#think there’s a term in family therapy for Dream: diagnosed problem.
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What Is Post-Traumatic Stress Disorder? (PTSD)
Post-Traumatic stress disorder, also known as PTSD, is a psychiatric disorder that may occur in someone who has experienced or witnessed a traumatic event such as a natural disaster, a serious accident, a terrorist act, war, rape, or who has been threatened with death, sexual violence or serious bodily injury.
PTSD has been known in the past as “shell shock” during World War I and “combat fatigue” after World War II. However, PTSD is not exclusive to combat veterans. PTSD can occur in all people, of any ethnicity, nationality, or culture, and of any age. PTSD affects approximately 3.5 percent of U.S. adults every year, and approximately one in 11 people will be diagnosed with PTSD in their lifetime. Women are twice as likely as men to have PTSD. Three ethnic groups; Latinos, Blacks, and American Indians have higher rates of PTSD than whites.
PTSD is characterized by disturbing thoughts and feelings related to the experience that lasts long after the traumatic event has ended. There are flashbacks or nightmares; they may feel depressed, fearful, or angry; and they may feel detached from other people. People with PTSD avoid situations or people that remind them of the traumatic event, and have strong negative reactions to something as ordinary as a loud noise.
A diagnosis of PTSD requires exposure to a traumatic event. The exposure could be indirect or first hand. For example, an individual witnessing a robbery or a shooting. It can also occur as a result of experiencing or witnessing trauma such as first responders.
Symptoms of PTSD are found in the following categories:
Intrusive thoughts which include repeated, involuntary memories, bad dreams; or flashbacks of the traumatic event.
Avoiding reminders of the trauma which include people, places, activities and situations that may trigger distressful memories.
Alterations in cognition and mood: Inability to remember important aspects of the event, negative thoughts and feelings leading to ongoing distorted beliefs about oneself or distorted thoughts about the cause and consequences of the event leading to self-blame; constant fear, anger or shame. Decreased interest in activities previously enjoyed; feeling detached or estranged from others and unable to experience happiness.
Arousal and reactive symptoms include irritability, anger, behaving in a self-destructive way, being suspicious, easily startled, and having problems with concentration and sleep.
For a person to be diagnosed with PTSD, symptoms must last for more than a month and must cause significant distress or problems in the individual’s daily functions. Many develop symptoms within three months of the trauma, but symptoms may appear after and often persist for months and sometimes years.
PTSD often occurs with other psychiatric conditions including depression, substance abuse, anxiety, memory problems and other physical health issues.
When you have PTSD, it might feel like you’ll never get your life back. But it can be treated. Short- and long-term psychotherapy and medications can work very well. Often, the two kinds of treatment are more effective together.
PTSD therapy has three main goals:
Improve your symptoms
Teach you skills to deal with it
Restore your self-esteem
Most PTSD therapies fall under the umbrella of cognitive behavioral therapy (CBT). Group or family therapy might be a good choice for you instead of individual sessions depending on your situation.
These are some therapy modalities:
Cognitive Processing Therapy
CPT is a 12-week course of treatment, with weekly sessions of 60-90 minutes.
You talk about the traumatic event with your therapist and how your thoughts related to it have affected your life. Then you’ll write in detail about what happened. This process helps you examine how you think about your trauma and figure out new ways to live with it.
Prolonged Exposure Therapy
If you’ve been avoiding things that remind you of the traumatic event, PE will help you confront them. It involves eight to 15 sessions, usually 90 minutes each.
Your therapist will teach you breathing techniques to ease your anxiety when you think about what happened. Later, you’ll make a list of the things you’ve been avoiding and learn how to face them, one by one. In another session, you’ll recount the traumatic experience to your therapist, then go home and listen to a recording of yourself. Doing this as “homework” over time may help ease your symptoms.
Eye Movement Desensitization and Reprocessing
With EMDR, you might not have to tell your therapist about your experience. Instead, you concentrate on it while you watch or listen to something they’re moving like a hand, flashing a light, or a sound.
The goal is to be able to think about something positive while you remember your trauma. It takes about 3 months of weekly sessions.
Stress Inoculation Training
SIT is a type of CBT. You can do it yourself or in a group. You won’t have to go into detail about what happened. The focus is more on changing how you deal with the stress from the event. You might learn relaxation and breathing techniques and other ways to stop negative thoughts by relaxing your mind and body. After about 3 months, you should have the skills to release the added stress from your life.
Medications
The brains of people with PTSD process danger signals differently because of the imbalance of neuro-chemicals. They have an easily triggered “fight or flight” response, which is what makes you jumpy and on-edge. Constantly trying to shut that down could lead to feeling emotionally cold and removed.
Several types of drugs affect the chemistry in your brain related to fear and anxiety. Your doctor will usually start with medications that affect the neurotransmitters, serotonin or norepinephrine (SSRIs and SNRIs), including:
Fluoxetine (Prozac)
Paroxetine (Paxil)
Sertraline (Zoloft)
Venlafaxine (Effexor)
It should be noted that the FDA has approved only paroxetine and sertraline for treating PTSD. Your doctor may prescribe other “off label” medications due to people responding differently to certain medications. (That means the manufacturer didn’t ask the FDA to review studies of the drug showing that it’s effective specifically for PTSD.) These may include:
Antidepressants
Monoamine oxidase inhibitors (MAOIs)
Antipsychotics or second-generation antipsychotics (SGAs)
Beta-blockers
Benzodiazepines
It’s OK for you to use an off-label medication if your doctor believes there is a reason to do so. Medications might help you with specific symptoms or related issues, such as prazosin (Minipress) for insomnia and nightmares.
Which one or combination of meds is likely to work best for you depends in part on the stressors you’re experiencing in your life, what the side effects are like, and whether you also have anxiety, depression, bipolar disorder, or substance abuse problems.
It takes time to get the dosage of some medications right. With certain medications, you might need to have regular tests. For example, to see how your liver is working you need to check in with your doctor because of possible side effects and to monitor response.
Medications probably won’t get rid of all your symptoms, but they can make them less intense and more manageable.
In conclusion PTSD can be life altering. However, with the right combination of medication management and therapy, you will come back to enjoy a safe, fulfilling, and satisfying life.
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Childhood Schizophrenia Causes
Schizophrenia in Children:
Learning your kid has schizophrenia, or believing your child has it, may be overwhelming and frightening. However, early detection and treatment are critical in controlling symptoms and improving your child's long-term prognosis.
Schizophrenia is a mental disease in which people interpret reality incorrectly. It is characterized by a variety of cognitive, emotional, and behavioral issues that hinder a child's capacity to function.
The symptoms, aetiology, and prevalence of schizophrenia in children are discussed in this article. It also discusses how the condition manifests in children, the potential therapies, and what parents can do to assist their children manage.
Schizophrenia Prevalence in Children
The disease generally manifests itself between the late teens and the mid-thirties. The peak age of onset for males is early twenties and late twenties for females; however it can occur at any age. According to the National Institute of Mental Health, schizophrenia affects between 0.25% and 0.64% of people.
Childhood schizophrenia, defined by beginning before the age of 13, affects just one in every 40,000 children. Childhood schizophrenia involves unique diagnostic and treatment issues. Consult the Best Psychiatrist for best schizophrenia treatment in Indore.
Childhood Schizophrenia Causes
Scientists have not identified a single cause of schizophrenia. Multiple genetic and environmental variables are thought to be involved:
Genetic factors: Studies on families, twins, and adoptions all point to a major hereditary component in schizophrenia. Parents of children with schizophrenia are ten times more likely to acquire schizophrenia themselves. If one identical twin has the condition, the other twin has a 40% chance of developing it as well.
Environmental factors: There may be certain environmental variables that contribute to schizophrenia in youngsters, especially if genetic components are already present. Prenatal infections, obstetric difficulties, and maternal malnutrition all have the potential to play a role.
Schizophrenia Symptoms in Children
Children with schizophrenia have been observed to experience hallucinations, thinking dysfunction, and flattened emotion. Delusions and catatonic symptoms are less common.
Childhood schizophrenia is frequently accompanied with developmental deficits. Cognitive decline is common during the outset of schizophrenia, although after the first drop; intellectual deficiencies tend to remain stable rather than worsening.
Early Warning Signs
In younger children, schizophrenia might be more difficult to diagnose. Early indications of the illness in children might include:
Abrasive behavior
Weird speech
Confusion of reality with imagination, dreams, or television
Having trouble sleeping
Problems with hygiene or self-care
Mood swings
Absence of emotion
Inadequate motivation
Problems with reasoning
Strange phobias
Are you searching for the psychiatrist in Indore? Visit Dr. Rathi’s Mind Centre, they provide excellent services for mood disorders.
#childhood disorder treatment in indore#childhood psychiatry problems treatment in indore#childhood disorder treatment indore#best psychiatrist in indore#psychiatrist in indore#best psychiatric doctor in indore
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oliver jackson-cohen for flaunt magazine, by jessica romoff, july 2019
***
The first horror movie I ever saw was The Exorcist on my grandmother’s RCA console TV, midnight on Christmas Eve. My grandmother is a Catholic Portuguese woman who was devout to cross stitching and Jesus Christ, resulting in crucifixes nailed into every wall of the living room. So, as every flash and jolt from the TV screen would animate the tortured figurines with chilling white light, I prepared in panic and thrill for each one to flip upside down.
Not only did this movie ignite my passionate love for horror, but actor Oliver Jackson Cohen’s passion as well. Mine lead me to accumulating random 70’s slasher movie memorabilia and sporadic nightmares, while Cohen’s lead him to eventually being the star of hit Netflix horror miniseries The Haunting of Hill House as his character Luke Crain, with a few nightmares as well. The 10 episode show is a modern reimagining of Shirley Jackson’s novel “Hill House” and follows the Crain family during the summer they lived in the haunted home, and flashes forward on their lives decades after the tragic events.
During a phone interview with him, I learned Cohen is much more than just a dedicated actor with a jawline that can cut glass; Cohen is a whirlpool of empathy, an artist who gushes his heart into everything he does, and demands that his character Luke, and those battling with similar struggles, are portrayed more than just their addiction.
With your role in last season, I was really impressed by how you portrayed a character with drug addiction, and how you refrained from making him a stereotypical, one dimensional person - and I was wondering how you avoided leaning on this cliche when approaching Luke?
Thank you, number one, I think we all have seen drug addicts portrayed in movies and tv shows before. Most of the time, they are always portrayed as their addiction, and I don’t think that’s very true for anyone who knows anyone who has substance abuse problems; there is actually a fucking person there. So it was very clear from the get-go that I had a responsibility to present a fully formed human being, and they actually brought in a specific writer to write Luke’s character- who was a heroin addict in recovery. I said to Mike, the director and creator of the show - before we even started that it’s very important that Luke is the sum of all his parts and is not just his addiction. So I think that the way I approached it, is that when I first began doing all the research and the pre-work before we started filming, I started looking at documentaries, because I had never done heroin before, so I thought, Oh I’ll start looking at documentaries - but then I realized quite early on that that was putting a judgement on him. And I don’t think it’s fair - because behind anyone who has fallen into this trap is someone who is deeply struggling. And I felt it - I felt a huge amount of, not pressure, but a need to show the person behind the addiction and show the person who is actually struggling, and why he had become an addict. So I focused on that - so I spent no time whatsoever seeing Lucas as a drug addict; I saw him as someone who was struggling to come to terms with everything that he had experienced and happened in his life. And so I focused on anyone who is trying to numb themselves, that know they’re running away from something. So I built up the terror of that, instead of focusing on “I need my fix.”
Was there something that happened in your own life, that was out of your control and not your fault, but regardless someone judged you because of that - perhaps driving your connection to Luke’s character?
Oh 100 percent, and that’s what is so interesting, because I don’t have a substance abuse problem - but I think that out of all the characters I have ever played in the past 10 years, there’s the most of me in Luke. Like, all of that stuff of just trying to function, and the vulnerability, and just trying to be normal, and being so ashamed - all of that is my own shit, and so [laughs] I didn’t need to be a heroin addict to understand the pain that he was going through, so, so much. I think it’s incredible getting to play someone like that because, in a weird way it felt like therapy - I was able to go to work everyday and just be all the parts of myself. I think it’s interesting as well for men, there’s this whole thing about having to be a certain way, having to always be strong, and I think inherently a lot of people do feel incredibly fragile. So all of that stuff of Luke is me, and my stuff, and I didn’t have to pretend - I just got to go to work and be as vulnerable as I feel. You know we all have incredibly complicated lives and incredibly complicated upbringings, and I used all of my stuff: I was diagnosed with PTSD a couple of years ago so all of that is in there with Luke - and it felt incredibly cathartic to be able to kind of put it all out there and be there.
When your work is something that is so emotionally rigorous, and strenuous, it must be very draining dedicating yourself to a character who is really struggling his whole life - How do you unwind and decompress from this intensity?
[Laughs] I….you know what, I’m not very good at it. I feel like I’m one of those people, I’m sort of with the school of thought that you either go to work and you fucking do it - and you do it for real, or go home. I’m not into this whole I’ll just pretend! thing, so it’s probably not the healthiest way of working. But I feel it’s necessary, and then I don’t know how to handle it. There were a couple of days on set where specifically we were filming all of Luke’s episodes or the stuff where he’s sort of roaming the streets - that got way too intense. We would rap at 6 am and I would go back to my house and sleep for a bit, and then wake up and just be so out of sorts: I would have to call people at home to reassure me that everything was okay.
I imagine the intensity can be overwhelming
Yeah, I mean, it sounds really wonky - but I think that when you’re messing around with stuff like that, and you’re tricking your brain into thinking something is real, and then on top of that you’re drawing from your own personal well of shit that probably should be kept untouched - it’s gonna be messy at times. So yeah, it gets… it did get a little hairy. But again I felt that it was important - and I think all of us across the board in the cast felt that it was so important to do that - to give Luke a voice. And what’s been so interesting when the show came out, it was so overwhelming, the response, specifically from people that have struggled with addiction. And it was so warming to hear these stories from people, so I think it was necessary for all of us as actors to go to those dark parts of ourselves, and put that out on screen.
Is there something that you wish you knew before you began acting in a horror TV series? Or about a TV series with intense family drama with horror influence?
Hm..I don’t know. Just… it’s all good. [laughs] it’s gonna be all good.
Honestly, that’s pretty solid universal advice. And I was wondering, are you a fan of horror in general?
Yes! Huge
And is this a genre that you want to continue with?
Yes, I had never done anything horror before, so this was a dream. I remember I watched The Exorcist when I was like eight or something, and it completely terrified me - and I still to this day have nightmares about it. I think what’s so clever about horror, and I think specifically with what Mike has done on our show, it becomes a metaphor for something else. So specifically with Hill House, if you take away the house and all the ghosts and all the horror elements, it’s about childhood trauma. So you can swap out what all those kids went through, the horror they experienced, can be swaped out for sexual abuse, or physical abuse, or anything like that. So you manage to kind of navigate all of these horrific things we kind of don’t want to look at, in the veil of ghosts, so it becomes palatable for an audience. I never knew this, Netflix told me this, that horror is the most watched genre in the whole world.
Really!?
Across the board, yeah! I thought it would be comedy. But that’s why Netflix made the show. Because they realized that actually there was such a massive market for horror. So yeah, a really long winded answer to your short question - yes I was a fan of horror, I always have been.
Me too! I’ve never thought about how horror can be a metaphor for trauma. That’s so fascinating. Just one last question - I know that you can’t say too much about the second season… right? Or they’ll shoot you.
Right [laughs]
So, see if you can answer this: if Season 1 and Season 2 were mythical creatures, what would they be?
[Laughs] What would they be… ahhh...I genuinely don’t know how to answer that question. They’re both just beasts from the darkest corners of our minds. Season 1…. Uh… what I can say - is that season 1 I believe was amazing, and with what they’re doing with season 2 is even…. More incredible.
#oliver jackson cohen#oliver jackson-cohen#peter quint#luke crain#haunting of bly manor#haunting of hill house#2019#tw: childhood trauma#ptsd
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Who in the a class is in some kind of therapy?
what a question LMAO. but honestly, a very fair one indeed. while discussing this, es and i ended up basically dividing it into three groups (if someone isn’t mentioned, it just means none apply)
Is In Therapy Currently
Isadora || as we know from the canon of S3, isa is currently in therapy to work through the grief of valerie dying as well as like... the built up abandonment issues, anxiety, and struggles she has articulating or processing emotions lmao. it also helps her learn better methods to work with her autism
Farkle || i mean... we all watched S1 & 2. we know why he’s there LMAO and by god does he need it. it’s good that he’s improving though!!
