So, travelling with mental health illnesses is on my mind today. But first, I need three to five minutes (probably ten) to rant, then I promise I will some what get to the point of this post. What do you expect? It is a diatribe!
Over the past few weeks since returning from Afghanistan, I have felt a literal hurricane of unstructured thoughts, emotions and volatile mood swings. I feel uncomfortably antsy and anxious one day, and completely obliterated the next day. To describe further, I do not want to get out of bed, and I wish the world would just finally disappear around me [take that for whatever you want that to mean]. My out-of-pocket ‘paid’ counsel is certainly cashing in on this, because it is the perfect time for them to say “step back, try not to make any changes yet; let’s take the next 487 days to walk through some of the hypothetical options you might want to consider”. On the other hand, I am pretty sure there are some sessions with my OHIP-paid psychiatrist where she has literally fallen asleep for the entire session, but has skillfully learned some trick to keep her eyes wide awake as I speak (reference ‘that guy’ in class in university who wears sunglasses to appear awake, but he is actually asleep nursing a hangover). If I did not need my prescriptions, honestly, there would be a lot of breaking up going on at least with the latter. My patience for professionals feels like it is on a cliff with serious intentions. But that warrants a whole post in itself for the next person to ignore.
People who find reading this really annoying (I mean, you could stop reading) would probably ask why I just do not find new support –> well, 1) it takes a really long time to build and figure out some sort of rapport, find the right words to tell and re-tell all your stories, and break down your walls with a stranger; and 2) I actually have a love and hate relationship with psychiatric professionals, and the three I have right now work to a degree (and ‘to a degree’ is better than nothing). Also, I know I am lucky to even have access to resources (let alone three), I am not blind to that.
But, I digress.
On the flip side, everybody else and their mother would say the feelings have arisen because I just came back from travels, and I need time to get over the “travel depression” –>
Which, mind you, people use that phrase in their social media statuses and in spoken word too freely. Seriously, try depression for a year, for a week, for a minute -> inconsiderate a-holes who come home and say they wish they were back in X or Y and will literally and without any sensitivity, use the word ‘depressed’ to describe themselves because they have to go back to work. Yes, you know who you are.
–> So, okay I have serious anger issues; everyone knows that; not the point of the rant. Trying to get to the point, this time, I feel like I am getting closer and closer to finally getting out of auto-pilot. That being said, I say that all the time, but I have allowed things like guilt, logic, regret and fear get the best of me. From a professional point of view, all these feelings can be controlled through techniques where you reign negatives in, and re-frame them into something else. However, for the 424th time, it is easier said than done. For me, the problem is herding all the thoughts in my brain, and contending with how they push back and re-distribute themselves on any given day. Some days, it is better – I have options, and on the best day, the options are binary. Those days are actually the days where I am suicidal ironically. The decision is actually very clear – die or don’t die.
But, other days, I find myself in 500 “choose your own adventure” situations, and I do not know how to focus my brain, to make the ‘right’ choice, to commit….to something -> stay in my current life, change a small aspect of my current life, change a large aspect of my current life, start over with a new identity, make my current life and a new identity work somehow -> or geez, just stop reading or thinking, and just pick something.
But then, because I cannot shut my mind up, I do not know if I am making a decision for myself, or to appease others (or the right words would be, to ensure that X or Y does not judge the hell out of me to my face or behind my back despite saying they are supportive). I am deathly afraid of making the ‘wrong choice’ again, mostly because I am afraid of living another few years through major depression (even though I know I am fated to that course for life). But, the truth is, I know I will never know what the right choice is until I try – cliche right? I can never ‘make a difference’ until I try something. I can never ‘find happiness’ until I try something.
At the very least, I should recognize that I have the chance and opportunity to do pretty much anything I want (within reason). And as I learned through my all-too-short experience to Afghanistan, for others in the world, that’s not always the case. And while others may have to repress themselves in their lost opportunities, they at least take their strength to try and move on. They make a choice based on what is available in front of them, and make things happen even if what is in front of them is bleak. And well, somehow, I have to do the same. I have to.
Strong people make risks and sacrifices all the time to get to their ‘right choice’. I want to believe I am strong, but in actuality, I am weak. I can say that because I know it is true, and I am not going sit here and deny it. I am not a strong person (though I would like to believe that I have strong character still; I think there is a difference), and I make excuses and talk myself out of everything I want to do because I am afraid of hurting others, and the worse one still, because I am afraid that others will judge me (my husband, my father and siblings, my in-laws, my friends or what is actually left of my friends – not really sure who’s left since I have been a shitty friend in return).
