CONTENT WARNING: SUBSTANCE MISUSE AND SEXUAL ASSAULT
I've been friends with A., thanks to the magic of the internet, for a while now. She and I have similar "coming out" stories; we both fully embraced our queer identities later in life. Every now and then, when times get tough, I reach out to her. Time can pass so quickly when I talk with her; she has an infectious energy and unparalleled brilliance that draws me in. During our talks, I can feel myself opening up to her, even though we've never met in person. I thought of pitching an interview to A. for inclusion in this collection since many of our conversations have revolved around our substance misuse and queer identities and how they overlap and intersect. The following is an emailed interview from earlier this year.
Ruth: Can you share a little bit about yourself?
Anonymous: I am 27 years old and work as a novelist and journalist in Chicago. I am queer and didn’t really make that known to the public until just last year. I spent over a decade in the closet, forcing myself into hetero relationships while other young queers were dyeing their hair and listening to music I didn’t know about. Even now, I don’t know what queer kids listened to in 2005—I was too entrenched in the music of whiny cishet balladeers, the women inexplicably pining for men, the men clueless about why years of abuse had lost them their women. I thought it was normal for a man to think of a woman as “his.” I thought it was adult to wear clothing with muted gray-black tones and to lose weight in order to be more attractive to men (even now, even after all the work I’ve done to distance myself from the cisheteropatriarchy, I find myself believing these statements—the culture I live in giving them such high purchase). Now, few of my friends are cis or cis-presenting, but back in 2005 I didn’t realize there were options outside the two genders a doctor chose for you at birth.
Predictably, I was in denial of who I really was while acting and dressing the way I wanted to be. I had, for instance, short hair and thick, black-framed glasses with a purple tint. I wore, as I do now, femme pants and boy shirts. Many people called me “gay” to make fun of me. I considered changing the way I looked but never did. I berated myself for my laziness, for staying “gay,” and set goals for myself: I’d grow my hair out long, lose ten pounds, wear makeup, and get a pair of Abercrombie sandals like the small, white, cishet rich girls who whispered down the halls of our high school, desired by everyone and obtainable by no one. I’d be like them.
Trying to be like them ruined my self-esteem. I can’t imagine that being like them treated them that well either.
R: A lot of people struggling with substance misuse live at the intersection of queerness and survivorhood. Can you talk about this?
A: I am a late-to-the-game queer person, someone who for whatever reason didn’t feel she could live her truth until she was almost 27. Nobody forced me to be this way—nobody aside from the millions of nobodies whose actions both intentional and unintentional reinforce and uphold the kyriarchy—I just ended up becoming this way out of a desperate desire not to be lonely. To be queer meant to be different meant to be alone. And I wanted friends, so I had to be “normal” . . . how badly that backfired.
I have been fortunate enough to avoid the traumas suffered by a lot of femmes. Being white, able-bodied, college-educated, middle-class, and from a supportive family go a long way in terms of avoiding state violence, the traumas and stressors of poverty, familial abuse, and abusive caretakers. And while these privileges aren’t enough to protect anyone from sexual assault, I was—and I say this with irony—fortunate enough to experience only the mildest forms of the latter. As femmes, statistics are not in our favor: our culture commands our violation. I am the partially shaded-in box, the point-five of the 3.5 or 4.5 out of 5 who will experience sexual assault in their lifetimes. My abuse begins and ends long before PTSD. And my contact with would-be abusers is now so diminished that I can almost hold my breath and think that my window has closed. But patriarchy isn’t that predictable. All I can do is hope for the best.
What brings me here is bipolar disorder, which makes people do and say embarrassing things. For a long time I thought I didn’t have this mood disorder because I saw other people in the throes of real, manic behavior and thought, “That sure isn’t me!” Other times I’d hear tell of catatonic depressions and would think, “I’ve never been there in my life!” Both misconceptions made for a particularly disorienting time when I thought I was leading the November 2016 resistance by stealing duffle bags-full of goods. Or walking around sobbing in my neighborhood at 2 a.m.
Back when I lacked a concrete support system in 2012-2013, I wasn’t apprehended from my exploits as easily. And by “support system” I mean “people who knew I had a disorder with symptoms worth looking out for.” I binged on drugs: ketamine, molly, amphetamines, cocaine, DMT, acid, opioids. I became obsessed with drugs, sex, and making money. I was bored unless I was doing something involving one of those three. I had no ambitions to be “cool” or financially solvent—I just wanted to be stimulated somehow. And I was surrounded by friends who were OK with that. Don’t get me wrong—they were all good people. But none of what we did together was particularly productive or healthy. We were probably all neurodivergent and longing for the easy companionship you get when you’re a kid in a group of fellow kids who only care about pulling pranks and running around outside. And instead of peeling off our masks and figuring out what it was we really wanted, we did drugs together.
