It hit me all at once as a new psychiatrist laid out my options before me.
I knew the drill. New doctor, long intake appointment, re-tell my story with craziness, get a diagnoses that may or may not match previous diagnoses, discuss medicines and side effects and whether or not I need it now or later.
But this one leaned in earnestly and said, “You know, it’s your brain. And you’re taxing it. It’s your body”
I’m the first to tell a doctor that I’m medication-phobic. I hate swallowing pills. In fact, I can’t; I have to chew them. I’m horribly compliant with basic vitamins. I have more than one nightmare story of having negative reactions to prescription medicines – stories that involve emergency rooms and IVs. But I also want to live. So I’m willing to take psychotropic medicine when depressive symptoms threaten my health.
This time, I was talking to a new psychiatrist before I was desperate. I wanted him to see me well and lucid … so he would know what I was like if … when … I’m not. This conversation about medicine was theoretical.
That’s when he told me that my aversion to medicine was straining my brain. My ongoing attempts to maintain functionality in the midst of depression literally makes my brain work harder. Working out, endorphins, healthy food, avoiding sugars and alcohol. Components of a healthy lifestyle for most people. Literal life lines for me. This thing I do:
pushing through low moods
asking the intellectual aspects of my brain work when the emotive parts don’t
relinquishing invisible things-I-need-to-do in order to do my job and care for my family
This high functionality thing I do – taxes my brain.
“You might,” the psychiatrist continues, “consider the medication so you don’t wear your brain out. So you can rest.”
I told him I would think about it.
It was a clear reminder that mental health challenges aren’t just mental. They are physical.
This became clear several months ago when a car hit me while I was cycling. I emerged from the accident with no broken bones or head injuries. So I went to work. Gave an evening lecture. I made an appointment with a chiropractor. I took my bike to the repair shop. And then the pain set in. Over days. Acutely. With bruises and pains.
It took two months to recover. From everything. I went to my chiropractor about the accident injuries and she found a year’s worth of bodily trauma. Internal bleeding from an ectopic pregnancy; another pregnancy with miscarriage and surgery. Sharp impact to my left side. I addressed the grief, but I forgot about my body. I forgot that my body had been through a lot. I was so happy to be alive, that I forgot that I had been hurt.
The accident had one clear message:
You’re asking a lot of your body. You need to rest. Sit your a$$ down and heal.
It was hard. I’m used to pushing through. And the injuries couldn’t be seen. My toddler said what most people think: “Mommy, you’re not hurt. I don’t see a Band-Aid.”
And depression and bodily exhaustion are co-dependent roomates. They settle in with one another, and feed off one another’s energy. Neither abating until both are given attention.
Doctors know this. They know that illness can cause depression. They try to eliminate “medical causes” before referring to a psychiatrist. But they still act like they are distinct. Like our minds aren’t part of our bodies.
Philosophers have long separated mind and body. Platonic dualism has left Western medicine and society with a hierarchical dualism that elevates our intellects over our embodiment. Religion does it too. I think of how often my church’s liturgy quotes Jesus as saying that the greatest commandment is to love God with all of our hearts, minds, souls and strengths. I love this scripture. I love the idea of loving God with all of who we are. But it also suggests that these are four separate parts of our selves: heart, mind, soul, and strength.
It’s not true. Not only are they linked. My heart, soul, mind and strength are one. I cannot be strong in one and weak in another. They are part of the same network.
As my body collapsed, I gave myself permission and room for my heart, mind and soul to sink as well. To rest. And recover.
Generations of church folk have sung the words, “It is well with my soul.” The implication being that there may be difficulties and challenges in our physical lives – poverty, slavery, hardship – but my soul is well.
Is it? Really? Can my soul be well if my body is not free?
If my soul soars, is my body also strong? Even if it looks disabled to some?
I don’t have smart answers to these, but I do know my doctor was right – it’s the brain and the brain is the body. Mental health is physical health.