Sarah McCarry's Blog, page 7

Working: Katherine Locke

Can you talk a little about the ways in which your illness works as a barrier to writing? What are some of the specific challenges you deal with?

It feels right that I procrastinated on this so long that now I’m doing this while depressed. My brain is either hypomanic or depressed. The time for which my neurochemical pendulum sits in the middle varies from hours to a day or so. My hypomanic brain writes. I write a lot. I finished NaNoWriMo in six days. That’s not normal and I won’t even pretend that’s normal. Except it is for me. When my brain’s on, it’s on fire. When it’s off, I might as well not even know how to string together words because I can barely finish anything at all.

Depression shuts me down and off. Tucks my brain away for recharging. I almost never finish drafts when depressed, and I tend to get very nostalgic about old drafts that honestly should never see the light of day. I’m a black and white thinker already but I think that depression magnifies this. I’m more likely to think and say things, “I’ll never get published” and “Everything I write sucks” and talk myself down. Protip: scolding yourself and calling yourself crap doesn’t help you write! But it’s hard not to get stuck in that toilet boil downward spiral. Gravity flush in the brain.

I also am recovering/in recovery from a lifelong eating disorder. Depression makes my appetite disappear, and I’ve never been good at listening to hunger cues. I have to bribe, force, and cajol myself into eating. Writing doesn’t happen if you don’t have fuel or if your blood sugar is so low that you feel too miserable and weak to write. Maybe this is just me, but writing takes energy. It’s an exhaustive process even when it’s an invigorating process. We’re always talking about writing fuel and writing snacks on Twitter, so maybe everyone’s subconsciously aware of this. But you can’t write when you’re not taking in some sort of calories (case in point: for my sickest years in my eating disorder, I wrote nothing at all. Nothing.) Depression compounds my recovery.

What are some specific things you do to manage your illness that you find effective?

I’ve written and rewritten the answer to this specific question several times. I don’t know that I’ve found anything effective. I took away my internet at home so that I have to go to Starbucks or Barnes & Noble. For me, this is socializing and this is a level of socializing that I can do whether my brain’s super speedy or my brain’s stuck in the fog. I can tell a few of my friends when I’m low, just to feel accountable. I make sure I write something basically every day, even if it’s just something like this or a blog post. Writing pulls me free. Like surfacing in an ocean.

What is your relationship to more traditional models of managing illness, like therapy and/or medication? Do you find them effective? Is accessing them an issue for you?

I was in therapy of some sort from January 2007 until June of 2013. Talk therapy was immensely helpful for me. I sought therapy for the first time at college on my own for OCD/anxiety type of behaviors and following a close family member’s multiple suicide attempts.

After I graduated, I found a therapist who did real talk therapy, versus CBT, and I truly believe she saved my life. I saw her from once a week to three times a week for several years until I was unable to continue to pay for her and I aged off my parents’ insurance. I have insurance again thanks to Obamacare, but I don’t think I’m pursuing talk therapy.

I have been on several different medications, never for long periods of time. I had several bad side effects (I’m not naming medications or side effects because I’d rather not scare anyone else away from something that may be lifesaving and I do believe that medication for many people is a lifesaver, including that close family member). I think I could benefit from medication but I am exhausted by the idea of starting with a new psychiatrist and going through the Whole Thing all over again. (I swear this isn’t laziness as much as it’s really honestly draining to go through my story and my truths and everything each time.)

When do you struggle most with self-care? When do you find it easier?

When I’m hypomanic, I’m less likely to do self care because there are things! To do! So many things! Do all the things! Write all the books! Go all the places! Talk about everything! Who has time to slow down? I don’t have time to do that!

When I’m depressed, I’m slow enough to realize that I need to take time for myself. I need to take a long bath. I need to splurge on the good decaffeinated tea. I need to reach out to a friend. It’s probably the only upside of my depressive swings, to be honest. My brain needs to recharge and so does my soul, as kooky as that sounds.

What kind of relationship do you have to your illness? Does how you think about it change the way you live with it?

I’m okay with it. I live with it. I understand now, and it’s taken me a long time to get here, that this is just how I’m wired. It doesn’t mean that I’m bad or weaker or stupider than other people. Self-awareness has helped me maintain friendships and learn how to live in each swing. I’m more aware when I’m moodier and more likely to take things personally so I remind myself that the way I’m experiencing things is through my illness.

What’s most useful for you in terms of support from other people? Is outside support important for you?

I don’t know that outside support as much as understanding and empathy. You don’t have to know what to say or do. There isn’t anything for you to do. You can’t change my brain chemistry. But when I say, “I’m having a horrible day. I woke up depressed,” saying, “I’m sorry” is so much more helpful than, “You need to exercise!” Someone saying that they are there for me if I need to talk is immensely helpful, even if I never take them up on the offer. In fact, I’m highly unlikely to take someone up on the offer which isn’t them, it’s me. But it means so much to have the offer made. It helps me feel accepted. All of me. This is me: my highs and my lows and my lack of middle ground, my eating and my not eating, my anxiety, my absolute thinking, my catastrophizing, my magical thinking. It’s taken me twenty seven years to start to realize that none of this should, or does, make me a lesser person. It’s me. I go to great lengths to make sure that my mood swings affect the people around me as minimally as possible but the people around me going to great lengths to make me feel accepted regardless means the world.

I have no idea if that made any sense.

How do you negotiate the balance between self-care and writing and working?

Can you ask me this again in ten years? I haven’t. I haven’t mastered this balance much less opened negotiations. I try to set a schedule and set rewards for myself (do the laundry, clean the house, shower, eat a meal = read a highly anticipated book type of goals) but I’m still working on this one.

Katherine Locke is a twentysomething Philadelphian (though she’ll remind you that she grew up in the rural ‘burbs, so ‘it doesn’t count. I say water, not wudder’) who has been writing and reading for as long as she can remember. She used to pack four books in the family van just to go to the grocery store. She now writes with her resident cats, and a rotating cast of foster cats, and assures you that she only uses capslock for fangirling. You can find her online at @bibliogato on Twitter, bibliogato on Tumblr, and writingwithcats.wordpress.com.

Previously in the Working series: Mairead Case, s.e. smith, Red Mills, Christine Hou, Litsa Dremousis, Jacqui Morton, Gina Abelkop, Elia Osuna, Wendy Ortiz, Roxane Gay, and B R Sanders..

On Precipices

A few days ago I woke up to the sound of a cat crying and didn't think anything of it, really.

There are a lot of scruffy street cats in my neighborhood; one of them in particular I am quite fond of, a little grey cat with white paws that almost seems friendly until you get too close, and then it scampers off. It started showing up on my street a few months ago and I like to think it recognizes me now when I say hello to it, although this is probably delusion on my part. I sat down at my desk to work on a freelance job and the cat's crying continued; I got up a few times to look down at the street, but didn't see anything. And then after a few hours I looked up from my desk instead, and saw it: my favorite street cat had somehow got stuck on the roof of the apartment building adjacent to mine, seven stories up, and was howling disconsolately into the void from the very edge, framed neatly by the window over my desk. There was no escaping the hopelessness of its situation, or its desperate cries, and there was nothing I could do to get it down--I could see it, but I had no way of reaching it. "Oh," I said. "Oh, no." I am, appearances to the contrary, rather soft-hearted, and I did not want to watch my favorite street cat die.

More than one well-intentioned person appeared on the roof throughout the morning and into the afternoon and made some attempt at rescue, but the cat was having none of it, and all of them eventually gave up. I went out on my fire escape with a container of food, which I rattled ineffectively while the cat, forty feet and a yawning abyss away, stared at me, no doubt rolling its eyes. I did not want to call 311--the near-mystical New York hotline one dials for every manner of difficulty ranging from My Apartment Has No Heat And Is Full Of Rats And My Landlord Merely Cackles When I Complain to I Cannot Imagine Which Tourist Attraction I Should Like To Visit Today Have You Got Any Advice (I always imagine it being staffed by, like, sprites)--because the best they could do would be to call Animal Control, and that did not seem like a solution (impoundment, euthanasia) that would end so well for the cat. I had mad visions of a Youtube-style rescue--firetruck, sirens blaring, pulling up outside the building--ladder extending--photogenic, strapping fireman, arms outreached, seizing the cat from its precipice and gazing nobly into the camera as citizenry cheers below--but no such miracle materialized. As the day wore on the little cat exhausted itself and quieted, hunched miserably at the very edge of the roof, looking--I swear to god--directly at me. At some point in the afternoon, it began to snow.

