Chapter 23 – Mental health

As I’ve mentioned before, I have a history of struggles with anxiety, being diagnosed with everything from a panic disorder to agoraphobia. I was prescribed a variety of drugs, having varying degrees of efficacy, each coming with their own ‘fun’ side effects. At some point during high school, I stopped taking prescription drugs and started smoking weed. It wasn’t a conscious substitution, I think that as I started to smoke, I noticed my anxiety dropping and probably just stopped taking the prescriptions because of the side effects and never felt like I needed to try new ones. I am in absolutely no way endorsing giving kids weed to solve their anxiety, but I’m not a huge fan of giving them fists full of pills either; however, because I am a dumb ass in biology, pharmacology, and anything medical, don’t listen to me, find a good therapist and trust in them, but also, get a second opinion if you feel uncomfortable with anything. Sometimes, medications are entirely appropriate and can be incredibly helpful. Also, weed didn’t cure my anxiety, it just made it more manageable.

In the hospital, Valium was not an infrequent addition to all the new meds I was taking. Also, when I discovered how quickly cyclobenzaprine [a muscle relaxer] knocked me out, I took it pretty frequently at night to sleep better; even if the effect was purely due to the placebo effect after a while. I, like all patients, was assigned a therapist who I met with regularly, with decreasing frequency as he saw fit, and got to just clear my mind. I remember being really nervous to tell him that I had thought about suicide; not that I wanted to commit suicide, but just that I had thought about the idea of suicide… was he going to understand and not overreact? I had probed him with some random tests beforehand to test the water, and whether he caught on to what I was doing or was unaware and answering genuinely, I determined he would most likely understand what I was trying to say despite my lack of eloquence. Sure enough, he was totally unphased, and, yeah, given my situation it would actually be more surprising if the thought hadn’t crossed my mind. He was great, and I enjoyed talking to him, but being mid-crisis, my brain was being overpowered by the “it’s fine” signal and my ability to just laugh and shake things off was at maximum. That “it’s fine” attitude was, of course, interspersed with random short-burst full melt downs, but while not in a meltdown, it’s hard to convey the weight of the feeling. We didn’t end up talking all that much, but he was always available and checked in periodically between appointments.

I still use my THC vaporizer pretty frequently and I talk to my friends Erin, Autumn, and Ashley about things when I’m struggling; sometimes just to vocalize it to someone, which can act as a little switch, making what seemed so impactful before, seem irrational or trivial as soon as it leaves my lips… fingertips… I’m not much of a phone call person, that is the modern equivalent of showing up at someone’s house unannounced, with facetime taking it to the level of screaming in their 2nd story window they left cracked open. Having friends who care and who stick around, even through periods of radio silence from me, has been invaluable. I don’t think I would ever kill myself, on purpose, but when I think about suicide, they always pop up in my mind; I just know that they care and would notice, as in it would actually make a difference in their lives. When I asked, Erin happily compiled a great list of therapists that fit my preferences and requirements… that was a few years ago and I still haven’t called. I am a big fan of people getting a therapist, but I can’t stand the initial getting to know you period, where I inevitably just test and prod at them, almost requiring them to be smarter than me and shut that shit down. If I feel like I can manipulate them then it’s pointless; but I know how problematic this is, especially because I had that same feeling as a kid, even though I was probably embarrassingly transparent. Bottom line is I need to just go, as therapeutic as it has been writing this all out, it’s no substitute for actual therapy; in fact, this may just have revealed how necessary it really is.

Another thing I have struggled with, post-accident, is anger issues. I’m not sure if the increase in anger or difficulty keeping it in check is because of some physical change in my brain due to concussive force [possibly CTE] or a limitation of the ways I managed the anger before being paralyzed. It’s also possible it just comes down to an increase in the sources of frustrations, adding up to a level I am not currently able to control as well as I might wish. More than likely, it is a messy mix of all three with sprinklings of other random factors. My inability to control my frustrations is also frustrating. Things that would never get to me before my accident feel infuriating sometimes. As my energy drains and my pain increases, the threshold between frustration and anger seems to drop precipitously. A lot of it comes with things that I just can’t do anymore; this is especially true with physical tasks that I have to instruct someone to do. If they are able to do it, I’m always happy and impressed; but when they are unable to complete the task, due to my poor instructions or their inability, my frustrations flair. I’m not frustrated or angry at the person helping, I’m just pissed that I can’t pop up and do it myself, but that anger definitely leaks or spills out and gets directed towards them when I can’t react fast enough to my own emotions.

