Category: Mental Health

Homeostatic Lemonade

It’s been a minute or two (or a semester and a half) since I’ve posted, so let me start by saying hello and welcome back. Happy 2020!

And boy, do we have a lot to talk about!

To make a couple long stories very short, I finished up my first semester of graduate school, am continuing to fight a stalemate battle with autoimmunity, and finally got hired into a position I’ve been working in for over a year. It’s been a long semester and we’re gonna talk about it. Some of it.

The broad, over-arching theme this spring semester 2020: Lemons.

Y’know the kind that life throws at you. Socially, professionally, medically. All these lemons, and very little to do with them. So you make lemonade, right? You advocate for yourself, because at the end of the day who do you have? Yourself.

And we have to be nicer to ourselves. So let’s dive in and talk about the messiness, the difficulty, the exhaustion of advocating for yourself – of making this lemonade. And hopefully we’ll be able to shine a light on why it’s necessary and oftentimes rewarding. Tasty.


Let’s start by taking it back to biology, I mean after all why are we even here?

At the base of your brain almost smack-dab in the middle, there is a small chunk of white matter termed the hypothalamus. Your body temperature, hormone regulation, biological clock, and appetite, among many, many other things, is regulated via this little region of tissue in your brain. Needless to say, it’s vitally important to everyday function and biological equilibrium. For all intents and purposes, the hypothalamus is a key regulator in homeostasis.

Homeostasis, simply, is the ability to maintain internal equilibrium of our physiological processes. It makes sure our set-points are maintained. It’s the reason we’re not running around with fevers at all hours of the night and instead (hopefully) sleep. It makes sure we’re stable.

All of this is, of course, intricate and complicated with different pathways and feedback loops we won’t get into now. But it’s a necessary process designed to keep us alive and, hopefully, well. So why am I bringing it up when I was just talking about metaphorical lemonade? Because your body is always doing the work necessary to keep you up and running (barring any disorder or disease that affects homeostasis). Our environments are always changing, throwing new stimuli at us, and our bodies acclimate and adjust. If our bodies can do that, we can try to make sure we’re getting the best stimuli we can and creating a homeostatic mental environment.

By that, I mean doing the most that you can to ensure you’re being treated how you deserve. Self-advocacy is a tricky business. And every facet of life is going to require its own version. Whether you’re juggling the academic, personal, social, medical or professional lemons, you probably know they can sour easily. Knowing how to advocate for yourself is of the utmost importance.

Academic

Academically, advocating for yourself often has to happen at numerous levels. Individual classes, discipline, department. There are layers to it.

Grades, on tests or papers, are a reflection of what you know and if you know how to present it the way your professors require. Don’t be afraid to ask questions about the material, why something is wrong, how to do better. Oftentimes, professors will consider your rationale and while it may not boost your grade it’ll help in the long run.

Applying is just advocating for yourself. And everyone hates applying. Whether it’s to a conference, a school, or a class it all comes down to knowing who you are and making sure everyone else does too. Personal statements, cover letters, resumes or CVs are just professional ways of doing that. Don’t forget to hype yourself up.

And get to know your professors and chairs. They will be able to help when things get hard and it helps to have people who can advocate on your behalf. Most of the time, they’re very understanding. And if you meet an advisor who isn’t, knowing someone who is can help take the edge off or help you find alternatives.

Also make sure you know what resources your institution has to offer before you need them. It’ll save time when you actually do.

Medical

Advocating for yourself medically can be anything from making sure doctors know you’re in pain, to explaining those pesky invisible symptoms. Why did I mention my autoimmunity earlier? This. Right here.

Going to the doctor is hard enough – between the high insurance rates, long waiting times, and having to take off from work or school. Then, of course, comes actually describing your symptoms.

There’s plenty of disparities in health care. Notably, chronic pain patients, especially those with neuropathies that are hard to diagnose, can struggle to receive proper treatment and often cycle through medications that may have little efficacy for their condition. Like pretty much everything, women are often short-changed in this department. Women are even more likely to have their pain dismissed or misdiagnosed as hysteria mental illness. Of course, there are disparities between women. Women of color are even less likely to be prescribed pain medicine, an inequality Wanda Sykes pointed out in her latest Netflix special. To make matters worse, much of what we know today stems from older research. Much of it done only in men. A problem not limited to clinical research.