Someone did call Animal Control and they showed up around four-thirty, as the color was beginning to leach out of the sky and head toward early twilight. My heart lurched in despair as the ominous figures clambered over the roof, blue-jumpsuited, butterfly nets aloft. Some people had gathered below to watch the cat's capture and I could hear them gasp--as did I--as the cat backed itself to the absolute edge of the building--one paw slipped off the ledge--I thought, with absolute certainty, that I was going to watch it tumble to its death--and then, defying all laws of physics and reason, it rappelled itself down the sheer brick face of the building to a narrow windowsill on the fifth story while the cats' law enforcement stared down at it in astonishment. The cat had disappeared from my view but its predicament now seemed even worse--where could it possibly go, from where it had got itself? It was still far too high up to survive a jump, and the windowsill was barely six inches wide. I watched, breathless, as the Animal Control officers went down the fire escape, another of their number poised below on the sidewalk, net at the ready, as if he could somehow catch the cat if it fell. As soon as the other officers reached the cat's level it reappeared in my line of sight, catapulted off the windowsill, skidded down the face of the building again, and then slipped. A woman below screamed. The waiting Animal Control officer held out his net. And that cat--it happened so fast I still don't understand it, but I'm telling you, that cat launched itself into the air and fucking flew. It landed on the Animal Control officer's shoulder, went sailing into the street, hit the ground running, and made its escape. Several people cheered.

Reader, I cried.

The cat has not experienced any improvement in its fortunes; it is still a scrawny little half-starved stray scraping by on the streets of Brooklyn. To be honest, I don't know that that cat is long for this world; it's a hard-knock life out there for a little street cat. But it has survived thus far this long, brutal, relentless winter; it's gotten by, somehow, against the odds; and it escaped the clutch of the authorities to resume life on its own terms and under its own auspices. Sometimes the metaphors that show up in your life are extremely literal: you never know, for example, what you're capable of until you are at the very edge and the cops show up. I mean, you know what I mean. There's no way out but through.

Last night I came home to find the cat sitting in the sidewalk in front of my building with a battered and disreputable-looking new tabby friend (one eye crusted shut, notched ear, horrifically dirty). My favorite street cat did not seem any the worse for its harrowing adventure. "Hey cat," I said, "live free or die, right?" It eyeballed me, seeming almost to consider my overture, and then it scurried under a parked car. This week I'm going to remember to start carrying cat food with me when I leave the house. Just in case.

Working: B R Sanders

Can you talk a little about the ways in which your illness works as a barrier to writing? What are some of the specific challenges you deal with?

Just so we’re all on the same page, my mental health landscape consists of a fairly high general level of anxiety which sometimes spikes into panic attacks and migraines coupled with intermittent major depressive episodes which manifest as hibernation—I go numb, I feel put in stasis, and really all I can do is sleep.

But this is a more nuanced question than it looks like on the surface. The obvious answer is that when I’m too anxious to do anything but panic or too depressed to do anything but sleep that I can’t write. At that point my brain is so broken I can’t even feed myself properly. Any level of emotional or mental effort is just too much and not happening. When things get that bad, it’s mostly just a struggle to keep surviving.

But not every moment is like that. There are the relatively stable periods between the panic attacks and the hibernations, and most of the time I’m living there in the general flatness. Generally I’m a bit anxious and often fending off some unnameable insecurity. So, most of the time the tension is trying to write, trying to create and produce while waiting for that other shoe to drop. The specter of another panic attack or another depressive episode is always looming, and for me it’s a matter of pushing through and living and working and writing in those blessed flat times anyway. If I don’t push myself to do things while I actually have the wherewithal to do things then the looming threat of overwhelming mental illness paralyzes me. And then it sends me into a panic or gives me a migraine. And then I crash into a depression. So, for me, the real problem my mental illness poses to writing is that nothing ever feels safe, it never feels like the right time even when it actually is the right time to write. There will always be times I can’t write, and that knowledge (paradoxically) makes it harder to write when I actually can do it.

What are some specific things you do to manage your illness that you find effective?

By training I’m a social science researcher, and by occupation I’m a data analyst. It may not be surprising, then, that one way I manage my illness is by religiously documenting it. I shit you not, I have a spreadsheet where I track my stress levels, my exercise habits and my dietary habits. I’ve attached a screenshot. Stress, physical activity and diet are all things I’ve tracked long enough to know have a direct impact on my sense of well-being. I’ve recently gone vegan because dairy is a clear trigger for migraines for me, and getting migraines both sucks and creates a tone of anxiety for me, so cutting out cheese (while tragic) actually helps manage anxiety by reducing the likelihood of another migraine. This gets meta, but filling out the spreadsheet every day also makes me take stock of my stress level and makes me accountable to myself to eat properly and get exercise. It’s the element of my self-care regime that actually enables me to keep doing the other parts of my self-care regime.

Not unrelated, I have a similar spreadsheet for writing. I track daily word counts, what project I’m working on, if it’s in submission and where. The sheet aggregates an overall ongoing total of words written that year to date and also calculates monthly average words per day. I do this mostly because I really need to write every day I’m able to write if I can. Writing does marvels for my general well-being—creating something makes me feel productive and engaged and proud of myself. And, like I mentioned before, I tend to get paralyzed when I don’t do something consistently. To reap the benefits of writing as self-care it has to be habitual. If I take a few days off I start down an anxiety spiral where I start convincing myself that my mojo is just GONE and I’ll never be able to write again EVER it’s just OVER and clearly I should give up. But if I just keep writing consistently, and the spreadsheet proves I’ve done so, then I don’t fall down that rabbit hole.

What is your relationship to more traditional models of managing illness, like therapy and/or medication? Do you find them effective? Is accessing them an issue for you?

I take medication. For me, the jury is out on whether or not the drugs are really making the difference or whether the act of taking a pill is such a powerful placebo that my brain tricks itself into coping better. I really crave a strong sense of control and I tend to latch on to doing things to help manage my illness, so even just knowing that I’ve decided to take a pill to help is something that helps already. I’ve been really lucky, also, that any time I’ve been on medication (I was on lithium for awhile because I have a very pervasive family history of bipolar disorder though I don’t have it myself and I’m currently on zoloft) I’ve suffered no side effects. Not having to struggle with the effects of the medication certainly makes that easier. I’m employed full time with health benefits, so medication is accessible and relatively affordable to me.

Therapy, though, is not. My health care plan doesn’t provide coverage for therapy really at all, and I can’t afford to pay out of pocket for it. Therapy has been useful in the past—specifically, I dealt with some really nasty postpartum anxiety issues after I had my kid, and therapy was absolutely essential to getting me to a place where I felt comfortable functioning as a parent. Having a kid after coming from a family with abusive parents while struggling with an anxiety disorder is not fun.

When do you struggle most with self-care? When do you find it easier?

Winter is hard for me. I suspect I have seasonal affective disorder. Doing anything in winter is difficult. Exercise is hard for me because I work all day, and I have an hour long commute both ways. It doesn’t feel like there’s enough hours in the day to work in yoga or running, and it’s especially hard in winter where my option is basically to run outside at 6am in the cold. Also, I’m such an introvert I’m pretty much a recluse, so getting the solitude I need to recharge is a constant struggle.

What kind of relationship do you have to your illness? Does how you think about it change the way you live with it?

