Dazed and confused, I was discharged from ‘The Haven’ in September of 2004 and entered an intensive outpatient day program (IOP) on the grounds of the same hospital. Before entering the hospital, I had naively hoped that becoming a psychiatric inpatient would mean an immediate sea change in my life—that the profound emptiness I felt would be filled with health, happiness, and clarity; that I would be ready to reconnect with all the friends I’d pushed out of my life; that I would be brimming with excitement about getting back to school the following semester and optimistic about a future for myself. None of this happened, and I didn’t understand why. I was armed with all I believed I needed—a new psychiatrist, social worker, plans for intensive Dialectical Behavioral Therapy (DBT), a ‘sophisticated’ medication regimen— so why was I just as miserable as when I arrived? Although I felt safer with myself, the immediacy of my self-destructive thoughts slightly lessened, at the root of my mental and emotional state of being, I was just as lost, just as disconnected, just as hopeless as when I’d come in. Nothing internally had changed; my surrounding environment had simply been reconfigured.
The next few months came and went, the foggy memories of that fall and early winter transient and fleeting in my mind. I know that I went to IOP treatment every day for the first month or so after being discharged. I know that I saw my psychiatrist at least once a week, that I diligently took my medications every morning and every night, that I accumulated not only stacks of handouts on a vast array of behavioral therapies but also an expanded repertoire of useful acronyms (with each utterance of DSM, DBT, CBT, ECT, GAF, HIPAA, or APS, I felt like I belonged, like I’d acquired an exclusive vocabulary that only those of us ‘in the know’ could comprehend). I know that I worked part time as a coach for a team at my old school in Connecticut, and that I traveled many weekends to Maine to spend time with my ailing grandmother, whom I admired deeply and from whom I tried desperately to keep the disappointing state of my life. I do remember telling myself just how important it was that she remember me as happy and hopeful— a state of being so far from my grasp at that point that I felt like an actor in her presence, working diligently at stretching the corners of my mouth into a painfully unnatural smile and forcing a sparkle in my eyes whenever we ate a meal together or sipped a cup of tea.
Beyond these facts, however, I remember almost nothing. This blackness is different than amnesia, the loss of memory, which implies that memory was created in the first place. It feels strange to know that large chunks of my life—months and months of existence— were never even formulated into cohesive memories in my mind, but instead went straight through a cognitive sieve and into a black abyss that undoubtedly was built in part upon physiological damage from the combination of alcohol and medications, but, more importantly, upon a fundamental denial of self. This denial—of the reality of my life, of everything about who I was and what was happening to me—had infiltrated me so deeply that acknowledging certain parts of my existence by allowing them to be remembered, to be respected enough to be given a permanent place in my mind, eventually stopped making sense. None of this was conscious, of course, but it was a survival mechanism of sorts, a way for me to pretend that if I didn’t have to face my life through remembering it—a true ‘ignorance is bliss’ approach—then some way, somehow, I could survive it. With each day successfully gotten through, I could put my head on the pillow, wait for the numbness from my medications to flow through my limbs and fill me with an intoxicating lassitude, and say to myself, ‘Another day gone, finally,’ while being pulled into an almost delicious oblivion of sedated sleep. I saw sleep as my only reward for ‘doing life’, morose each morning upon awakening and having to acknowledge that I would have to be conscious for the subsequent day.
With my life as something that didn’t seem worth remembering because it felt so barren—of emotional and physical health, of inner peace, of vitality— living no longer carried any meaning and became simply a series of repetitive cycles of days and nights, of minutes come and gone, of going through the motions of breathing, eating, talking, walking, thinking, or sleeping and seeing them as nothing but mindless tasks that were pointless, futile, even nonsensical. When it started to feel darkly ironic, humorous even, to take a shower, change out of pajamas, or eat a healthy meal, because seeing my own body and mind as something that deserved self-respect or self-care was fundamentally out of the question, holding onto such an existence by remembering it seemed utterly illogical. Without a life of meaning, memories served no purpose.
The proverbial reel of footage that I often choose to play in my mind today, rewinding or fast-forwarding my thoughts when I feel a need to reflect or make sense of something or reminisce, contains profound gaps; my attempts to splice together the fragmented internal narrative I have of myself in order to create cohesion, fluency, or even a basic logic have proved ineffective and futile. What I have learned through years of unsuccessfully trying to create a sense of order in my past is that such attempts, while impossible, are not unbeneficial. By accepting that in order to survive I needed to forget, I can find a new sense of meaning in those periods of time I deemed meaningless for so many years. My sense of self, today, is no less complete simply because I have blank pages in my book. Those blank pages carry just as much importance in shaping who I am today as the pages that are full of memories.
By January of 2005, the time had come for me to go back to school to start the second semester of my junior year. I’d come to accept that my state of mind wasn’t transforming any time soon, and I’d determined that taking yet another semester off from college wouldn’t change anything. I’d come to believe that my life was as good as it was going to get, and hoping for a positive change now felt like a pipe dream. I managed to register for classes and coordinate with my old roommate, whom I’d abruptly left two years earlier after she told me of her concerns about my mental and physical health, to make plans to move back in with her. When the time came, a little over a year after I’d left, I packed up my belongings and returned to Cambridge, Massachusetts.
The months of that second semester came and went, along with the following summer and my senior year. My world had become so small, most of my time spent trapped in my head with deeply troubled thoughts and completely disconnected from the world around me, that days flashed past like pictures in a slideshow while I sat, frozen in existential quicksand, afraid that if I moved or changed in any way, any semblance of stability in my extremely tremulous world would completely fall apart. Despite managing to function effectively on the surface—I rejoined my varsity squash team for my senior year and I wrote an undergraduate thesis—I was debilitated internally by the sense that there was no purpose to my life, and I was incapable of orienting myself towards any sort of a future. I kept it ‘in the day’, but not because I was living mindfully or in the present moment; I had simply lost any ability to conceive of a future for myself.
The imposed structure of being on an athletic team and having an important academic deadline were the only motivating forces that allowed me to keep pulling one foot after the next, dragging my weight forward day by day. I would realize this—the hard way— soon after graduating from college. Without these external supports, I had nothing to depend on to ‘keep it together’. I was left with myself, with what I’d become inside— an amorphous mass of twenty-two years’ worth of unprocessed and repressed emotions— and with the snap of a finger, with the receipt of my college diploma, the defensive walls holding this bubbling chaos within me were gone. I was off to the races, in the worst of ways.
Mad in America hosts blogs by a diverse group of writers. These posts are designed to serve as a public forum for a discussion—broadly speaking—of psychiatry and its treatments. The opinions expressed are the writers’ own.