With the rise in popularity of the social media platform Tik Tok, there has been a storm of internet backlash responding to “TikTok nurses.” Not all of them, but plenty of videos have circulated of nurses and nursing majors invalidating concerns of patients they’ve seen. The dismissals? Pain and invisible symptoms. It wreaks of ableism, one of the many -isms that permeates the medical profession. Disabilities, invisible or not, have been dismissed by doctors for being too difficult or inconvenient.

This is not to say all doctors are bad – there are plenty fighting for equality, better research, and above all, their patients. Dr. Jen Gunter, a gynecologist made famous by her twitter threads and book, The Vagina Bible, detailing women’s health and the lies that get told about it, is one such doctor. And the nature of medicine is changing every day, with medical programs including courses to teach previously ignored aspects of medicine like bedside manner. But this isn’t going to change overnight.

So, let’s make one thing painlessly clear: your pain is valid. Your concerns and conditions are valid. You are valid, M.D. or not.

It’s important to find a doctor who listens to your concerns, and if they don’t, leave. Realistically, though, leaving a particular doctor or practice isn’t always an option. It’s important to stand up for yourself. This in and of itself can be difficult, as doctors can be intimidating. Plenty of Google searches ask, “how to make your doctor listen.”

WebMD even has a page dedicated to it.

The key takeaways?

Bring notes so you have a list of what to talk about.

Tell your condition, disease, or injury like a story instead of just the ailment. Even doctors love stories. How and when did it happen? What does it feel like? How has it progressed?

Be direct.

And be honest.

Professional

When you can’t even convince your doctor that something is wrong, it can be even harder to convince your employer. Add on your professional experience, pay, opportunities, and bad coworkers, and work gets even worse.

Toxic work environments can be even more draining than what work you do. Men who don’t know how to talk to women or talk to them too much; bosses that make impossible demands, those that aren’t engaged at all with the work you’re doing or, conversely, micromanage; coworkers who challenge your every move. Toxic work environments can exist anywhere, unfortunately. And if HR doesn’t work or your administration doesn’t care, it even more unfortunately falls on the individual to demand respect. While conflict, especially in places you spend 8+ hours every day, is difficult, sometimes it’s necessary. Tell your coworker to stop questioning you, to use different language, to stop looking at you like that. Defend your work to the people who think they get it when they really don’t. Ask for a raise if you think you deserve it.

If you’re going to spend half your life doing it, make sure you feel safe there.

Social

And even when you don’t, build your support system. Friends, family, significant others play an integral role in our mental health and wellbeing. They’re the people to turn to when things go really well or really poorly. And they’ll do the same to you. The key is asking for your time or space when you need it without isolating yourself.

Self

And sometimes, you have to advocate for yourself to yourself. Your mind can be a messy, dark place and it’s easy to lose yourself in it. Mental health matters just as much as your physical health, and it’s harder to work out. This stuff is exhausting and messy (like the homeostatic pathway) and that’s okay.

It’s about growth, learning to say no, learning to go easier on yourself, learning that it’s okay to ask for help. We’re our own biggest critics because we’re stuck alone with ourselves all the time, but that doesn’t mean we have to do it alone. Appreciate your accomplishments. Hype yourself up in the mirror. Pick a personal mantra and remind yourself that you’re good enough, you’re valid.

It is not an overnight process, let alone a linear one. The learning curve can be astronomical, but it gets easier with practice. It’s a lot and easy to get overwhelmed, so take it easy as you learn and practice and grow your confidence.

I fell deep into imposter syndrome when I spent over a year getting hired into a position I’ve held for just as long. It led to financial difficulty which led to debilitating stress and a flare-up of my autoimmunity which fed in to compromised academics and plenty of self-hate. Everything feeds into everything else and untangling it can be like untangling a pair of corded headphones. The past eight months were one hit after another, and this week is when it all of it started to settle down. My stress level was way off it’s setpoint and is only now returning to normal. It’s a process. And sometimes it’s just about surviving the day.