And I can hear myself being shitty as soon as the words leave my mouth; with family it is more direct, while with others it’s typically more passive aggressive, but either way, I am an asshole. Immediately afterwards, the guilt comes rushing in like I just went a bit too deep into the river with my waders on. I hate that something so small can affect me so much, but even more than that, I hate that I don’t seem to be able to keep that shittiness to myself and I let it affect other people. The vast majority of the time, the frustration and anger fades as quickly as it arose, but the guilt lingers for hours, sometimes days. It’s an amplified version of saying something awkward in conversation, something that makes you wonder if you even know how to be human, and you think about it for all eternity; except this version negatively affects other people. I try to recognize when it is happening and bail out of the situation, but I think suddenly telling people to disregard whatever request for help you just made also upsets people. Having a quadriplegic tell you, “Never mind, I can do it,” or some variation, just seems insulting; in those situations, I am typically low on energy or blood pressure, and I can’t really run them through the whole deal of: I want things to be done in a very specific way, they aren’t getting it, which is fine, I don’t have the energy to keep trying to explain, it is usually satisfying to do it myself anyway. Ex. I make my bed every day. 

I have been working on being able to do more and more myself so that I find myself in fewer frustrating situations. Part of that has involved learning to not get things done immediately and not have them done exactly how I might want. I am still not great at managing the frustration but I am slowly learning to be more patient with myself, which has hopefully started to help me be more patient with others. The root of my anger are my own inabilities, so it will be interesting to see when I will finally be able to be ok with my physical state. Coming to grips with my injury and everything that comes with it, would definitely be a big step in the right direction; and I can get there logically, but emotionally, it still feels like I might have an ocean to cross.

As a part of maintaining my mental health before my accident, I used to go out hiking here in Colorado pretty often, most of the time going out alone. Two large motivating factors behind that were that I loved the isolation and, as an extension, the self-reliance. Seeing people briefly on the trails or guiding a friend visiting from out of town were great, but I wouldn’t have wanted to go much further than that. I would also mildly freak out when hiking with other people; I would constantly be worried about pacing, conversation levels, and a million other factors, meaning I very rarely fully appreciated my surroundings, which was the whole point. Living in Boulder, I could just grab my backpack, fill it with extra clothes, water, a few snacks, my hammock, and a book, strap my climbing shoes and chalk bag on the outside, and hop on my bike or in my car and head into the mountains to find a hike. If I was on my bike, I was typically headed up Boulder Creek to hike one of the front range trails or just to hang out in my hammock in the trees [remember that whole ordeal]. If I was going by car, my favorite place to go was up in the mountains a bit, just past a small town by the name of Nederland, on a hike to Diamond Lake. I have done that hike so many times that I can almost run through the whole hike from memory. I can smell the grass and wildflowers, and I can hear the little waterfalls you cross along the way; the start of the trail is at the 4th of July trailhead, possibly a nod to the plethora of wildflowers along the trail that resemble a fireworks display. I would give just about anything to go back there… I’ve considered a number of options but unless someone wears me as a backpack or I get dropped off by helicopter, I don’t see it happening any time soon. It seems silly, but it brings tears to my eyes thinking about how I lost access to my favorite place in the world.

