I’ve been back on 15mg of Mirtazapine for the past week and while it has helped me fall asleep, I wake up feeling like I’ve been binge drinking the night before. It has also caused nightmares that are both long and traumatic, causing me to either wake up in a state of panic or even crying. I had a particularly vivid and disturbing dream last night involving an ex-partner, which has affected me quite badly. I can’t even say that I notice any improvement in anxiety or mood; in fact, my mood is worse in the mornings.
In the 15 years or so that I’ve been seeking help for my depression and anxiety, I have not found anything that helps, except for sleep. Many of the pills I’ve taken have made things worse, particularly SSRI’s. SSRI’s seem to do nothing but make me feel like a zombie or even induce mania and clarity of suicidal ideation, which made me even more likely to actually commit suicide. Citalopram did nothing for me, although perhaps I needed a higher dose. Paxil caused me to feel so disassociated that I ran away from where I was living, to the cliffs of Beachy Head in late 2002. The withdrawal from stopping was worse than any drug I’ve taken. When 2 psychiatrists in Florida diagnosed me as bipolar, one put me on Mirtazapine (then called Remeron) for the first time, which rendered me useless for the first 6 hours of the day and caused Matrix-like hallucinations.
I was formally diagnosed with Borderline Personality Disorder last year by a psychiatrist in Watford (I was living there at the time). I am more inclined to go along with that diagnosis than I am of bipolar, although a few people have told me I have many of the traits of Asperger’s Syndrome. He wanted to put me on mood stabilisers, but because that was never communicated to my GP before I ran away to America for the second time last September, I never got to try that option.
When I left to stay with a friend in New York, I managed to see a therapist and a psychiatrist there. He was actually a great therapist and his train of thought was more along the lines of PTSD, rather than BPD. The psychiatrist there put me on a drug that wasn’t FDA approved, but was used to treat war veterans with PTSD. This actually worked as it severely reduced my nightmares and flashback experiences while awake. Unfortunately, I cannot remember the name of the drug and it isn’t even available here in the UK, so I could no longer take it upon my return to the UK in January.
Anyway, the fact of the matter is that neither therapy or medication will ever fix my gender dysphoria. No one will ever be able to convince me to be comfortable in my own skin without further physical changes (GRS, voice feminization, electrolysis on my face and a rhinoplasty to reduce the size of my hideous nose). Unlike BDD (Body Dysmorphic Disorder), this is both distress caused by real (versus imagined) deformities and because my voice and aspects of my body do not match my identity at all. I do not wish to diminish the struggles of anyone with BDD, but gender dysphoria is a pain that not even people with BDD would be able to fathom. The only therapist I’ve been to that at least respected that and didn’t blame my thought processes was the therapist I saw weekly during my 4 months in New York. Other mental health professionals have done little or nothing for me, aside from giving me a chance to vent out my frustrations. Some have made it worse, through their lack of understanding and knowledge regarding transgender issues. I even had a support worker while I was living in Watford who almost intentionally misgendered me, even though she knew it caused me major distress.
I take the blame for misdiagnosis pre-transition though. I could not even tell mental health professionals that at least 3/4 of my depression was caused by my desire to have a sex change. In late 2001, I did try to tell my therapist at the time, although I couldn’t even bring myself to tell her flat out what I was. I did manage to tell a couple of online friends at the time, I tried to tell my best friend at the time. I told my mother that same year, but her reaction at the time was “But you’re male”. That, plus the fact that I felt too hideously ugly to be a girl since I was young made me bury it again, until it resurfaced in 2011. But had I been honest with myself and with doctors and therapists, I would have fully transitioned long ago and at a time when the gender clinics were far less swamped. I would never have lost all those years in my 20’s and who knows, I may have been content and at least comfortable in my own skin by now. It was truly an opportunity forever lost.
What worries me about my mental health is that it will put my sex change operation at risk, if I make it that far. BPD does cause identity issues in many sufferers, but one of the few things I’ve always been sure about is my gender identity and who I am in that sense (a woman). Assuming I do have BPD, it does cause other conflicts in my identity, including my sexual orientation, although I have learnt to accept that my sexual orientation is fluid (sometimes I feel straight, sometimes I feel lesbian). But my gender identity, my political and social beliefs and my sense of humour have always remained constant throughout my life.
Today is Saturday and I feel pretty low, mood wise. My mum and her husband get back from their short break tomorrow, so I have to somehow find the courage to go out and walk to the supermarket on my own, as I need to replenish the food I used and buy what I need to make dinner tomorrow. I am absolutely dreading it, largely because it’s the weekend and I’m far more likely to bump into kids and teenagers. I will explain why I am so afraid of kids and teenagers in another post as that is a separate topic, but it makes it very difficult for me to go out, except during the week and during times of the day when most of them will be at school.
I just feel too tall and too ugly to be seen by anyone and this is both gender-related and non-gender related (just plain old ugliness). I would love to be a foot or so shorter. Perhaps I could accept other flaws, if it weren’t for my height. Being tall, ugly, shy and transgender is the worst combination you could possibly have if you suffer from social anxiety and social awkwardness. What makes it worse is when people do not understand the severity of it or are completely dismissive and disbelieving. I’m not only sick of feeling this way, but I’m sick of having to justify why I feel this way and then still be seen as over-exaggerating or making excuses. I feel totally hopeless, as there seems to be no help for much of this. I feel like I’m living on borrowed time, waiting for the next catastrophe to be the final push I need to attempt to end this existence before I go truly insane.