But, I am learning to get used to the fact that – right now – I have to take risks and make sacrifices, and face judgment if I want to get to a better place. And by a better place, a place where I will stop taking for granted the current privileged life I live, and finally embrace the life that is set out for me by previous choices that I made (i.e. grow up, build a life and a family with that really good man I have at home, and hopefully just die of natural causes and not out some 40-story building). Somewhere inside me I know there is still a story to tell though. I can fulfill the dreamer inside of me. But the hard question is – at what cost right now? So, then at the end of the day, while I think I am a risk-taker, I am actually more risk-averse because of how I perceive guilt and regret. I am afraid of hurting people in action, because I cannot let go of what people will think. That being said, I am sometimes heartless, and I will say things without thinking; and probably cause all the hurt in the world to detach myself from anything and everyone. But, at the end of the day, I am afraid that if I disappear off the face of this earth, that choice is going to result in leaving someone behind. Mind you, I talk about this in reference to both suicide, or to just leaving and starting over somewhere new (or what might appear to others – going somewhere that could ‘do the job’ for me, case in point Afghanistan).
So, I will say it again. I am afraid of leaving someone behind. I would walk away from the chance at happiness (or peace, which has been the resonating feeling for me with suicide) not to leave someone behind because of my own inexplicable fears and residual trauma from abandonment; and I have done it quietly for years now (whether all the people in my life realize it or not). But, that has resulted in me feeling repressed, internally broken, and in many ways, unable to function emotionally properly, or make choices to save my own life, literally. I cannot deal with abandonment because of how it has affected me, so why would I ever want to impart that on someone else (regardless if they do not have abandonment issues of their own)?
Some stranger reading this is probably thinking – what the hell is she talking about? Well, it’s complicated and personal (and has to do a lot with wanting to do things that are different from what I have been raised logically to believe is right), but whatever decisions I make that feel right – right now involve abandoning someone. If I make those decisions, all I can see is that I will be villainized, but no one will know or understand the other side, what I had to give up to get to this place, and the right to make these decisions now –> to protect myself, to keep myself alive, and to try at a chance to be happy for real. And well, to be quite honest, I offered the ‘other side’ the chance to take my leap with me, and received an honest, blunt –> “no”, and what actually felt like a “never”. So, what am I supposed to do?
What I am describing is probably actually really obvious now, but I cannot continue with describing this right now because internal and external demons are still binding me to auto-pilot for now, so this will maybe all unravel in time. I am not asking for anyone to solve my frivolous, convoluted problems, but I am always grateful for my own outlet here just to scream, so the walls in my house can retain their structure. Anyways, okay, enough of this – onwards to what I really wanted to talk about.
->Travelling with Mental Illness <-
I can only provide perspective with regards to depression and bi-polar disorder, so if you are reading this, remember this is coming from one person’s overarching perspective.
Travelling with mental illness can be two-pronged.
-> All the good reasons <-
Travel has always afforded me the opportunity to leave toxic environments (case in point, the city of Toronto), and just allow my brain to genuinely unhook and breathe. The experiences, conversations and interactions with other cultures that come with leaving home to different countries have always allowed me to stretch my brain, challenge and test my problem-solving skills, and more importantly, open up new perspectives – about a world I did not know, and maybe a better way of living and experiencing life (the better way can exist too you know, even in the developing world). It too, depending on what I experience, will always remind me that I am lucky – and that despite being suicidal, etc. etc, at the end of the day, I will always be lucky. Now, this is not to say that I am on some mission to find something just “to feel better about myself”. That’s not the point of travel at all, but my point is, is that travel can remind you of the things that you take for granted, internally and externally, especially as the basic day-to-day begins to blur.
Truth be said, I always go back home a bit more ‘mentally rested’ (this time being an exception with Afghanistan because it left me with more questions than answers), and with more knowledge around how the world works. Aside from my time in school (both undergrad and Masters), I do not actually think I have learned or been challenged more than when I have been travelling overseas – from both a theoretical and applied perspective, and most critically, from a human perspective. After all, if we interact with the same people every day, and experience the same situations over and over even if just in different permutations (one job to the next; one neighborhood to the next; one Torontonian interaction to the next), we never truly learn anything new as human beings.