Chai || she officially started therapy after the events of S1 while she was abroad because evidently her parents divorce really fucked with her emotional state and coping mechanisms -- as well as having sort of emotionally distant parents and having to navigate the world on her own. basically, money =/= nurturing. but yeah i think she realized what she did with tormenting her classmates wasn’t Healthy perhaps and so she sought out the resources to fix it on her own. her parents certainly weren’t going to be much help
Clarissa || clarissa has been in and out of therapy here and there since she was little, mainly for managing OCD. usually she’s fine and her appointments are infrequent (monthly at this current rate), but she tends to go back to her therapist when circumstances get very stressful, like the events of S2 (she mentions going back to therapy in a scene with charlie and haley in 210)
Not In Therapy Currently, but Has Before
Riley || though not by choice, riley went to therapy for a stretch of time in the aftermath of her bullying experience freshman year. by the start of S1, though, she’s on the tail-end of it after a whole summer full of it. she also had stints in family therapy when she was little when cory and topie were having their first bouts of marriage problems, but she doesn’t remember all that obviously. she’s thought about going back for herself because of all the divorce strain, but ultimately opted against it bc she didn’t want to go through cory or topanga. she mainly sticks to talking to eric if things get too overwhelming and using the coping mechanisms she already has
Darby || miss darbs spent some time in therapy in late elementary school due to having issues socializing with her peers. i think she’s always been a bit awkward and desperate to please, so that can get messy with kids cause kids are mean. she was also definitely bullied at that age for being really tall and so i think her parents put her therapy out of genuine concern just with the hopes that like, she’d be able to develop some coping mechanisms and have a safe space to get advice if they didn’t have the answers. and in some ways it helped, other ways no -- her friendships aren’t the healthiest still (as she’s the doormat), but i think she holds her own BETTER with the plastics having gone to therapy than if she never developed those emotional tools at all
Has Not / Is Not but Really Fucking Should Be in Therapy
LUCAS || this is like the most obvious blinking lights sirens wailing example ever. he is a walking textbook for endorsing therapy. between the domestic abuse, mommy and daddy issues, self-esteem in the subbasement, lack of life purpose, inability to read others well emotionally, inability to process his own emotions, the physical aversion due to his trauma, his kleptomania, his risk-taking behavior, his habit of lying, the fact that he has canonically walked off for days at a time with no warning, explanation, or safety net, that he sleeps in a fucking technician’s booth, he used to free-climb buildings SOMETIMES IN THE RAIN, no sense of self-preservation, intrusive thoughts, inability to express appreciation or affection in a normal non-stressful way...... this man is a therapist’s dream and nightmare. they could spend YEARS unpacking him. but will he ever go to therapy? no. because he a) doesn’t think he needs it, b) can’t ask for help ever, and c) could never afford it. and at this point, d) if his dad heard he was seeking help like that he would shut it down instantly. anyway, he’s the biggest case here. underline him in red
Charlie || charlie is a great example of someone who is like coping... sort of... not really... it Looks like they’re coping but they aren’t really and they really need help. like yes, charlie has stability in certain areas of his life that others don’t, and he’s extremely self-aware of his privileges, but i think that’s part of the problem. he’s convinced himself he doesn’t need or shouldn’t get external help because there are people who have it so much worse than him and he doesn’t... he doesn’t really need it, does he? he’s fine. he’ll be fine. and even if he did think about getting “help,” i think his first instinct -- and advice from others -- would be to go to his church leadership, which is not a suggestion made with ill will but just isn’t helpful considering half of his trauma is tied to his relationship with god and the church and faith. he needs a more objective space to unpack all of that, and obviously church itself is not the answer. i think that charlie will be able to work through a lot of his initial issues on his own with time and patience with himself (something we’re in the thick of right now -- we’re just barely in the acceptance phase), but he should really go to therapy in the future just to like... work through all of the long-term trauma he endured from his upbringing and bridgette’s exile and the dueling psychology of church vs sexuality. like... that’s gonna take some time to unravel and he needs to be in the right place to pursue that on his own. will he, i dont know, but i think when he does a certain heaviness he’s been carrying his entire life will finally like... lift. and he’ll be able to breathe better
Asher || so asher is a bit of a clusterfuck LMAO like he’s diagnosed officially with generalized anxiety disorder but he never saw a specialist, his mom diagnosed him since she’s a psychologist. the complexity here is that because of that... well, they say you should never let family be your personal doctors and i think that’s true for mental health professionals too. like emily basically gave asher the generic coping rundown when he was really young, and then he went on to develop his own coping mechanisms with, at least, a very fundamental understanding of what’s wrong with him. but he kind of developed his own complex about it all too, bc i think emily took pride in him being able to figure it all out and be so capable with his own mental health without ever going to therapy and he kind of internalized that, as well as having internalized a lot his mom’s perspectives and opinions as a mental health professional in a way that its like... well my MOM said that, so i feel kind of some type of way about it. so its all really complicated and twisted in his head and he just doesnt bother to unpack it (something, ironically, therapy would probably help lol). the thing about asher is that for all intents and purposes, he does cope well and he is really in tune with his own mental state. it’s just that he could seriously benefit from having an objective party help him untangle some of his neuroses i think and it would take some of the constant stress off his shoulders, but he’s honestly too stuck in his ways at this point to go. that being said, he’s a vocal advocate for therapy and its benefits -- just not for himself
Nigel || as discussed a bit in the ask i answered about him, i just think nigel carries way too much pressure on himself and he could benefit from someone helping him work through things instead of carrying all his stress on his own -- even if its less complex than some others. he’s like same range as clarissa.
Maya || maya has no issue with self-esteem, but i think she could still benefit from someone helping her actually unpack her issues over her dad and why she is the way she is. a therapist who specializes in narcissism would be a good fit for her -- not because she is one, but she does have... certain quirks where i think having that specialization can help unravel her motivations and actions a little more easily
Missy || she’s just a fucking mess. she shouldn’t be redeemed but i think therapy could really do her a favor and maybe make her less terrible and psychopathic towards people who aren’t like her. maybe
-- Maggie & Es
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Champagne Problems
I am about to get as real as I have possibly ever gotten on social media. This is deeply emotional, deep stuff. If cheery, happy posts are your thing, you may want to skip this one.
My entire life I have been a deeply emotional person. For most of my life I have tried my damnedest to hide the emotions. “Conceal, don’t feel, don’t let them know,” was the anthem of my life years before I was dreamed by Menzel. I feel deeply and words cut me down like a knife.
I was hurt very badly by children when I was younger and transferred to public school for the first time. I was the “weird, quiet girl from the Christian school” and I never stopped being an outsider. I searched my entire school career for a nice group of friends. I did have a friend group for a few years and that turned very, very sour. I never stopped trying. But something inside of me always feared getting hurt, knew deep down I was less than, and was not liked. That’s not to say I wasn’t friendly. I was friendly with the majority of the people I went to school with, but I never found one of those lasting friendships you see in the movies.
Some of those friendships fell apart for simple reasons. Someone transfers, someone changes interests. And some of them were because I seemed to have a knack for saying or doing the wrong thing. In therapy I learned this was a defense mechanism. When I thought someone was going to hurt me, I did the hurting first. It’s so messed up, but that is me.
I cannot describe to you how lonely my adult life has been only having casual friendships. Going through illness, turmoil at work, marital issues, family disputes, everything all normal people experience and your only close friend being your husband. I love my husband dearly and I truly cannot imagine doing life with (or even living with!) anyone but him. He is exactly what I need in so many ways but your spouse cannot also be your best and only friend. There are some things you just need to bounce off of exterior people. I don’t think I will ever truly have what I see other people have. A circle of girlfriends they trust and love dearly.
So why bring this up now? Well, I have been asked why I made the decision to “remove” certain people from my life that I was close to and why I “unfollowed” old friends from social media. I feel like the best way to truly answer these questions, is to explain my history.
Anyone who has known me for more than ~4 years knows that I went through a several years long spell where depression ruled my life. I cried multiple times every single day. I took depression naps every day, sometimes multiple times a day. The depression and anxiety not only controlled many facets of my life but it also caused me physical pain. Beyond that, the depression medication and alcohol packed on pounds. I put on over 60 lbs in less than two months’ time. I sought out and stuck with therapy for the first time in my entire life. I was able to right my ship. I no longer take any depression medication at all. But it wasn’t just talking out my problems that helped me come out the other side. It was a total lifestyle change.
Any good therapist will identify your triggers and help you control them. PTSD, Anxiety, Depression. Things that will never be in the rearview for me but that I control every single day. Part of it involves taking a serious look at the people that you choose to surround yourself with. Certain people in my life were constantly causing turmoil, constantly setting a tone of depression and whining and that often left me in that same headspace. There were triggers on social media. Slowly, over time, with the help of lots of research, I learned that social media sites like Instagram or Facebook where people sugarcoat their life and only post the best of the best can be used to cultivate envy greener than a four leaf clover or it could be rebuilt as a tool to help me in my journey. I unfollowed people who caused me pain, to make me feel like I wasn’t enough, like I was doing things wrong and I followed accounts that posted fitness motivation, healthy meals, home décor and tidying techniques, beautiful landscape art, and accounts that I align with in terms of social justice education.
It has changed my entire life. You truly are what you eat. If you ingest negativity, toxic people, drama, people that make you feel like you aren’t enough, that is what YOU become and believe you are. You have the power to flip the script. Eleanor Roosevelt said “no one can make you feel inferior without your consent.” So stop giving people that aren’t worth it an access pass to eff up your psyche.
For me this goes beyond unfollowing things that are obviously negative. Things I also take into perspective: does this person add more to my feed/life than they take away? If someone posts things that you overall do not identify with, and frequently raises your blood pressure then you need to make sure that you are getting a heck of a lot out of their other posts. If not, you just unfollow or hide or whatever the case may be and you move on. This isn’t canceling someone. You can still see someone in real life and decide their social media content is not for you. You decide what fits into your daily headspace, and bloodlines or long standing friendships shouldn’t overrule your inner peace.
For years I thought there was something wrong with me because of my empathy. I watch a movie or a news report, cry like a baby when people die. I follow people on social media and though am not deeply close to them, am extremely moved by cancer diagnoses, critical illness, etc. I am effected deeply by issues like BLM and LGBTQ rights and feel so insanely helpless that I cannot help more than I can but also so deeply guilty on a personal and “on behalf of a larger group” level that sometimes it is a physical pain that I feel. Deaths of certain celebrities that I have never met bring me to tears. I thought for so long it was a flaw to be so deeply emotional. But being so empathetic is what helps me relate to people, to grow and see other sides of issues that I was raised oblivious to. I no longer see this trait in such a negative light.
But the other side of being deeply emotional is that you feel ALL emotions deeply. Disappointment. Anger. Frustration. Hope. Darkness. Sadness. You have to guard yourself more, because no one else is going to look out for you, to fight for you. No one else is going to understand the way that words tear you down and replay in your head for hours after they’ve been said like a highlights reel.
So I’ve gone around the world to say that life is complicated. Every person is fighting a battle that you don’t know about. There is almost always a reason people are private and protective of themselves. I do not expect anyone to understand, to relate, but I had to get this out onto paper.
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Therapy, Medication, And Mental Help
I’m gonna level with y’all here. This post will likely not be quite as articulate as some of the other ones. It’s been a really rough morning, but I wanted to address this issue while it is still fresh in my mind. I have yet to ask for advice or feedback on a single one of my posts, but if anyone has any I’m definitely not opposed to receiving it on this one.
Uh oh. That doesn’t sound great. What’s going on?
I’m going to attempt to keep this as brief as possible, and it likely will still be quite lengthy, but I’m going to have to give a bit of context here as well. My current life situation has been radically altered in the last year. 2020 has thrown so many wrenches in my plans and Covid isn’t even the biggest of them. However, lets take this from the top.
When I was 9 years old my parents divorced. Not a huge deal. It happens to a lot of kids as sad as that is to say. I grew up with my mother, brother, and sister in a single parent household with a skewed picture of who my father was and didn’t want too much to do with him. Fast forward a few years, my dad moves to Idaho and remarries and has a wonderful relationship with my stepmother. I wasn’t able to visit too often, but it wasn’t horrible when I was able to make it out there. As much as I minimize the normalcy of being a child of divorce though it still had a horribly impact on my emotional well being and my mental health as a child. Many other kids throughout school came were content with their home life. They were able to enjoy being children and did not have to worry about the pressures of caring for their siblings started at a young age. I, on the other hand, was not content with where I was at in life and wanted desperately to change it.
My mother was incredibly supportive of us kids as best as she was able. She made sure that we had routine trips to the doctors, that we had what we needed in terms of food and shelter, and even got us therapy and psychiatric help. I was blessed to have that available to me as a child. Many children going through similar situations do not have access to that level of external help for a myriad of different reasons. However even though I had these things I still ran into trouble. As I was growing up my father discredited mental healthcare as a practice so I always had that rattling around in the back of my head. By the time I was 15, I decided to stop taking my bipolar and depression medications because I didn’t feel like they were helping me. This is honestly the biggest mistake I’ve made in my entire life. I continued to see my therapist, until I not longer had insurance at age 18, but I didn’t feel as if I was making any real strides there either because I had also adopted the mindset that nothing was working and therapy and caring for my mental health was a joke.
Wait. Isn’t this a place where you talk explicitly about your mental health and how to manage and cope with various aspects of it?
Why yes. Yes it is. I’ve been handling my manic depressive bipolar disorder unmedicated for the last 13 years. It has been absolute hell most days. A few years ago I hit rock bottom and realized that I needed help. The girl that I had been dating for a few years, was living with, and planned on proposing to cheated on me and I ended up moving back in with my parents because of the situation, I slept on a futon mattress on the floor for months before we ended up moving, and due to this my mental state deteriorated to the point of suicidal ideation with intent.
This is when I realized that I was wrong in my views on medication and therapy. I had been putting myself in a position where I was running people out of my life due to the fact that I was using my friends as free therapy and they drew a line and I had to respect it. There was only one problem with finally accepting that I needed to get help. That problem is that help is expensive. I had been uninsured for mental health since I was 18. I accepted the fact that I needed to get help, but the fact that I could afford it drove me even deeper into despair about my circumstances.
So what did you do? Did you get the help you needed? Clearly you didn’t give into your suicidal tendencies.
Well. Yes and no. I didn’t get the help I needed, but I managed to find a way to distract myself from the troubles of the real world. I poured myself into my job and decided that that was the time to go to college. I do understand the irony or going to college after complaining that therapy was too expensive. Believe me that is not lost on me. The difference is you can’t get student loans for learning how to take care of yourself.
Rather than allowing myself to begin working through the existing trauma in my life, I decided to put myself in a position to where I could start to try to live a “normal” life again. Whatever the hell that means. I had a routine, albeit a poor one, I was socializing, albeit minimally in my classes and typically only for group projects, and I was too distracted by other pressures to reminisce on how much I hated my life. I started taking steps that I felt like a therapist would tell me to and began working towards chasing a dream again. This felt different, but I don’t think I’d venture as far as to say it felt good. It was just a different kind of stress that I was piling on myself. I still felt like I needed help handling the day to day. Learning to cope with my bipolar unmedicated took years and the singular trauma of living with my family again meant that all the coping mechanisms I had worked to develop became even more difficult to manage and I had to once again learn different strategies to handle all the new challenges.
Instead of schooling and attempting normalcy on your own wouldn’t it have been easier to get help?
Easier? No. More beneficial? Absolutely. The hoops that one has to jump through even to get seen by a therapist nowadays is challenging enough and that doesn’t even include financial ramifications for those without health insurance that covers mental health, which most workplace insurance plans don’t. With that in mind, the benefits of getting the help that you need often are not able to outweigh the cost.
Realistically, even if I had been able to afford to get myself the care that I need I likely wouldn’t have. I have always been the type of person to do everything on my own until I have exhausted all of my options. This is not something I recommend. One of the biggest things that I want to learn to do is ask for help when I need it instead of asking after I am already at the end of my rope. Even as I’m typing this I am beyond frustrated and want nothing to do with with the stress I’m under from today and it took me hitting that point to finally open up about talking about it even though it was among the first topics I decided to address when I first started this blog. Asking for help at appropriate times is a topic all on it’s own so we’ll save that conversation for another day.
So I’m starting to see a bit of where you’re coming from, but what happened today?
So this part of the background info I plan to address more in depth in the future and will keep the context of this very brief. Remember how I said that my dad and I had a strained relationship even after he moved? Well that changed once I was about 20. We reconnected and for years spoke nearly every day and he became a close confidant and more of what most people with a healthy relationship with their father have. We disagreed on a lot of things, but we were able to understand each other. A few years ago my stepmother passed away. Even before she passed my dad was diagnosed with early stage dementia. He had been having memory issues and it felt like he was a completely different person. At the start of this year he moved back in with my family and that has been a challenge having my divorced parents living under the same room without the ability to properly communicate with each other.
Fast forward to this morning. I woke up to both my mother and father bickering with each other about something related to Dad’s socks. Rather than handling it like adults they were both fighting like toddlers from what I could hear in my bedroom. This has become an increasingly common occurrence. One gets frustrated with the other, situation escalates, I feel pressured to step in and deescalate the situation, I typically end up frustrated and my mood is shot. Dad feels more comfortable talking and listening to me, Mom backs off because I get what needs to be done done, I wind up once again in the middle of a weird situation between my parents. I tolerate this because of the fact that I am able to assist in my father’s care in a way that is beneficial to his understand of what he needs and it eases the burden on other people that are trying to convey the same message with zero results. However over time this would wear anyone down and that point is where I finally reached this morning.
Rather than being able to calmly handle the situation with a level head I ended up snapping at all partied involved. I snapped at Dad for not wanting to do anything to mitigate the problems he complained of, I snapped at Mom for escalating the situation, I snapped at my sister who was just checking it see if I was okay, I ran the gambit of getting frustrated with people. Instead of handling the situation the way I normally would with patience and dignity, I mismanaged the situation and likely made it worse.
This is where we get back to the topic at hand. I have finally managed to actually get myself on some half decent health insurance that has wonderful mental health coverage. This kicks in at the start of the year and I will be able to finally get some help with handling the fact that this entire situation has been traumatic and has left some serious scars. I’m excited but this also got me wondering about the part that I need help on.
My bipolar and resistance to most psychotropic medication had to come from somewhere, as it’s a disorder that is tied to genetics, and my mother is not bipolar. This tells me that my father, who exhibits clear symptoms of having bipolar depression, is where I got my proclivity for the development of this condition. That being said, with my father’s resistance towards getting psychiatric care, and being medicated to balance any chemical imbalances, puts me in a weird state for doing what is best for him and his care. Do I force this help on him? Do I accept that he’s not ready for it and sit idly by and continue to watch him deteriorate? With his dementia he’s less likely to be able to receive the care he desperately needs due to his inability to create a coherent thought in regards to what his needs are for the large scale rather than just being fine in that exact moment. So I truly am at a loss. This is the part where I ask for advice. If anyone who has read this far has any experience with dementia and psychiatric care I could really use some advice on how to best have these conversations with my dad. This has been one of the biggest hardships I have faced and I am getting to be at a proper loss for words in how to help the situation which as you can tell by the verbosity of this post is difficult to do.
You’re totally fine in not knowing how to handle this situation. This is a difficult situation to be in regardless of who you are. You’re doing well.
Thank you. All of that stuff is an absolute nightmare to handle and life has been absolute hell, but I hope that that helps you to understand where I’m coming from when I encourage you all to once again remember the three reminders! I know most days, including today, I need to remember them to so lets run through them together before we end things for today. You are so much stronger than you think, you are beautiful inside and out, and jinkies you are worth love, kindness, respect, admiration, and all those things you think you’re not worthy of. Lets turn today around together and kick some butt and take some names.
