Review: Coming of Age on Zoloft

A lot has happened since I last updated. I’ve started my new job, and I do want to talk about that, but that will be another entry because I just finished the most amazing book. And I must review it. Also, sidebar, happy Mental Health Awareness Month AND Happy Foster Care Awareness Month!ūüôā

So, without further ado, I recently read a book called Coming of Age on Zoloft: How Antidepressants Cheered Us Up, Let Us Down, and Changed Who We Are by Katherine Sharpe. This book is a fascinating mix of personal memoir and sociological cross-section of America in the late 1980s through roughly 2012, though most hard numbers data is from 2005 or before. The author, Sharpe, was put on antidepressants for the first time at 18 and was on them more or less continuously for about ten years. She found that she personally experienced some existentialism in being put on medications so young and reached out to other people age 18-40 to ask about their responses to medications at a young age, their feelings about the medications then and now, and how they’ve adjusted into adulthood since, including whether they still take medications. She also talked with professionals to get their perspective and did her own research.

Phenomenal book. 5/5 stars, would recommend. It taught me a ton about the era in which I grew up. I could relate to a lot of this book.

I was first diagnosed with major depressive disorder at 14 (then changed to bipolar by 15) and medicated more or less continuously from 14 to 22, and on and off from 22 to 25. Sometimes it was something I wanted. Sometimes it wasn’t. Especially 22-25, it was my choice, and that made a fairly significant difference for me. This book explored a lot of the issues that came up for me around medication. Like, who am I on meds vs off meds? Are the meds changing who I am? These issues, as Sharpe explains, are remarkably more common in adolescents and young people put on medications because the central issue of adolescence is “Who Am I?” To add meds into the mix – and Sharpe is crystal clear that some kids absolutely do need them – is to complicate that search for answers.

Sharpe also talks about the changing landscape of talk therapy, and the onerous impediments many insurance companies put in the way of getting good, long-term therapy. She talks about her own experiences, and eventually going off medications. She talks about others’ experiences who stayed with it. She talks about others’ experiences who didn’t stay with it and are doing well now without drugs. She talks about the pharmaceutical industry’s interest in medicating-for-life, and the changes in drug marketing with direct-to-consumer advertising (think the Zoloft/Prozac/Abilify/Seroquel/Cymbalta/etc. ads on TV).

And one thing that hit home so much for me was when she talked to her sample group (a convenience sample of people who answered her request) about what has changed now, and what they are doing now, with or without meds, many said over and over again that they just live healthier. They don’t socialize when they don’t want to. They make sure to get good sleep, even if it means leaving friends at the bar to be home by 10 or 11 at night. They eat better and exercise. And I couldn’t help but reflect on my own youth, when doctors again and again told me I needed to sleep better, that I was hurting myself by not sleeping, and again and again, I would tell them that it wasn’t¬†fair¬†and that I didn’t ask to be bipolar and that none of my friends had to get 8 hours of sleep (nevermind all teens should try for that…) and that I wasn’t going to make lifestyle changes because it just wasn’t¬†fair.¬†And I reflected on where I am now, when I do make sure I get at least 7 hours of sleep, if not 8, and I do make sure I eat relatively well and I do make sure I go for a walk pretty much every day. I set boundaries in my personal life and live healthily. And at 15, 16, 17, that felt like this death sentence to not be online until 3 in the morning. And at 26, it feels like self-care and peace and healthiness. And it just struck me that these same sentiments were playing out in other people interviewed in this book.

This book was really well done. My only real complaint is that it was very much from a white, privileged background. The author was white and, as far as I could tell, all of the participants were white. And that changes the dynamic. While she touched on 30% of all foster kids being on psychiatric medications, and many of them being on 3 or 4 or more, this book wasn’t the place to examine those issues because the sample was not former foster kids. So that is the only caveat, but if you’re interested in mental health in the 1980s-2000s, this is a good read anyway. And I will leave with some excerpts from the book.