I truthfully could never understand why someone would never want to leave the comforts of their home base, if they have the financial means and personal capabilities to do so; I am not ignorant of the fact that some people do not have the means and physical or mental capabilities to travel. I still also do not understand why if a person has the means and capabilities to do so, they would only travel within developed countries, or only the developed part of a developing country (i.e. the pretty sides of the Caribbean, or say for example, via a cruise). But, as Jon drills in my head repeatedly, people are different with varying motivations and expectations, so “if they just want to go a beach and relax”, that’s their choice, just let it go. I mean, someone could equivocally look at me, and think that I am a lunatic who appears to be purposefully ‘seeking out danger’. I do not have kids either, most likely because I am a psycho.
–>Case in point, I have this one coworker who has noted in the past that he could never understand why I travel to the places I do, and that he once left “his all-inclusive resort for a quick trip to the town, and it was already too much for him”. Second case in point, this was the same person who, when I said I was travelling to Central Asia, asked if I was going to drop by our office in Hong Kong. And….we work for a supposedly global business? Let’s maybe not note what facial expression I have on my face right now as I describe this past awkward occurance. He is at least better than the #$%& who keeps on asking me after each trip when I will “finally be done fighting the rebels”.–>
That being said, I am stubborn, and I always wish I could just scream “there is so much to see, experience and feel if you just left your comfort zone”. And so for me, I have concluded it to be fear, mixed with a bit of ignorance. I mean, it has been suffocating to come home, and to have the only questions, comments coming from co-workers, (dad did not even really acknowledge I traveled except in relation to the cough I had going in), and family, be around “whether I actually felt safe?” (even after reading the stories I wrote)–>
- Oh, let’s also not forget the circus of messages I got from social media, WhatsApp around the fact that – “Jon is a really good photographer” -> [HE DID NOT GO WITH ME].
–>What about the people I met? What about what I saw? What about what the experiences made me feel? What did I learn? Why did I go? All the beautiful, interesting things I could have described of Afghanistan and what the journey meant to me as a person, were reduced down to the one muffled, albeit honest answer – “no, I never felt once unsafe”, and then my mind shut down (wish it did not because I should be advocating, scream advocating) because I knew in defeat that I could never convince any of these people back at home anyways to think differently, and that they would never go themselves until the day some flag ship American or international resort brand (hell, McDonalds, Starbucks) somehow invaded the pure, still authentic streets of beautiful places like Mazar or Herat, and warlords were abolished into the genie’s lamp.
In one instance, my mind opened up for 4 glorious seconds as my curious niece asked “What is Afghanistan?”; but before I could even open my mouth to tell her 30 beautiful “there’s this world out there” things I discovered about this unfairly-alienated place, I painstakingly heard the words behind me, “[x], it is just somewhere you do not know“. And then, I felt immediately deflated and I crawled back into my drowning head space, unwilling to open my mouth anymore when I really should have.
It is true, she did not know what Afghanistan was, but I should have told her something. I should have told her about all the little children I saw flying their maybe one possession – a kite – and how it made them smile and laugh like she does all the time. I should have told her that it is a beautiful place where children play soccer like she plays soccer, but where a soccer field is set against mountains and endless valleys. I should have told her that it is a place where little girls have the same types of dreams she does – perhaps to grow up, to have a strong voice, and possibly change the world….and that we are so very lucky as Canadians to be able to go to school, and that some kids do not have that chance (okay maybe that point is too harsh since she is still basically a baby). I should have told her that Afghanistan is a place where some ‘mean’ people (umm…let’s call them Jafar, Ursula, Gaston, etc.) caused a lot of hatred and sadness, but things are getting better, and people are trying to get along now and live happier lives.
I should have done that. I should have been the one to tell her something, and in the process, told the adults something too.
And, I can still do that, but it felt all completely lost in that moment, and I feel really sad about that now. I do not know if she will ever ask the question again. I certainly hope she does – especially when she is grown, and hopefully has the same will as foolish Aunt R, to explore and learn about the world boundlessly. I maybe kind of see that in her, but it is still too soon to tell. Deep down somewhere in me, I too want my own curious little girl who will one day want to explore 190 plus countries and learn about the world boundlessly (just hopefully please, without mental illnesses in hand).
But beyond that, and getting back to whatever I was screaming about before, there then came the self-judgment.
Asking me “whether I actually felt safe” opened me up to 200 negative self-judging thoughts again -> like being perceived as crazy, or selfish and lazy –> ‘having fun’ ‘somewhere dangerous’, engaging in ‘war tourism’, while my worried husband was back at home working hard, because I am ‘stupid and yes, selfish’. But, I am getting into a whole can of worms that I am probably just really too incredibly upset to address properly this week. Once again, I digress too much.