#suicidal tendencies#suicide#dementia#mental health#bipolar#bipolar disorder#depression#help#i need advice#three reminders#self help#Psychiatry#Therapy#Medication#cognitive dysfunction
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okay, this time an actual TW
i'm serious, it's my past and not recent, but contains mentions of sh and s*icide attempts, although nothing specific
i'm kind of terrified, kind of unstable, but it's not even about food. it's like, hey, i'm working on getting better, trying hard and i have for so many years now. what the fuck is going on?
my whole past seems so surreal. are my parents ... really my parents? they seem just like strangers, on the other hand it still makes me feel strongly to interact with them - just different feelings every time. sometimes i get panic attacks, sometimes i turn into a full on zombie and won't show any expressions or talk, sometimes i get so angry and it is far from any normal kind of rage that i have ever felt, sometimes i feel fragile and very sad, and sometimes, rarely, i even feel hopeful and i am okay with seeing my mother
the group homes, psych wards, moving out when i was 14, it really did something to me. sure, i was one of the lucky ones, getting out in time and ending up in a therapy group home, being offered many opportunities and getting chances. unfortunately though, these places always come with tons of triggers and unstable people, and a group home can never really be family-like, it does not even come close. these different groups, new caregivers, people moving in and out constantly, people freaking out frequently
also, the 3 emergency/short-term group homes i went through before, all while i was still 14, some things have happened there that i still fail to understand. back then, i somehow survived it, clinging to my writing, food restriction and some sort of numb acceptance. but ... it probably cannot end well to keep up to 20 young girls, ages 13-18, in a house like that. no phones, no money, not allowed to go outside - to protect those who were there anonymously. nobody there who wasn't taken from home for a reason, nobody who wasn't in some way traumatized or had mental issues, and if you didn't look out for yourself, nobody did. this place ... it turned many of the older ones into monsters. selfish and aggressive and angry, leaving out their frustration and fear on each other, but also on those who just went numb and quiet. i suffered, writing being my saviour, but most of the time these memories are repressed. when i read my writing from back then now, it makes me shiver. nothing was safe, people even stole used underwear, and you never had space for yourself, we did not even have a garden, and it was not uncommon to have new roommates every day. it was like being imprisoned, but to protect us, i guess. people coming and leaving every day, nothing unusual. yet i would always have chosen to stay, if my other option had been to go back to my parents, yes, if i had been given a choice
afterwards, the therapy based group home i was referred to, mainly because of the suicide attempts (all while i was still 14) and selfharm ... oh, in comparison, a dream. i had sworn to myself i would do anything within my power to never be forced into a psych ward again, i worked on my issues and actually managed to avoid that step - there were relapses with selfharm, especially hitting myself was something that flared up over and over again, i had started it in the emergency group home, being out of opportunities, and i also still had these suicidal thoughts, terrible mood swings, increasingly often panic attacks, depressive episodes, boundary issues and of course my food problems, but despite some very bad moments, i always was able to avoid being taken to the psych ward. breakdowns still come frequently to this day, including everything, but i am able to handle it a lot better, reaching out before it is too late, riding out the waves, keeping everything in a safe way without longterm harm to my body or mind. something else i have learned is to ... not deal with everything at once. sometimes i'm tired and i don't want to take a shower, you know? i still do, although on my bad days i sit in the shower, but that's fine - i still do take the shower. which i know is not possible for everyone, sure, nobody feel offended or bad please, it's just not one of my biggest struggles. i do things bit by bit if possible, to avoid being too overwhelmed. usually, it's pretty good
no idea what my point is in writing this? well, everything that happened in my life, it feels very far away and surreal at this point. i suppose i will never be able to fully let it go - for example how very jumpy i am, it is something everyone around me is aware of, because it cannot be hidden, my reaction comes instantly and is out of my control. will it ever go away? or is the way my father treated me forever going to haunt me like this? who knows ...
i'm better than i used to be, for sure. i can cope with things better, i'm legally an adult and i do not depend on my parents, i live by myself, i managed to still finish school with a 1,1 gpa and have all the opportunities, am right now doing my dream job. hell, it could be a lot worse, right? also, how i was diagnosed and labelled - it's not what i base my worth on and i do not see it as a constant, but to this day it makes me feel strange to think that ... yes, during the general diagnosis they also tested my IQ, which was done in primary school as well due to me being overly bored and hating school, both times resulting in me being declared "gifted". well, i guess i have a good memory, i can read pretty fast and understand things easily, but do we need this label? those who know about it, like every caregiver in the group homes for example because they read all the papers, have always treated me a bit differently. it's like people have higher expectations, which sometimes may sure be justified, but in general it is so offputting. the human brain and "intelligence" are way too complex to be described by a simple number, and me, it is true that i get bored easily and often have to wait for others to understand things, but that's about it. i'm human, please just treat me as that
but there is this problem, how easy it is to let go of people, how hard to let them in. how i turn on people, suddenly feeling no emotions toward them anymore. i do have friends and i am social, but it always feels like i am just pretending? pleasing people, craving closeness, but not actually feeling it and being scared of commitment? i have learned how to behave, how others behave, i know how to act in certain situations, but it does not come from my heart?
i am weird today, sorry to everyone who actually read this far. despite a lot of guilt and a need to procrastinate, i'm going to prepare and eat dinner now. my weight cannot slip further
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If you’re okay with answering, I want to ask some advice. I have a mental illness and basically I can do fine w/o medication- as in, I function in my daily tasks, I don’t lose touch with reality, I’m never in danger b/c of it- however, it’s still a severe case & rather miserable to live with. Therapy doesn’t seem to be working. I’ve thus far refused meds (ssri’s) out of fear of short and long term side effects, & a belief that if I can function alright it isn’t worth it. Am I being an idiot?
i certainly don’t think you’re an idiot - i think deciding whether to take medication for mental health issues is an intensely personal decision, and it’s both normal and okay to have complicated feelings about it
i can’t speak to your exact situation or tell you what to do, but i CAN give you my personal experience
i’ve had some bad go-arounds with medication: when my bipolar was misdiagnosed, i was on meds that made it worse; when it was properly diagnosed, i was on lithium for a while, which had potential to cause kidney damage and made me have an allergic reaction; i also ended up taking an antipsychotic that gave me a horrific case of akathisia (which kind of feels like having a swarm of bees under your skin if you aren’t moving constantly)
some of these experiences with medication made me want to swear off treatment entirely - in fact, the only thing that kept me seeking treatment was that i couldn’t be prescribed ADHD stimulants if my bipolar wasn’t managed (and i DESPERATELY wanted to treat my ADHD)
but i can also tell you that i am so SO grateful that i kept seeking treatment, because i am WORLDS better now that i’m on a medication combination that works
when i’m not on my meds, i end up caustic, cranky, depressed, hopeless. i cry pretty much every day. i snap at people. my empathy and conflict-resolution skills all end up shot to hell. my impulse control also gets blown to hell and i almost always end up being hurtful to people in ways that were not necessary or even understandable
when i’m taking my meds, i end up having a whole range of human emotion that’s inaccessible w/ my normal brain chemistry. i have happiness i can hold onto. i have feelings about other people. i have hopes, dreams, goals. i feel like i can face the day, usually. on bad days (because i do still have bad days even w/ my meds adjusted), i can seek support and remember that the shitty feelings are temporary.
so if the question is “is taking medication ever worth it, even if i’m functional regardless” my personal-experience-based answer is a resounding 110% YES.
but! the worry about side effects is completely understandable
this is the advice i have about taking mental health medication for the first time, should you choose to do so. (again, i’m not saying you HAVE to - like i said, it’s an intensely personal decision. but if it’s an avenue you want to explore, it’ll probably make you feel better to know how to address your fears)
be sure you’re working with a doctor that you trust to listen to you
i cannot emphasize this enough
some doctors fuck up with mental health treatment, even if it’s their specialty. that’s especially familiar to me because i have a psychotic disorder - it’s very common for psychotic people not to be taken seriously by health professionals because our interpretation of reality is constantly being questioned.
most notably, when i had the akathisia side effect, i was thankfully being treated by a doctor who recognized it and took me off the medication. with less lucky psychotic people, some doctors will see that they’re experiencing akathisia, believe it’s a sign of increased psychosis, and then increase the dose of the antipsychotic causing the symptom
so this is always always ALWAYS the first thing for me, in terms of what to look for. it’s VITAL that your doctor listens to your experiences and trusts your point of view.
that way, if you DO have short term or long term side effects, you can discuss them with your doctor & either try a different medication / different dosage, or come up with a different treatment plan entirely.
your autonomy matters more than anything else when it comes to treating mental health issues with medication.
assuming you do have a doctor you trust to work with you rather than speaking over you, the rest of my advice is just:
tell your doctor about your concerns
if you have any known family history of medication side effects or mental health problems, let them know
ask your doctor about the side effects of different medication options when going over them, so that you can make an informed decision about which to try
self-monitor for any unusual changes in your thought processes / behavior / moods
if you live with other people, tell them that you’re trying new meds (assuming you’re close enough and trust them enough to do so), so they can let you know if they’re noticing any unusual changes that you aren’t
if there are guidelines about not drinking alcohol / taking certain drugs with your meds, follow them strictly
be aware that you can try different medications if the first (or second, or third, or fourth, as was the case for me w/ my bipolar meds) doesn’t work for you
talk to your doctor about medication as a temporary solution vs a permanent one, and ask about their thoughts on your case
personally, i’ll have to keep taking my meds for the rest of my life. that’s st i’ve come to terms with - my illness is chronic and won’t be alleviated by any number of lifestyle changes or therapy regimens. but some people do use mental health medication as a temporary measure while learning other coping mechanisms to deal with their symptoms.
that’s all i’ve got for now, but this is another question i’ll open to the floor - if any followers have additional thoughts or guidance, feel free to reply or reblog!
#replies#mental health#medication#medical abuse#psychiatric abuse#just mentioned but for blacklist tags#bipolar blogging#i'm psychotic tag#Anonymous
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Hi yes. I start Prozac tomorrow at 10mg so this is a little entry to come back to and see how the meds affect me each week.
Current Mental State (8.31.2020): official diagnosis by a doctor today
switching between emotional numbness and overwhelming depression with the occasional burst of happiness or at least okay-ness
thoughts of self harm multiple times a week but have not acted on it!! Yay!
suicidal ideation but I don’t have any urge to act on it, more of just fantasizing about not having problems
I can be very irritable over small things
anxious a lot over small things
always hungry but too nauseous to eat most times
I can go to work fine but I struggle to find energy to be creative or active in my free time
very low energy and motivation for hygiene. Can’t wash hair and body in the same shower, only brushing my teeth once a day, shaving arm pits but not legs, etc., can’t do laundry or wash dishes, and rarely cleaning my room
I find it extremely hard to concentrate on anything that takes more than a couple minutes (can’t watch TV shows, fold laundry, cook a meal, etc)
poor short term memory and recall of long term memories if other people bring it up
I find myself crying at everything that goes wrong or on the other hand not having any reaction or empathy to very important events (sobbing for an hour over a sad movie scene vs being angry at my friend for complaining about her breakup instead of helping her through it)
very low sex drive
low self confidence
having a hard time maintaining friendships, my romantic relationship, and relationships with family members that I used to be really close to.
Side effects I’m worried about having: {heard from the prescription sheet and Internet forums}
increased anxiousness
irritability
drowsiness
changing heart rate
increased forgetfulness
increased suicidal thoughts
seizures
manic episodes
Side effects I’m not really worried about:
I heard it gives weird dreams, I already have super weird dreams so that’s no biggie
low appetite, kind of welcoming this one because I overeat and I’m always hungry
low salt levels, I already have to eat extra sea salt because of my mineral deficiency so no biggie 
no sex drive, already got that from my depression so probably won’t even notice a change
heavy periods, tbh my cycle is pretty light and it’s not something I would be upset about
I’ve been struggling with depression (MDD is my official diagnosis, feels so so nice to be able to say I’m no longer self diagnosed and that an adult understands and validated how I feel) since I was 11 or 12 (at least I started self harm when I was 12, I don’t remember exactly when I started feeling depressed). The doctor said that medication should be good for me because my depression wasn’t caused by an event, rather just a chemical imbalance in my head. This week I’m going to look into therapists and try to start talk therapy as well. My mom isn’t happy with me taking medicine, but I’ve tried every coping mechanism you can think of so I am excited to try something that will help me stay stable. It’s hard to explain to her that I’m not taking it to be happy, but just to establish a baseline so I won’t sink into my low lows. I am really hoping that I don’t have terrible side effects so that I can see how this med works out.
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Fibromyalgia Masterpost
As someone who has struggled with severe chronic and pain fatigue for over a decade and have recently been diagnosed with Fibromyalgia - I have decided to research my condition amd educate myself on my symptoms.
Fibromyalgia, also called fibromyalgia syndrome (FMS), is a long-term condition that causes pain all over the body. As well as widespread pain, people with fibromyalgia may also have: increased sensitivity to pain. fatigue (extreme tiredness) muscle stiffness.
Through my own research i have learned that many difficulties i have are directly linked to Fibromyalgia. There are over 200+ symptoms and while not everyone will expereince all of them, we experience our own combonation of debilitating symptoms.
With anything, education is key.
If you have fibromyalgia, have a family member or friend with the condition or would like to be more educated on the condition this post can help.
Disclaimer: I am not a medical professional and do not claim to know everything about fibromyalgia. This post will not list everything so i urge you to do your own research. And if you have any of these symptoms, go to your doctor!
Symptoms (most common)
All over pain is the most common symptom of fibromyalgia but the syndrome causes many others. Extreme fatigue , trouble sleeping and feeling stiff and achy. Your ability to think and make decisions can be affected (this is known as fibro-fog).
As well as widespread pain, your muscles can be very tight and knotted. They can be painful to touch and they radiate pain to other areas - these firm knots are myofascial trigger points. (These knots are commonly used to diagnose fibromyalgia in a physical pressure point exam)
Other Symptoms
Cold feet and hands
Feeling cold often/feeling hot often
Heart palpitations
Craving carbohydrates
Symptoms worsened by temperature changes
Unexplained weight gain or loss
Joint pain
Feeling spaced out
Restless Leg Syndrome
Noise intolerance
Scalp Pain (like hair being pulled out)
Sensation that you might faint/ Syncope (fainting)
Tinnitus (ringing in one or both ears)
Photophobia (sensitivity to light)
“Growing” pains that don’t go away once you are done growing
Transposition (reversal) of numbers, words and/or letters when you speak
Difficulty with long-term memory/and short-term momory
Difficulty following conversation (especially if background noise present)
Difficulty expressing ideas in words
Blind spots in vision
Eye pain
Excessive sleeping
Difficulty falling asleep/ Difficulty staying asleep
Difficulty balancing
Vivid or disturbing dreams/nightmares
Sensitivity to the sun
Bruising easily
Sensory overload
Allodynia (hypersensitive to touch)
Menstrual problems
Suicidal thoughts
Irritability
Abrupt and/or unpredictable mood swings
Frequent crying
Diagnosis, Medical Help and Treatment
If you think you or someone you know has fibromyalgia go see your doctor. Tell them about your symptoms and explain that you think it might be fibromyalgia. Keep in mind that a diagnosis can take time and you have to be persistant and in many cases fight for your diagnosis!
Common treatment involves pain medication, anti-depressants, physiotherapy and therapy (CBT and pain managment).
Self Help
The most common coping technique for chronic pain is breathing exercises and meditation. Try the following,
Put yourself in a relaxed, reclined position in a dark/or low-light room. You can shut your eyes or focus on a point.
Begin to slow down your breathing. Breathe in deeply, using your chest. If you find your mind wandering or you are distracted, then think of a word, such as the word "Relax," and think it in time with your breathing...the syllable "re" as you breathe in and "lax" as you breathe out.
Do this for 2 to 3 minutes or until you feel relaxed.
Now that you feel yourself slowing down, you can try to use imagery techniques, like the ones below.
Positive imagery
Focus your attention on a pleasant place that you can imagine going to - the beach, mountains, a place where you feel safe and relaxed.
Positive self-talk
Encourage yourself and tell yourself: I can do this, I am strong and capable. Find a positive coping statement or affirmation that works for you (even if you don't believe it at first!). Write it down and memorise it for when you need it.
Counting
Counting is a good way to deal with painful episodes. You can count aloud or in your head. You can count breaths, the number of yellow items in your room, the floor tiles, or even visualise some sheep and count them!
Grounding techniques
Look around you, what do you see, hear, smell, sense? Say aloud (or in your head):
5 things you can see? 4 things that you can touch? 3 things you can feel? 2 thing you can smell?
It can also be helpful to use sensory items like plushies, fidgets, slime, and more! Anything that brings you comfort or joy or relaxation.
Pamper yourself
Do something you really enjoy, or do something relaxing like a bubble bath!
Mindfullness Box
Make a box of items that remind you to use the techniques that help, or put photos on paper, or write and decorate a list. (This box can be filled with items to help with depressive episodes)
The daily fight with fibromyalgia goes beyond pain management and fatigue and it's important to be educated on all aspects of the condition.(Especially if you or someone you care for has a diagnosis)
What are the facts
Fibromyalgia is a neurological illness and involves neurotransmitters (chemical messengers in the brain) that are also involved in some mental illness. This means that depression and anxiety are common overlapping conditions in fibromyalgia.
Stress is a major exacerbating factor in many, if not most, cases of fibromyalgia. It's suspected as a causal factor and known to make symptoms worse and cause flare-ups.
It is also believed that childhood trauma may alter the body's physiological stress response leading to illness later in life.
Looking after your mental health is just as important as physical treatments when treating fibromyalgia. (I should state that fibromyalgia is a chronic illness and that there is no cure for the condition.)
When it comes to fibromyalgia patients seeking mental health help it's not much different from someone without the condition seeking similar help.
The major difference would be around pain managment and the emotional distress that comes with daily pain and the inability to live a normal life. It's common for fibromyalgia sufferers to feel hopless/helpless and worthless alongsides feelings of frustration.
It is believed that depressive episodes, mood swings, suicidal thoughts and suicidal attempts are all symptoms of fibromyalgia and it is very common for fibro-sufferes to struggle severly with poor mental health.
Treatments such as anti-depressants, anxiety medications and therapy are commonly suggested alongsides pain medications. Both help the other as stress and low mood decrease our ability to cope with pain.
Mental Health Techniques
Keep a mood diary
This will help you keep track of any changes in your mood, and you might find that you have more good days than you think. It can also help you notice if any activities, places or people make you feel better or worse.
Connect with people
A good support network will always be a good thing. Having people you can reach out to when in distress is a important part of recovery and having good mental health.
Take control
If the problem has a solution, make it happen! Don't let thoughts like "i cant do anything" hold you back as they only add to the problem. But,
Accept the things you can't change
Changing a difficult situation isn't always possible. Especially when you have a disability. Instead, try to concentrate on the things you do have control over.
Try to be positive
Look for the positives in life, and things for which you're grateful. Challenge thoughts like "I can't do this" or "there's no point" or anytype of thoughts which are negative and defeatist. They won't help, chuck them out!
TIP: Try writing down 3 things that went well, or for which you're grateful, at the end of every day.