I don’t mean to brag, but I got away with living this lifestyle for a while. This is because I did everything in intense bursts and then left when the academic year was over (I was teaching at a college). Being peripatetic was one of the things sandbagging the flow of energy. And there was my class: I could blow as many rails as I needed to beforehand, but I would always be perfectly self-possessed while teaching. And there were of course the many friends I had who didn’t do drugs, the friends to whom I had obligations. If I maintained all these obligations to nice, sober activities, I figured I could do as many drugs as I wanted with the rest of my time.
R: I know the last time we spoke, we shared about our experience living with mental illness. For many of us, self-medication is a means of survival. Can you talk about the blurry line between substance use and substance misuse?
A: Absolutely, though I’m not sure how enlightening my answers will be.
Substance use is when you’re getting together with a group of friends for a night on the beach, let’s say. There’s going to be a bonfire and someone’s going to bring a tent and someone else is going to bring kettle corn or something (full disclosure: I’ve never had a night like this, so sorry if this sounds contrived). You’re all hanging out by the fire and someone says, “Hey I have shrooms!” and some people spontaneously decide to take shrooms. It’s a memorable and beautiful night. That’s substance use.
Substance misuse is you’ve been told you have a history of pathological mood fluctuation, but you’re ignoring that. You’ve been feeling really great lately and you want to do whatever you can to keep the feeling going. It’s 10 p.m. on a Monday and you carefully weigh out and take some shrooms from the eighth that you bought. On a Friday, you round up a group of friends (now you are the one who’s got shrooms at the beach party) and you take shrooms with them. Then you do this again the next week. (Not that there can’t be memorable and beautiful aspects to this, too. The human experience is messy and interesting in that gorgeous things can emerge from moments of extreme duress.) You do this until you burn out or you find a new drug to focus on.
"...THERE WERE OF COURSE THE MANY FRIENDS I HAD WHO DIDN’T DO DRUGS, THE FRIENDS TO WHOM I HAD OBLIGATIONS. IF I MAINTAINED ALL THESE OBLIGATIONS TO NICE, SOBER ACTIVITIES, I FIGURED I COULD DO AS MANY DRUGS AS I WANTED WITH THE REST OF MY TIME."
Substance use is spontaneous, and sometimes the would-be users say no. When I’ve been in the mood to misuse substances, I’ve never said no to anything offered to me. Substance misuse is obsessive, planned, calculated and frequently concurrent with mental illness: you either want to obliterate a bad feeling or feel more of a good one.
What does your substance misuse look like?
My substance misuse looks like an intense spike in consumption followed by a period of relative sobriety. Certain “socially acceptable” drugs (alcohol, marijuana) are usually in the background, but the harder stuff tends to come and go with the waxing or waning of my mood. A manic mood means uppers and a depressive mood means downers. Funny how these coping mechanisms don’t even pretend to counteract the harmful biology: I kept good moods up and bad moods down and thought I was helping myself.
Now that I’m taking my medication, I’m actually not doing any drugs or even drinking. At first I was scared of how it was going to look and a little hostile toward the idea of living a sober life. Now I can say with full confidence that it’s a really wonderful feeling.
R: Do you feel like you have access to sufficient support systems in your community?
A: Big time. My girlfriend is hugely supportive and very much a both-feet-on-the-ground realist when it comes to diagnosing and treating mental illness. My family is wonderfully supportive and compassionate, but there’s some stigma around naming and treating mental illness. My girlfriend functioned to bridge that gap, getting me out of denial and into a place where I could begin to recognize the various toxic factors that were keeping me stuck. Friends are good, too, and pretty down to work with me on whatever aspect of myself I’m feeling I need to work on.
The key to transforming people from a group of well-wishers and loved ones to a bona fide support system is being honest with them about the mental illness you have. I resisted doing that for such a long time because I didn’t want people patronizing me, assuming I wasn’t in my right mind every single time I expressed a strong emotion. As it turned out, the people I cared about thought of me as more than a push-button bipolar machine, responding in a Turing-like manner with either mania or depression to a set of triggers. Being considered an autonomous and complex human being does wonders for my self-esteem.
R: What (if anything) do you you feel is missing in the conversation around substance misuse and mental illness?
A: What isn’t missing from this conversation? I’d say participants, for one. And listening ears. Substance misuse and mental illness are stigmatized enough on their own: combine the two and you’re dealing with something our puritanical society is quick to regard as unseemly and “beyond redemption.”