“As our vocabulary for sadness, conflict, alienation, and exhaustion merges with the language of biomedical mental disorder, we lose the language of ordinary distress. The nonmedical words come to seem imprecise or old-fashioned. As it spreads, the new language breeds uncertainty, until almost any uncomfortable feeling comes to seem potentially abnormal. In our age, it has become increasingly hard to feel sad, angry, or overwhelmed – or have someone close to you feel that way – without wondering if you, or they, are sick.” – Sharpe, 2012

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The In-Between Places

There once was a Charmed episode I watched as a middle schooler about a little girl who was rescuing a fairy. The fairy was most in danger in the “in-between” places – doorways, shadows, and other such places. And there’s also a great social work book called Beginnings, Middles, and Ends that tells amazing stories of social workers doing their beautiful work.

I feel like I’m in an in-between place right now. And in a beginning, middle, and end in my social work journey, all rolled into one. One foot in my old job and one foot in the new.

Oh yeah – that happened since I last updated. Short version is I tried for my boss’ position and struck out so I decided to use it as an¬†opportunity for growth¬†and start looking for a job I wanted. A job working with kids and teens. And I was offered a job with an in-home counseling company. And it was a remarkably quick turn-around, which only scared me a little, but I said yes, and I’m super excited to start!

But I’m also¬†super.anxious.¬†I officially put in my two-weeks notice today at my current job. My new boss (since my old boss has since vacated the position) was surprisingly awesome about me taking a job that is more in alignment with my dreams. Which was great. But I still feel trapped now.

Like, there’s this great opportunity that is starting in two weeks. But there’s two weeks until then. And there’s this niggling background fear that my dream job will fall through in the next two weeks. That then I’ll have NO job. It’s probably¬†almost definitely a ridiculous fear. The chance of everything falling apart is almost nil. But the fear is there. The anxiety that roars to life whenever there’s a quiet moment is definitely there. When I’m driving. When there’s downtime at work. When I’m watching mindless television.

The in-between sucks. All that talk about how much healthier I am in times of change still applies, but this is a reminder that, sometimes, when you’re in the thick of it, it really, really sucks.

So, the tl;dr version of all of this: I’m SO excited for my new job. I’ll finally be doing what I want to do. I’ll be working with middle grade kids and preteens and teens and I could not be more thrilled. But the in-between time is hard. And I need some reminders to take some self-care and be gentle with myself during this time of heightened stress. So I’ll enjoy my adorable new bunny (yes, that happened, too). And my chinchilla. And some good children’s books, plus some Brene Brown and Terry Pratchett for good measure. And just ride out this wave of uncertainty. In the meantime, I can hardly wait until April 18 when my new job begins!

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Social Work Month

I’ve been neglecting this blog in a big way recently. Some days, it’s really hard for me to get the motivation to write. But I’m trying to get back to updating regularly. I’m trying to find my way back to my passion that has gotten lost in the day-to-day shuffle of life.

This month is National Social Work Month. As is clear, I am a social worker. I’ve been helped by social workers and I aim to help others as a social worker and as a human being. And I want to take this post to express my gratitude to the profession, and talk about my own meandering path into the fold of social work.

When I was a kid, I was determined to be a doctor from age 3-11. I knew that is what I wanted. I knew I wanted to help people. I was rarely sidetracked by acting dreams or singing dreams; I wanted to help people. Then my 5th grade teacher told me about cadavers (he was rather unconventional, but I learned so much, and he respected us as people and learners). I abruptly changed my mind. Dissection?! Not me! I moved on to dreams of being a teacher, perhaps a special needs teacher, and also a dolphin trainer at Sea World during the summers (before I knew Sea World was terrible for many dolphins and whales, but props to advocacy organizations for getting Sea World to discontinue their breeding program recently!). Teaching remained at the forefront for a few years, until my grandmother retired in large part because teaching had become so bureaucratic under No Child Left Behind. I started to consider therapy around the time I myself was re-entering therapy as an adolescent.