There are lots of organizations, such as high5 and Craig hospital’s therapeutic recreation, that are doing great work getting people with disabilities back outdoors and having fun. They get people back into skiing, biking, climbing, surfing, flying, hunting, fishing, and just about any other activity you could want to do. But what do you do with someone who doesn’t really want to be around people but will also probably just die if you send them out on their own? Also, as a straight white cis-male, I have been given so much in life that I feel guilty asking for anything from these organizations and have simply looked on with envy seeing others skiing or mountain biking. I try to justify it by telling myself I had my entire 20’s to run around, travel, party, make friends, explore, be promiscuous, etc. But in reality, I’m not even sure if I would enjoy doing any of it. I look at all of it as if I was a paraplegic and can use my arms/ hands, which makes it particularly disappointing when I am forced to come face-to-face with my disability. It’s not the walking thing, I don’t think about that much, I just wish I could use my arms and hands again. I’m sure this is just a disability version of “If you give a mouse a cookie,” where everyone wishes they were just a little less disabled. Let’s take skiing as an example. The wheelchair equivalent of skiing is called, unimaginatively, a sit-ski, and is basically a seat bolted to some skis with a bit of suspension; obviously things are fairly high tech, but the idea is still very rudimentary. If you have the requisite function, you have two short skis at the end of what look like newer type crutches that help break, steer, and balance and not fall over. However, as you approach my level of injury and have no hand function and no triceps, you get to where you are basically just sledding with someone controlling your descent with a leash or by handle on the back as if you were being pushed in a stroller… hard pass. Also, over the last few years, increases in sensation have made it feel a bit like I swallowed glass, in that, if I sit still, I feel alright but the more I move or get jostled, the more it feels like my insides are screaming. So, I don’t even know if I could enjoy any of the things I am interested in trying. I guess I don’t really know until I try but I feel like I have a fairly educated guess as to how it would go.

Thankfully, there are a number of accessible trails that I can go on in my power chair. Granted, because they are accessible, they are also fairly highly trafficked; the more difficult the trail, the fewer the people, typically. However, being in the mountain air with those views, you can quickly forgive the occasional run in with other humans… mostly. The biggest issue is that the places that I want to go to the most are the least accessible and would have been a challenge to get to for the fully able. My brain simply refuses to readjust what it considers pleasurable; if I wouldn’t have enjoyed it before, it’s very unlikely that I will like it now simply because I am stuck in a wheelchair. That said, I am entirely content just finding a spot outside with a good view and just reading and relaxing, just not 15 ft up in a hammock. We are certainly not short on accessible spots with great views here, even those away from people. Literally 300 yards from my previous apartment, I had a view of the entire front range, with snow-capped peaks in the distance and a view of the start of the great plains that makes the skyscrapers of Denver look small and fragile. All of this is to say that while I am still happy and able to enjoy the outdoors, the experiences I lost access to are still crushing; like losing a close friend, you have to move on and enjoy life, but it doesn’t prohibit you from feeling that pain and mourning their loss.

To preface this next part, I should mention that I don’t think I am the type of person who would ever really intentionally end my own life, but I don’t think negatively about those who are; though, I obviously wouldn’t want anyone to end their life. To anyone who says suicide is “selfish,” just a friendly reminder, fuck you [“why wouldn’t this person endure absolute misery to occasionally interact with me on a surface level? How selfish…”]. Now, that doesn’t mean that I haven’t thought about ending my life a lot; both before and after my accident, but definitely more since. Importantly, it pretty much always feels like an academic exercise more than an actual plan for the future; or maybe it’s more that the thoughts feel like the empty threat of a child. However, I have gone through countless times when I told myself, “I’ll be fine, it’ll pass, I don’t need to bother anyone,” that I might be losing the ability to tell if it is actually serious. It doesn’t help that I get positive reinforcement for the assumption, as I am clearly still alive. It is a bit of a boy who didn’t cry wolf situation, where I see something that legitimately might be a wolf and I don’t say anything and think “ahh, it’s just the wind…”; but one day you dismiss those telltale signs of impending danger, only to wake up, face to face with a hippopotamus and now you’re dead… Fun fact, hippos are surprisingly cute, surprisingly athletic, and surprisingly murderous; meaning they can go from cute and far away to terrifying and “holy shit those teeth are huge,” in the blink of an eye. One of my favorite tid-bits about them is that they kill as many humans as, if not more than, any other mammal on the planet [aside from other humans] but they are 100% herbivorous, not omnivorous, herbivorous; meaning they are just killing people as part of their “fuck around and find out” philosophy, and humans LOVE to fuck around...

