Paper Skin


One humid August afternoon, I sat in a waiting room, my eyes fixed on my hands. I kneaded my palms and listened to the gurgle of fish tanks and the crinkle of magazines. On my upper back I felt the firm, steady hand of my husband, Will.

“You can do this,” he whispered and kissed my temple. A door opened, and the doctor called my name.

I followed the salt-and-peppered man down a hallway, past generic landscape paintings, and into his office. As he gestured toward the couch, the psychiatrist introduced himself and asked a very difficult question.

“What brings you in today?”

I fussed with my shirt sleeves and tried my best to explain.

Two years earlier, I was a newlywed and a recent college graduate, struggling to find engineering work in the shaky economy. I had little choice but to embrace the role of a housewife. At first it was fun to decorate my new home, hone my cooking skills, and spend so much time in the company of a kitten.

Within a few months, though, the novelty of domesticity wore off. I grew bored and antsy, and the daily “we’re not hiring right now” emails distressed me more and more. Eventually a pattern emerged, and each day would go one of two ways: I’d sit in front of reality shows and cry, or I’d skitter around my apartment, rearranging wall art and baking endless dozens of cookies in a desperate clambering to make myself feel worthy. I became an emotional cyclone.

I’d spent my lifetime thriving in the structure of academia, relying on good grades and professor approval for my sense of self-worth. Suddenly the scaffolding was torn down, and I didn’t know how to hold myself up.

Late one morning, I paced around my apartment, fists clenched, eyes darting all about. I felt trapped and desperate. I marched into the kitchen, pulled a knife from the drawer and began to slice my arm with quick, controlled fervor. With each shallow swipe, tension drained from my body. After several minutes I stopped, took a deep breath, and surveyed my inner arm—blood-red railroad tracks lain from wrist to elbow, intersected with tangly clusters of scratches. I felt more relaxed than I had in a long time.

I was fascinated by the way blood droplets surfaced along the cuts a few seconds after a knife pass, like strands of crimson pearls. I relished the stinging feeling when I pulled on a sweatshirt. I smiled, having created something that was truly my own. In the world I had no control over, I had found a source of power.

I ordered a pink-handled x-acto knife, and soon cutting myself became a beloved ritual. I began to crave the pang of the narrow blade ripping through my skin and the subsequent relief of feeling normal for awhile.

But each time, as the high subsided, shame bubbled to the surface. I’d quickly affix band-aids and put on long sleeves, regardless of the weather. I felt stupid and weak, adding fuel to the fire of self-loathing. I didn’t want anyone to find out. Of course Will inevitably did.

While celebrating our first anniversary in Cannon Beach, we reserved a time slot in our hotel’s private jacuzzi—a large wood-paneled room overlooking the ocean. As I lowered myself in, Will noticed my thigh—hot pink and criss-crossed with swollen lines. His face froze and looked like it might shatter.

“Don’t be upset,” I said meekly.

“Then stop hurting my wife.”

Variations on this conversation passed between us constantly. Each time he begged me to get help, to find other ways of coping. I broke his heart over and over again.

My pain continued to snowball until I was barely able to function. I ignored persistent messages from friends. I flaked on commitments. The job search stopped entirely. I lost thirty pounds from taking long, fast-paced walks around the neighborhood, trying to escape myself.

Finally, I agreed to visit a counselor, who suggested that I should seek medical help, and fast.

So late one evening, I sat on an emergency room table, white paper crinkling under my nervous squirms. The hospital’s social worker scrawled on her notepad. Her first bullet point: “superficial cuts.”  It referred to how deeply the skin was pierced, but my heart—my vulnerable, self-deprecating heart—splattered on the polished floor. Superficial. My wounds were trivial.

She looked at me through her reading glasses.

“What do you think about staying here for a night or two?”

“Yes,” I whispered immediately. I was exhausted and ready to get well.

When she left the room, I looked at Will and exhaled deeply. I felt a burden slip off as he wrapped his arm around my shoulder. There was hope. We were going to get this thing figured out. I imagined my family showing up with flowers and balloons and happily walking me out of the hospital.

The social worker returned with some papers and rolled her chair next to me.

“I thought about it a little more,” she said. “Once someone is hospitalized for depression, it’s easy to keep coming back. I’d hate to start that cycle at your age. We’re going to send you home with some resources.” She patted my knee and wished me good luck.

I walked out through the automatic doors in tears, empty-handed except for the phone number for a psychiatrist who would never return my calls. I felt embarrassed for showing up with my superficial problem.

I felt even worse a few weeks later when a $400 bill arrived in the mail and I was no better off. So life just went on. I took a part-time job at a preschool, where each smiling four year-old face was a little dab of glue to keep me together. After work. I’d drive across a bridge, wondering how I could crash my car and sustain minor injuries—but bad enough to get me back to the hospital.

Eventually I gathered the courage to try again. I chose a random psychiatrist from the insurance website and called.

In his high-rise office, I told him I thought I might be depressed. He asked very few questions and sent me home with an antidepressant. Later that night, after one dose, I was pacing around my living room, extremely jittery. I talked nonstop for probably two hours, which is far from normal for me. The next day, while my dear friends were cutting their wedding cake, I was down the hall puking in the bathroom.

I began to think I would never feel better. I couldn’t quiet the repeating voice in my head: You are a waste of life.

On an icy winter morning, I shakily turned the key to my parents’ front door. I worked nearby and often went to their house to drink coffee or use the bathroom while they were at work. This time I left the lights off. In the kitchen I rummaged through the cabinets, searching for some sort of pills that would kill me.

But before I could down the Costco-sized bottle of ibuprofen—I’d found no interesting drugs—I thought about my younger brother, whose bedroom was just upstairs. We’d been close since the day he was born, and I loved him too much to put him through my death. I settled for a hysterical cry and a late arrival to work.

