isabelthespy:

in high school i went through a phase where every night, as soon as i shut off the light to go to bed, i would be seized by the thought tonight is the night i am going to die, and unable to let it go. i’ll sheepishly admit that i’ve always been susceptible to getting creeped out by things that go…

So many hearts. My wife coined a term — “the chocolate cake” — to describe the big obvious thing that, in the prison of my own mind, I’m totally discounting as probably contributing to 99% of feelings of [mix and match]: hopelessness, anger, depression, inadequacy, fatigue, general shut-down behavior (chronic napping, the urge to sleep in the middle of a conversation, etc.), self-loathing, self-pity, etc.

Basically when we had been dating for about a year or so, I called her up one night and whined at her for like an hour about how nothing in my life seems to be going right, I just can’t get it together, and on top of all of that my blood sugar is completely out of control and I’m probably going to die and it’s because I am awful. She told me to tell her about what I’d done that day — surely something must explain why my blood sugar’s out of control.

“Well, I did have two slices of chocolate cake. And I forgot to give myself insulin for them.”

That’s not to say that chocolate cakes “cause” all this stuff, just that once you can jar yourself out of thinking that everything is nebulously connected in some ineffable way just beyond your understanding and start pointing out some concrete reasons why X Y or Z is happening, lots of other things click into place. Getting my anxiety under control was the first thing I had to do for my blood sugars and other health concerns to fall in line; I always saw it as this “final hurdle” that awaited me after I “got my shit together.”

But it’s usually the first hurdle, maybe biologically, but more likely because we don’t talk about mental health like we do physical health. When someone tells you “I haven’t been to the dentist in ten years,” you might think (barring the big possibility of inadequate health care coverage), “that’s a long time not to see the dentist.” But we don’t say the same thing about mental health. People with health insurance treat it like people without health insurance are forced to treat physical illness — wait until an emergency and hope you get the right treatment given the urgency. There also seems to be something of a cult of expertise in a lot of forms of therapy, where doctors don’t really want to “reveal” the process you’re going through. I’ve seen a few people like this — very reserved, won’t answer questions directly, seem to be groping toward something that they feel uncomfortable sharing with me. Whereas with any good doctor, they sit you down, tell you the entire process from soup to nuts, explain the what, where, how, when, and why of what’s going on, and even admit limitations of the procedure or process.

I was so upset the other day when K-punk wrote a shitty article about how “cognitive therapy doesn’t work because CAPITALISM,” and I didn’t respond to it then, and won’t now, or link to it, because fuck him, and whatever, y’all ignored it for the most part. It’s the only process I’ve experienced that actually works like a medical intervention, in which patient knowledge and behavior outside of the office actively contribute to the process. You finish treatment, you leave, you come back as needed or in a year for a check-up. It’s not the kind of thing where you go in once a week, spill your guts, and are left wondering where it’s all going until you move or miss enough sessions to have lapsed. It would be nice to have that practice established early, too, expected of all parents and children whether or not they think there’s something “wrong” with them (and, obviously, for health care to support that line of thinking).