It’s a constantly moving target. For years I didn’t even realize I had an anxiety disorder because it manifests in culturally sanctioned ways by and large (like spreadsheets and never missing deadlines). My first major depressive episode was absolutely harrowing. It colored my whole perception of myself—I remember thinking as it passed and I went back to living that everything I thought about myself was wrong. My brain was broken, and it would break again and again and again. It was terrifying; that’s when the mental paralysis started. Writing fiction was actually the only way I found to break myself out of that paralysis. I hadn’t really written before.

It all changed again with my kid. Partly because of the post-partum anxiety, and also partly because there’s an extremely high likelihood that my kid will have mental health issues down the line. Both me and her father do, and it’s highly prevalent in both of our families. So it was important to me to create for her right from the outset a family space where we talked about mental health honestly and openly and without stigma. It was also important to me to create a space where, unlike in my natal family, there was an expectation that people actively engaged with and managed their mental health to the degree they can. Which meant I had to work through the feelings of shame I had about my mental health issues and that I had to really manage and engage with it in order to parent the way I want to parent.

I try not to feel antagonistic towards my mental illness. I’ve come to a point where it’s not me and it—it’s my brain. It just is. There’s a lot of acceptance in it, and I’ve lived with it long enough to know that the bad times will come, and then eventually they will abate. It’s just how my life is. And that has to be ok, because it’s not going to change. All I can do is manage it and live in it.

What's most useful for you in terms of support from other people? Is outside support important for you?

I use my partners as check points. I’m not always able to tell if the anxiety is taking over. Mostly outside support is useful for anxiety—it does nothing for depression. My depressions are just utter blankness, and nothing anyone says or does penetrates them. But for anxiety, sometimes I need to articulate a fear or a thought to someone else and have them tell me if it seems realistic or not.

You also have a full-time job and a family--how do you negotiate the balance between self-care and writing and working and parenting?

Oh, god, it’s always so precarious. I’m the breadwinner for my family, so I have to work and be good enough at my job that I don’t get fired. Parenting well is extremely important for me, so I have to devote the time and effort to my kid that she deserves and be fully engaged while doing it. That’s like 80% of my time and energy right there just those two things.

Like I mentioned before, writing is a form of self-care, and as I also mentioned, I have an hour long commute to work both ways. I write on the bus. Usually I edit on the way in to work and I write new content on the way home. I can’t write at home—my partners would make space if I asked, but if my kid is awake I want to play with her and if my kid is asleep I’ve usually already run out of energy to do anything more than play a videogame or watch a movie. If I don’t write on the bus I basically don’t write at all. For that reason, I rarely write on the weekends.

The real work of making all of this work is that I have to be very reflective and self aware—the spreadsheet helps—and I have to advocate. At work, I have to fiercely protect my work-life balance. At home, I have to make sure I get my alone time (usually going to bed really early and reading alone). I take the bus in even when my partner can give me a ride because otherwise I won’t write and I’ll get anxious about it. It’s all just very intentionally and very carefully managed. But it’s hard. It’s really hard to do all of this and to do it well, and I will say that mercifully me being a recluse makes it perfectly fine that working and writing and parenting and managing my mental health leave virtually no space for a social life.

How do depression and anxiety intersect with gender identity for you? (Or do they?)

They totally do. Me coming out as trans* was a whole process fraught with depression and anxiety. Being genderqueer means no one ever gets your pronouns right and you’re constantly misgendered. I’m polyamorous and my partners all date but I don’t, largely because I really don’t do well with going out with someone new and having to explain my gender identity and having it get questioned. Like a lot of trans* people, I struggle with body dysphoria periodically, which makes me both depressed and anxious.

And since parenting is a general weak point for me in terms of mental health, the way my gender identity intersects with that is not always pleasant. People question whether or not my gender identity will somehow harm my kid, and while it clearly won’t the anxious part of my brain is always like but what if it does. I was pregnant and gave birth, but I’m not a woman, and I’m not a mother. But of course everyone calls me one, and it’s a constant grind to correct everyone or to grin and bear it and not correct everyone.

Do depression and anxiety intersect with class for you? In what ways?

I grew up poor in a family rife with mental health issues which went unchecked in part due to issue of access due to class. So there’s that—I’m not poor anymore, but I still have a poor person’s sense of when to ask for medical help which is basically don’t do it unless you’re dying. I tend to wait too long and let my anxiety and depression get too severe before seeking outside help to cope with it. I also push myself way too hard. Like, I’m anxious, but I absolutely have to go to work even though I was up all night crying for no reason because I can’t afford not to go in. Growing up poor means your poorness lingers even if you are living a middle class life. And growing up poor means there’s no safety net. There’s no way to ever slow down or to trust that there’s someone to catch you and let you rest. It means I will keep working even when I can’t feed myself because I don’t feel I have a choice not to. Which, in the long run, contributes to fatigue and overwhelm and all these things that further prolong that wretched bout of anxiety or depression.

B R Sanders lives and works in Denver, CO, with their family and two cats, where they spend a whole lot of time writing character-driven fantasy. Their work explores sexuality, gender, and resistance set against a rich and fully realized fantasy backdrop. They studied Psychology, Law and Society, and Religion at Oberlin College, and earned a Ph.D. in the Personality and Social Contexts Area of the University of Michigan – Ann Arbor’s Psychology Department. When they are not knee-deep in words, they are crunching spreadsheets as a K-12 Education data analyst.

Previously in the Working series: Mairead Case, s.e. smith, Red Mills, Christine Hou, Litsa Dremousis, Jacqui Morton, Gina Abelkop, Elia Osuna, Wendy Ortiz, and Roxane Gay..

Working: Roxane Gay

Can you talk a little about the ways in which your illness works as a barrier to writing? What are some of the specific challenges you deal with?

Motivation is a big problem. I can spend hours just staring into space, not reading, not writing, just staring and it's hard to go from that to productivity. I'm really lucky I can write fast. I also deal with a lot of self-doubt and this sense that I'm not good enough, which in turn makes me sit and stare a bit more. Once I get past that, though, writing is definitely a place of comfort for me, a place of salvation, and it always has been.

What are some specific things you do to manage your illness that you find effective?

I take medication. When I am motivated, I exercise. As much as I hate it, exercise truly makes me feel better but the challenge is that it takes a lot for me to feel motivated enough to get into an exercise mindset. I watch a lot of movies and Law & Order SVU.

What is your relationship to more traditional models of managing illness, like therapy and/or medication? Do you find them effective? Is accessing them an issue for you?

I am all for medication when I need it. I've been lucky in that I've taken only one medication, off and on, for the past 20 years or so. It works for me, without terrible side effects. I need to get back in therapy. I've seen therapists, off and on, for about 26 years now, which is crazy. I am not an easy therapy patient. I have a lot of walls. Right now, I live in a rural town so I haven't really liked the therapists I've met. One lady gave me worksheets and I was like, "Lady, no." I have no problem accessing these services. I am lucky enough to finally have health insurance and I am comfortable using it to get the healthcare I need. I was not always this way but I no longer feel shame admitting, I'm a good person and I also suffer from depression.

When do you struggle most with self-care? When do you find it easier?

I am terrible about self-care. This is one of my greatest weaknesses but it gets much worse when I am very busy so lately, hot mess there. I find self-care easier when I am not in the town I currently live in, which I hate. When I'm here, I think, "What's the point?" This place is grim. I no longer even try to sugarcoat it.

What's most useful for you in terms of support from other people? Is outside support important for you?

I am also not great about asking for support. I recently went through a pretty bad spell and few people in my life knew. I always find a way to maintain and get things done so people assume all is well when sometimes, it isn't. Really, just companionship, acknowledging that I exist, spending time with me really helps. The isolation of where I live makes me really eager for companionship and a friendly smile.

You're also a freelancer, and you teach, and you run a press, and you do about forty other things on top of that--how do you negotiate the balance between self-care and writing for love and writing for work and working?

Right now, I don't balance self-care and writing for love and writing for work. All I do is work, work, work and fortunately I love what I do so it doesn't much feel like work. I'm also really isolated where I live, not much of a social circle or any kind of support system so keeping myself very, very busy is kind of all I have to keep from really sinking into the void. I suspect work is the most effective way of self-care I have right now.