Work smarter
What i mean is, some tasks are more important than other. As someone with a chronic illness it's not always, if at all possible to do more than one task a day. Often we are forced to choose between making food or cleaning and we have to learn to prioritise based on a number of factors. Don't feel bad when you can't do a lot or even anything, your pain and illness is valid and the last thing you need is to feel guilty about something you can't control.
If you have to choose between washing the dishes or preventing a flare up - your health wins everytime.
Diet, sleep and exercise...
It can be frustrating we all you hear is "you should exercise, eat healthy and have a good sleep routine..." and somehow people think that this will heal us. This is not the case.
Yes, a healthy diet, sleep schedule and light exercise is good for us but it's not as easy for us to achieve. There are many factors that make access to these difficult (poverty being the big one). But, lets ignore that for now (like everyone else does).
Okay, lets say we eat a healthy diet. We can't always follow a sleep routine because we have severe pain that is generally worse at night. We also struggle with other symptoms that are more prominant at night (restless leg syndrome, heat intolerence, twitching, nightmares...) that make getting to sleep and staying asleep very difficult. And, exercise is the hardest of them all. We cant go to the gym and get our sweat on. It's not in the cards. Every chronically ill person has been told to eat healthier, sleep better and exercise and it's not helpful. In fact, it only adds to our stress. If you don't know what you're talking about (e.g. you suffer from a similar chronic illness or are a medical professional) then shut up!
Excerise when you can. Don't excert yourself. Swimming is one of the best options. Eat as healthy as you can (but any food is better than nothing) and try your best to keep a sleep routine. But don't stress when these things arent possible, they won't cure you, they will only help you decrease your symptoms and make them more managable.
This has been a long post, congradulation on making it to the end! I hope this post has been educational and helpful in some way or another. Feel free, encouraged even, to reach out to me with any questions, i am happy to amswer any to the best of my ability. Please reblog this post so other fibromyalgia sufferes can have a read and add to the post if they wish.
I would also like to add that i am looking for fellow spoonies to follow on here and instagram (@gogh_save_the_bees) give me a follow and ill do that back!
#fibromyalgia#chronically ill#chronic pain#chronic fatigue#masterpost#information post#mental heath support#positive mental health#mental health#positivity#positive#disability#disabled#disabilties#self help#recovery#affirmations#text post#depression#personal#text#positive mental attitude#anxiety#signal boost#long post#fibrofighter#fibrowarrior
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(1st EP of the new chronic illness leader series!)“If you do not solve your inner piece problem, all of these dietary changes not going to fix these chronic illness issues"Contents· 2 min: Adrienne’s story – her and her families battle with Chronic Lyme and Hypothyroidism --> Hashimoto’s Disease· 7 min: diet affecting her period leading to Amenorrhea· 11:30 min: the tragedy of her mother’s mental health and how it impacted her · 14 min: Adrienne’s ignited dream to fix our healthcare system· 16 min: her journey through business school and first creating WellBe + her ironic work in Chronic Disease management in a hospital· 19:30 min: benefits of experience in healthcare before launching a healthcare company· 22 min: becoming a board certified chronic illness advocate, and discussing never having regrets · 25 min: knowledge on issues with Chronic Lyme testing · 27 min: what “woo woo” medicine really is; how integrative medicine is full of brilliant professionals · 28:30 min: natural medicine can improve all aspects of your health issues but you need to include a few or several different modalities, not just one. Why it takes a “team” and the “who” treating you matters· 31 min: her testing journey · (whoops! Lawn mower interruption!)· 3:30 min: Getting personal with nutrition and finding a “ferocious investigator” practitioner · 36 min: Eva not having fibro fog for weeks (lasted for 3 months and still barely there!) · 37 min: Adrienne’s management of Hashimoto’s· 42: chronic illness tied to emotions and freeing the immune system· 46:30 min: re-evaluating the healthy lifestyle vs. healthcare system culture – disconnected even though trying to do the same thing, using WellBe to bridge the gap (bringing research to the conversation with their weekly wrap up · 49 min: how all of her films/interviews of chronic illness recovery stories involved them having a perspective change· 49:30 min: “[Changing your mindset] - it’s the hardest work of all, and I think it’s much easier to each vegetables than to sit quietly and connect with your dark thoughts….especially with chronic illness…[those voices] build up so much inflammation”· 51 min: what WellBe is all about – stories, videos, research, newsletter, podcast, events, etc.· 56 min: how it’s going to take a village to make true change in the chronic illness community ADRIENNE NOLAN-SMITHIn her personal and professional experience, Adrienne Nolan-Smith has seen how integrative health and wellness are key to preventing and reversing disease. When she was 11, Adrienne was diagnosed with Lyme disease. Her conventional doctor prescribed antibiotics, but they didn’t work and her mother was then told there were no other options. Two years and multiple integrative therapies later, Adrienne was Lyme-free. Over the years, other health issues came up and each time it became clear that conventional doctors had tools to treat her symptoms, but they never got to the root of the problems, nor did they really try to cure them...Click here for full SHOW NOTES (INB post)➡️ Watch the video version of this interview (blog video page)➡️ visit getwellbe.com SHARE 😍RATE & REVIEW 👍 ----👉 find more episodes like this on Invisible Not Broken👉 read and watch more content (or submit your own) on the #Wellspo blog ___ Episode supported by Wellacopia - the first matching site that helps people with chronic illnesses find their ideal, long-term, specialized practitioners (a similar approach to a dating site!). Our mission is to help build better, trusting healthcare relationships and therefore, see better outcomes and quality of life. 👉 Find your ideal practitioners - https://ift.tt/2OF7GdO by Monica Michelle
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I know you aren't a counselor, but you do know a lot, so I was wondering: what are symptoms of PTSD? Also, how do you know if someone is a narcissist?
Well, PTSD is a bit of an easier question, but it’s still not easy to answer. There are a lot of different symptoms that can be related to it, and it’s a complex disorder, but the simplest definition is from NIMH. I’d highly recommend going to that page. But the summary is: a combination of re-experiencing symptoms, avoidance symptoms, arousal/reactivity symptoms, and cognition/mood symptoms as the result of a traumatic event.
Re-experiencing symptoms are the classic “flashbacks” of PTSD. It doesn’t mean necessarily seeing the event happen over and over (tho that can happen), but can include being unable to stop thinking about it, and having physical response as though you were in that same event again. Re-experiencing can also involve bad dreams/nightmares.
Avoidance symptoms are just what they sound like–you avoid places, things, situations, thoughts, or conversations that remind you of the event. For instance, someone who was in a car accident may avoid getting in a car, or driving. If you watched someone pass away, you may avoid the place where it happened, or places similar (ie, a hospital).
Arousal/reactivity symptoms are things like being “constantly on edge,” being easily startled, problems sleeping, angry outbursts, and being unable to concentrate.
Cognition/mood symptoms usually overlap with depression and can include negative self-perception, irrational blame, and lack of interest or pleasure in things, as well as emotional numbness and trouble remembering details of the trauma.
PTSD starts after a traumatic event, which doesn’t necessarily mean a near-death experience; it could be after the death of a loved one, or seeing some other person get hurt/killed. But most often it is a dangerous situation that happened to you, like a rape/assault, an accident in which you were injured, or living through a natural disaster. From the American Psychiatric Association: “A diagnosis of PTSD requires exposure to an upsetting traumatic event. However, exposure could be indirect rather than first hand. For example, PTSD could occur in an individual learning about the violent death of a close family member. It can also occur as a result of repeated exposure to horrible details of trauma such as police officers exposed to details of child abuse cases.”
Situational anxiety can have similar symptoms to PTSD, but is not the same disorder; it could be that because you had bad past experiences with school (mean teachers, bullies, and difficulty in course work), going to school now gives you anxiety. Maybe you were extremely poor growing up, so now you have crippling anxiety centered around money, like you get panic attacks when shopping or you may routinely fear becoming homeless even though you’re doing okay. Or you had a rocky, angry relationship with another person and now being around them triggers your anxiety. These are not PTSD, as there was no traumatic event to trigger it, but it is a chronic stress and anxiety related problem, one which can be debilitating and needs to be dealt with in conjunction with professional help, or else avoidance/anxiety may become your norm. Which, needless to say, is not healthy.
Now, for narcissism. We use the term narcissist a lot, and very loosely in common speech to convey someone who thinks so highly of themselves that others become lesser, and are rude to others as a result. But clinical narcissism, or Narcissistic Personality Disorder (which I’ll refer to as NPD) is much different. People with NPD do consider themselves better than others, but it goes much beyond being rude. Here is a link that I once again highly recommend reading on the subject, that explains it better than I can. Also, halfway down this document is the DSM criteria for a diagnosis of NPD. But here are some traits that you see in NPD, which show what I mean about going beyond just thinking highly of themselves:
Feels like they can only associate with people “worthy” of them (delusions of grandeur); fantasizes excessively about power, beauty, success, etc; sees others in terms of how they can be used to the individuals’ ends; relationships are based on appearances and superficial criteria (aka, how does this person make me look to the world); expect to be recognized as superior and becomes irate when others don’t notice and point out their supposed achievements and brilliance; unable to empathize; believe others envy them (can become paranoia); fragile sense of self worth based on whether other people treat or praise them in the way they feel they deserve; requires constant attention/to be the center of attention; and requires special treatment from everyone (ex, if they aren’t given priority seating at a restaurant, or are forced to wait in line, they may start screaming).
These are not just people thinking they’re cooler than they are. These are crippling, destructive habits that wreak havoc and inflict pain on people who associate with them. And it’s not something you see every day. Overall, true narcissism is extremely rare, less than 1% of the world population (and that’s a generous estimate), and most affected are male.
Given that these two questions were asked together, I would hazard a guess that you may be dealing with a difficult, possibly traumatic event or relationship relating to a person in your life. It is possible for a person with NPD to lash out sufficiently to qualify as a traumatic event, but more likely people who are forced to deal with a narcissist are having situational anxiety, as described above. But again, true narcissists are rare, so it could be that this person, while having narcissistic tendencies, is not clinical.
If you had a serious fight with someone where you feared for your safety, it is possible you have PTSD. However, the more common situation is that this person stressed you out for so long that being around them, thinking about being around them, or having to deal with them made your subconscious associate them with anxiety and stress; aka, they are an anxiety trigger for you now. Neither PTSD nor situational anxiety is good or ideal, and neither is better than the other. If you are suffering with either, I feel for you. But please know that there is assistance, and it doesn’t always have to be like that.
Also, if I’ve totally misread the situation/ask, I’m sorry, and ignore the above 2 paragraphs.
As always, I would recommend speaking with a professional. Even if you don’t have PTSD or clinical anxiety, a counselor or other psychological professional would be in a better place to help you work out whatever it is that’s really going on. A common misconception is that therapy is only for people who have a diagnosed mental illness; therapy is for anyone who is having a hard time dealing with things on their own, or for anyone who wonders if they might have a problem. Many insurance plans will also pay for a certain number of counseling/mental health visits per year, so it may be worth checking out.
Good luck, and I hope this was helpful for you!
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My mother was not the only mentally ill person in our family.
I was diagnosed with obsessive compulsive disorder as a young adult. Contrary to pop cultural depictions, it's not organizing your bookshelves by color and washing your hands 50 times a day (although I have met some fellow OCD-sufferers with telltale raw, red, cracked hands). It's also definitely not, "Ohmahgahd I haaaate olives in my martinis, I'm so OCD."
My obsessions were a cycling voice on repeat in my head since puberty telling me, "Kill yourself. Kill yourself. Kill yourself. Kill yourself." My compulsions were biting my nails until they bled and the quicks throbbed in pain with any environmental change (being submerged in water, eating salty french fries, stepping outside on a cold day, et cetera), picking my skin so ruthlessly I looked like a crystal meth addict, and ripping out my hair. For many years I had a bald patch on my head that I obscured with hairstyling. A lifelong atheist and critic of superstition, I became obsessed with ripping out my eyelashes and making wishes on them. "I wish my skin would heal. I wish my mom would get better. I wish my niece would turn out normal." You have eyelashes for a reason, and without them my eyes were constantly irritated and watery.
I've always been adept at putting a pretty facade on things. I was careful to leave my bottom eyelashes alone, and I glued strips of false lashes on the top. I skillfully hid the scabs on my face with makeup. My face held people's attention enough that few people noticed my miserable, ragged fingernails.
In my mid-twenties, I started going to a new therapist. I'd been to many therapists before and didn't find them particularly helpful. I was in the throes of the worst valley I'd ever experienced in terms of my mental health. The constant voice in my head telling me to kill myself was as relentless as ever. It felt like torture, like captors blasting death metal at a prisoner so he couldn't have any peace of mind and eventually caved to their demands. I was very, very close to caving to the demands of the OCD voice in my head.
I made a plan for how I was going to kill myself. It took me a long time to think of a way where Nic wouldn't have to find me or clean anything up, and hopefully I wouldn't be in too much pain before I died. I was not resolute. I didn't want to die. Every time I pictured my plan in my head, I sobbed and begged myself not to. It just felt like the only way to get the voice to shut up. I can't describe the voice. It wasn't my own. I tried to figure out the source of it but I never could. It felt like a taunting whisper rising up to me from a crack in the ground.
I made a compromise with myself: we would try therapy one last time. We would give it a good go, the old college try. We would actually put in the work and make an honest effort. We would do it for three months. If I still needed to kill myself at the end of the three months, then it was okay. I was allowed to do it and not feel guilty.
I don't know if it was my own desperation or if she was just that great, but to my immense surprise the therapy actually worked. I feel like my life could be divided into two sections: my life before I met her, and my life after.
Right around the three month mark is when I found out my mom had cancer, and Nic and I decided to move back to my hometown to help take care of her. I talked to my therapist about the upcoming move and she helped prepare me for what I was going to experience. I don't think I would have handled everything as well as I did without her.
For the most part, my life now is not particularly hindered by OCD. I know how to interrupt myself when I feel the urge to pick at my skin or hair, I have long, manicured, well-kept nails, and the voice only makes occasional cameos and I know well enough by now to brush it off.
I have one irrational obsession I haven't been able to shake, and it's a weird one. Much like the fixation with making wishes on my tormented eyelashes, this one doesn't make a lot of sense and will never happen.
I have this scene play in my head at least once a day. I'm home, it's late morning, and I hear a knock at my door. I go to answer it and there is a swaddled baby on my doormat. I recognize her immediately from the photos. I can tell by her giant, blue eyes, the wispy corn silk hair, and delicate mouth. It's my mother. I pick her up and take her inside and I take care of her. She's my baby now. I show her the unconditional love and patience and consistency that she needed as a child and didn't get. I see her grow up well-adjusted, free from the cycle of abuse. If it turns out her problems were more nature than nurture, I don't take the stoic, 1950s Catholic route. I take her to therapy, just like she did for me. She learns how to cope with her mental illness in a healthy way. She finishes college and becomes a nurse, like she always wanted to. She finds a partner who makes her happy. She doesn't have seven children to fill a void in her heart. She faces her problems head on and doesn't die at 66 after an exhausting, ruinous battle with cancer. She has the beautiful home of her dreams. She thrives.
In December of 2017 I had an elective bilateral salpingectomy. I don't want to get pregnant. I don't want to have a baby. There is only one baby I want, and I can't have her, so what's the point?
Nic and I bought a house about a ten minute walk from her childhood home. Sometimes I walk over and take it in. Nearly any time I drive in that direction and I don't have a passenger in my car to ask me why I'm being such a weirdo, I slowly drive past it. I hope the current residents haven't noticed me. I'm not trying to be like, the neighborhood Boo Radley or something. I just like to stop and look and picture little toddler Leslie playing in the grass. I like to imagine her little kid chubby wrists and knees. I imagine how differently her life would have ended if she'd had an easier start.
Like I said, not my most rational obsession. Checking to make sure I locked the front door 37 times would probably be healthier.
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What is Parkinson's disease? by the best neurosurgeon in Delhi
Parkinson's disease is a nervous system disorder that impairs movement function. The disease usually begins slowly and worsens over time. You can shake, have muscle stiffness, and have difficulty walking and keeping your balance and coordination if you have Parkinson's disease. As the disease progresses, you can experience difficulty speaking and sleeping, mental and memory issues, behavioral changes, and other symptoms. Dr. Arun is the best neurosurgeon in Gurgaon, having vast experience in treating Parkinson's disease.
CAUSES AND SYMPTOMS
What is the cause of Parkinson's disease?
Parkinson's disease develops when nerve cells (neurons) in the substantia nigra region of the brain become damaged or die. These cells normally produce dopamine, a chemical (neurotransmitter) that aids brain cell communication (transmits signals, or "messages," between brain areas). Dopamine production decreases when these nerve cells become damaged or die. Dopamine is particularly essential for the functioning of another region of the brain known as the basal ganglia. This part of the brain is in charge of coordinating the brain's commands for movement. Parkinson's disease is characterized by movement symptoms caused by dopamine deficiency.
People suffering from Parkinson's disease also experience a decrease in another neurotransmitter known as norepinephrine. This chemical is required for the sympathetic nervous system to work properly. Any of the body's autonomic functions are regulated by this mechanism, including digestion, heart rate, blood pressure, and breathing. Any of the non-movement-related signs of Parkinson's disease are caused by a lack of norepinephrine.
Scientists aren't sure what kills the neurons that generate these neurotransmitter chemicals.
What are the signs and symptoms of Parkinson's?
The symptoms of Parkinson's disease, as well as the rate of deterioration, differ greatly from person to person. The following are the most common symptoms:
Tremor: This is a form of tremor. The shaking starts in your hands and arms. It can also happen to your jaw or foot. Typically, only one side of the body or one limb is affected in the early stages of the disease. Tremor can become more widespread as the disease progresses. It worsens as a result of stress. Tremor usually goes away when you sleep or shift your arm or leg.
The slowness of movement (bradykinesia): This is a slowing of movement caused by your brain's slowness in transmitting required instructions to the appropriate parts of your body. This symptom is unpredictable and can easily become incapacitating. You might be able to move easily one minute and then need assistance moving and completing tasks such as dressing, bathing, or getting out of a chair the next. You could even stomp your feet as you walk.
Muscle rigidity/stiff limbs: Rigidity refers to the muscles' failure to relax naturally. This rigidity is caused by uncontrolled tensing of your muscles, and it prevents you from moving freely. Aches and pains in the affected muscles may occur, and the range of motion may be impaired.
Unsteady gait, as well as balance and coordination issues: You can develop a forward lean, making you more likely to fall when bumped. You may take short shuffling steps, have trouble starting and stopping, and you may not swing your arms naturally as you walk. When attempting to take a step, you can feel as though your feet are stuck to the floor.
