Confidante

When I was younger I was dismissive of people who saw therapists. “What’s the use in that?” I used to think to myself. I didn’t get it at all; it made no sense.

But now I think I’d like to have somebody I could talk to about anything that was on my mind without worrying about being judged or that it might affect a relationship with a friend.

I need a confidante. Somebody to listen while I pour out a stream of thoughts from my turbulent mind. I’m not looking for answers or advice so much. But somebody who could prompt and guide the process would help.

I’m not seeking offers here; I don’t want to have to worry about how much I open up, about confidentiality. I need the reassurance of a relationship that is entirely professional and governed by professional standards.

I guess I’m in the market for a therapist. The younger me would be aghast.

The bottom line is that I need to open up about certain things. Keeping it all in is becoming harmful. It’s making me more vulnerable to depression.

There are some things from my past, some from my present. Things I’ve locked away, things I try to avoid. Things that worry me and others that absolutely terrify me. They’re not going to go away, but just maybe I can learn to live with them.

The Ennui of Pointless Exchanges

So much time alone
Discourse a forgotten art
Even with myself.

Social relations
A memory on a wall
Posted on Facebook.

I think about Death
And the high cost of living
Balancing my books.

Monotonous trap
Even pain is no relief
Routine no solace.

Chocolate fixes
Addict’s way of marking time
Needle track stretch marks.

Life is but a joke
Reasons to get excited
Like thieves in the night.

Slowly fade away
Melt into billowing swirls
Of media dreams.

My Broken Mind

I suffer from depression. From time to time my mood drops and I find it almost impossible to motivate myself to do anything. These spells can last anything from a few hours to several months.

I’ve taken medication for it in the past. It doesn’t cure it, it just alters my brain chemistry to even out the peaks and troughs in my emotional state.

You see, a mental illness like depression is rather like a physical illness such as arthritis. Medication can alleviate symptoms, and it can flare up or go into remission for a while. Things you do and your environment can affect it.

But there’s one important difference between a physical illness and a mental one: too many people see mental illness as something unwholesome, a taint on the person affected. This stigma causes prejudice and abuse.

It’s used as an excuse for firing people from their jobs, for isolating them socially. All these things inflict further harm.

Then there’s the ableist responses, common to any invisible disability (yes, a mental illness is a disability: it affects your ability to function in a variety of different ways). I’ve been told to “get over it”, to “make an effort”, to be thankful “there’s nothing really wrong wth me”.

In a way there is nothing “wrong” with me. There’s nothing shameful in suffering from a mental illness: it’s not a judgement on my character. I just have depression. My mind is not completely healthy.

It’s long past time that mental illness was seen in the same terms as physical illness: as something requiring support, not judgement.

So instead of avoiding someone who is mentally ill, instead of fearing, abusing and harming them, be a friend to them. Support them and help them with some of the day-to-day things that they’re not able to cope with. Let them know they’re not on their own.

Mental illness can be isolating. It’s hard to ask for help, to approach people, and when we do the last thing we need is to be ignored or turned away. So don’t. Be there. Be a friend. Support those with mental illness.

Thank you.

We Care A Lot

Being a carer is hard work at times. Don’t get me wrong: I’m not complaining. I do it through choice. But lately caring for Anne has become a whole lot harder. Her illnesses have gotten worse and she has become very depressed, frequently experiencing suicidal thoughts.

I can’t switch off from it. I’m receptive to her state of mind, and — believe me — when you’re prone to depression yourself it’s extremely stressful to feel the echoes of somebody else’s. It negatively affects my own emotional state and after a while, day after day, it builds up to the point at which I have to do my best to shut off. To lock myself away and wait for the overwhelming feelings to recede.

It is exhausting. I have found myself needing to take a break more and more often. And that is a cause of stress in itself because I feel guilty for failing to be there constantly. She relies on me, she needs my help, and I’m not always able to respond.

I’m aware that I’m not looking after myself as well as I would normally. I’m mostly subsisting on take-out food and candy. Things like washing are falling to a bare minimum. I’m becoming snappy far too often, my motivation is poor and I’m feeling low. Oh, and aspects of my gender dysphoria are increasingly intruding on my thoughts.