Roxane Gay lives and writes in the Midwest.

Previously in the Working series: Mairead Case, s.e. smith, Red Mills, Christine Hou, Litsa Dremousis, Jacqui Morton, Gina Abelkop, Elia Osuna, and Wendy Ortiz..

Working: Wendy C. Ortiz

Can you talk a little about the ways in which your illness works as a barrier to writing? What are some of the specific challenges you deal with?

Because depression is more fleeting in my experience, it’s hard to imagine it even as “my illness.” I suppose I see it as the shadow I have to walk with and occasionally interact with, if not downright wrestle with (if I have the energy) or just meld with (at worst). I’ve experienced depression more often after having my daughter in 2010; before her, I could count on my hands the number of times I experienced depression and even tell you what years they occurred and what may have triggered them. I can even look back at them with some fondness for where I was at.

Writing for me simply dries up during episodes of depression. I try to write two pages in a notebook everyday and that falls by the wayside. I write longhand. It becomes a scrawl as though all the self-hate (a symptom of my depression) turns my handwriting into something spiny and ugly. That is, if I manage to write anything at all. The challenge here is pushing through because this particular kind of writing is touchstone stuff, not “new material” to work with. I need the touchstone stuff to make it through to my other side but is never so clear or easy as when I say/know that when not experiencing depression.

Also during depression, the internal critic and hater’s volume goes up really loud and it takes special effort to turn it down, or shut it the fuck up (and shutting it down does feel kind of violent).

The main challenge for me is remembering that if I don’t write, I feel homicidal (which can be taken as a joke, right? I’m not really going to kill someone else), when in truth, if I don’t write for long periods of time, if I feel like I don’t have the time or space to write, I feel suicidal. I have not felt that extreme since around 2002, 2003, when I realized that was what was happening—not writing=suicidal—so I made some serious changes to my life to avoid that feeling again (saved money, quit my job for a time, recommitted to somehow living off part-time work so I had time to write).

What are some specific things you do to manage your illness that you find effective?

I stay in Jungian analysis/therapy when I can afford to (just returned in fall last year after a three year absence). The two pages minimum per day reminds me I have done something and I allow it to be trash writing, lists, whatever. I move away from social media when the internal voices start hating on me too loud and I need to regain perspective. I start blocking out future writing time on my calendar so it exists. If possible, I arrange a day when I can go to the library alone most of the day to work. Ideally, I arrange an overnight somewhere so I can be alone or in the company of one other writer with the intention of writing (favorite location: the high desert of California). I avoid music that I know will completely sweep me into its undertow (I feel absurdly affected by music, often). I tell my partner when I’m struggling. I make sure to not interact with people I know have the power to also sweep me into their undertow. I also resort to the HALT method of stopping and asking myself if I’m hungry, angry, lonely or tired and then respond to the need that presents itself. It’s so simplistic but it works for me.

What is your relationship to more traditional models of managing illness, like therapy and/or medication? Do you find them effective? Is accessing them an issue for you?

I’m a believer in therapy. I met my first therapist when I was 23 and we worked together for over ten years, the final years via phone when I moved away. Our relationship shifted over time as relationships do—the first six or seven years I was processing everything and it was important to have a witness, an objective person who could also jump in with love and alternative frameworks. The last few years felt like a mentorship of sorts. The content completely changed. All of it was effective for me. When I began Jungian analysis I’d been in therapy for over 10 years and it felt like all those years of therapy prepared me to go deeper. Hugely important life changes occurred, so yes, effective! I’ve managed to be in therapy this long because the two therapists I’ve worked with offer sliding scale fees. Without that, I would never have been able to afford therapy.

When do you struggle most with self-care? When do you find it easier?

I struggle most with self-care when I’m scheduled to be at home with my three-year-old and don’t feel up to the challenge of self-care on top of childcare. There may be an urge to stare at the walls and let the tears come but I don’t really have the time or space to do this when someone is chattering happily at me and wants to dance and sing and dump all the toys out of the toy box. On the worst days I try to establish some strong(er) boundaries than usual: don’t go to Facebook or Twitter, or at least ask myself why I’m going there before I open a browser window. Try to maintain a calm voice when speaking to the toddler, who has no idea what I’m going through. Sometimes I’m able to force myself outside which is good for both of us. But the constant of being at home coupled with the tendrils of depression wanting to loop around my calves and pull me under is when self-care is the hardest.

I find self-care easier when I can believe the mantra that this is all temporary. This feeling is temporary. Sometimes repeating this is enough to pierce the numbness and remind myself there are a number of things I can do to get myself millimeters freer of the depression. It really helps to have a go-to list of things that have worked in the past or things I have yet to try that I’ve learned from others.

What kind of relationship do you have to your illness? Does how you think about it change the way you live with it?

Our relationship is spotty. I don’t know this depression part very well because it took one form before I had a child and another form after I had a child. I respect that it changes and I even respect that it exists. (I can say this right now because I’m on the other side of a visit this past weekend. When I’m in it, there is no respect, just an out-and-out fight, typically.) There’s more I want to learn about it and yet I never want to feel it again.

I used to keep subject-based notebooks and had one titled “Loss.” It was a place to focus purely on losses, which were, at the time, completely related to a couple of extended episodes of depression I faced in my late 20s. Now I have a “dialogues” notebook that is partially about using active imagination to get at the root of things I’m struggling with, so there are some conversations with depression.

It’s only in the last year or so that I feel a sense of knowing and trusting I will get to other side. In fact, I don’t feel I have a choice but to get to the other side. My daughter ensures that.

What's most useful for you in terms of support from other people? Is outside support important for you?

The support of my “husband-wife,” also known as my domestic partner, is incredibly useful. She’s at work all day and is able, somehow, to come home and listen to me talk the most coherent, mature sentences I’ve formed all day when I maybe haven’t spoken to another adult. She helps me keep my writing dates and retreats by taking over childcare duties with a fierce and loving presence that continually makes me wildly happy that she’s parenting with me.

As I think about this question what I am considering are ways in which people have helped me with my daughter, made opportunities possible for me to leave her in good hands so I could write or do writing-related projects. That is an enormous form of support that keeps me balanced and is incredibly important to me. The people who come forward willing to hang out with my kid are total lifelines to me.

You do a lot of caregiving--as a mom, as a therapist. How do you balance giving to others and taking care of yourself?

As someone who struggled mightily with boundaries most of my life I’ve developed what might seem like hyper-boundaries to some (occasionally, even to myself). I can look back at my early 20s when I began therapy, which was the place where I really started looking at the lack of boundaries I had and started experimenting with throwing them up, sometimes willy-nilly. While I’m not proud of some of the decisions I made based on my developing sense of boundaries in the past I see those times as totally necessary, episodes of muddling through with too much boundary as opposed to zero or little boundaries, all of which was good for me to practice.

Now I feel like I can enjoy a more flexible sense of boundaries but have no qualms about putting up big ones if needed. This is super important and useful to me when wearing any of the hats—mother, therapist, friend, etc. At the same time I feel like I have to apply an almost painful sense of self-awareness at all times to keep boundaries intact, stay somewhat balanced, and be effective with everything I’m working on.

How does being a parent intersect with depression for you?

This is a question I’m still asking myself. There’s the obvious—I experienced post-partum depression (and a severe reaction to medications post-labor) in a way that told me in no uncertain terms, Oh yeah, you have a body and it responds to traumatic shit (AGAIN)! and then I experienced several more depressive episodes later. It often feels related to not having enough time or space to write—which is related to that extreme homicidal/suicidal feeling I’ve felt before when I don’t have time or space to write. If I feel unsupported as a primary caregiver, here comes depression (which only gives me stronger deeper empathy for those who don’t have another engaged co-parent to lean on). If I start to feel like being a parent is my only identity (a trapdoor I sometimes fall into, especially on the days when it’s just me and my daughter and I’m not making connections with the world at large), it gives depression more space to enter.