Twisting muscles, spasms, or cramps (dystonia). You can feel a painful cramp in your foot, as well as curled and clenched toes. Dystonia may occur in other areas of the body.
A hunched stance. Your stance is “hunched over.”
Some signs and symptoms include:
Reduced facial expressions: As the disease progresses, you can find yourself not smiling or blinking as frequently; your face loses speech.
Changes in speech/vocalization: Speech can become hurried, slurred, or soft in tone. You could pause before speaking. Your voice's pitch will remain constant (monotone).
Changes in handwriting: The handwriting can become smaller and more difficult to read.
Anxiety and depression
Drooling, chewing, and swallowing difficulties
Urinary issues
Difficulties with mental "thinking"/memory.
Delusions and hallucinations
Constipation is a common ailment.
Problems with the skin, such as dandruff.
The loss of smell.
Disrupted sleep, acting out dreams, and restless leg syndrome are all examples of sleep disturbances.
Apathy, pain, weight gain, and vision changes are all symptoms of apathy.
Blood pressure is low.
DIAGNOSTIC AND TESTING
How is Parkinson's disease identified?
Diagnosis of Parkinson's disease can be complicated at times because early symptoms can resemble those of other conditions and there are no clear blood or laboratory tests to diagnose the disease. CT (computed tomography) or MRI (magnetic resonance imaging) scans can be used to rule out other conditions that cause similar symptoms.
To diagnose Parkinson's disease, your medical history and family history of neurologic conditions, as well as your current symptoms, medicines, and potential exposure to toxins will be asked. Your doctor will examine you for symptoms of tremor and muscle rigidity, as well as how you walk, posture, and balance, and slowness of movement.
If you suspect you have Parkinson's disease, you should see a neurologist, preferably one who specializes in movement disorders. Treatment decisions made early in the disease may have a long-term impact on the treatment's effectiveness.
TREATMENT AND MANAGEMENT
What is the treatment for Parkinson's disease?
Parkinson's disease has no known cure. Medication and other therapies, on the other hand, may help alleviate some of your symptoms. Exercise will greatly improve your Parkinson's symptoms. Physical therapy, occupational therapy, and speech-language therapy can also assist with walking and balance issues, feeding and swallowing difficulties, and speech disorders. For certain patients, surgery is a choice. schedule your appointment with the best neurosurgeon in the world.
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Self-Medication
A Kimi no Na wa/Your Name oneshot
Word count: 13K.
Green Tea
“So, what brings you here today?”
They’d already covered the simple stuff. Name, pleasantries, basic info. This Ueda ishi didn’t look how Mitsuha had imagined that a therapist would; her black hair was loose and her clothes were somewhat casual. Perhaps a bit bright for her age, which looked to be forty, pushing fifty. But, apparently, with only a half-hour to meet, she liked to get to work quickly.
Mitsuha quit trying to analyze Ueda ishi’s look and instead focused on the familiar scent of the freshly brewed green tea warming her hands, knowing that it was there to give her comfort and provide a homey atmosphere while she tried to formulate the best answer that she could provide.
“My friends suggested that I try speaking to a therapist,” Mitsuha admitted. “Since this is a free service that the University provides, I figured what’s the harm?”
The woman was looking at her with an implacable expression. Mitsuha knew that she was comparatively easy to read. Her whole body was tense, the epicenter being where she was hunched over her tea and clutching it like someone was trying to steal it. It was like she was aiming to make herself small enough for Ueda ishi to look right past her. She tried sitting up a little straighter.
“Are your friends concerned for you?”
Mitsuha blew on her tea a bit. “I’m not sure I’d say that they’re concerned but…maybe a little worried that I’m not happy.”
A touch of amusement warmed Ueda ishi’s expression. “So, concerned for your happiness?”
Mitsuha blushed. “Yes, I suppose so.”
“What kinds of things have they said?”
A daring sip of tea made Mitsuha’s lips and tongue tingle. She hid her face in the white cup as she said, “They think that I might have depression or, um, PTSD.”
Ueda ishi’s eyebrows rose as she wrote something down in her notebook. “Oh, really? Why’s that?”
Really, it was because Sayaka had decided to go and become a school counselor. When they’d all moved to Tokyo, their respective high schools had all set them up with a session of crisis counseling in case of emotional trauma. Mitsuha had found it uncomfortable—even more so than she did now—as she’d never been in that kind of situation before. Tessie, at the time, had been on her side as well. But Sayaka had loved it; it was how she had learned that she had anxiety. Now she wanted to be able to do the same for others.
And Mitsuha was her next project.
Sayaka had already been working for a few years and had volunteered back when she’d been in university. So it had taken her a good six years before she started going about diagnosing her friends. Mitsuha figured it was because Tessie and Sayaka had started dating. Now that they were all happy, they were hell-bent on getting Mitsuha out of her fabled funk.
Honestly, she wanted to as well. Not because she felt she was actually depressed, but because she desired answers. “Once in a while, when I wake up, I find myself crying. I can never recall the dream I must have had. We call them my ‘lost days’.”
“Lost days?”
Sayaka had coined that term. Mitsuha thought that it was an exaggeration, but she went along with it nevertheless. “Yes. The sensation that I’ve lost something lingers for a long time after I wake up. It affects my whole day,” Mitsuha admitted. “I manage to go to work, complete all of my tasks, but something feels missing. It possesses me.”
“Well, Miyamizu, I will say that that description is consistent with symptoms of depression,” Ueda ishi said as she brushed some of her gray-streaked hair back. Though, that isn’t to say that you necessarily have depression. But let’s go back. You say that you wake up crying?”
Mitsuha nodded. “It’s different from when I usually cry. Tears simply spill from my eyes. And it only seems to happen in the mornings.”
“And you suspect that it comes from dreams?”
“What else could it be?”
“You said that your friends have mentioned PTSD in addition to depression. Perhaps it could be the feelings of a repressed memory?”
Mitsuha frowned. To some degree, she had understood when Tessie and Sayaka had said that she might have depression. Mitsuha thought of herself as a generally positive person, but those lost days…well, they were suspicious. Mitsuha knew that they weren’t normal. But over the years, she’d grown used to them.
PTSD, though…Mitsuha was fairly certain that no one would suggest them unless they knew what Tessie and Sayaka did.
“I’ve never experienced anything particularly awful in my life,” Mitsuha said. “I don’t know what I could possibly be repressing.”
“Nothing from your youth? Perhaps something a little more out of reach than recent history? It could be something hard to admit.”
Something hard to admit…
Ueda ishi was looking at Mitsuha like she could see the truth hidden right behind her face. And Mitsuha knew that the longer she didn’t say it, the more suspicious of it Ueda ishi would be.
“Well, I don’t think that this is the cause of my problems, but I’m sure of why the idea of PTSD occurred to my friends.”
A smile grew on Ueda ishi’s face, like she felt as though they’d accomplished a minor breakthrough. “What’s that?”
Mitsuha looked in her teacup of yellow liquid, watching it swirl around as she rocked the cup in a slight circle. She would catch bits of her reflection in the tiny whirlpool and then they’d roll right past her.
“Well, seven years ago…”
Chocolate Pie
“Mitsuha, over here!”
Mitsuha’s head whipped in the direction of Tessie’s familiar voice as he waved her over to the stools he and Sayaka were perched on. Back in the day, Sayaka would have been embarrassed by Tessie shouting over the heads of a dozen other patrons in a café, but now she was just shaking her head to hide the fond smile on her face.
Then again, back in the day they never would have been at a café in the first place.
“Hi, guys,” Mitsuha said warmly as she took her sweater off and placed it on her lap. Tokyo was fairly mild come late April, but it was still chilly enough at night to warrant layers. “Did you order yet?”
“No, we were waiting for you,” Sayaka said as she handed Mitsuha a menu. “We couldn’t deny you the great pleasure of ordering your own dessert.”
Going out and ordering the fattiest, most saccharine foods they could was an awfully bad habit the three of them had picked up as soon as they’d moved to Tokyo. For their first year or two they had and sampled the local cafés whenever they could afford it. The practice was bad for their wallets and their waistlines—especially Mitsuha’s. Sayaka had filled out a little bit, but in the good way. And Tessie didn’t seem to indulge as much as the girls did, not to mention all the exercise he did—but it was too divine to skip.
Fortunately, by that point they had decided on a few favorites that they frequented. This one wasn’t Mitsuha’s personal favorite—hers was a little out of everyone’s price ranges—but they had really good pie, which Mitsuha was going to order the second the waiter appeared.
She didn’t have to wait long. Mitsuha gleefully ordered her chocolate pie and a coffee. She saw Tessie shaking his head at how obviously excited she was, but she didn’t care. This was, without a doubt, her favorite pastime.
“So, Mitsuha,” Sayaka smiled conspiratorially, “how’s therapy going?”
“Oh, Saya—Mitsuha, you don’t have to answer that.”
“Of course she doesn’t have to, but I thought I’d ask my friend a question about her life—”
“Just because you enjoy talking about therapy doesn’t mean that everyone’s going to be comfortable with it.”
Mitsuha couldn’t help but smile as her friends devolved into a full-on argument. They seemed to fight more after being together over a year than when they’d just been friends. Luckily, it always seemed to be good-natured. In fact, Mitsuha really thought that it showed their love for each other. So, Mitsuha sat back and mindlessly blotted off her lipstick in preparation for the pie that certainly had priority over makeup. Sayaka was getting through with blowing a raspberry before Mitsuha finally bothered interrupting.
“Thanks, Tessie, but it’s okay, really.” Her two friends calmed down and Sayaka shot Tessie a gratified expression. “Therapy is fine. In the last couple of sessions we’ve just talked about Itomori and my parents.”
“Do you feel like you’ve made any progress?”
A slight bit of hope was shining off Sayaka’s face. Some people’s faces hardened with time, becoming cold and untrusting. But Sayaka never seemed to outgrow the glimmers of naïveté that had always shone in her eyes. And it made Mitsuha so want to bring a smile to her face with good news.
“Well, I mean, it’s nice to talk about these things with someone. Working through the family stuff was, uh, nice. Um, it’s possible that I am depressed, but if so, she says that I handle it well. Uh,” she looked at Sayaka’s expectant face, “and that’s it. So far.”
She finished with a deflated shrug, happy when the waiter returned with a pot of coffee so that she could focus on that instead of Sayaka’s assured disappointment. She reached for some sugar to stir in. Coffee was always too bitter for her, but it was even more pronounced when it was accompanied with something really sweet. Like pie.
“So are you gonna keep going?”
Again, Sayaka was looking oh so hopeful while Tessie sat back disinterestedly, trying to cool down his coffee. At least, he looked disinterested, but Mitsuha caught him arching an eyebrow in her direction for just a moment before his eyes flitted back to his drink.
“Of course I’m going to keep going. Why wouldn’t I?”
“Well, you just don’t sound like you’re getting that much out of it.”
Mitsuha shrugged, not sure what she was supposed to say. “I mean, I’m not sure that I should be going in looking for answers. I’m not sure that there’s any specific reason why I feel the way that I feel. But it’s nice to have someone to talk to and add some insight. Plus,” she raised her mug as if in a toast, “it’s free.”
Tessie came to life as he raised his mug too. “Here, here!”
“Oh, good!” Sayaka cheered, livening instantly. “You know, I think that everyone should go to therapy on occasion whether something’s wrong or not.”
“We know,” Tessie groaned, rolling his eyes and sharing a look with Mitsuha.
Mitsuha laughed, trying to hide it behind her hand so Sayaka wouldn’t pout. Sayaka had said repeatedly that if Tessie ever proposed—and Mitsuha thought that he was putting it off just because of this—they would have to go to pre-marriage counseling.
The waiter was their saving grace at that moment, arriving with everyone’s wishes for the day, topped off with whipped cream. Mitsuha felt her own eyes glittering as her heart swelled with the kind of love that humans should only have for other people and not chocolate pie. As she lifted that first sweet morsel to her mouth, and she felt her lips puckering as she salivated at the sweetness, she wondered if it was possible for her to be depressed when she could get such joy from such simple pleasures.
Retail Therapy
University was kicking Mitsuha’s butt. She’d been so jealous of Tessie and Sayaka because they’d been able to breeze through university, like most students. But medical school was harder. It was without a doubt the most masochistic thing you could choose to do with your time after high school. Somewhere along the way she’d grown to look forward to her half-hour sessions, because they were a break in which she was fully allowed to not focus on finishing up her—hopefully—last year of school.
They had grown more comfortable over time. She’d had about a half-dozen of them and she no longer hid behind her mug, but rather just enjoyed the familiar tea. And Ueda ishi was growing to feel more like a friend than someone paid to listen to her issues. Especially since Mitsuha wasn’t doing the paying.
Mitsuha walked into the office at sat down, the pleather chair not nearly as comfortable in late-June as it had been in early-April. She was dressed in a short pink skirt and her legs were warm from being outside, so they instantly sealed themselves to the chair, promising to hurt when she ripped them up.
“Hello, Miyamizu,” Ueda ishi greeted as she set some hot water to boil. “How are you doing today?”
“I’m good; how are you?”
“Just fine, thanks.” Ueda ishi sat down in her chair and crossed her legs at the ankles, brushing down her knee-length skirt automatically. “And how was the rest of your week?”
“Uneventful, I suppose. Just work and school, mostly.”
“Still no lost days?”
“No.”
The electric kettle began to bubble and Ueda ishi stood up to pour the water. “No strange dreams?”
“None that I can recall.”
“None that you can recall…” Ueda ishi handed Mitsuha her saucer, which was happily accepted, before returning to her seat. “I find that dreams vanish very quickly after waking. The only way to catch them is to write them down immediately. I suggest that you keep a notebook and pen by your bed so that you can record what you remember. Even the slightest detail like an image or an emotion.”
Mitsuha nodded. “I can do that.”
Mitsuha went out that afternoon, intent on following Ueda ishi’s instructions. The fact that the instructions were fun was just a perk. Notebooks and stationary were beautiful and always fun to look at. Plus, it was just a little bit of indulgence without being as expensive as, say, buying a new dress or some shoes.
After some time absently browsing, she settled on a navy blue diary with shiny golden stars and a honey-colored moon on the cover. A few more weeks passed before Mitsuha could make use of it.
She woke up that morning with her knees up close to her chest and her pillow damp, as though she’d been crying for a while. She lay there for a moment, letting the tears dribble down her nose before she remembered that she was supposed to write down what had happened. She picked up the shiny new notebook and pen and realized that nothing was in her head. It felt completely empty, save for that tugging feeling of longing that she’d grown so familiar with over the last seven years.
All she could place on the page were the date and the last of her tears.
“Wow. And here I thought you were faking.”
Mitsuha nearly spit out her tea. “What?”
Ueda ishi laughed as Mitsuha tried to collect herself and keep from coughing up a lung. “I’m just kidding. I’m just surprised that we had to wait three months for one of these infamous days of yours.”
“I’m sure I said that they were only once in a while,” Mitsuha rasped. She cleared her throat and wiped away the tears from the corners of her eyes. “Sometimes they’re more frequent, sometimes they’re not for months.”
“I suppose you did say that,” Ueda ishi agreed. “Did you manage to recall a dream from this particular bout?”
Mitsuha shook her head. She hadn’t even bothered bringing her dream journal, since she hadn’t managed to put anything of substance in it. “No, nothing. I just woke up crying. As though I had been crying for a while.”
“And the lingering feeling you described…”
“Yes. I felt lost all day. I mean, even now, it still remains. Just not as strongly.”
She knew that the feeling would continue to ebb until the next dream. But it never went away entirely. Sometimes she felt that she had gotten quite good at overlooking it, but today, days after the dream, she was certain that it was still wringing her heart.
Tart
It was getting hot.
August in the city was not fun. At least out in the country there was plenty of tree cover, and grass to absorb the heat instead of buildings and cement that simply radiated it. Not to mention the promise of a huge lake that Mitsuha and her friends had loved splashing about in as kids.
No, August in the city was something else. Mitsuha had been dreaming her whole walk to the café of all of the frozen or iced drinks she could freeze herself with.
She’d finally decided on a frappuccino and a small fruit tart á la mode.
Mitsuha was absently sipping on the drink, trying to enjoy how cold it was before the air conditioning in the café made her regret it. She’d tuned out Tessie and Sayaka’s bickering; she didn’t even know if she’d done so on purpose or not.
“Mitsuha,” Tessie said, obviously not for the first time.
“Huh?” Mitsuha said, all but spitting her straw out of her mouth as she did so. “Sorry, what?”
“You just seem awfully quiet today,” Tessie replied gently.
“Oh.” Mitsuha supposed he was right. She’d been quiet all day. Ever since her last therapy session, actually. “I’ve just had a lot on my mind.”
“Like what?” Sayaka asked.
“I just…” Mitsuha paused, trying to figure out how to explain it. Maybe a question would work better. “Do you remember much about the comet?”
“The one that hit Itomori?” Tessie asked.
“No, the other one,” Sayaka jibbed sarcastically.
Tessie hardly acknowledged the comment, answering, “Yes, of course. How could we forget?”
“Do you remember how it was that we all ended up safe?”
“Of course,” Sayaka started. “There was an emergency dri…” Sayaka trailed off, eyes narrowing as a strange expression flickered in Mitsuha’s face. “That’s not right, is it?”
“Tessie?”
“Well, that’s definitely what was on all the news sites,” Tessie affirmed. “But why would your dad schedule a drill during the spring festival? That was that day, wasn’t it?”
“Yeah, it was.”
“Mitsuha,” Sayaka interrupted. “What brings this all about?”
Mitsuha stabbed at her fruit tart, the ice cream finally at the optimal level of meltiness to start eating. “We circled around to Itomori in my sessions again. You know we’ve usually just talked about what happened after, because that’s when any, you know, psychological unrest would occur. But this time we were talking about how things were right before and I hardly remember.”
“Well, that’s not crazy,” Tessie reasoned. “It was seven years ago. Of course there’ll be gaps.”
“But I remember what happened after really well!”
“Sure. Because that was a time where you were going through a lot of new experiences.”
He had a point there. “Well, I also remember things that happened, like, ten years ago really well!” Somehow her argument sounded less convincing when she was saying it around a mouthful of glazed fruit and flakey crust.
“Only important or interesting experiences, though,” Tessie insisted. “Things were really ordinary before the comet. But I’m sure you remember the stand-outs still. Like, do you remember doing the ritual that year? That was only a few weeks before the comet, right?”