A therapist I had was also a social worker. Actually, several of them were, but one in particular, I spoke with about my dreams. She encouraged I consider social work. I looked into it, I liked what I found, and I discovered Longwood’s social work program. The rest, as they say, is history. I fell in love. It was everything I could have hoped for. I was surrounded by people with desires to help people. I was ensconced in a profession so broad that people from my program have done everything from CPS to higher education work to mental health to drug treatment to policy advocacy work to teaching in a Montessori School. The breadth and depth of social work called to me like nothing else ever had.

Social worker became my primary identity, and it remains so to this day. As a social worker, I am a mental health clinician, a mental health advocate, a feminist, an antiracist activist, a white ally, a political mover and shaker. Social work skills infiltrate every relationship I have unconsciously. Being a social worker makes me a better daughter, sister, friend, aunt, granddaughter. Being a social worker has forced me to really evaluate how little I give back to myself, and has challenged me to make self-care a priority in my life in a way I don’t think another profession would have done. At the same time, being a social worker inspires me to give back, give more, give better. It inspires me to consider what people really need, instead of what I am wanting to give. It inspires me to be my truest self, to be both self-full and selfless.

Social workers get a bad reputation from a lot of folks. We are often seen as the baby-snatchers. The meddlers. Some even see our desire to help people self-determine their fates as dangerous or malpractice. We often are moving silently in the background until a tragedy happens. Then, we are blamed and blasted all over the news, whether it is something we could have prevented or not. Social workers are true Hufflepuffs – we work hard, we work for justice, we work for equity, and we do not ask that our praises be sung. But, sometimes, we need to be acknowledged. We need people to see our worth. We are routinely at the bottom of payscales for college graduates, making amounts commiserate with some non-degreed work. Non-degreed work absolutely is crucial and needs to be fairly compensated, but too many social workers end up having to leave the field just to pay bills, including student loan debt.

Too often, public servants of all stripes (nurses, teachers, social workers, etc.) are underpaid and overworked, our value not seen in the eyes of society who only look when something goes wrong. For social work month, I ask you – thank a social worker. Acknowledge them. Be more aware of what they do. Ask them what they do, if you don’t know. Be aware that confidentiality means they cannot talk specifics about clients, but show interest in their work, in their lives, in their struggles. Be there for them, the way social workers are there for countless people every day.

Thank a social worker. I know I thank them every day. If not for one in particular, I may never have found the field that changed the way I live my life.‚̧

Self Injury Awareness Month

This post is deeply personal. I’ve talked before about my history of self-harm. Today, March 1st, marks the beginning of Self Injury Awareness Month and kicks off with Self Injury Awareness Day (SIAD). This month, barring unforeseen slip-ups, will mark 10 months self-harm-free for me.

Ten months. It might not seem like a long time and, indeed, when I started this blog, I was at war with myself when trying to decide if I’d been in recovery long enough to post about my personal struggles without jeopardizing my future career. The jury’s still out, but I decided my journey as a social worker and as a person in recovery is more important, and can help more people, than my staying mum about my past.

Self-injury is an addiction much like drugs or alcohol. It is not a suicidal gesture – and is in fact often called Non-Suicidal Self Injury to distinguish it. It is often a way to avoid suicide. It is a way of dealing with intense emotions, or even a lack of emotion. It can be a way to break out of disassociation; it can be a way to dull intense fear, anger, sadness, or¬†anxiety. It is almost always a reaction to shame – the belief that the individual is bad on some intrinsic level. It is exacerbated because self-injury is stigmatized heavily and shamed in the community at large. People who self-harm often are met with looks of disgust, even from hospital personnel. The behavior is so alien, so foreign to so many people. I remember clearly a discussion about self-harm happening in my high school near where I was sitting as a freshman and a peer said “Why doesn’t she just cut an apple?” talking about a peer who was not present. It wasn’t long after that that I first picked up the blade. And it was that memory that kept me absolutely petrified of anyone finding out for a long time.