Aaaanyway… The vast majority of the times the thought has popped up in the years since my accident, they have centered around the inescapability of the pain I am feeling. It is usually a tolerable amount of pain where you can see the light at the end of a tunnel, but a lot of the time it feels like the light at the end of the tunnel is that light they say you see when you die. A few times, enough things would go wrong, simple things, things that should be effortless, and the frustration, disappointment, anger, and helplessness just overflow into every corner of my being. I want to scream but I don’t really have the lungs and diaphragm for that. Maybe I want to hit something but I don’t have the strength to make it satisfying. I end up shoving it down inside and attempting to calm my body down so it can lead my mind back to normality. However, some part of it stays down there and on occasion it causes an irrationally large and dark reaction. 99 times out of 100 I can just laugh it off or give it a quick “fuck!” and push forward, but every so often I’ll clean up some mess, only to spill my drink, and it feels like I just want to give up on life; “Don’t cry/ kill yourself over spilled scotch.”

When I am feeling especially lonely [very rare] and I am not necessarily operating in the most logical manner, the thought has crossed my mind to kill myself as some sort of fucked up lesson to people who would possibly be sad but really have no right to be… because killing yourself is a potent lesson for people you don’t think actually care... [sarcasm] I guess part of it comes from hearing people talking about the need to “check on your friends” and the contrast between those statements and never hearing from them after being paralyzed. Now, if I really wanted to talk to them, I could just reach out and I’m sure the majority would help; I told you this wasn’t logical. Maybe it feels like the last dramatic cry for attention, ironically the increase in attention only comes when you are unable to appreciate it. That is probably why I don’t see this as a possible motivation to do something stupid. What good is a cry for attention if you don’t get the attention? I don’t care what people say about me once I’m dead or if I will be remembered, I’m dead… love me while I’m alive and forget about me when I die. With as much as I have talked about being extremely introverted, it might seem counterintuitive to crave attention from people, and yeah, fair point. It’s like I want to play a perpetual game of hide-and-seek, but never really want to be found, just always to have people looking.

I guess the most dangerous times are when I don’t see an end to the pain and I convince myself that a few people might be sad but they would generally be just fine if I died. Sometimes I feel like a burden on the people around me when I ask for help with things and wonder if the benefit of not having to do all that outweighs any negatives. However, because of that I have learned to do almost everything myself and learned to just leave anything I can’t do, undone. As that list grows, I feel increasingly useless and my frustration with being paralyzed peaks. I almost want to destroy my body, as if I am taking revenge on it for being so incapable. My internal voice can be an absolute terror at times, especially in the face of simple tasks that I am failing at.

That said, I don’t want to die. Which is why I have endured years of anger, frustration, pain, etc. and continue to push forward. Granted, when that pain peaks and lasts long enough, I don’t want to be alive, but I still don’t want to die, whatever that means. Also, I am incredibly lucky to have a few friends who make me feel important in their lives; not just a part of their life, but that I actually serve a purpose and my absence would be an impact. In the worst of times, they seem to be those final threads of a fraying rope, holding back the worst of thoughts. I can’t predict the future, but these friends have made it clear they aren’t going anywhere, so I don’t really feel any concern for self-harm.

So, yeah, “check on your friends” and all that [I don’t think saying that actually instigates anyone who wasn’t already doing it to do it, still worth saying]. But also, fucking reach out if you need help or even just attention; it may feel like you are asking people to love you, which may feel artificial, but sometimes people just need to know its ok to love you. Maybe you appear as a hedgehog with spikes all over and people are afraid to approach you, you just need to show them you are cute as fuck and aren’t going to hurt them for coming closer.

Finally, I randomly hear people debate if they would kill themselves if they were paralyzed, and the real kicker is, I’m fairly confident they aren’t even aware of the worst aspects. I always chuckle because I don’t think people realize how much they can endure until they have no other choice; a quick look around the world provides countless examples of humans enduring all sorts of hardships and tribulations. Even though things may be really tough, some days are still beautiful and everything just seems brighter and more vivid, like your eyes just upgraded from an old-school CRT TV to a fancy new 8k HDR screen. I think it has something to do with the contrast; if you are able to endure the more difficult times, the good days just seem to have that extra sparkle or shine; maybe why groups who endure consistent hardship, sometimes have the most beautiful celebrations.