There is a feeling that I’m losing control, adrift and at the mercy of life’s currents. I know from past experience that this is a dangerous situation for me because it is a powerful trigger for self harm: cutting in my case. The thoughts and impulses are there, even as I write this. I sat for about an hour over the weekend holding a blade, just thinking about using it.

I haven’t yet because I do consider it something of a last resort. I’m just concerned that the time when I yield to my impulses is getting closer by the day: the time when I will regain the illusion of control over my life, at least for a while. The temptation is strong but so far my fear of falling into the cycle of dependency has stayed my hand.

The Opposite of Hugs

I love hugs. That comforting feeling of envelopment engendering an ambiance of safety in the folds of a loving embrace. Sometimes my need is so great and the release so totally involving that I am reduced to tears.

It is said that a thing is known by its opposite, and that is true of hugs for me. Because there are times when I yearn, when I physically ache for those few moments of relief. To be held tightly and be able to let go of all my immediate fears and worries.

My need manifests as a feeling of absolute emptiness. My heart is a void that cries out to be filled with that demonstration of love, of physical closeness. Such a desolation of spirit. I am exposed, flayed, eviscerated. Left as an empty husk of a person.

My world is without light; all I see is shadows of what surrounds me. Until I am released by the touch of another, bringing a golden light into my darkness, restoring my pain-wracked body, showing me that there is hope. Giving me another day to live.

My Experience of Gender Transition

It’s over seven months now since I transitioned to living full-time as a woman and I think it’s a good time to review what has happened in that time and what I’ve learned.

My Work Transition

At work

Hard at work (soundtrack by Green Day)

The time has certainly flown. It doesn’t seem so long since I first turned up at work as Alex. Perhaps preparation was the key — I discussed it with HR beforehand — but it went without a hitch. I visited a local solicitor on a Friday evening to have my Statutory Declaration — my legal change of name — witnessed. I had printed several copies of my own document based on a template on the Citizens’ Advice Bureau web site. The solicitor checked the wording and I had four of them witnessed at £5 each. Quite a bargain! and I ended up with four original documents from which I made a number of photocopies. (Some organisations require an original when changing one’s name; most do not.)

The following Monday morning I arrived at work as a woman for the first time and sent a company-wide email in which I simply stated that I am a trans woman and I had changed my name. I included a brief description and links to information on the web as well as two of my own blog posts.

The reactions ranged from total indifference to active support, and sitting here months later I can say that I have not had a single negative experience at work. Understandably, since I had been in the job for seven years as a male, some people have slipped up occasionally with pronouns but they correct themselves and I just let it go as an honest mistake.

Changing my name on my employment records was straightforward with a copy of the declaration for my personnel file, and I had already contacted the Inland Revenue and my bank to inform them so that all my details would be in step. I was issued a pass in my new name with an updated photo, and my company login and email address were altered that same day.

What Happened Since

When I transitioned at work I was taking medication for depression that was caused by my gender dysphoria. I’ve written about that before, but I’ll just summarise: the SSRI pills (Citalopram) helped a lot initially with the low mood, loss of appetite and poor concentration, but I did suffer moderate side-effects including nausea and disturbed sleep. After I transitioned I increasingly felt that the negatives of the medication were outweighing the benefits, especially since transitioning improved the circumstances that were the main cause of my depression.

Now that I’ve been off the pills for several weeks I feel more myself. I’m better motivated, I’m sleeping well, my appetite is normal and I’m able to concentrate fully. I do still feel very low at times — the depression hasn’t been magically cured — but it’s manageable.

My relationship with my wife, Anne, continues to be strong even though her illness means we have not been out socially at all since New Year. Her support is another factor helping me cope with my depression.

What I’ve Learned

I went into my transition with an open mind and only the minimum of planning — not one of my strengths. All I have — all I need — to guide me is my self-image. I know who I am and the steps I take along the way are to bring me closer to that.

That’s not to say I didn’t learn all I could about transitioning, about the various options for medical treatment and about other trans people’s experiences through their writings. There are a number of things I’ve learned; some practical, some important and some trivial.

