Volunteers.  I feel that I would have benefited from this or a similar workshop during my time in the Peace Corps, so even if you don’t get to do it as a group, perhaps you could do the parts that you are able to do by yourself or even just read through it.  If you have been accepted to the Peace Corps but haven’t left yet, you may wish to put this on your flash drive or external hard drive that I suggest you take with you.  I do request that you leave my name on the document and credit me properly when utilizing these tools.  If you’re looking for easy ways to practice self-care, most of which are feasible even while serving in the Peace Corps, I suggest you also check out my blog post at Illuminated By U, 50 Ways to Practice Self-Care.

Good luck during your service and I hope this helps!

mental health

One Good Day

Today was such a good day.  I slept in until noon because I stayed up too late last night, but lately that has become the exception rather than the rule.  For the past several months, I’ve been going to sleep around midnight and waking up around 1PM.  Since I started a new medication, I’ve been going to sleep by 11 or 12 and waking up between 8 and 10.  I think some people who don’t have mental illnesses don’t realize how fortunate they are.  Today was a good day because I’m sleeping well, my thoughts are clear, I’m not having to nap during the day, I’m writing more, I feel productive, I have more energy to play with River, and I don’t feel hopeless or useless or suicidal.  I also don’t feel like I’m slipping into mania.  My speech is normal, my spending is normal, I’m not having any delusions or hallucinations, and I’m able to focus.  I don’t have a million thoughts competing for attention at lightning speed in my head.  I don’t feel like there are bugs crawling all over me.  I am cautiously optimistic that we have finally finally FINALLY found a medication combination that will work for me.  For the time being at least.  I never anticipated that that medication combination would include a stimulant, but here we are.  I had a whole day without breakthrough bipolar symptoms and that is definitely something to celebrate about since it hasn’t happened in about nine months.  If you are mentally healthy, please be grateful.  If you are physically healthy, please be grateful.  I am very aware that a few good days do not a well person make, but I have a kind of fragile hope that this is at least a good sign.  Even if I wake up tomorrow and have symptoms, I can be grateful that I had this one good day.

mental health

Service Dog Etiquette by Catherine Cottam — RAISING MENTAL HEALTH AWARENESS AND REDUCING STIGMA

As those of you who know me in real life, follow @RivertheWonderdale on Instagram, or keep up with my blog Accio Adventure know, I am the very proud “mother” of a three year old Airedale Terrier named River. I got River as a puppy after two therapists and a psychiatrist suggested I get a dog […]

via Service Dog Etiquette by Catherine Cottam — RAISING MENTAL HEALTH AWARENESS AND REDUCING STIGMA