Which brings me to another point. While I did start self-harming at 15, and while many people who self-harm start in adolescence (often at 11, 12, or 13), it is not just an adolescent problem and it is not just a female problem¬†(trigger warning on this link for imagery) and it is not just a white problem. ¬†Self-harm doesn’t magically go away when people who cut or burn or scratch or bruise turn 18 or 21 or 30. Self-harm is often linked to traumas and/or to the inability to regulate intense emotions. It is manageable, and possible to stop, with help, but it is not just a kid problem. And, like any addictive behavior, the person involved has to want to change. You can find anything to use as an instrument of self-harm, so coercing someone rarely works.

This was a big road block to my own recovery. I had resources from 15 onward (I was in therapy, though I didn’t dare mention I was cutting until I was about 17, when it was not as easily hidden), but I didn’t want to quit. I didn’t see the big deal. I figured it was my body, my choice, and as long as I didn’t cut too deep, it was fine. I still struggle, on some days, with those feelings. But now I have the resources to cope, the tenacity to endure, and the foreknowledge that no feeling lasts forever. It wasn’t until I was into my 20s and involved in fairly intensive group and individual therapy at my university that I really got serious about quitting. It was with the support of my group therapy, the support of my individual therapist, and the knowledge that my dream was to work in adolescent mental health. I knew that I couldn’t help others until I could help myself – I had to put on my own oxygen mask.

So I started getting serious about my mental health. I started putting in the work in therapy. I started putting in the work at home. And I had a few slips at first, but now, I’m almost 10 months free of self-inflicted injuries. Almost 10 months free of having to administer first aid on a semi-regular basis. Almost 10 months free of having to nervously plan outfits based on what will hide the most recent marks. And it is freeing and wonderful and beautiful. And it makes my work with people who self-injure so much more authentic. I feel their struggles and I can meet them where they’re at and I love my work. I just have to remember to take care of myself first.

There are a lot of great resources for self-harm. I recommend To Write Love on Her Arms (TWLOHA), Self Injury Outreach and Support, S.A.F.E Alternatives, and, for help, Crisis Textline (741-741), a 24/7 text support line. The color of self-injury is ORANGE so you can show support by repping orange. If you want to reach out here, I’m more than happy to chat as well. If you self-harm, you are not alone. If you know someone who self-harms, you are not alone. And I care about you, no matter who you are.

Eating Disorders Awareness Week

This past week was Eating Disorders Awareness Week. I intended to get a blog post up, but life happened, and so here we are. Eating disorders seem to be the butt of a million jokes, so many you may ask why we need eating disorder “awareness.”After all, who hasn’t heard of eating disorders? An easy answer is that eating disorders have the highest mortality rate of any mental illness. But that’s only part of the equation.

The thing is, we have a very specific stereotype in mind when we think of eating disorders as a whole. We think white. We think female. We think skinny or thin. We think teenagers or young women (under 25 or so). And we think middle to upper class.

We don’t think about people of color. We don’t think about men¬†(and when we do, they certainly aren’t straight). We don’t think about people of “average” body weight, or those who are overweight. We don’t think about children ¬†and we don’t think¬†older adults. And we don’t think about people of low socioeconomic status. And that’s a problem. When we don’t talk about people outside the rich white girl having eating disorders, we make them invisible. We make it painfully difficult to ask for help. We help people with eating disorders normalize their habits – “I can’t have an eating disorder. That’s a girl disease,” says a hypothetical fifteen-year-old boy who is only eating protein and exercising 5 hours a night in hope of six-pack abs.

When people can’t see themselves portrayed, they minimize their eating struggles. Or they recognize their eating struggles, but don’t seek help because of the stigma that surrounds them. When the overweight woman doesn’t seek help because no one will believe her because she doesn’t “look” the part, we have a problem. When the black man doesn’t seek help because that’s a white women’s disease, we have a problem. When the seventeen-year-old boy engages in all kinds of disordered eating behaviors to make weight on the wrestling team, but only his thirteen-year-old sister’s eating habits are policed, we have a problem.