It’s important to point out that I am able to speak from a place of privilege. I’m a white, middle-class academic, and while the fact that I’m a woman comes up far more than I’d like, I’m still privileged in a system entrenched in racism, homophobia, ableism, sexism, etc., etc. I’ve been lucky to have mentors who understand the difficult nuances of navigating these aspects of life, bosses who will go to bat for me, and sanctuary from (most kinds of) harassment. Each of these institutions – professional, medical, academic – have a long way to go before we can see equality and understanding, making advocating for yourself that much more important. Maybe you’re told you’re too sweet, too sour, too watered down, too strong. So be it. If you’ve struck your homeostasis, keep your balance.

As my PI told me, sometimes life gives you more than enough lemons to make lemonade.

You just gotta make sure you have enough sugar.

Autonomy, Autophagy, and Apple Pie

A look at self care, coping with trauma, and making a stressful field a little less stressful

TW: Mental illness, sexual assault

I. Autonomy

At sixteen, the human brain is entering the final stages of development. Synaptic pruning begins to die down. Neurogenesis and migration have already plateaued, but executive functioning is solidifying connections and the myelination of neurons continues to increase.

In short, a sixteen-year-old’s brain is almost done developing, but oh boy is it emotional. Everything has salience and it feels like the end of the world.

You remember puberty.

So, at sixteen, when a boy robbed me of my autonomy and justified it by citing my ass as the only redeeming quality of my intellectual inadequacy, it was a little salient. So salient, in fact, that I stopped confidently participating in classes. I stopped participating at all. It exacerbated my pre-existing mental illnesses and sent me spiraling down a rabbit hole that would make Alice prefer her own.

Like 40 million other people in the United States, I struggle with anxiety disorders. As a kid I learned to navigate it, living in between the shallow breaths of panic attacks and limited minutes of sleep. As long as I was busy and distracted, I was good. Not necessarily a healthy coping mechanism, but a coping mechanism nonetheless. For the type of problems I was having, it worked.

Until it didn’t. Because sexual assault wasn’t the type of problem that I previously had. Because, you know, no one should have that problem (despite the fact that one in three women in the U.S. do). So I repressed it, wrapping it in the stress of the event that preceded it – the reason we were working together – shoving it as deep into the recesses of my memory as I could.

I had convinced myself it was my fault. If I had been smarter, or smaller, or stronger or something, it wouldn’t have happened, that’s what my friends told me.

Naturally, unhealthy coping mechanisms turned to worse coping mechanisms — and also stress baking which was beneficial from a utilitarian perspective — until I was in therapy a year later where I stumbled upon the memory I tried so hard to bury. Words caught in my brain like a splinter, and tore the memory out.


II. Autophagy

At sixteen, I saw the quote circulating around tumblr:

Today my professor told me every single cell in our entire body is destroyed and replaced every seven years.
How comforting it is to know that one day I will have a body you will have never touched.

unknown author, plenty of known reposters

This, of course, is mildly misleading. We don’t morph like Mystique, suddenly shedding our cells for a whole slew of new ones. Instead, they turnover gradually, some dying here, some dying there, but as long as we’re alive it won’t ever be every cell in the entire body. We’re stuck with whatever neurons we’ve got, everybody.

Skin cells, though? Get him off of me.

The biological inaccuracy doesn’t negate the weight of what the quote is implying.

And I know, Em, stop being melodramatic.

Except, no. Because when we’re kids, everybody warns us about the strangers out to hurt us. Not the people you know who think they deserve to know more. They don’t warn you about the self-loathing that comes after. There’s not a disclaimer that if it happens to you, you’ll feel like a stranger in your own body. Everybody warns you not to put yourself at risk, but nobody warns you about the risks you start to crave after. The nightmares, the anxiety, the triggers, the flashbacks are all listed as symptoms on pamphlets you only see after you’re able to process it happened. Only in the past decade was post traumatic stress disorder (PTSD) even recognized in survivors of sexual assault, up to half of whom are at risk of suffering long-term.

The subtext of that “corny” tumblr post speaks volumes.

So, stop thinking I’m being dramatic and pay attention.

The biological process of programmed cell death, apoptosis, is a natural phenomenon that promotes healthy cell turnover. To assist in apoptotic regulation, cellular components within the cytoplasm are broken down in a tightly regulated process otherwise known as autophagy.

Autophagy also plays a super important role in butterfly metamorphosis. Do you remember being in grade school and raising butterflies from caterpillars? Remember the magic of watching them emerge after weeks of being in a chrysalis? Remember that magic?