  • There are no “right” or “wrong” ways to transition, no particular order in which steps must be completed. Indeed, there are no compulsory steps at all. It’s important to find what works for you because your situation and individual needs will be particular to you.
  • It takes longer to get ready in the morning. Showering, dressing, applying make-up and styling my hair means that my morning routine is longer and more time-consuming than it used to be. Rather than get up earlier I now start work later. (I’ve never been a morning person!)
  • I am very self-conscious about my facial hair. I have not yet had any form of hair removal treatment so I rely on shaving my face and reducing the shadow using make-up. I am reluctant to go out the door, even into our back garden, without at least a shave and some foundation.
  • I hate shaving my face! I have sensitive skin and after shaving it is always reddened, dry and sore in places. I also, despite all my years of experience, still manage to cut myself with the razor more often than not.
  • Pretty much everybody I interact with at work and outside just treats me normally. Maybe I shouldn’t be surprised, but I kind of expected to be regarded as a bit of a freak. This was one of my most pleasant surprises.
  • I feel more vulnerable when I’m out on my own than when I was presenting as male.
  • The NHS services for the treatment of gender dysphoria are seriously under funded and under resourced. It took over 6 months to even get a response from the Charing Cross clinic after my referral, and it is likely to take many more months before I get my first appointment for assessment. All this is required before any treatment such as HRT will be considered.
  • There is more variation in the sizing of women’s clothing than men’s. One item labelled size 20 (UK) could be equivalent to another labelled 16. Being able to judge a garment’s size by eye is a useful skill to develop.
  • Driving in heels doesn’t affect my control of the vehicle but can cause a lot of wear on the backs of the shoes. I now wear flat shoes for driving and change when I get where I’m going.
  • Having my ears pierced didn’t hurt much at all. I guess the earlobes are not very sensitive.
  • It’s not worth spending a lot on clothes when starting your wardrobe for your new gender role. It takes time to learn what colours and styles suit you, and what feels most comfortable.
  • It is worth having a reasonable budget for shoes, and taking your time when choosing them. Don’t forget that any shoes for work will be on your feet all day, so don’t sacrifice comfort for looks.
  • Sports bras that have built-in padding work great with breast enhancers (aka “chicken fillets”). They’re comfortable, keep things in place well, and the pads smooth out any “lumps” as well as adding a little extra size.
  • A lot of women’s clothes use softer fabrics than men’s, which is a bonus for someone like me who has above normal tactile sensitivity.
  • Fancy outfits are fun and great for going out (or to work), but don’t forget to include something casual for popping down to the shops, lounging around watching movies, and doing chores. As much as I love a dress and heels, I find a T-shirt and leggings or pyjamas are most comfortable and practical in and around the home.
  • Invest in a practical bag. Very few dresses or skirts have pockets, so you’ll need something to carry your wallet/purse, keys, phone, etc. while making sure you can actually find these items. It’s not good if retrieving your keys means emptying your bag every time you arrive at your front door!

Does Mental Illness Scare You?

The brain is a mysterious organ. Unlike the heart, lungs or kidneys, its workings are shrouded in a veil of complexity. For all that we know about the chemical and electrical activity it exhibits, for all our mathematical models of neurons and synapses we simply cannot fathom how its activity gives rise to self-awareness and consciousness.

Throughout history most people have viewed this consciousness as a uniquely human trait. Yes, we are learning that this is not the case and other animals also have consciousness, but the idea that the human mind is special persists.

Many people cherish the idea that we are set apart from the rest of life on earth, that we are more important as a result of the functioning of our brains. And perhaps this is one reason why mental illness carries such stigma.

When other organs malfunction modern medicine can often repair the damage, or even replace the damaged part (heart valve replacement, pacemakers, kidney dialysis, transplants). There is confidence in these treatments: we can understand a surgeon replacing a worn out valve in the same way that we understand an auto mechanic swapping out a fouled spark plug.

When it is the brain that suffers damage or illness things become much less certain. Because we do not understand its inner workings and how consciousness arises from them there is a deep fear that mental illness will corrupt who we are. That we would no longer be ourselves. We fear the unknown.

