My head has been spinning all morning.

I forgot to take my medication the past two days. I’ve been straying from a normal schedule the past few days, and have been forgetting to take my medication in the mornings. And at night. I know the consequences. It’s happened before. Brain shivers, difficulty concentrating, just a slight feeling that everything is behind a foggy windowpane – that I can’t quite make out the outline of the people around me. Not structurally, it’s not like I’m blind of my vision is going. But somehow, things feel foggy anyway. The idea of them.

As I sit in my office in an inpatient psychiatric facility, I think about taking those same symptoms and compounding them. fifty times. A hundred times. A million. For every missed dose, for every time a patient goes on a medication and then takes themselves back off of it at will, without guidance. Brain fog. Shivers. Side effects. Mania. Panic. A slight distance from the world around them. A feeling that things are slipping away.

I’ve tried to write this blog so many times, and each time I manage to make one post and decide I’ve finally gotten my wheels turning, I step away again and logging in becomes difficult. Maybe I intentionally forget my passwords. I get too busy. And then starting up again seems like too big a river to cross. The medication I take, though it can be used for many things, is used on me to treat obsessive compulsive disorder. A lot of people in my life don’t really believe me when I say I’m OCD. I don’t have the things that are stereotyped as OCD: the cleanliness, the neatness. But it’s there nonetheless. As one of my patients would say, that’s the beast of it. Whether you believe in mental illness or not, it’s still there – the faulty wiring, the misfiring synapses.

My particular brand of OCD is, I’ve started to learn, part of what makes things I want to do – creative things, writing, art, poetry – loom like monsters at the back of my closet, unfinished. Because if I start, then I have to keep going, and I have to keep going perfectly. Perfect or it doesn’t count. On pattern or it doesn’t matter. Follow the rules.

The problem is, I’m not always sure what the rules are, or WHY they are.

So I go for months at a time without writing because I want it to be exactly right, but I know it can’t because I know that nothing is.

But that’s the beast of it.

Do the impossible. Be something that isn’t. Fight with things that aren’t there.

And so as I sit here with my brain shivers thinking about how my own schooling is teaching me more about my brain and how it works, I realize how much I WANT to write this blog. There’s a lot out there in the world about reducing stigma for mental illness. But anytime we try to reduce stigma surrounding something, we tend to paper over it a little, make it palatable and marketable. But as I sit in the office and type, I realize that my patients need much more than that. They need for people to understand what a brain feels like when it’s overtaken. And more people who work with those with mental illness, or who love those with mental illness, need to learn the things I’ve learned in school.

How the medications work, and how they don’t. How we make choices about what to prescribe, and what we do when those choices go wrong. What happens to people who fall outside the system and don’t get treatment – not just from an institutional perspective, but from a human one.

Because that’s the beast of it.

The things you most need people to understand are the most difficult to communicate. Especially when you didn’t take your medications this morning.