I’ve never been through a twelve-step program, but I have friends who have and I’ve heard mixed reports. Most people think the programs are amazing, but there’s a stubborn minority that feels left out, or thinks pledging faith to a higher power is ridiculous, or is terrified to share their experiences of substance abuse. I think the conversation around substance misuse and mental illness needs to be big and accessible enough that even these people can get up at the podium and courageously tell their stories.
Right now, the conversation is happening among clinicians behind closed hospital doors. And no one is saying, “We as a society should take a long, hard look in the mirror and figure out what it is that drives the mentally ill among us to self-soothe with substances.” They’re saying, “This patient needs 40mg Librium for alcohol withdrawal,” or “This patient exhibits isolating tendencies, suicidal ideation, and cannabis abuse.” The clinical language surrounding mental illness and substance abuse expands to include the layman’s lexicon in group therapy settings and places like Alcoholics Anonymous (AA) and Narcotics Anonymous (NA). And while learning to cope with impulses and cravings is certainly important—arguably more important for one’s health than piecing apart why being mentally ill under a certain set of social structures leads to the consumption of substances—it’s a shame there’s no language for non-clinicians to talk about the intersection of mental illness and substance misuse.
Some of us (or a very intrepid one of us) needs to start a national conversation on this topic. I can honestly think of no activity more American than self-medication.
R: I’d love to hear you talk about the idea of “recovery.” With addiction, sometimes from the outside, things appear fairly clear-cut. Either you’re engaging in substance abuse or you’re not (although the 12-step community does a pretty good job of seeing some nuance here, I’m speaking specifically about the discussion around the difference between “abstinence” and “recovery”).
A: This can be a little trickier for those of us who are “dual-diagnosed” (aka: substance abuse disorder + another mental illness). With mood disorders (depression, anxiety, bipolar disorder I & II, etc.), the idea of recovery can be harder to pinpoint. When you consider your situation, what does recovery look like for you?
"SUBSTANCE MISUSE IS OBSESSIVE, PLANNED, CALCULATED AND FREQUENTLY CONCURRENT WITH MENTAL ILLNESS..."
Mental health professionals are fond of reminding me that recovery doesn’t look like a straight line on a graph. It doesn’t look like the total cessation of symptoms and doesn’t look like me being a brand new person totally restored from mental illness. I think a lot of us patients think of our experiences as a series of episodes and recoveries. We spend a lot of time sitting in hospitals and group therapy and individual therapy desperately wanting to be better. We compare ourselves to others (“I don’t deserve to be here,” or “I’m better off than him,” or “She’s doing so much better than me!”) and beat ourselves up when we don’t measure up to our own expectations. “Recovery” is such a fraught word for me because it conjures up these associations with impatience, insistence, and trying (and failing) to hurry things along.
For me, an episode would typically look like a combination of intense substance use and impulsivity occurring over a period of days or weeks (look how clinical I can sound!). It’s safe to say my substance use is a symptom of the bipolar component rather than a disorder in itself—I don’t think there’s a point at which one begins and the other ends. So when I’m having an episode, I’m grabbing for the things in the world that confirm my emotions, that soothe me, that keep the high going or keep the low dulled. I’m indulging in a cycle of indulgence and my impulse control is eroded to the point of non-existence.
After that happens, I crash. (If I was low, I’ve crashed already.) I spend some time thrashing around in the hellspace of depression because I can’t do anything else. Then, haunted and sleepless, I try to embark on the path to recovery. This often looks like me feigning “being OK” and pretending that some substance use won’t affect me (spoiler alert: it always does).
Recovery begins, but it’s slow. It comes in sputtering fits. I feel better one day and horrible the next. I feel stable one day and plagued by flashes of hypomania the next. I feel good about myself one day and terrified of failure the next. But throughout all this I’m slowly beginning to take interest in the world around me again. I’m beginning to perk up and notice the changes in weather, the expressions on people’s faces, jokes, or music I like. As time increases, I start to remember who I am, what I’ve accomplished, and my set of core values.
By the time I’ve recovered, I’m not fully functional (that’s a myth), and I haven’t gotten “back to normal.” That’s the beauty of recovery: you only ever move forward because time moves forward. Even when you backslide, even when you relapse, you’re still in what my therapist likes to call “uncharted waters.” Which is I guess a therapeutic way of saying you’ve wound up someplace new. No two episodes are the same, even if they look the same. There is no moving backward in your life. Metaphysics won’t let you move backward. Neither will your brain—and your brain will let you do a lot of weird shit.
So I guess I’d define recovery as “inevitably moving forward.”