Wendy C. Ortiz is the author of Excavation: A Memoir (Future Tense Books) and Hollywood Notebook (Writ Large Press), both to be released in 2014. Wendy writes the column “On the Trail of Mary Jane” for McSweeney’s Internet Tendency. Her work has appeared in The New York Times, The Nervous Breakdown, The Rumpus, PANK, Specter Magazine, and other journals. She is co-founder, curator and host of the Rhapsodomancy Reading Series in Los Angeles. Wendy is a mother and a registered marriage and family therapist intern. She is @WendyCOrtiz on Twitter. Visit her at www.wendyortiz.com and wendycortiz.tumblr.com.

Previously in the Working series: Mairead Case, s.e. smith, Red Mills, Christine Hou, Litsa Dremousis, Jacqui Morton, Gina Abelkop, and Elia Osuna..

Working: Elia Osuna

Can you talk a little about the ways in which your illness works as a barrier to writing? What are some of the specific challenges you deal with?

I have episodes of both mania and depression, but depression is obviously the worst to deal with. My depressive episodes don't allow me to do anything at all. I just want to stay in bed so writing is not possible. Even brushing my teeth is impossible. My depressions are debilitating, but fortunately over the last couple of years I have found ways to battle it and have actually been able to write even when I'm starting to fall under its influence. The most challenging aspect of it is getting out of it. It's really difficult for me to pull myself out of my darkness.

What are some specific things you do to manage your illness that you find effective?

The horrific thing about depression is you can go in such a deep hole and get into a dark place that nothing or no one can get you out. So I have to really work hard to not go to the dark spaces. To do this I force myself to call or write someone I love, so really the most important thing for me to do at the onset of a depression is reaching out to my close long-term friends and/or family who know and/or understand my illness. This helps me get out of my sad little orbit.

I also am pretty fanatic about having to know my schedule each day. So every night and each morning I have to have a general plan of what I'm going to do each hour or half hour; this helps me have a routine and a purpose. If I don't have a purpose that makes me feel even more depressed. I probably spend way too much time making lists.

Seeing my therapist once a week is also critical. He is a relational psychotherapist and I've been seeing him now for two years.

I used to do Kundalini yoga with an incredible teacher but she left the city. I prefer Pilates now because it's so physical and I don't have time to think about anything, only my breathing. A new thing that I really like doing is going to a community sound meditation workshop that takes place in downtown Manhattan. It's difficult for me to relax so listening to those singing bowls and singing along with the sruti boxes really calms me down. I would never think I would be into such things, but at this point anything that will help me try and relax I will try. Ultimately I think the most important things that I do that help me manage my illness on a consistent basis are going to therapy and just making my work.

What is your relationship to more traditional models of managing illness, like therapy and/or medication? Do you find them effective? Is accessing them an issue for you?

I started therapy when I was 12 years old with a therapist I really liked. I felt like she helped me until she told me she could help me no longer and referred me to a psychiatrist. I was 15 and I felt very rejected. I never saw her again. The psychiatrist wasn't helpful but referred me to adult group therapy and I guess that helped me see that many people suffered with depression and anxiety; I was also put on anti-depressants and anti-anxiety medication at that time. I eventually got off of them when I found they were making me feel like i was living in a fog. Xanax did help me, however and when I no longer had a prescription, I would ask my grandmother (who also suffered from anxiety and depression) or mother for some if I was ever nervous. After college, I had a major breakdown and immediately saw a psychiatrist who diagnosed me with cyclothymia (a milder version of manic depression) and I was on Celexa and Depakote for several years and when I didn't have health insurance, I would get pills from friends or family members and would self-medicate. Once I called my psychiatrist cousin for a prescription and he didn't help me, so when I couldn't get meds it was often frustrating for me.

But then again, that was the period when I was self-medicating. It was surprising though through my persistence and socializing how many pills I could get at parties and through strangers. When I didn't have health insurance, I went to therapy through psychotherapeutic organizations offered in the city for sliding-scale fees. The therapists were usually social workers and I went through a few of them--decent to terrible. It's been nearly ten years now that I've been completely off any kind of medication so I don't have to worry about paying for it. Unfortunately, my current therapist doesn't accept insurance at all and is very expensive. I work an extra job (one night a week) right now just to cover his fees.

When do you struggle most with self-care? When do you find it easier?

If I am in a deep dark space, it is the most difficult to do anything for myself. I have to really pull myself out if it and like I said, I do my best to reach out to other people so they can help me to help myself. Extreme temperatures during the winter and summer are the worst. Fortunately, I have managed my depression much better these last several years. But the big depressions do come and when they do I am incompetent. I find it easier too look after myself when I'm having neither a depressed nor manic episode--when I'm more balanced and matter-of-fact about the world. In times like these I can handle self-care much better.

What kind of relationship do you have to your illness? Does how you think about it change the way you live with it?

It helps me to know that I am not alone with my illness. Even though I think of it as an ancestral disease (I have several family members who suffer from depression) I also think of it as a way to help my work. For instance, when I'm having one of my more manic episodes, I can get a significant amount of work done. I do still struggle with accepting the fact that I do live with a manic-depression. Years ago, I was given Kay Redfield Jamison's Touched by Fire: Manic-Depressive illness and the Artistic Temperament. In the appendix she has sections divided into poets, writers, visual artists and musicians/composers, and indicates which of these artists were in a mental institution/asylum, committed suicide, or attempted suicide.

Going back to this table helps me from time to time and so does reading her clinical and diagnostic criteria for mood disorders. If I'm starting to feel a bit off, on the verge of something that's not really healthy, I'll read, "Irritable-angry-explosive outbursts that alienate loved ones" and it will remind me, oh right, that's one of my behavioral manifestations! It helps me clarify my dysfunctional sides. A close friend of mine who was also an artist killed herself a couple of years ago. She was going through something very severe and spiraled downward quickly. It devastated me in a way nothing ever had before and I saw how it affected her family and friends. I thought I would never ever want to do that with anyone so I do try hard to fight it as much as I can. It's a constant struggle.

What's most useful for you in terms of support from other people? Is outside support important for you?

Outside support is essential to me--from my friends and my current therapist.

How do you negotiate the balance between self-care and making work and working?

As I get older I find it more difficult to begin to make work. I really, really have to force myself to do it. Just starting is the most challenging. I cry, or I get hysterical, or I put on lipstick, or maybe I put on a bathrobe and reel about something and then somehow it just starts. I realize I need to give myself the freedom to just stare into space or at a blank page or sheet of paper. Once I give myself permission I can start. And once I do begin and am finally in my process, for the most part I feel sane (the way I know sanity to feel) and eventually I do stay focused. If I didn't force myself to make work and stay with it, it would be incredibly difficult for me to function.

Elia Osuna is the author of two novels and a radio play. She is trained as a mezzo-soprano, is the co-founder of the record label and arts collaborative Ö and currently lives in New York City.

Previously in the Working series: Mairead Case, s.e. smith, Red Mills, Christine Hou, Litsa Dremousis, Jacqui Morton, and Gina Abelkop.

Working: Gina Abelkop

Can you talk a little about the ways in which your illness works as a barrier to writing? What are some of the specific challenges you deal with?

When I was younger--like, a teenager--there was this romantic notion of "I only write well when I'm sad!" The older I've gotten, the more I know that idea to be a total lie, at least for me. When I'm deep in a depressive period basically all I feel capable of doing is laying in bed staring at the ceiling or watching TV. Totally void of any kind of energy whatsoever, never mind the energy to create something. I've been paralyzed by anxiety under the same conditions: too nervy to sit still and write, or keep my mind on anything for very long. When I'm anxious or depressed I can't concentrate on reading either, which is the worst, because reading is one of my favorite leisurely pleasures. Also, my brain has no original thoughts when I'm depressed.

I have never been suicidal, but most of my thoughts revolve around noting that I cannot live like this, nothing is fun, and I'm exhausted. That's it. I remember being told to snap out of it as a teenager and being so frustrated in trying to explain that there is no choice to be made. You come out of it when you do. The last time I had an extended depressive/anxious spell I had just moved somewhere new, by myself, and it was summer. I couldn't find a job and the only thing I could/place I could go to feel okay was to the river in the town I lived in. As soon as I got there I felt good, and calm, and I could even read, and then when I got home it was back to the gallows. So I spent all summer there by the water.