Mitsuha cringed, the food in her mouth suddenly feeling uncomfortable as she remembered the sensation of having to spit it out in front of a few dozen people. She swallowed heavily.
“I’ll take that as a yes.”
Sayaka—who had been stealing sips of Tessie’s drink while he was arguing with Mitsuha—piped up, saying, “Let’s go back for a second. If you’re wondering what happened before the comet, why not ask your dad? Certainly he’d remember if it was a drill or not.”
“That,” Mitsuha started slowly, “is not a bad idea.”
With a smug expression on her face, Sayaka shrugged happily. “What can I say? I’m full of good ideas. Now enjoy your ice cream before it melts too much. You know these places frown upon you licking the plate.”
Mitsuha blushed.
Then, only to add insult to injury: “Which we all know from experience,” Tessie added.
Mitsuha hid her face behind her bangs as she reached for her drink. “I’ll ask my dad later,” she mumbled.
“Of course it’s normal not to remember everything in one’s life,” Ueda ishi said. “The only way otherwise would be to have an eidetic memory, and that’s little more than a myth of pop culture.”
Mitsuha nodded attentively. The semester was just about over and she wouldn’t be able to go in for session anymore until school started up again in October. So she wanted to make sure that she got all the answers she could before they went on hiatus.
Ueda ishi had been taken aback that Mitsuha had been carrying their last session with her all week. Especially about something that was so ordinary.
“Yes, I get that, I…understand that,” Mitsuha agreed. “But I feel like something’s missing. Like I should remember what happened in that period better.”
“You said you spoke to your friends about this?”
“And my family. No one was able to remember much more than me. Even my dad didn’t remember what happened just before the comet hit.”
Ueda ishi nodded, pressing her fingers to her cheek, making the fine lines around her eyes more pronounced. “Then you’re friends may be very right and there was little significant about the time before the comet hit. As for the day of, it’s possible that those events were overshadowed by the comet, or a surge in stress hormones overwhelmed the short-term memory, which is proven to happen. But again, all of this is perfectly normal.”
“Even the feeling that something’s missing?”
A hum escaped Ueda ishi’s mouth as she picked up her notepad. “That is interesting. You know what it sounds like?”
Mitsuha shook her head.
“It sounds like how you describe your lost days.”
Ueda ishi took a sip of her own tea, which was probably lukewarm by that point, looking over the rim at Mitsuha’s face. She was slightly slack-jawed and, if you looked closely, it seemed like you could see her thoughts flickering behind her eyes.
After a few silent moments, perhaps unnecessarily, Ueda ishi added, “Maybe they’re related.”
Booze
Mitsuha felt a weak buzzing trailing from her purse up its strap and onto her shoulder. She had a lot of things in there to muffle the device and, consequently, make it quite hard for Mitsuha to find. She was moments away from crouching down on the sidewalk and dumping out the contents of her bag when she finally touched the rubberized edge of her case.
“Hello?” she answered quickly, not even sparing a moment to look at the caller ID. She didn’t know how many times it had already rung and she didn’t want it going to voicemail.
“Mitsuha!”
Mitsuha’s eyes widened as she brought the phone a few inches away from her face. “Sayaka, you’re screaming,” she said with a laugh.
“Of course I’m screaming! Tessie proposed!”
“Oh my gosh!” Mitsuha noticed people on the street eying her strangely as the exclamation squealed out off her. “Sayaka! I’m so happy for you! For both of you! I want to know everything!”
“Thank you! So, we’re absolutely going out tonight and you’re coming with, okay?”
“I’m there!”
“Great! I’ll text you the details.”
“Okay!”
Mitsuha hung up the phone and put it back in the danger zone of her purse, a dopey smile on her face the whole time. Honestly, she shouldn’t have been surprised that Tessie had proposed—it had been a long time coming. But she supposed that no one could be fully prepared for something like that until it happened.
Then the smile seemed to sink a little. Slowly, the happy feeling pulling at her cheeks moved down her body, slithering around her heart a few times before landing coldly in her abdomen. It was the same kind of feeling that occurred sometimes when she would watch an American rom-com. The guy would get the girl through some over-handed gesture and some insipid pop song would play. Sometimes she loved those movies. And sometimes they made her…
Well, sad. And lonely.
And that made her feel guilty, and right then and there Mitsuha knew that she was gonna slap on a nice dress when she got home—to feel good about herself—put her braided chord around her neck as a choker—Yotsuha said it looked trendy and sexy—and get rip-roaring drunk.
For her friends. Of course.
Yomogi Dango
“So, here we are.”
“Here we are.”
“How are you feeling?”
Mitsuha looked down into her tea, wishing that it were a mocha or even some boba instead. Perhaps a nice hot chocolate, even though October was still a little warm for such an indulgence. Maybe a frozen hot chocolate? No, it was too cold for that…
“Miyamizu?”
“Oh,” Mitsuha said, slowly looking up to meet Ueda ishi’s kind eyes. “Um…it’s hard to explain.”
“Take your time.”
“Okay.” Mitsuha looked back at her drink. At least it smelled nice. Nothing decadent, but pleasantly familiar. “I guess I feel kind of heavy.”
“Weighed down?”
“Yes. It’s like time is moving slowly, but yet its passing right by me.”
“So, out of your control?”
Mitsuha nodded. “Very out of my control,” she whispered.
“That’s perfectly normal for people about to graduate,” Ueda ishi said. “Do you feel sad?”
A shrug. “I’m not sure. I’m not sure it’s active enough to be sad. It’s closer to nothing than sad.”
“An emptiness, perhaps?”
“A hole,” Mitsuha clarified. “Like there’s a hole inside of my stomach and the wind is just rushing right through it.”
“That’s a little more evocative.” Ueda ishi set her pad aside and leaned forward on her knees. “I’m starting to understand why your friends thought that therapy was for you.”
“It only took six months,” Mitsuha commented with a wry smile.
A chuckle. “Yes. Impressive. It’s interesting to see; this is quite a departure from your usual composition.”
Her friends had said that to her before about her lost days. But they’d also said that she’d seemed different ever since moving to Tokyo. But, in all fairness, a lot was different. It was only natural for her personality to adjust. Both of theirs had too, after all.
But she didn’t need her friends to tell her that she was different on these days. It was obvious from the second she woke up. Tears aside, for the whole day her heart ached. Or longed. For something. On the outside, her speech was slow and expressionless. Her face was expressionless. The effort to fake otherwise felt useless. Still…
“I’m not sure. Sometimes I think that too, but I more think that this is always a part of me and it’s just the bigger part on these days.”
“Interesting observation.”
It quickly became evident that Mitsuha had nothing else to say. She seemed altogether unwilling to speak unless answering a question.
“Miyamizu,” Ueda ishi began again, “before, it was more or less speculation, but now it seems relatively evident that you suffer from some sort of depression.”
Ueda ishi looked for some change of expression on Mitsuha’s face, but there was none. She was looking straight across the room into her eyes—a gesture that not many of her patients shared—but all that was there was dull resignation. As though she’d already known. Or didn’t care.
“There are about eight different kinds of depression distinguished as of right now. There’s overlap between all of them; some sufferers switch from one to another, some even suffer from multiple at the same time, depending on the diagnosis. Judging from what I know of you…”
Mitsuha did her best to listen attentively. She did want to know. After all, that’s why she’d started therapy in the first place. To figure out what was wrong with her.
A combination of Persistent Depressive Disorder and Atypical Depression. Strangely, having a name put to something didn’t make her feel better.
It kind of made her feel worse.
Ueda ishi had encouraged Mitsuha to list simple things that brought her happiness. Since her bouts of severe depression were relatively infrequent, there was a good chance that regimen changes on those days could help.
All Mitsuha knew was that she wanted to eat something sweet. If anything could improve her mood, it would be something that tasted awesome.
Mitsuha’s first impulse was to go to a café and get something smothered in either syrup, whipped cream, or powdered sugar. Or some combination thereof. But she never went to cafés without Sayaka or Tessie unless it was just to grab a cup of coffee. It was awkward to sit and eat alone. Plus, as expensive a habit as it was for the three of them to frequent cafés, it would be even worse for her to augment that by going alone as well.
So she’d probably go home and snack on some of the reserves she had in her cabinet; though she couldn’t decide if that was more sad than eating alone in a café or not.
Her thoughts were interrupted by her nose catching wind of something that piqued her interest.
A food stand.
Mitsuha caught sight of a man in a loose white shirt boiling some yomagi and putting it on a stick with some red bean paste. Well, it wasn’t as syrupy as her insatiable sweet tooth would have liked, but it did taste good.
And even better: it was right there.
Pills
Another lost day a few days later was what really hit hard.
“This has never happened before?”
Mitsuha shook her head despondently.
Sayaka was looking at her with such pity. Mitsuha hated to bring her down when Sayaka was so happily in engagement, but she didn’t have a session that day and she needed to talk to someone.
Well, she could have stayed in bed until she had to go to class, but it hardly seemed like the wise decision.
“Have you thought about medication?”
“No.”
Sayaka absently twisted her engagement ring around. “It’s really helped me. I don’t even want to think about how I’d be today if I hadn’t started with medication.”
Mitsuha managed a small smile. “I know. We were so happy for you.”
“Tessie and I would both be happy if you could get the same kind of thing.”
Mitsuha brushed her bangs out of the way and pressed her cold hands against her eyes. “I guess it’s just hard to admit you need help from something else.”
“I know,” Sayaka said, putting a hand on Mitsuha’s shoulder. “But it’s just a hump you have to get over before you’re on the other side.”
There was silence for a few moments as Mitsuha curled her fingers so that her eyes were uncovered, but her cheeks still rested on the palms of her hands. Her eyes were pulled down a little bit, and Sayaka staggered a bit at just how sad she looked.
“I’ll think about it.”
“Anti-depressants can take a few weeks before you start to notice a difference. It’s also common to have to try a few different anti-depressants before you find one that works for you. Think of it like dating.”
Mitsuha giggled, being in a moderately better mood than she had been in a few days before. “I’m not sure that’s a good metaphor for me personally, but I’ll take it.”
“Good enough for me,” Ueda ishi said as she wrote down the names of a few medications. “These are the ones I recommend in descending order. I can’t prescribe them to you, though; you’ll have to go to your general practitioner for that. Feel free to call if you have any questions before your next session, though.”
“I will, thank you,” Mitsuha replied as she took a picture of the paper on her phone before folding it and putting it in her bag.
“Since you haven’t been making much use out of your dream journal as of yet,” Ueda ishi began, “I suggest that you use it to keep track of your mood once you start the medication to keep track of any changes.”
“That’s a good idea.”
Ueda ishi bowed her head a little. She then leaned back, crossing one leg over the other and putting her hands on the notepad in her lap. “You are a peculiar subject, Miyamizu.”
Mitsuha blushed a little. “Why do you say that?”
“Well, you say you have had two major depressive episodes in the last week and yet today you seem fine. Almost cheerful.”
“That’s been the mystery,” Mitsuha offered with a shrug.
Mitsuha had been searching for diagnosis. Well, not diagnosis precisely, but answers. And if that was in the form of diagnosis, so be it.
When she’d finally gotten that answer, she’d told Sayaka and Tessie. Tessie, for one, hadn’t known how to react, until Mitsuha had been able to bolster the mood enough to convince him it was a good thing. Sayaka was quicker to jump on board, and shortly the three of them were celebrating with some depression dessert.
The excitement and novelty of a name, however, quickly wore off. Suddenly, every time Mitsuha was feeling unproductive or a twinge sad, she wondered if it was normal or if it was depression. If it was depression, than did that give her a good excuse to feel it, or should she be trying to shake it off?
It felt like a cloud constantly around her. A coat that she’d put on and wasn’t able to take off. And she wondered if she was worse for it.
But she was still functioning. She hadn’t had any grand bouts of depression since the last lost day and Ueda ishi said that was victory enough for the moment.
It was December before Mitsuha was able to record anything of substance. Ueda ishi had suggested the possibility of trying a different drug, but Mitsuha had been hesitant. Perhaps it was the uncertainty in starting anti-depressants hitting her a second time, but she hadn’t had any bad days yet and no real negative side effects, so she was worried that a new drug might be worse than this one.
Then, of course, came a day where she woke up in tears. She had no idea what to expect, and was almost a little nervous to see if her medication would make the day any easier or if it was to be as heavy as all the ones before.
When the day was done, she picked up that lovely blue notebook with its honey-colored moon and honey-colored pages and wrote her thoughts.
I usually report ‘lost days’ as weighed down or out of control…mostly like something’s missing. But today I didn’t really feel any of that? Not even like something was missing. Everything was more of a daze. Really, I just didn’t feel much at all. Not emptiness but just…nothing.
I suppose that’s improvement. It felt more like other days.
Sometimes she would catch sight of a random boy and feel a strange sensation. It had always been weird, because she didn’t even have to see their face or anything. The most cursory glance could send an odd awareness pinging through her body. It had been happening since she was a teenager.
Obviously, she was lonely.
She certainly hadn’t dated anyone back in Itomori. About a year back, Sayaka had laughed at the memory of Tessie’s “very obvious crush on her” but that had left Mitsuha stuck feeling like someone had pinched her coronary arteries off just for fun.
She had never noticed. Never ever, ever. But Sayaka—apparently to this day—made fun of him for it. “It’s funny how things ended up, huh?” Sayaka had said.
“Yeah, haha,” Mitsuha had agreed with choked off laughter.
Mitsuha supposed she could only be happy that it wasn’t a source of strain on their relationship.
As for boys in Tokyo…Well, she’d been too busy just trying to survive senior year when she’d first moved. Then there was surviving medical school, which she was still trying to do. Not to mention taking care of her grandmother and sister, and fostering a new relationship with her dad. Plus, she was too busy falling in love with her dream city of Tokyo—and all the cafés—to fall in love with any boys.
So she’d chosen her own path. But as she sat in her sessions talking about it with Ueda ishi, she realized that it was quite a lonely one.
Realizing that fact only served to make her lonelier.
It had been months since she’d passed a boy that made her body begin speaking for itself. Perhaps even over a year. It was an infrequent occurrence, and Mitsuha wondered if her medication would stave of those reminders of loneliness. She hadn’t been longing for male company hardly at all since she’d started the medication. So perhaps it was working?
All Mitsuha knew was that she was happy Ueda ishi had ruled out Seasonal Affective Disorder. Because when she walked outside, it was snowing.
Her grandmother needed some medicine and it wasn’t too long of a walk to the pharmacist. Yotsuha was busy with homework and her dad had work-work, so Mitsuha had volunteered. She hadn’t even considered the possibility of snow.
So she darted back inside, switched into her rain boots and grabbed an umbrella and went on her merry way.
Snow was almost a novelty in Tokyo. Mitsuha had lost her enchantment with it back in Itomori where it snowed with some frequency. There were hardly any fields to play in there, so it only caused sidewalks to become muddy and dangerous because you couldn’t see where the rocks were. If the snow got really high, you couldn’t even see the steps.
Usually snow in Tokyo made Mitsuha feel an itch of longing for Itomori. If they were lucky, it would snow once or twice in January, maybe February. Never in December. When it came upon them, she would watch as the snow fell, but never ever stuck. It always melted on the windows, at her feet, on her skin. The only place it could survive for a moment was in her hair or on her clothes.
This year, she didn’t much bother with it. She was glad that her rain boots were more than enough and that she didn’t need any extra cling on the concrete overpass. No snow, ice, or even puddles to make it slippery. Besides that, it was nothing more than a little change in the scenery.
Then she felt something.
A feeling that she hardly noticed, and then a harsh ache crashed down on her. All at once she knew that it was more than she had felt in a month and she froze, confused. It was a phantom sensation like she’d done something wrong, like she was guilty of something, but she couldn’t remember what. But the guilt lingered on anyway.
She felt compelled to turn around, but she only saw a boy in a suit walking away.
For a moment, she considered how cold he must have been. The snow had probably taken him by surprise too.
And then she wondered why she was even thinking about him in the first place, and she turned back around.
The tears didn’t come until she was almost at the end of the bridge. She wouldn’t have noticed them had it not been for the cold nearly freezing them on her face. She brushed them away with her scarf, confused, but choosing not to linger on it.
Her grandmother was waiting for her.
Mitsuha didn’t know what it was about fireworks. She’d always scrambled to watch them on TV with her parents and her grandmother. Her mother would be urging her to go to bed even though it was obvious she knew it wasn’t going to happen. Grandmother would doubtlessly tell a story about how much younger of a holiday New Year’s was in comparison to the small town celebrations of Itomori. Her dad would be getting out the champagne.
Then Yotsuha had been born and her parents were busier and more tired. Even Grandmother was getting too old to stay up with her. Then her mother had died and her father had left and holidays were never the same.
But watching the fireworks with Tessie and Sayaka was always something that she looked forward to. And she knew that they did as well.
They continued that tradition in Tokyo, finding a fun festival to join and often partying the night away until the new year began to crack on the horizon. Then it was time to go home and entirely sleep through the year’s first day.
This year, though. This year, as Mitsuha watched the fireworks shooting up into the air and splitting in fiery pieces, she was reminded of a comet cracking into fragments in the night sky. She didn’t know if that caused her to lose enchantment in them or gain it tenfold. Because at the same time that she couldn’t stop staring, she had no idea what it was that she was feeling. She only knew one thing.
It was a beautiful view.
Mitsuha could think of very few things—most involving food—that sounded more fun than the prospect of wedding dress shopping. She and Sayaka had dreamed of going to a fancy salon in Tokyo and trying on designer wedding dresses. Nothing in Itomori could even compare to the things they saw on their phones from Tokyo or—God forbid—Europe or America.
And here they were finally doing it.
Well, the salon wasn’t that fancy. Apparently there was a monetary reason why the dresses in Itomori didn’t compare.
After a lot of flip-flopping, Tessie and Sayaka had decided on somewhat of a fusion between a western and Shinto wedding—but with a western dress!—that would take place in Itomori. It was to take place in June, which meant that there was a little less than six months to get the dress. In other words…
It was crunch time.
“What about this one?”
Sayaka stepped out in a large tulle ball gown and Mitsuha couldn’t help but think that Sayaka looked like a large, heavily frosted cake. Not that that was entirely bad…
“Too much?”
Mitsuha smiled gently, wrinkling her nose and nodding her head. “Maybe try an a-line?”
“Coming up,” Sayaka said.
She was having fun. She really was. But maybe she’d built it up too much in her head since they were little girls. Because as much fun as this was, it just…wasn’t as much fun as she’d thought it would be. Or maybe she’d enjoy it more when it was her own wedding. Right now it was just a vicarious sort of fun and that isn’t as fun as one’s own fun, right?