Over time I made numerous plans to commit suicide, but I always chickened out. What a worthless person, I thought, who was too scared to give herself the only thing she really wanted—death.

I refused to share my struggles with anyone except my husband. I kept thinking my pain would probably go away on its own eventually. Maybe it was just a normal rough patch, the growing pains of becoming an adult.

But the cuts were hard to deny. Like blackberry brambles they grew, until fresh and fading marks encompassed all four limbs. Among them sprouted bubbly blisters from a lighter flame. The injuries lingered long after the inciting feelings had passed. In the rare moments when my head was clear and I felt okay, my arms screamed at me. You are not okay.

Ultimately it was a tiny glint of courage that brought about the help I needed. I stood in the narthex after church one Sunday, slurping weak coffee and trying to fake a human conversation with a friend. She mentioned that she had recently been diagnosed with depression.  I seized the opportunity to make the understatement of the century—I, too, was perhaps feeling a bit down. She wrote down the name of her psychiatrist, and before I knew it, I was sitting in a waiting room on an August afternoon.

The doctor had me count backward by sevens. I memorized lists of words and repeated them back. He listened to me fumble through my story and asked pointed questions, all the while taking notes on a yellow legal pad. At the end of the hour, he uncrossed his legs and leaned forward.

“This is a pretty straightforward case of bipolar 2.”

He was calm and thoughtful as he explained that I had a less severe version of bipolar disorder, or manic depression. And that awesome word straightforward, meant there was something we could do about it. The doctor talked me through my medication options and other methods for coping with mood swings.

I was shaking but full of hope when I climbed in the car that afternoon. My husband drove to the pharmacy while I tried to process aloud what had happened. I was encouraged by how comfortable the doctor was when discussing my symptoms, as if what I was going through was not so weird after all.

Will squeezed my hand. “That’s promising. Maybe this is almost over.”

I stared at the prescription slip. My last name was misspelled. “I hope this works.”

Once home, I immediately took to the internet, opening tab after tab to learn as much as I could about bipolar disorder. Sadness, isolation, hopelessness—check. High-energy, agitation, grandiosity—check. The list went on, and the jigsaw pieces clicked into place. All at once, when I thought of myself as manic-depressive, I made sense.

A counselor later likened the diagnosis to Harry Potter saying the name of Voldemort when nobody else would—that simple identifier transformed a nebulous power into a finite foe.

My first act of magic, if you will, was taking my medicine. Each morning I dumped two chalky white pills into my hand. I was fearful, given the previous medication disaster, but I summoned the nerve and swallowed.

The change was stark and swift. Within a few weeks, I felt stable and functional. The urge to hurt myself faded away. My evenings were now refreshingly boring—watching Jeopardy with Will and arguing over who would do the dishes. I felt like myself, though I wasn’t entirely sure who I was anymore.

Around that time, I read a book called Touched With Fire. Author Kay Jamison, herself manic-depressive, writes about artists and poets throughout history who’ve struggled with mental illness. With each page I turned, I felt a little flicker in my heart.

Back in elementary school, I used to sit and write stories for hours in front of my family’s Macintosh, hunting and pecking at the keyboard. I threw out the floppy disks during adolescence, but now, at twenty-four, I yearned to create again.

On a damp January evening, I walked across a community college parking lot. My feet sloshed through the puddles, mimicking the churning in my gut.  I opened a classroom door, removed my hood, and sat down. As I nervously clicked my pen, I glanced around at the roomful of creative writing students—a bunch of weirdos with the urge to make art out of words. I fit right in.

Five years on, writing is a daily ritual for me—poems, essays, crappy fiction—it’s a way to release my feelings and focus my energy. My pen is like a knife on paper skin. In a world I have no control over, words give me power. It’s a power I will continue to rely on, because there is no cure for manic depression. I treat my illness vigilantly, but it remains a constant presence in my life. There are days when the ten blocks to the pharmacy seems like lightyears. Library books sit by my door collecting fines. The simple tasks of life are daunting.

Other days, my mind spins faster than my body’s ability to keep up. I’ll start a dozen household projects and finish none of them. But the oscillations tend to be small and manageable. I consider myself healthy—happy, even.

I can reflect back to my childhood and see subtle signs of emotional instability, but the full-force of manic depression was lured from the shadows by the stress of unemployment, along with the physical growing into young adulthood—I’ve learned that this is a typical time for symptoms to emerge.

Now, I am a woman with mental illness who lives a fulfilling, productive life because of medication, support, and other healthy coping tools. I have a life that was not possible even fifty years ago, and for that I am eternally grateful.

One morning recently, I awoke to the familiar whine from the baby monitor on my nightstand. I groaned. As a stay-at-home mom, I’ve been waking to this unpleasant croon for two years. I went to the bathroom, took my medicine, and trudged across the hall.

I cracked open the door to my daughter’s room and flipped on the light.

“Good morning, Sweetheart.”

She squinted and tried to brush her tangled hair away from her face. As per ritual, she held up each of her stuffed animals for me to kiss. Then, as I prepared her changing table, she did something new. She pulled herself up and reached over the crib bars.

“Mommy hug!”

My eyes teared up as I embraced her and she leaned her head on my shoulder. She soon wiggled free and ran after the cat, but a warm joy lingered in my chest.

That beautiful snot-coated creature depends on me to love her, feed her, and teach her how to count her toes. She needs me to model confidence and self-care. I wonder sometimes if I am up to the task, but there is no greater motivator to keep trying.

I still bear scars, both physical and not, from those rough years, and the journey is not over. Now that I’ve surfaced, though, I’m finding so many people and things that I want to hang on to in this life.

And, it seems, some of them want to hang on to me.