But I had monetary support and most people don't, so how the fuck do depressed people deal with having to deal when you are deep into the pit? The depressive period before that was when I was trying to quit Paxil after being on it for 15 years. I had a retail job and was taking Ativan all day so I could bare to be around people, but I could barely eat and instead of taking a lunch break I'd go on these uphill walks to try and squash the anxiety. That lasted for six months and finally I just went back on the Paxil. I couldn't live like that.

What are some specific things you do to manage your illness that you find effective?

I had a really incredible therapist for a few years who helped me SO MUCH. And I'm very lucky to have a partner who is supportive and helpful and concerned in the right ways. Reaching out to someone really does tend to help but it is very, very hard for me. I have to force it, which sometime I manage and sometimes I don't. Taking walks with my dog and spending time with my dog in general helps. Long baths. Crying, which I do less and less as time goes on, which worries me.

What is your relationship to more traditional models of managing illness, like therapy and/or medication? Do you find them effective? Is accessing them an issue for you?

I am not currently in therapy but the few years of therapy I had a couple years ago basically saved my life, by which I mean I just couldn't have gone on operating as I did for so many years. So yes, I am a STRONG believer in therapy, but only if you have a really good therapist. I know from experience that there are lots of rotten or just mediocre ones. A good therapist will call your bullshit out in a constructive way and lead you to think more clearly about your choices and perspectives, as well as (hopefully) helping you figure out healthier coping mechanisms. And it's EXPENSIVE! Free mental health care would change the entire universe, I am sure of it.

I have insurance now and parents who paid for therapy when I couldn't which is an extreme privilege. I have many friends who would like to be in therapy but can't afford it, even at sliding-scale costs.

When do you struggle most with self-care? When do you find it easier?

When I'm deep in a depressive period it's hard to practice real self care, like reaching out to friends, getting out of the house, eating well. What feels like it might be self care--staying in bed all day, etc.--is not actually effective at that point. It's easier when it's just a period of a few days, and I have to say it's easier now that I have a partner, because when I lived alone it was really easy to isolate myself without anyone asking any questions.

Practicing self-care is something I am constantly working on, and try to be aware of in regards to offering care to other people, though I sometimes fail at that too. It's often a case of three steps forward, two steps back, but I do believe that I am getting better it with age, as I learn what works and what doesn't, as my true desire to live with less pain (i.e. not romanticize the emotional pain of myself or others) increases.

What kind of relationship do you have to your illness? Does how you think about it change the way you live with it?

For the most part I think about it very little unless I'm going through an intense depressive period. I used to get really scared every time I had a hard day, wondering if it was the start of a depressive cycle, but something that helped A LOT with that was beginning to track my period (I quickly discovered that most of the time my harder days happen about a week before I bleed). This way I can calm myself down much of the time by realizing that there is always a time of the month that is harder, and it will probably pass.

I fear being incapacitated by depression in the future, especially when I think about trying to go off medicine, which I may or may not ever want or need to do... I tried to quite Paxil once (with the help of a doctor), as I mentioned, and ended up going back on it after six months due to withdrawal and depression/anxiety that never went away (tried to switch to another med and it didn't help). So I've spent a lot of time since then thinking about how fucked up the pharmaceutical industry is, how frightening it is that I was put on a medication at age 13 and no one bothered to check in on that until I was in my late 20s. What did that medication do to my growing brain? And there are all these lawsuits against Paxil. But I function well on it, so? It doesn't fee like much of a choice.

What's most useful for you in terms of support from other people? Is outside support important for you?

It would help me so much for people to check in on me when I'm isolating myself, but I also do no invite that kind of response and am not a super social person to begin with. I have also never explicitly asked for that from people, so I know it's not fair to expect it, and the burden of care cannot be placed on people who don't know what I want/need because I've never asked for it. It does help me to talk with the people I'm closest to, but it is incredibly difficult for me to take that step most of the time. So yes, outside support is important, but I haven't yet figured out how to ask for it when I need it.

How do you negotiate the balance between self-care and writing and earning a living?

I've never been a very disciplined writer--I just write when I feel moved to, for the most part. And I've discovered that I don't necessarily write more when I have more free time. A lot of my self-care is part of the process of writing: listening to music, reading books/magazines, watching movies, people watching, walking, taking long baths, talking with friends. All that self-care time translates to thinking which eventually, sometimes, translates to writing. I currently work an eight-to-five job Monday through Friday and am still figuring out how to manage my time best. Giving myself permission to be a slow writer who writes when she writes helps tremendously, in terms of attempting to alleviate guilt about not being productive enough (which I still have). I also run the small press Birds of Lace, so I spend time on that, which feels like self-care because I love it, and it allows me to engage with a larger writing community in a way that is relaxing and fun, for the most part.

Gina Abelkop lives in Athens, GA with her sweetheart and two funny dogs. She is the author of Darling Beastlettes (Apostrophe Books, 2012) and runs the DIY feminist press Birds of Lace. She is currently working on a series of poems about the artist/art of Rachel Feinstein and a novel about a Pebbles-and-Bam-Bam-esque duo who abandon the planet Earth for Venus. themoonstop.blogspot.com

Previously in the Working series: Mairead Case, s.e. smith, Red Mills, Christine Hou, Litsa Dremousis, and Jacqui Morton..

Working: Jacqui Morton

Can you talk a little about the ways in which your illness works as a barrier to writing? What are some of the specific challenges you deal with?

Isn’t the first rule of mental illness that we don’t talk about mental illness? Kidding. I do have to say the word illness is the first barrier to the whole thing for me. I’m not ill. I’m bipolar. That said, it sometimes makes me feel icky, just like any illness. And we do need to recognize mental health on the same level as physical health, so I understand our need to have terminology.

Anyhow! Writing was a passion before it became a profession. This in itself brings challenges but I don’t think they’re any different for me than they are for any writer who has to pay bills or take care of the kids. I always want to be with my passion, but sometimes I have to keep that at bay until I’m done with the writing that pays the bills. I do find that when I am particularly engulfed in a creative project that I can’t get to because of other obligations, I don’t feel completely healthy. Is that because I’m bipolar or is it because I am a writer?

I have been very depressed at times in my life and during those times I have written, but I don’t think they’ve been very productive periods for me. Another barrier for me is focus. As in, it takes a while for me to get focused on my creative writing. I always have a long list of writing projects, but I don’t have the kinds of time and quiet I used to. I fell in love with poetry in college and it’s what I love to write. But since having children, I find it hard to get in that space.

The biggest barrier for me in writing right now is that I’m trying to write about the words “bipolar” and “motherhood” together. They are words that people feel uncomfortable putting together, but it’s possible to do. I’ve written about some personal things before but as a professional and as a parent, this is the scariest – this knowledge that there will be places and times in my life that will be a) difficult to visit and b) more difficult to share with the world.

But that’s where I am. And I’m chatting with you about it as the first step toward moving that barrier out of my way. So, thanks for this. And thanks for bringing this conversation to light.

Can you talk a little more about how refusing to identify being bipolar as a sickness has been helpful for you? (I'm particularly interested in your answer because for me personally, coming to think of depression as an illness has been helpful in learning how to manage it.)

Maybe I still have some accepting to do. And it’s not that I don’t see it as an illness, because it is. Maybe it’s because my label is “bipolar” that I have a harder time. The stigma that comes with it is difficult. Also, I’d be much happier to term it an “illness” over a “sickness”. And that said, I think anyone with any kind of mental health challenge needs to term it however is necessary to a) love themselves and b) keep themselves healthy.

What are some specific things you do to manage your illness that you find effective?

I cry. It actually keeps me from getting depressed. The world saddens me, but I can’t let it be me. I don’t bottle things up like I used to. I write.