Most mental illnesses are also invisible. There are no outward physical signs that somebody has depression, schizophrenia or Bi-polar disorder. You never know. And that not knowing triggers fear, compounded by a general ignorance about mental illnesses.

The media doesn’t help (surprise, surprise!) by actively seeking to explain many violent acts as the result of mental illnesses, and often describing the antagonist in thrillers and horror movies as mentally ill. Schizophrenia in particular has a long history of being unfairly linked to violent behavior. I’m not saying that schizophrenics are never violent, but the reality is far, far removed from the picture painted in popular culture.

One statistic relating to mental illness and violence does stand out, however. A person who suffers from a mental illness is far more likely to harm or kill themselves. The misplaced fear of the mentally ill person needs to be replaced by a fear for them.

Because you can help by fighting the stigma, by being there when somebody you know is affected — because it’s more likely than not that somebody among your family and friends will suffer from a mental illness at some point.
Mentally ill people are often afraid to disclose their illness because of the stigma. It can be a sure-fire way to lose friends overnight. It might lose them their employment. How would that feel? Not only are you ill but now you’re on your own with no job. “Good luck with that!” Can you understand why that would push some people to kill themselves?So yes, disclosing mental illness can carry a sizable risk. But not disclosing means that there’s no chance to get the necessary support. It’s a catch-22 situation, and all because of the stigma. You wouldn’t shun somebody because they had asthma, would you? So why do it when an illness affects their brain?It’s not a difficult concept. Here’s a person who is ill. Support them. Simple.

Being True

My journey through life has been a series of roles. I fell into routines, habits of behavior that became so ingrained that I could barely think of myself in any other terms. Life reduced to drifting on the currents as I was drawn along by others’ influences, the powerful need to conform, to be accepted.

There is a dangerous attraction to this kind of submission, suppressing one’s own desires and impulses in the service of others. Fulfilling the strongest desire of all: my compulsion to seek the approval of my peers. Measuring my worth by the praise I received.

For a long time it felt like the perfect existence. I didn’t have to worry about my decisions causing change because my path had been mapped out for me in advance, other people’s suggestions crystallizing into a solid picture of the future.

And like crystal it was brittle.

The problem with trying to become other people’s versions of myself was that I lost myself in the process. I had willingly entered the cage and made my home there, and in the process my ability to identify my own aspirations and dreams atrophied.

Suppressed, reduced and weak but not dead. I slowly — very slowly — began to awaken from my state of comfortable numbness and grew to realize that I had become trapped. I had become a stranger to myself, a mindless automaton.

The realization that I was nothing more than a set of roles, a set of made-to-measure costumes in which to act out scripts penned by other people, was shattering. For a while my mind was broken, in pieces, struggling to reassemble itself into its native form.

My need to be accepted had led me to impose so much pressure on myself, driving myself so hard to meet the targets of others, that in the end my strength failed and I was overwhelmed by depression.

I’m getting better. I’ve made changes and will continue to do so. The depression is not beaten: it lurks and reminds me of its presence every now and again. But change has become a positive for me. As I evolve I put distance between myself and the shackles of those old roles.

I do have a destination in mind — a goal, a dream — and while I know I may never fully achieve it and completely become the person I feel inside, it helps that my life is now taking me in the right direction.

A Word About Anti-Depressants

I no longer think that my prescribed anti-depressants are helping my state of mind. Since I have been unable to arrange an appointment with my doctor until the middle of next week I have taken the unilateral decision to halve my dose.

I was finding that I am less able to function. My concentration is impaired and it has been affecting my work: I have had to take time off sick because of the side-effects. These include nausea and light-headedness. I have come to realize that my difficulties in establishing a routine in the morning are not entirely due to my autism: the medication is preventing me from concentrating sufficiently to move from one task to another.

When I finally do see my doctor I am going to tell him that I no longer wish to take these SSRIs. I will start the process of weaning myself off of them. I am not saying that I no longer have depressive episodes; I am saying that I do not believe that this medication is helping. I would rather try to deal with the low mood with a mind unclouded by chemicals.