Mitsuha tried to blink herself out of her thought spiral as she looked around at the frothy, bedazzled creations around her. They were beautiful. And they were gonna find the perfect dress for Sayaka. She was swearing that she was gonna lose three pounds before the wedding, but she didn’t need to.
If anyone needed to, it was Mitsuha. Ueda ishi had informed her that emotional eating was a thing and…well…
Well, it was a good thing the pills were making her less emotional.
“How about this one?”
Sayaka ripped open the curtain to her dressing room dramatically, a goofy smile on her face.
Mitsuha couldn’t help but gasp when she took in the dress. And, more importantly, Sayaka in the dress.
“Sayaka, it’s beautiful.”
“It kind of is, isn’t it?”
The dress had cap sleeves made of lace, which trailed most of the way down the skirt, where it tapered off in little tendrils onto light chiffon, hanging loosely all the way to a short train. And with the perfect pair of heels to make Sayaka less of a midget next to Tessie, it was perfect.
Mitsuha took in the joy on Sayaka’s face and was happy. Happy for her friend.
But a little deeper down, she wondered when she was going to be happy like that.
The time had finally come. Her eight years of school had finally culminated to this moment.
While Tessie and Sayaka had been able to goof off the whole time they’d been in university, Mitsuha had studied rigorously, passed truly difficult classes, failed even harder ones, and suffered a few setbacks in the last eight years all to prepare her for this.
If she passed, she’d be able to be a trainee, well on her way to a medical career.
If she failed…well, she supposed she’d just have to take it again next February.
But right now she wasn’t thinking about that. She was fighting to keep her mind focused. It had been so hard to study the past few months, harder than it usually was. But that was just because the stakes were higher.
Mitsuha twisted the braided chord in her hair around a finger as she waited for the tests to be handed out. She’d pulled her hair back the same way she’d done in high school to keep it out of her way. In recent years, she’d tried to get more creative with how she wore it, but she always liked to have it with her. Her grandmother seemed to talk more and more about the importance of musubi as she aged, and Mitsuha thought that maybe touching the chord brought her closer to something…important.
Somehow, when Mitsuha hadn’t been paying attention, a test had landed on her desk, and everyone else’s. And before she knew it…
“Begin.”
“Well, Miyamizu, I suppose this will be our last meeting.”
Mitsuha looked fondly at Ueda ishi. She was sitting cross-legged, weight heavily against her right hip as her left leg absently kicked at the air.
A few months back, Mitsuha had finally gotten up the nerve to pull legs into her chest, putting her feet on the nice pleather chair. She’d looked nervously at Ueda ishi at the time, but she’d only laughed. Now she did it without thought, as long as she wasn’t wearing a skirt. And it wasn’t warm enough yet for skirts, so her jeans did a fine job of covering her up.
“It is,” Mitsuha agreed, a surprising hint of dolor coloring her tone.
“I’m sorry that I haven’t been able to be of more help to you.”
Mitsuha cocked her head to one side. “What do you mean?”
“Well,” Ueda ishi took her notebook and flipped back through dozens of pages, “do you really feel any better than you did when you first started coming here?”
That question surprised Mitsuha. Her first impulse was to say yes, of course, but she supposed that the question deserved more thought.
The truth was, she wasn’t sure. She’d come looking for answers and she supposed that she had found some. Maybe not the kinds she’d been hoping for, but perhaps those were things that couldn’t be answered. Her medication had somewhat flattened the dips her mood took during the lost days; they more resembled her other days.
“I guess I do in some ways and I don’t in others,” Mitsuha answered, fully aware of her ambiguity. “At the very least, it’s been nice to have someone to work through everything with.”
“I’m glad for that,” Ueda ishi said with a bow of her head. “I hope that these sessions have provided you with some coping techniques and ways to consider the feelings that you go through so that you’re better equipped to handle things on your own.”
“I think they have.”
Ueda ishi began flipping through the notebook again, this time to the end. “I still suggest therapy if you’re going through a particularly challenging time. Since you’ll no longer be seeing me, here are a few names and numbers of people that I can whole-heartedly recommend.”
She scribbled down some info on the last page of the notebook before ripping it out and handing it to Mitsuha, who took it gratefully, straightening a leg and slipping it in her pocket. A part of her hoped that she wouldn’t have to go to therapy again, but at least she felt that if she had to face it again, it would be with more confidence. It wasn’t something to be nervous about. It was something to be grateful for.
“Although, if you would prefer to see me, you can call me anytime. But since you’re not at the school any longer, you’d have to pay!”
Ueda ishi said it with a burst of good humor that made Mitsuha laugh. “Given that I’d have to pay either way, I might take you up on that!”
“Alright. Now, one last piece of advice,” Ueda ishi said, sobering up a little as she set the notebook behind her, on her desk. “Keep track of how your medication is making you feel. If there comes a time that you feel it isn’t doing anything for you, or it’s doing more harm than good, talk to your doctor about your options. Okay?”
“Yes,” Mitsuha answered with a nod.
“Okay. Now that that’s done,” Ueda ishi got up to grab their last teas together, “let’s shoot the shit.”
Mitsuha laughed, a touch surprised, but pleasantly so.
“Sounds excellent.”
It was one of those perfect spring days. The first light pink flowers of spring had bloomed and were already beginning to fall, but now everything else was lush and verdant. It was a pleasantly warm day in April, so Mitsuha felt free to don a pair of capris, not having to worry that a chill would give her a flash of goosebumps—and therefore stubbles on her freshly shaved legs.
It was too bad she couldn’t enjoy it more. She was in a daze. Again.
She’d woken up crying, but the medication did a good job of dulling everything enough for her to get on with her day and go on her interview.
The best part of med school—aside from it being over—was being courted basically from your last or second to last year on by places looking for your employment. The world always needed more doctors. Mitsuha had been spending the last month…well, first waiting for her results, but after that she’d been looking at different places to begin her trainee program.
She knew that small towns in the country were the places most in need of doctors; a place like Itomori could really use her. But…as much as time and loss had made her nostalgic for the scenic town, she knew she’d literally hate herself if she moved back to the country. She loved the city. It had been her dream since she’d first became aware of all she was missing. Which had probably been when she’d been old enough to hold her head up and look at a TV.
No, she would definitely stay in the city. Besides, all her friends and family were here. It was just a matter of which hospital.
Fortunately, the one she was headed to was only a short train ride away and hardly any walking. Capitalizing on that, Mitsuha dared to wear some sensible heels to this interview.
Usually, Mitsuha liked to make good use of her commutes studying, reading, or at least messing around on her phone. But on days like these, even with the medication, it was hard to concentrate, so she could only really stare out the window, eyes unfocused.
Then, suddenly, everything sharpened.
She felt a surge in her body, eyes widening first, then posture shooting upwards. That boy…That boy!
That was as far as her thoughts went as her eyes began to water, just a bit. Then the boy, perhaps feeling the eyes of another on them, glanced her way before abruptly gasping. The world seemed to freeze for a second.
And then it started again.
Her train entered a tunnel and it took a few moments for her brain to catch up with her. She needed to get off the train.
She needed to get off the train!
She was in the middle of her car currently—the stop for the hospital was still a ways away—but she began pushing her way through to the door. She knew the next stop was only shortly after the tunnel and she needed to get off if she had any chance of finding him.
And damn it if she wasn’t going to find him.
She’d grown to know the city very well in the past eight years. Probably from all the exploring she, Tessie, and Sayaka had done searching for cafés. She remembered very little of that first time going to Tokyo, but she did remember how scared she’d been of navigating the public transport system. The most motorized thing she’d done by herself in Itomori was ride a bike.
Nevertheless, she couldn’t be sure what train he’d been on, what stop it was headed to, or even in exactly what direction it’d been going.
But direction was her best guess, so as soon as she got out of the terminal, she dashed off in the opposite direction of her own train.
It was all she could do to keep track of where she was going. Even the most innate city-dweller would be hard-pressed to identify their whereabouts as they blurred past you. She turned her head at every cross street to make sure that she hadn’t somehow turned herself around. And to check to see if he was there.
He never was, though.
She reached a staircase and was fully prepared to fly down it when she saw him dart around a corner. Calmly, he began to walk up the other staircase.
And then everything caught up with her.
She was getting blisters on her feet. The heels had not been a smart choice; they were now covered in dirty water, left over from the recent rain. She’d managed to splash water up her legs and even onto the cuffs of her capris. Even though it was a mild day out, the unexpected sprint had caused her to sweat nearly through her cardigan.
And she was supposed to be on her way to an interview miles away.
Furthermore, she didn’t know who this boy was, he didn’t know who she was, and yet here she’d been, prepared to make a fool of herself.
Closing her mouth, as she tried to hide the fact that she was heaving for breath, she began to descend the staircase, hoping that he’d let her pass and she could put this strange incident behind her before her interview.
And yet…hoping that maybe he wouldn’t.
Without her permission, that hope built as she walked down the stairs, and as he walked up them the other way. He didn’t seem to be breathing hard; maybe this stairwell was just close to his stop and he was on his way to work. That would be embarrassing.
Her hope built to an apex as less than a foot separated them.
And then he walked right past. And so did she. And she completely deflated.
And felt awful.
She hadn’t felt that bad since before she’d started on her medication. Usually it seemed to buffer her bad days but right now she felt stupid and mad at herself, but mostly sad. Terribly, terribly sad.
Then:
“Hey!”
She froze. She’d been so far in her thoughts that she hadn’t even seen the stairs in front of her. She wasn’t even sure that her brain had been controlling her legs going down them. But with that one word, it was like he’d reached into her mind and pulled her out of that quagmire.
“Haven’t we met?”
The hope swelled again. She turned around and his voice, his face, the hope made her tears come in buckets.
But they were different. Usually the tears that rolled down her face on those mornings came with an emotion that she couldn’t place, that was fading away from her. But now it was a different one, and it was bursting. In fact, it was all she could do to keep from laughing at the absurd mood-swing that her stomach was flip-flopping to.
“I thought so too!”
When he started crying too, everything made sense. Well, no, it still made no sense, probably even less sense that it did before. No, she felt validated. Like she wasn’t crazy for feeling the way she’d felt before. Like she wasn’t crazy for feeling the way she felt now. And like maybe those unanswerable questions just hadn’t been answered yet.
“Your name is?”
“Taki.”
“Mitsuha.”
They spoke at the same time, but nevertheless heard each other. “Mitsuha,” Taki said reverently as he slowly walked back down the stairs. “Mitsuha.”
“Taki-kun,” Mitsuha whispered, the honorific rolling off her tongue accidentally. She blushed, embarrassed that perhaps it was inappropriate, but he just smiled at her.
“I like it,” he said, seeming to read her thoughts. “Would you, um…”
Up until that moment, he had seemed perfectly confident. He had dared to turn around while she was about to keep walking away. But now she saw a hint of a blush arise on his tan skin as he scratched at his cheek awkwardly. “Would you what?” she asked, letting just a microtone of teasing into her voice.
He moved his hand to straighten his tie as he now avoided eye contact with her. “I was going to ask if you would like to maybe go somewhere, but I now realize that you’re probably already on your way somewhere, right?”
She’d totally forgotten about her interview. Again. There was still a possibility that she could make it on time but…suddenly she didn’t care. She’d already interviewed at a number of places. She still had a few more interviews set up. What would it hurt her to skip out on one?”
“Actually, I’m not but, ah…” A wave of embarrassment swooped up Mitsuha’s spine as she remembered her current state of disarray. Her stained pants and shoes, her sweaty shirt; truly today had not been the day to wear pastels. It was a miracle her hair hadn’t fallen out of its do. “I’d hate to have to accompany you looking like this.”
“You look beautiful.” He said it without skipping a beat.
Mitsuha’s brows raised in surprise. She thought she could see Taki’s own eyes widen at the admission as well, as though he hadn’t meant for it to come out.
“Er, uh, where would you like to go?”
Mitsuha smiled, a twinkle returning to her eye. “I actually know a café near here…”
Mitsuha looked at the bottle. She looked at the piece of paper to the left of it and the one to the right of it. Then she looked at the trashcan.
The paper to the left had a message that Yotsuha had written from the pharmacist, saying that she was due to pick up a fresh prescription. The paper on the right had the names and numbers of the psychiatrists Ueda ishi had recommended to her at their last session. The bottle was empty.
And she was considering leaving it that way.
It had only been about a month, but Mitsuha was feeling different. She was feeling happier. But she was noticing other things too.
She was foggy. It had been harder for her to focus on school and studying and she knew that her emotions weren’t all there. Not even the good ones. She’d hardly been a good maid of honor to Sayaka over the last few months and she hadn’t been able to bring forth much enthusiasm towards her friends for what was certainly the most exciting time in their lives. And she was only just now realizing this.
Because with Taki, that cloud seemed to fade away, and she remembered what she used to be like.
Sure, the lows had been lessened, but so had her highs. And she wasn’t sure that that was any good for her.
She’d always been able to manage her lost days. She’d told Ueda ishi that at her first session. They weren’t fun, but they were manageable, because she knew that she’d come out the other side the next day. And she was in a different place now than she’d been a year ago. She was a university graduate—and it was a long time coming!—having started her trainee program. She had a boyfriend and her best friends were getting married in a month.
Mitsuha wanted to experience those things fully. The good and the bad.
The bottle went in the trashcan.
Cakes
Okay, watching Sayaka search for the perfect wedding dress had been fun. Observing the bickering between Sayaka and Tessie—and all over a bit of facial scruff—was continuing to be fun.
But cake tasting was definitely the most fun.
“Hi, Mitsuha! So glad you could make it!”
“Oh, believe me; I wouldn’t miss this for the world.”
Mitsuha had already heard the discussions—to put it lightly—between Sayaka and Tessie about the cake. Tessie thought they could save some money by doing it themselves or having someone in the family do it, but Sayaka had dragged him to a cake tasting anyway.
And that had quieted him right away.
But not for long.
“Neither would Sayaka,” Tessie said cheekily. “The only reason we’re having a second tasting is because she wanted more cake, not because she couldn’t decide.
“Untrue!”
“Okay,” Tessie agreed, although not without throwing Mitsuha a meaningful glance.
“Hmph.” Sayaka sat back, pouting and glaring at Tessie before turning it to Mitsuha. And then the expression morphed into one of sharp curiosity. “You look good.”
“What?” Mitsuha asked, taken aback by the abrupt shift. She fingered her hair and blushed a little at Sayaka’s increasingly discriminating eyes. A cake tasting was hardly something to get dolled up for. She was wearing a flared out skirt with a blousy top tucked into it and her hair was haphazardly tucked into its standard half-up half-down.
“You look really good,” Sayaka stated again. “What’s different?”
Then Tessie started to get in on the action. “You know, she’s right. Your eyes look…clearer. Somehow.”
“Oh. Well, I did go off my meds…”
“What?”
“Good for you!”
“Tessie!”
Sayaka was, once again, giving Tessie a sidelong glare. He threw her an exasperated look as he said, “Hey! If this is the way that she reacts to being off of them, then good for her! Not because meds are bad, but because, well, look how much better she looks now!”
“No, yes, that’s great.” Sayaka was sputtering, obviously struggling to get all her thoughts out coherently. “But you’re not going to therapy anymore. Did you talk to your doctor?”
“Um…” Mitsuha couldn’t help but look somewhat guilty. Like she’d been caught with her hands on her breasts in public. “No…”
“Mitsuha,” Sayaka chided. “It can be kind of dangerous to go off anti-depressants like that.”
Mitsuha sighed, feeling like she was talking to her father. Or rather, being talked at by her father. “I know you’re right. I’ll call Ueda ishi later. As soon as we’re done here.”
“Good.” Sayaka looked satisfied before abruptly reverting to looking sharply at Mitsuha’s face. “Seriously, you look great. Can that really just be from going off your meds?”
“W-Well, I have been feeling clearer lately…”
“Yeah, but it’s more than that…” Sayaka went in closely with no regard for personal space. Tessie, meanwhile, palmed his forehead, totally missing Mitsuha’s anxious eyes begging for help.
“What?” Mitsuha finally blurted, drawing away from Sayaka’s prying eyes.
Sayaka sat back, satisfied. “You’ve met a boy, haven’t you?”
“What?” Mitsuha and Tessie said in surprise. However, Mitsuha’s surprise was instantly taken over by embarrassment, untucking some hair from behind her ear so she could subtly hide her face.
Sayaka threw Tessie a look of gratification. “She’s met a boy.”
Tessie looked at Mitsuha with wide eyes, though she couldn’t tell if it was due to intrigue or concern. “Is that true? Or is Sayaka being crazy again?”
“Cr—Again‽ Tessie!”
Tessie put a hand out and Sayaka relented, simply because she was waiting for Mitsuha’s answer too. She could let Tessie have it later.
“Yes.”
The admission was meek, and Mitsuha instantly covered her face with her hands, trying to deflect her friends’ prying eyes. Their words, however, pierced right through.
“Who?”
“When?”
“Where?”
“Why didn’t you tell us?”
“Yeah, why didn’t you tell us‽”
“Oh my gosh, you should bring him to the wedding!”
“What?”
“Stop!”
Mitsuha put her hands out towards both of her friends, reaching for their mouths to hush them up indefinitely. But they pulled out of her reach, nevertheless silent, so Mitsuha saw it as mission accomplished.
“How about I tell you all while we eat some delicious cake?”
Tessie and Sayaka looked at each other, trying to figure out if it was just a clever diversion—as cake would be the one thing to unify all of them—or if she actually planned to tell them.
“She will be happier if we’re eating,” Tessie whispered behind his hand.
“I will be too. Okay!” Sayaka agreed, the last word being directed towards Mitsuha. “You guys can try all of those other ones, because I’ve already decided on the French vanilla!”
Tessie groaned, dragging his hand down the scruff on his face. “That’s what I said ten minutes ago!”
“I know,” Sayaka said cheekily, sticking a forkful of cake in her mouth. “But no more bellyaching about it. It’s storytime.”
Whipped Cream
When Mitsuha had shared her love of cafés with Taki, he had been more than happy to indulge her. In fact, it turned out that he had a favorite of his own. When he led her to it, she recognized right away.
Which meant that she knew precisely how expensive it was.
The place was very rustic with strange wicker chairs that could have passed for patio furniture. But the exposed beams shone with light bursting from the bay windows. The place had character. And it certainly didn’t look like a place worthy of a costly price tag, but its menu options were unbelievable.