I don’t do some of the things I know I should. When I have maintained a meditation practice in the past, it’s been tremendously helpful. When I actually began to manage my illness, I attended a 12-week program at a place called The Mind Body Medical Institute, and learned a great deal about the importance of mindfulness and relaxation. I meditated every day and kept a journal in addition to my other writing. I was able to manage negative thoughts and protect myself emotionally. I need to get back to this.

I have been staying off of social media a bit more. It’s hard, as a writer, I think, to disengage, for fear of feeling irrelevant, I guess? I’m not exactly sure why we are afraid to disengage. But I very much need to and lately I’m honoring that more. I also try to find ways to laugh every day. Or at least smile.

I should exercise more. I work part time and have my kids home part time, which gets me outside moving with them. They love to dance like I do. Which brings me to music. Music has saved my life, like poetry.

Of course, it is winter in New England, and how I feel definitely shifts with the seasons. I should be taking my vitamins and spending quality time with a light box. (I have one that dear friends passed on--just one example of the help I have received along the way.)

But what’s truly most effective for me is to not beat myself up for the things I’m not doing. This is really, really hard for me and something I need to be very conscious of. Beating myself up has been a lifelong habit and it’s a dangerous cycle for me. Life is, hopefully, long. I remind myself often that if I can get through this moment, I can get through the next and then the next.

What is your relationship to more traditional models of managing illness, like therapy and/or medication? Do you find them effective? Is accessing them an issue for you?

I have a love/hate relationship with both therapy and medication. I have found both to be, at times, extremely helpful and at times, tremendous wastes of time and money. I’ll spare you some of the stories but, right now, I see a therapist and take medication.

I’ve spent a good portion of the last five years pregnant and/or breastfeeding and I’ve had to find a balance that weighs the benefits and risks. I had visited a psychiatrist at the MGH Center for Women’s Mental Health before my husband and I started “trying” to conceive. It was a couple of years after I had been diagnosed--finally--as bipolar, late in my twenties. I was feeling healthy enough to start a family, but quite worried about what starting a family meant in terms of staying healthy.

Regarding medication--for years, like literally from the age of 13, I was treated for migraines with antidepressants, because neurologists believe(d) there is/was (I’ve lost track) a link between migraines and serotonin levels. Later, I actually was depressed, and off of antidepressants and anti-anxiety medications. When I was diagnosed correctly, I learned a lot about how antidepressants can fuck with you if you are bipolar. Since then I have been on and off of a mood stabilizer and an antidepressant--but never the latter alone.

Anyhow, currently I take a pretty low dose of a mood stabilizer, Lamictal. I feel the need to throw in that “you always need to be in touch with your medical provider about your own healthcare decisions,” disclaimer, but I wish we could be more open about this, particularly for women who want to have children, and that’s why I’m getting specific. There are safe medications and there are specialists who can work with you during pregnancy and beyond. You need a support system, and medication can be a safe part of that.

To the last part of your question about access; finding someone that I have been able to see for both medication and talk therapy has been a key for me. It took years to find someone that really worked for me.

My therapist is not “in network” for our crappy insurance company, so I pay out of pocket until I reach the deductible--spreading the appointments as far out as I possibly can--and then once I meet the deductible and insurance kicks in to pay a portion, I cram in some more visits if I need them. But it’s better than spending bad money on co-pays and time with people who don’t get me. This woman likes for me to wrap myself in a blanket and eat my banana on her couch. And she’s the only therapist I’ve ever been truly honest with about my addictive personality. She knows that if she were to prescribe one Ativan per day, I would like to take five, at least.

I have to acknowledge that my above statements come with the fact that I have health insurance. I feel a grateful that through myself or my husband, I have always had coverage, even if crappy. I’m cognizant that accessing mental health care is a barrier for many and this is one of the things that make me sad. I also will say that even with insurance, our system isn’t friendly towards people facing mental health challenges. Everything is a huge pain in the ass.

When do you struggle most with self-care? When do you find it easier?

It’s hard right now. My four-year-old is a smart, bouncing boy, which is to say he is challenging. I am weaning my almost-18-month-old. So I should say I think it’s getting better. I’m getting more sleep. We had the baby in our bed for at least half the night until a couple of months ago. Sleep is always the biggest area of concern for me, along with remembering to eat, and take my medication. I guess those are three big ones.

How does being a parent intersect with depression and illness for you?

That’s a super tough question. Before I was diagnosed as bipolar, I spent a few months in a deep depression, basically living in the corner of my couch. I no longer own that couch and there’s not really a good metaphor to insert here that will tell you how happy I am to be the mom of these two boys. I don’t want either of them to ever feel that kind of sadness.

That is the hardest part of it for me. Also, the fact that mentally and physically, I need time away from them. Is that because I’m bipolar or is it motherhood? And, of course, I don’t want them to see me sad, but it happens. And we’ll talk about it in due time. But, also, I have anxiety. A lot, and obviously more as a parent. This is a hard intersection. I might not meditate, but I take a lot of deep breaths.

What kind of relationship do you have to your illness? Does how you think about it change the way you live with it?

I tried to commit suicide when I was 17 and didn’t take seriously the fact that I had any illness until I was 27. When this extremely well-put-together psychiatric resident told me I was bipolar, I didn’t like it. When I finally accepted it, I was glad to have a new understanding of myself and some of the choices I made along the way. And now, it helps me stay healthy. If that means being labeled, I’m okay with it. That said, I don’t wear the fact that I’m bipolar on my sleeve. It doesn’t define me. I think some people I know will be surprised to read this, though I’ve been much more open in discussing it in recent years.

What's most useful for you in terms of support from other people? Is outside support important for you?

It’s very important. I am close with my family and have a very supportive partner. He doesn’t think of me as someone with an illness, though he is understanding of the fact that it’s sometimes how I feel. It’s not an option for me to put myself to bed for a few days, but it is an option to ask for help when I need it. It’s also not an option for me to let myself go too far into the mania part of bipolar. I can feel that coming, when I’m driving too fast or wanting to spend too much money. That’s when I know I need more self-care. If I let myself get too far up, I know now that it’s a lower place on the other side. (And the “up” isn’t always this euphoric place that some people think it is. For me, it’s a very hard to describe sense of wanting to leave my body.)

I also have good friends that I talk to--they aren’t my therapists, but they get it. Also, just being with people, having fun, enjoying my kids, being alive; it’s important enough in itself. That said, I sometimes require more time alone, and people in my life understand that too. I’m fortunate to have a lot of great people around me.

You're also a freelancer--how do you negotiate the balance between self-care and being a mom and writing for love and writing for work and working? (Or do you feel like you can balance all of that at all? That's a lot to balance.)

I’m a freelancer and I work “per diem” for an executive search firm that serves the nonprofit world. The work I do means I create my own schedule--it also means some weeks I have a lot of work and some weeks I have less. I have the same childcare schedule every week. I have had to figure out how to manage the shifts in my work life--mentally, financially and physically. I also work “from home” and some weeks it feels like self-care is just impossible.

But work is also really important to me. I’ve had a job since I was 13, except for once in my twenties, when I left a bad work situation. (It’s after that that I moved into the corner of my couch--and then finally found my way out.) I care about the work I do, which impacts my mental health in a very positive way. Work also means childcare and as I said above, some weeks I have more time for things that really nourish me. It’s then that I can write more. Needless to say, I would like to be writing every day. While it’s a goal, my priorities shift day to day and I have figured out, mostly, how to manage this. It’s definitely more difficult as a mom, but it’s totally worth it.

Jacqui Morton's writing has been published in places such as The Rumpus, Salon, RoleReboot and The Mom Egg, She holds an MFA from Antioch University and is a trained birth doula. A chapbook of her poems, Turning Cozy Dark, was published in 2013 by Finishing Line Press as a semi-finalist in the New Women's Voices Competition. Visit her at confessionalmama.blogspot.com, on Twitter @morton919, or at jacquimorton.com.

Previously in the Working series: Mairead Case, s.e. smith, Red Mills, Christine Hou, and Litsa Dremousis.