We need to talk about eating disorders. We need to talk about them when connected to young, white, skinny women and girls. We also need to talk about the when occurring in children, in older adults, in people of color, in men, in LGBT and in straight communities, in transgender and cisgender communities, in impoverished communities and in better-off communities. We just need to TALK about them.

This is a shorter post, but I do want to leave you with a link to another blog I follow. A2Eternity has a very brave blog about her struggles with eating disorders. It is vulnerable, raw, and real. Her whole blog is fantastic, but the post I’m linking to is her overarching story. If you care about eating disorders, if you want to learn more, I suggest strongly you follow her blog.

Perfectionism versus Personal Growth

I’ve mentioned before that I’m taking Bren√© Brown’s Living Brave semester¬†online. This week, part of the reading focused on the biggest barrier to shame resilience in my life – perfectionism.

Perfectionism is the armor I’ve worn like a second skin since grade-school. I grew up hearing about how I was reading at 3, correcting my mother during bedtime stories by 4. I bragged about this, relishing that moment of awe – except when I met people with similar stories, sometimes even stories about reading at 2 instead of 3. Then, I would be steamrolled by shame.

By middle elementary school, I prided myself on getting perfect scores on assignments while not actually paying attention to the lessons at all. I believed that the more I got 100s without actually putting forth effort, the more I proved I was perfect. This had an added protective bonus – when I wasn’t getting 100s, I could brush it off by saying “I didn’t try on that anyway.” Either way, my identity of a perfectionist was assured.

By sixth grade, I was using vocabulary words so far above my grade level that I was completely ostracized from the “cool” kids, who couldn’t understand what I was saying. I ate lunch alone, reading novels. But I felt like my teachers respected me and I had this idea that it was only my teachers who mattered. I didn’t care – or I convinced myself I didn’t care – what my peers thought as long as my teachers adored me.

By high school, I was dealing with my chronic shame, isolation, depression, and anxiety by cutting, sifting through daily suicidal impulses, and hiding behind hygiene lapses, sometimes not showering for over a week at a time. I was procrastinating on anything I thought there was a chance I could’t get a perfect score on. I was hiding behind lank, greasy hair and long-sleeved shirts and Harry Potter Role Play. It was, in fact, my online friends who knew me best during those times. It was only with the buffer of screens and wires that I felt safe to disclose my pain.

In college, when I found social work, I began to explore another side of achievement. Achievement for personal growth, not achievement linked to perfectionism. I still struggled – and still struggle – with perfectionism, but social work taught me about self-care and learning for enlightenment and empowerment rather than just grades.

I still wanted straight-As. I still achieved straight-As, in both college and grad school. And I still bit off more than I could chew more than once.

But I started to figure out what I really wanted. And, taking this Bren√© Brown course, I’m exploring the issue of perfectionism and shame more closely than ever before. As she has said on Oprah (see second link in the first paragraph), “When perfectionism is driving, shame is always riding shotgun.” I’ve come to learn that whenever I was seeking accolades for accolades, whenever I’m trying to be the perfect daughter and perfect sister and¬†perfect friend¬†and perfect student and perfect employee, I’m doing so because I don’t feel good enough. My most vulnerable areas tend to be being a good enough daughter, being a good enough big sister, and being a perfect enough student/employee. Also known as 90% of my life.

Perfectionism is my go-to shield. I feel shame when I’m not doing ALL THE THINGS for ALL THE PEOPLE. It’s what leads me to agree to tasks at work that are too much; it is what led me to agree to extra work in school, especially in group projects; it’s what led me to ignoring myself so I could tend to family drama. And, if I’m really, really real, it’s what led me to being hospitalized in a psychiatric unit 3 times in 18 months in high school. And it’s time to change that. As I said last week, I’ve found that I’m in an almost constant state of change anymore, and it’s the healthiest I’ve ever been.