Autophagy.

A caterpillar’s transformation into a butterfly is a grueling process. A delicate packet of goo, or more specifically, digested caterpillar, turns into a whole new organism.

And, yes.

Caterpillars literally digest themselves whilst in their goo packet…in fact, they are the goo. Then they reconstruct themselves and emerge as a butterfly. Or a moth if you’re a man I guess (haha, cryptid humor. We have fun here).

But in all seriousness, being a butterfly takes a lot of work. It’s an easy analogy to make – a metamorphosis for when it feels like the end of the world. It’s a beautiful metaphor (call it “metaphorosis”) to mask the pain-staking time and energy it takes to get through it.

But Maya Angelou, like the icon she is, summed it up best.

We delight in the beauty of the butterfly, but rarely admit the changes it has gone through to achieve that beauty.

Maya Angelou

Was she right or was she right? When was the last time you looked at a butterfly you thought was beautiful or aesthetic or whatever and appreciated its auto-digest journey?

When was the last time you looked at yourself and appreciated your auto-digest journey?

III. Apple Pie

At sixteen, I thought twenty-one was going to look a lot different. By now my brain is almost fully developed, an organ shaped by my experiences as much as my genetics. I’m a neuroscientist entering graduate school with a full-time job and thriving with the help of my incredible support system, including two cats who drag me out of bed for catnip. I do yoga regularly to practice mindfulness and bake in my spare time instead of when I’m stressed.

Eevee (left) and Oliver (asleep) will wake me up and meow at me until I feed them. They’re cute.

On this particular day, I baked banana bread. Now, I’m sitting outside with my dog at my childhood home. The way the light shines through the trees stirs a memory that regularly plays peekaboo in my hippocampus. It smells like spring and it feels so good to breathe it in and fill my lungs with it. With my eyes closed the memory is dancing in my synapses and suddenly I can see it.

The light, just like that, shining gently through the trees onto the water flowing downstream. It spotlights fish swimming below and highlights the grass in every direction. Birds flit through the air in an intricate dance. It’s quiet until I hear my dog bark excitedly that she retrieved her throw. I am happy.

I remember.

I exhale and it fades away but the contentedness stays. It’s been five years since I splintered. It’s taken about as long to get to the point that I can write something like this. And getting to this point, where I can take a deep breath and say I made it, was hard.

And every day is a new trial of making it. Some days are harder than others. Some days are just about looking in the mirror and saying I made it. There are still days I can’t get out of bed because everything is too heavy, too loud, too much. And that is okay. I’m learning to make peace with that.

This is just my story, my timeline, my lessons learned. Every person has a different healing process, and that is perfectly and completely okay, too. Caterpillars take 5 to 21 days to do their thing. The great thing about healing is that there’s not a right way to do it. I baked 73 cookies one day and filled up a journal the next. I had to retake a major class after missing too many because I couldn’t get out of bed. It’s taken a lot of therapy, reconciliation, and acceptance to understand what happened to me is not my fault. Taking steps to get better is. My success is. And in the long run, if you are doing things that help you, it’s a step in the right direction.

It’s difficult going through any of this by yourself. It’s sometimes even more difficult to talk about any and all of these things with other people. There’s a stigma for everything. But your experience doesn’t warrant an explanation. Literally everything about this is exhausting, let people help you rest.

It’s not just coping mechanisms that need work. Schools, elementary to university, need to better accommodate their students’ mental health needs. Normalized abusive behavior needs more comprehensively addressed and all together changed. Self-care needs to be a priority not a privilege. The current environment, both socially and academically, boasts of advocating for self-care, mental health and sexual assault resources, which wildly exaggerates the reality. Students are forced to sacrifice their well-being to make deadlines or attend classes without adequate resources to supplement their mental health. The gross mishandling of sexual assault cases bears little explanation.

Individuals who suffer from mental health issues and sexual assault survivors have enough to worry about. Society needs to pick up some of the slack. And that means talking about it. Check on your friends. Look out for your loved ones. Say something because some people can’t. Let’s do better.

If nothing else, imagine how many of your cells have already turned over. Keep drinking water, keep feeding yourself, keep helping them do it. You’re gonna make it.