Working: Litsa Dremousis

Can you talk a little about the ways in which your illness works as a barrier to writing? What are some of the specific challenges you deal with?

I’m in no way romanticizing my depression or anyone else’s. I want to be clear about that. But mine has rarely posed a barrier to writing. If nothing else, it often fuels it. If I weren’t compelled on a cellular level to revisit past traumas and transform them into stories, I wouldn’t be writing. The one caveat: when I’m monumentally, terrifyingly depressed, then I mostly write in my journal. When the depression reaches that depth, yes, it can pose a barrier to creating work for other readers. But that’s rare on all on counts.

In some weird way, because I’ve contended with recurring bouts of major depression since I was twelve, I’m really good at not letting it stop me. I’ve never missed a deadline. As I wrote in a recent essay, I tend to overcompensate, both as a way to outrun the awfulness and to throw others off the scent.

What are some specific things you do to manage your illness that you find effective?

I’ve learned I absolutely must stay on Zoloft. It’s dangerous if I go off it. Also, though I walk with a cane or crutches most of the time (I have an illness similar to MS), I still walk a mile to a mile and a half each day. I cry when I need to. I curl up with my dog, Thomas, who is quite possibly the cuddliest little creature ever. I spend time with loved ones who understand depression. I read voraciously, see matinees and obsessively revisit 30 Rock. (But I do those last three when I’m happy, too.) Oh, and the occasionally ingesting of Kettle Chips with Theo’s dark chocolate can render all sorts of happy neurological fireworks.

What is your relationship to more traditional models of managing illness, like therapy and/or medication? Do you find them effective? Is accessing them an issue for you?

Like I said above, I have to stay on Zoloft. I ended up in a dangerous place the last time I went off it. And I’m fortunate b/c I don’t experience side effects. My insurance covers most of it. I did benefit quite a bit from both my former therapists. (One retired; the other is nearing retirement.) The tripwire with the second therapist, though: he was great in a crisis, but didn’t understand creativity. So, that ongoing, lower-grade depression most of us face both as a prompt and as a result of writing, well, that usually stumped him. And he’d come up with these solutions that were too bumper sticker for my taste. I have a close circle of friends in several fields, but many are writers. Times like that, I find it most useful to gather with them and eat absurd food combinations and laugh our asses off.

When do you struggle most with self-care? When do you find it easier?

Again, because I walk with a cane or crutches, self-care can be a bit of a challenge for reasons that have nothing to do with depression. Or at least they’re not about depression at the start. Unsurprisingly, when I’m very ill for a lengthy time period, I often become more depressed. Also, my partner died four and a half years ago. So, my best friend who’d help me during these times is dead. Sometimes, it’s hard to tell what pain is causing what pain. It can all fold in upon itself. I’m maniacally tenacious, though, and that saves me again and again. 

As for when self-care is easiest: when I’m in a good place emotionally. Because I have the necessary perspective to realize everything might not be apocalyptic. When I’m in the worst of the depression, it very much feels like my brain is trying to kill me. And that’s exhausting. Anyone who’s ever had to enumerate the reasons they cannot kill themselves knows what I’m talking about.

What kind of relationship do you have to your illness? Does how you think about it change the way you live with it?

Again, I don’t romanticize it, but I view it as “the creativity tax”. (One of my shrinks adopted this term after I started using it.) When a certain degree of intellect and creativity intersect, recurring bouts of major depression often result. So, I try to remind myself that the neurological gifts that bring me talent are the same ones that occasionally try to derail things.

And, like many depressives, it makes me funnier. Because if I couldn’t laugh about life’s ceaseless morbidities, I’d be dead. As I write this, I’m tucked into a wonderfully comfortable bed. But much of my family still lives in Greece, where the austerity measures are unraveling the social fabric. Suicides are at their highest recorded rates. Homelessness is at an all-time high. Impoverished families are putting their kids up for adoption, which hasn't been seen on a large-scale level since Greece's civil war after World War II. (These figures come from the U.N., BBC and Greek government. Also, I'm hearing it anecdotally from my loved ones.) My family members are safe, thank god, but how come I ate a lovely dinner tonight when so many other Greeks are living in agony? Geographic lottery, basically.

And how do you ever wrap your mind around that? I donate my time, money and writing, but I know in the course of my lifetime, kids in impoverished nations will die of diarrhea. I.e. something for which I can purchase a remedy in several places within blocks of my home. I return to Christopher Hitchens’ line, “The deck is stacked.” So, in addition to taking action, I laugh when I can. Too much of life will never make sense and humor sometimes nullifies the deep sting for the luckiest among us.

What's most useful for you in terms of support from other people? Is outside support important for you?

I’ve finally gotten to a point in my life where I’m open about saying, “I’m extremely depressed. I need to talk. Do you think you might have time soon?” I’ve always had a rule my loved ones can call me anytime, day or night, if they need to talk. Sometimes just knowing someone would pick up at 3:00 a.m. makes any of us feel less lonely. I tend to be a caretaker. Also, because I’m physically ill, I never want to be perceived as weak. (That last part is ridiculous, I know.) But yes, finally, I’ve gotten good at just saying, “Dude, things are grim right now and it feels like they always will be. Can we go get some egg rolls and just talk?” And I’m really fortunate so many of my loved ones understand. For their sakes, though, I wish it weren’t because they also live with depression. But it does give some of us a shorthand and we don’t have to explain what it’s like.

Also, my mom is a fantastic listener. She also contends with depression and she’s wonderfully compassionate and encouraging.

You're also a freelancer--how do you negotiate the balance between self-care and writing for love and writing for work and working?

My physical health is much more of a problem here than is my mental health. But again, it all ties in. When my health prevents me from working as much, I have less money. When I have less money, I worry more. When I worry more, it intensifies the depression. And when I’m depressed, his death seems more piercing. I make every effort I can to try and focus on what’s empirically real and what is the giant miasma of doom my brain is creating. I’m usually successful, but sometimes I fail. 

Recently, I composed a playlist for my funeral. When I told a loved one, she insisted I stop writing and leave my fucking house and go to a matinee. And it wasn’t until I heard myself say it to her that I realized, “Yeah, maybe I should not be compiling my funeral playlist. That’s not a sign of awesome emotional health.” So, I got dressed up, hobbled to a nearby theater and saw “Dallas Buyers Club”. And it really helped. Paradoxically, creating art is usually painful, but the best of it can help alleviate pain. So, art usually provides solace, too.

Litsa Dremousis' work appears in The Believer, Esquire, Jezebel, McSweeney's, MSN, Nerve, New York Magazine, The Onion's A.V. Club, Salon, Slate, The Weeklings, on KUOW, NPR, and in sundry other venues. She’s completing her first novel, assuming it doesn't complete her first. On Twitter: @LitsaDremousis.

Previously in the Working series: Mairead Case, s.e. smith, and Red Mills.

Dirty Wings Pre-order! and miscellaneous business

Treasured friends! it is with great delight that I inform you that you can, once again, pre-order signed and personalized copies of Dirty Wings, the prequel to All Our Pretty Songs, from WORD bookstore in Brooklyn--and you should! as WORD is a very fine store, staffed with wonderful persons. The books comes out July 15. (And you can still order signed copies of All Our Pretty Songs, if this project interests you.)

If you are in New York on February 11th, I'll be reading with Kathleen Hale, Adele Griffin, and Mariah Fredericks at McNally Jackson at 7pm.

And the audiobook for All Our Pretty Songs is out now, and is very special to me, as it is narrated by my dear friend Renata Friedman, who I've known since we were 17 and met at a high-school arts workshop. "I'm going to be an actor," she said; "I'm going to be a writer," I said; and here we are, seventeen years later.

Lots more interviews in the Working series coming up in the next weeks! and don't forget to pre-order Guillotine #6 from Sarah Jaffe and Melissa Gira Grant! This month, you can find Guillotine chapbooks at Ugly Duckling Presse's Gowanus pop-up shop and at Salt & Cedar Letterpress in Detroit.

xo

sarah