So what does change look like? Change looks like asking, why am I doing [x]? Am I doing it because I want the accolades? Because I am concerned about what others think? Or is it because I’m trying to grow as a person? Am I trying to stretch myself? Am I taking risks? Or am I doing what’s safe in such a way that I’m guaranteed to succeed? When I applied to fellowships this weekend, it was related to personal growth. It was rooted in risk and uncertainty – I want to be offered a fellowship, and it is no guarantee. Acting from a place of perfectionism would have looked, for me, like skipping over them because I’m too busy/I don’t really want them/I’m better than them. Taking a risk, though; that’s personal growth. And personal growth is right where I want to be right now.

Change is Constant, and other platitudes-turned-truths

As I drove into work, I was musing about life and change, and I came across a fairly significant discovery.

Periods of flux or change are when I am the most healthy.

This was nothing short of monumental for me to discover. If you know me at all, you know I have not generally had a healthy relationship with change. In fact, even as recently as a year ago, I would’ve told you I hate change. I would have said that, while living in a period of constant change and being the healthiest self I had ever been.

Apparently, I like living in contradictions.

When I was in high school and at the community college I began my undergraduate studies at, I was not in a period of constant change. I was, in fact, mostly in a period of stagnation. There were changes, of course – change is the only constant and blah, blah, blah – but I wasn’t changing. I was railing against change and staying stuck. Stuck in my home town, stuck in my unhealthy habits of cutting and putting myself last, stuck in place with nowhere to go. And I would say, again and again to anyone who would listen, I hate change. I would claim I was comfortable in this incredibly unhealthy place I was living. I was comfortable cutting myself every day. I was comfortable being anxious, depressed, isolated, and lonely all the time. I was comfortable feeling a ton of very dark emotions, like shame, almost constantly. I was comfortable going to therapy and not really trying to change anything (because I hated change, obviously). And I was, in a way. I was comfortable. Change was scarier than living what I knew. Until it wasn’t. Until I needed change.

So I changed direction. I went away to school for the rest of my undergrad. I went further away for my graduate school experience. I took internships outside of my comfort zone. I went to therapy in Texas – group and individual – and started changing. Taking a hard look at myself and my struggles and making an effort to change, listening when people made suggestions. And even as I stopped railing against change quite so hard, I still claimed, again and again, I hate change.

But I didn’t. I didn’t hate change anymore. I was developing a relationship with change even when I denied it. Of course, then, they were carefully orchestrated changes. Changes I could control, predict, and perfect. Then came the changes I couldn’t predict, couldn’t control. The changes like my sister having a baby¬†while I was 1200 miles away and couldn’t be with her at the hospital. The changes like my sister becoming a single parent. These changes that inspired me to make an unplanned detour. My five year plan suddenly needed massive adjustment.

I needed to be in Leesburg again, near my sister, near my nephew, but that wasn’t part of the Plan. The Plan dictated that I stay in Texas for two years, get my LCSW, and then move to Michigan for my PhD. The Plan didn’t say anything about moving home. And yet, I found myself drawn to moving home. So I did. I moved home and I had to wrestle with myself to conceptualize the move not as a failure, but as a detour that could lead toward growth just as much as staying in Texas could lead toward growth.

And here I am, having been back in Leesburg since June and working since September, contemplating new changes. I started Brene Brown’s online Living Brave Semester (which is amazing and everyone should take next year!), working on living a more authentic, vulnerable life full of shame-resilience and daring greatly, which does involve failure, but also growth. I’m applying for fellowships, looking at other job opportunities, getting ready to start supervision for my LCSW hours. I’m still in a constant state of flux, and I’m healthier for it. It is when I’m in stagnation that I feel most acutely mental instability. It is when I am in stagnation that the urge to self-harm is strongest. So I stay in constant change, in a constant state of trying to better myself and the world around me. It is in this vein that I am beginning to consider, not just supervision, but pursuing some in-depth therapy for myself.

Change.

It really is the only constant in my life but, honestly, I wouldn’t have it any other way.