“I know this place is suffering from a bit of schizophrenia on what it’s trying to be, but I promise, it has the—”
“The best food! I know! This is my favorite café, Taki-kun!”
Mitsuha couldn’t hold back her excitement, even after all these years.
“Mine as well,” Taki said, almost matching her excitement. “My friends and I used to go here all the time in high school.”
“You’re so lucky.”
They found a seat and ordered. Mitsuha wanted to show some restraint, but—oh, who was she kidding?—she just couldn’t. So she got caramel apple pancakes with whipped cream. And a latte…with whipped cream.
Not too long into the lunch, her phone began to ring, buzzing its way all over the wooden table. Embarrassed, Mitsuha flipped the phone over without looking at the screen, the rubberized case helping to absorb some of the vibrations.
“You can answer that, you know,” Taki said.
“No, I wouldn’t want to be rude,” Mitsuha said, already embarrassed that Taki had gotten a salad and she was sitting across from him with her mountains of whipped fat. And sugar.
The phone buzzed again and for a moment, Mitsuha thought that it was going to start ringing again, but she quickly realized that whoever had called had left a message.
“You should listen to it,” Taki insisted. “It could be important.”
Figuring that it would be better to get it over with so they could move on, Mitsuha flipped her phone back forward and unlocked the screen, bringing up her message box. It was a voicemail from Ueda ishi. She hadn’t picked up when Mitsuha had called a few days earlier, so she must have only just gotten around to returning the message.
Mitsuha held the phone up to her ear and listened to the whole message before locking the phone again and putting it in her lap.
“Is everything okay?”
Blinking out it, Mitsuha looked back at Taki. He was looking at her with interest and concern. “It’s nothing.”
She regretted the words as soon as they came out. It felt unnatural to lie to him.
But it wasn’t really a lie. The message was nothing of his concern. It was the same response she would have given had her dad asked. Probably even if Yotsuha had asked.
Eh, definitely if Yotsuha had asked.
He was still looking at her, but the earnest expression was fading as he turned his attention back to his food, forking some leaves and sticking them in his mouth. “Okay,” he said after a moment.
Guilt-free. He wasn’t asking her for more; he seemed to trust that it was none of his business.
And that was good enough for her.
Except it wasn’t.
They made it through the meal, still enjoying each others’ company. Mitsuha managed to eat all of her pancakes and finish her drink, feeling quite satisfied, if slightly embarrassed. Taki asked if she’d like to go on a walk, and her heavy stomach very heartily agreed.
During their last few dates, Mitsuha had marveled at how comfortable their silence was. She’d never appreciated silence much, always seeing it as a bad sign when she was hanging out with people at school. It meant that you didn’t have enough in common or you weren’t interesting or, worst of all, no one wanted to talk to you. That’s why it was always such a comfort that she, Tessie, and Sayaka had always been able to chat about anything. And with the two of them now as verbal as they were with each other, Mitsuha didn’t even have to participate for a conversation to keep going for hours. Even that was comforting.
But just walking through Tokyo with Taki in silence—even though the warmth of spring didn’t take too long to become quite sweaty after a few minutes walking—was pleasant.
Not today, though.
It was eating at her. She knew that the feeling was coming from her response to his inquiry about the message, but that just seemed so trivial to be causing her so much discomfort. Still, it was only a matter of time before it became too much.
“It was my therapist,” Mitsuha blurted out before she realized what she was doing.
They’d been walking side by side, but Mitsuha had stopped, and was only barely resisting covering her face in shame. Taki was a pace or two in front of her and turned around, obviously confused.
“Huh?”
“That call. It was from my old therapist.”
“Oh,” Taki said simply, though not trivially. Mitsuha expected more, maybe some questions or something, but he didn’t seem like he was about to press. Nevertheless, she felt the need to spill her guts.
“I was on antidepressants. I quit taking them just a couple of weeks ago,” she admitted, her voice more muted that it had been at first admission. It wasn’t exactly the kind of thing she needed all the passersby to hear. She leaned against a railing, the black paint too warm against her bare legs. Taki followed suit. “My friend told me that I shouldn’t do that without professional guidance, so I gave her a call a few days ago. She just got back to me.”
“What did she say?”
“She said to go back to therapy if things go back downhill, but if they don’t, then it’s probable I made the right decision. I just have to be careful, I guess.”
They were silent for a minute and Mitsuha just focused on the warmth of the black bar against her thighs. The day was at the threshold temperature for her to be able to do this; any warmer and the heat would have been blistering. Still, she imagined that it must have been far more comfortable against Taki’s pant leg than on skin.
“So…antidepressants?”
“Yeah.”
He’d probably figured that she would continue her explanation. Honestly, she hadn’t expected that he would want to know anymore. They’d only been going out a month; was that really enough time spent together for him to be interested in her emotional baggage?
He turned to her, eyebrows raised in curiosity, but a tender look in his light eyes. “How long?”
Well, apparently yes, it was.
“Um,” Mitsuha had to think back, “only a few months. No, actually about six.”
Wow, she hadn’t realized it had been that long. Everything had just kind of blurred by…
“Okay…” Mitsuha noticed Taki shifting awkwardly out of the corner of her eye. He looked vaguely uncomfortable. Though it might have just been the heat; a bead of sweat was forming at his sideburn. “Um, you don’t have to tell me anything about what you’ve gone through if it’s, uh, too personal, but.”
“You want to know?”
“Uh…” Taki looked at her shyly, brushing back his hair from his forehead, trying to take some sweat with him. “Really, I feel like I can’t know you too well. Like I can’t know you closely enough.”
Mitsuha blushed, shifting her body a little bit away from him so he wouldn’t see. “Well, how do I say no to that?” She gestured forward with her head as she stood up. “Let’s keep walking.”
It was hard to summarize something that still felt so ambiguous. How long had she been depressed? Well…who knew? Eight years? Just the past seven months or so? Something in between? Was she actually depressed when she started therapy? Possibly…
So, she decided to show him.
Yotsuha had choir rehearsal on weekends, she knew, and her grandmother had gotten involved in some gardening club in the city. Since there were so few gardens, apparently it was necessary to get involved in a club if it was something you wanted to do.
So, Mitsuha was free to bring him into her house and it was only when she had led him all the way to the door to her room that she realized that maybe that wasn’t quite what she wanted to do. She stopped so abruptly that Taki nearly ran into her before awkwardly taking a few steps back. She turned to face him with a blush on her face.
“Maybe you should stay here. I’ll be right back.”
Taki seemed to be holding back a laugh. “I’ll be waiting.”
Mitsuha returned only a few moments later, creeping out a crack in her door before closing it all the way behind her. She might be baring some of her soul to Taki, but that didn’t mean she was ready for him to see her room yet.
“This is my journal,” Mitsuha said, presenting her navy blue notebook to him. “Or, rather, more of a log of sorts.”
Taki took it, holding it lightly on his fingertips, as though he wasn’t sure if he should be holding it or not. “Do you want me to read it?”
Did she? She reached back, pulling at the fringe of her braided chord. “Um, maybe we should read it together.”
She showed him a few key entries.
“That’s the worst of it,” she explained when they were done. “I’m not really sure how to explain the rest of it. But the pills did make the worst of it better. It just…made the best of it worse too.”
“I understand why you went off of them then,” Taki said, gently handing the diary back to its owner.
Mitsuha ran her hand over the indentations of the cover. The texture of the moon, the foil of the stars, the almost rubbery, soft feel of the black-blue sky. “I’ve been feeling better since being off them,” she said finally. “Honestly, I’ve been feeling better ever since I met you.”
The silence that followed made Mitsuha wonder if her admission had maybe been too much on top of the psychological revelations that had just occurred. But then Taki said something that instantly cleared any doubts.
“The same for me.”
Mitsuha’s eyes shot to his face, looking at him for the first time in a while. He was still looking down, a hint of sadness in his eyes, but the smile on his lips still seemed genuine. “You?”
Taki nodded, then shifted his gaze to the ceiling letting out a ripple of carefree laughter. “I’ve had days like that too. Waking up crying for no reason. It’s been happening to me for the past five years or so. I’m not sure I’d call it depression, but it’s been really hard.” He finally looked at her. “It’s felt like I’ve lost something.”
“And that you’ve been searching for it,” she whispered.
Taki cocked his head a little. “Or them.”
For the first time in a while, Mitsuha felt tears stinging the backs of her eyes and tried anxiously to blink them away, to no avail.
Taki laughed, putting a thumb up to her waterline to wipe them away. “Maybe that’s why you and I cried when we first met.”
Mitsuha grabbed his hand, caressing the palm with her thumb. “Maybe.”
They were content to sit like that for a little while. Mitsuha knew that she couldn’t expect her family to stay out of the house forever, though, and that she needed to be ending this date before her traditional grandmother came home.
“One more thing,” she murmured. Taki looked at her with warm eyes. “Are you doing anything a week from Saturday?”
Wedding Cake
“You’re from Itomori?”
“Mhmm.”
“The town that disappeared?”
Mitsuha was walking around the remains of her hometown, observing the destruction and chaos as well as the peace that had since taken over. New plants were growing at the edge of the crater and the larger lake glittered in the morning sunlight. Not a soul was around for miles.
Save for the two of them.
“That was my old school,” Mitsuha gestured towards probably the largest remaining building. It was sagging and decrepit, so ‘remaining’ was an iffy word, but it certainly was one of the largest pieces of evidence that man had ever been there. “Over there is where my house was and we used to have festivals down there.”
She continued to point out invisible memories with ease, but Taki lagged behind. When he’d asked Mitsuha where the wedding was taking place, she’d just said that it was their old town, out of the way from Tokyo. Obviously, she’d figured he wouldn’t know it by name, so why bother attaching one to it?
Apparently, she hadn’t noticed that everyone had heard of Itomori.
He’d staggered when he and Mitsuha had come to ‘town’ that morning in order to set up all of Sayaka’s requirements for the ceremony. They’d finished setting up, and Mitsuha had offered to show him around her hometown.
“It used to be quite beautiful,” Mitsuha said reverently, leaning against a tree, carefully, so as not to ruin her furisode. She’d already had to tie back the sleeves in order to be of any use in setting things up.
“It still is,” Taki said, finally joining her. “In a way that Tokyo never will be.”
Mitsuha scoffed. “Tokyo is still so much better.”
Taki drew back in surprise. “What?”
Throwing him a sassy smile, Mitsuha said, “I always hated it here. I couldn’t wait to move to Tokyo. The comet just made it come a little faster.”
“You don’t care that your whole town was destroyed?”
That brought a somberness to Mitsuha’s eyes. “Of course I care. But it feels dishonest to claim to miss something that you didn’t like back when it was around.”
“I suppose that’s fair.” Taki began kicking at some of the rocks, digging down to the dirt and uprooting small shoots. Having so much nature around was almost a kind of culture shock after living in Tokyo your whole life.
“Still,” Mitsuha sighed, looking out at the lake, “it’s nice to be back.”
Silence in Itomori was different than silence in Tokyo. In Tokyo, it consisted of the sounds of traffic and trains passing by. Maybe an alarm going off somewhere in the distance or a dog barking, and lots of muffled conversations from people at every angle.
But here…well, it still wasn’t silent, but it was quieter. All around were the sounds of bugs or leaves brushing up against each other when the wind hit. Taki bet that down by the lake there was the peaceful sound of water lapping as well. He could probably record all that and sell it as a sleep track online.
“You know, I’ve been here once.”
It was Mitsuha’s turn to look shocked. “What‽”
Taki chuckled, knowing that would be her reaction. For some reason, whenever a new thought occurred to him, he felt the need to share it with her. Like withholding any information from her was as unnatural as missing a whole night of sleep or having an arm spontaneously grow out of your back.
When Mitsuha had worked through all of her typical reactionary phases: surprise, skepticism, disbelief, and annoyance, Taki spoke again. “About five years ago.”
“Really?” Back to skepticism.
“Yes. Me and two of my friends.”
“Why?”
Mitsuha’s interest had pulled her off of her tree and she was looking at Taki with so much confusion that he couldn’t help but smile at how cute she looked. He shrugged. “I don’t remember. They left without me and I woke up on some mountain.” He looked around, trying to figure out which direction the mountain was, but the whole area was so hilly that he couldn’t even tell where they’d entered the town from.
Mitsuha laughed a bit. “That’s a strange story, Taki-kun.”
He scratched his head, “Heh, yeah, I guess it’s not much of a story after all.”
“It’s nice, though.”
Taki looked at her doubtfully. “Is it?”
Mitsuha smiled that wide smile off hers. She had such thin, pert lips, but they seemed to split across her face when she smiled fully. “It’s nice that our histories braid back that far.” She touched her chord, still in her hair, but now just an accessory to a fancy updo. “Musubi.”
“I’ve never thought about it much,” Taki mused, “but it seems that I should remember more from my trip here. I mean, we couldn’t have come here without a reason. It’s so out of the way. And try though I might, I can’t fathom what I could have been doing on that mountain.”
Mitsuha reached over and brushed his bangs out of his eyes. “I guess we both have some lost memories of our time here.”
“I guess so.” He smiled. “We have a lot in common.”
“And here I’d thought I’d never have anything in common with a handsome Tokyo boy,” Mitsuha said through that smile of hers.
“Handsome?” Taki asked, all kinds of teasing floating around in his voice.
Mitsuha shoved him away, continuing their walk through the nature and the debris. “Oh, please. With those eyes, you know you’re handsome.”
Taki pulled out his phone and looked at it. There might not have been any service or wifi for miles, but the clock still worked.
“Everyone else should be arriving soon,” he said, grabbing Mitsuha’s hand. “We should head back.”
He began walking back the way they’d come when he felt a tug on his arm. Mitsuha was looking at him with an eyebrow raised.
“What?”
“Do you know where you’re going?”
At that, Taki blushed and looked down. “No.”
“That’s what I thought,” Mitsuha said smugly, pulling ahead of him, keeping a tight grasp on his hand all the while.
The ceremony was, honestly, harshly bipolar in Mitsuha’s opinion.
Sayaka was in her beautiful, western lace and chiffon wedding dress and the boys were in tuxes while Mitsuha was in a furisode and her grandmother was in a kimono. Sayaka and Tessie were exchanging sake—thankfully, not the same kind that Mitsuha had experienced in her youth—but the ceremony was more like a western chapel wedding than a Shinto-style.
But it didn’t matter. All that mattered was that she was right beside her best friend as she was marrying her other best friend. And that she was privy to a rare moment of them looking adoringly at each other, not a word of bickering on their lips.
After the ceremony was over, it was time for festivities. It was strange up on the flat in front of the school instead of down where the square had been, but it was the only large area of land around that hadn’t become overridden with plants and felled rocks.
But Mitsuha didn’t muse on that for too long. Because it was time for cake.
At their second cake testing, Sayaka had been true to her word and not let anyone else get so much of a nibble out of the French vanilla cake. And the other flavors had been to die for, so Mitsuha was practically drooling as she waited for it to come to her.
And then the moment of truth came.
Sayaka, having already gotten her piece, sidled up next to Mitsuha saying, “Oh my God, it’s even better then I remember it. This is what the dieting was for; not the dress, but so I can eat as much of this cake as I want and not be fat for my honeymoon.”
Mitsuha laughed. “You’re really building this cake up, Sayaka. I hope it delivers!”
An eyebrow arched, Sayaka said, “Oh, please; knowing you, you’ll like it even more than me!”
Anxiously, Mitsuha forked a sliver of the large wedge of cake that she’d gotten and lifted it to her mouth. And then she moaned. “Ugh, so good.”
Sayaka smiled, smug and satisfied.
Mitsuha liked things sweeter, more decadent than any of the rest of her friends. So, usually she had a different taste in desserts, even from Sayaka, but this cake. Yes, the taste was a soft, subtle vanilla, but the texture was so light it made you feel like you could eat it for days. But then the frosting was thick and sweet, so a little bit of it went a long way. When the wedge of cake somehow disappeared before it’s time, Mitsuha used her finger to wipe every bit of that white frosting off of the plate so none of it went to waste.
And then it was time for a second piece. A benefit to a small wedding: you’re able to go up for seconds. And thirds.
Meanwhile: behind them…
“I think they’ve forgotten all about us,” Taki said, having quickly made friends with Tessie, seeing as how they were the only boys there of even remotely the same age.
Tessie was stroking his chin. “And here I thought that she would be most excited over the fact that I finally shaved.”
“No contest for a bit of cake, I guess…”
Suddenly, Tessie stiffened. “You know, there’s a good possibility that this is the only reason she married me.”
“To have wedding cake?” Taki laughed. “That’s not true, man.”
Tessie looked at Taki darkly. “We only just met. You don’t know.”
“Well, I guess we’ll just have to see what happens when Mitsuha and I get married.”
That earned Taki a strong look from Tessie. Taki didn’t know him well enough to discern what the expression meant, though. “What are you talking about?”
Taki pulled a small box out of his pocket. He didn’t even need to open it for Tessie to know precisely what he was talking about.
“I’m doing it tonight.” Taki put the box back before the girls noticed—not that they were bound to while there was still some cake left.
“That’s kind of crazy,” Tessie said. “It’s only been a couple months.”
“I know,” Taki agreed. He looked around, admiring the increasingly familiar scenery. “But seems this is the right place for our story to really start.”
FIN
DISCLAIMER: I want to address some things that I couldn't make explicit within the story, because the characters didn't explicitly know. This is not a cautionary tale against medication. Medication is absolutely the right choice for some people, as we see in Sayaka. But it wasn't great for Mitsuha, because her condition wasn't actually depression; she didn't have the chemical imbalance in her brain that the pills were trying to correct, so the pills didn't help they way they should. They made things foggy for her—a common side-effect of anti-depressants—and lowered her sex drive. But, to complicate things, Mitsuha did develop a kind of depression or depression-like state, especially once taking the pills. We see this in a loss of satisfaction primarily, and inhibited emotional state. Even before the pills, being diagnosed with depression was confusing for Mitsuha, because she took it on as a label and then began to perceive everything she did and felt as relating to depression. This is not a caution against being diagnosed—diagnosis is good. False diagnosis is not good. And Mitsuha does suffer from somewhat of a misdiagnosis, to no fault of the fictional character of Dr. Ueda. (Therapy is also a good thing! It helps and hurts Mitsuha in this story, but really, therapy is good!) It is the fault of science fiction, which she was not trained to deal with, haha. Lastly, having a boyfriend is nice, but being in a relationship does not solve all problems and it certainly doesn't solve mental illness. To reiterate, the fact that Mitsuha's 'depression' vanished when Taki entered her life is the science fiction. Also, please don't self-medicate.
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