Getting back to my point about travel and mental health, I will always think there is such a beautiful and positive correlation between how seeing the world and how that experience can help re-shape your perspective. I obviously am not a proven case yet since I am still clearly a gong show, but I think that if I had more time even just to speak to more people, and have the opportunity to “experience communities” in an unselfish open-minded way (roll up my sleeves and do something), I would experience more and more change, maybe to the point that my way of thinking would reach somewhere pivotal. I am an applied thinker, so it makes sense.
In my ideal right mind, mental health funding (ummm…not sure where this will come from yet), or even just directive programs should be in place to send or maybe just even, encourage mental health patients to experience the world – whether to just travel, to volunteer and make a difference internationally, or the most ideal, a mixture of both. I do not know how to brand and operationalize it in my mind exactly at this moment – but it would be like international rehab or international support groups.
[With reference to Canada] I am thinking of even 1) a subsidy to help someone who is almost there financially, 2) just awareness for people who are already there, and 3) well, I think that existing (better) resources need to help those in income disparity more before 1) and 2) can occur, so that’s a different story and would need time and other approaches.
But, not diverting from 1) and 2), the travel would be completely structured (as I will point out all the negative aspects travel below) [or maybe even not – because my Afghanistan trip was not structured, and it let me calm down as a person completely], and it would afford patients the real, actual opportunity to 1) see things they have never seen and relax their brain, as I did; 2) learn in an environment that is not judged and graded for the anxiety-prone; and 3) really talk to people who have seen and suffered the world, but half the world away in an eye-opening place we, as Western society know not too much about. A psychiatrist, or psychiatric-trained team would maybe (emphasize maybe) need to be there to structure and shape what is taken away from 3).
Further to my pipe dream, I would want people to stay connected with the people they meet, like pen pals, so there is mutual learning; and perhaps, a translation app will need to come into play to keep those relationships going. Similar to X, Y, Z therapy, and the 500 drugs out there, I think that travel should be structured and offered as an opportunity to saving one’s life. I think that it is that powerful. It has been that powerful for me. Where I could not resonate as well with support groups at home or professionals, and well, not really anyone at home – my supposed “support structure”, I resonated with things that occurred to me by leaving home. But, not all people realize that that alternative exists.
And, apparently, I have read there are some tour groups out there that screen for mental illness (well, hell with you too). I actually worried that was going to happen with Inertia Network, when I first hit the button to ‘apply’ for Afghanistan. They ask all travelers to apply, but it is simply to understand and align their ‘community’ and experiential travel motivations and values, so someone who wants a 5-star hotel, the opportunity to hippie swirl a pretty off-the-shoulder dress in front of the next monument, and wants to get out within 2 days because they just want the passport stamp and iconic photo, does not end up realizing that the only bathroom they have to work with is a bush or squat hole [was definitely not the case in Afghanistan – I only squatted once, and I have powerful thighs from running marathons]; there’s a community learning “impact” aspect (from both ways – travelers to locals, and vice versa); and you are there long enough to hopefully meaningfully connect with the country somehow. The Inertia team never really realized how ‘different’ I was until we got home, and I started ‘speaking’. But somehow, they still might like me anyways. *smiles*
Anyways, and so we get to the ‘negative’.
-> Everything that stands in the way. <–
I think I already mentioned some of the obvious obstacles somewhere already in the tirade (the problem with writing posts that are so damn long)– differences in condition, income disparities, attachments to work, familial obligations, head-on fear. But, for the purpose of the below, let’s assume, one could just freely travel, and read thoughtfully that travel could be a saviour from their mental prison.
As you could all see with my Band-e Amir story, travelling to new places can sometimes lead to messy emotions, because as much as you are exposed to new and eye-opening experiences, there’s the anxiety associated with getting to those new and eye-opening experiences, both physically and mentally. And so, when travelling (and for a longer period than four weeks, something I have not experienced yet, and have yet to write about – but it may be coming), there are a number things to keep in consideration:
- What to do about fear of strangers and crowds, especially in countries with intense security and scrutiny (aka 600 pat-downs)?
- What to do about being afraid of flying?
- What to do about leaving home in general?
- What to do about being in these high-anxiety situations without a physical attachment figure – spouse, dad, best friend, pet?
- What to do about being away from your regular “support structure” – doctors, hospitals, support groups, said physical attachment figures?
- How do you deal with loneliness, even if you travel with a group?
- How do you find your meds in other countries?
- How do you stay on track with meds when it’s easy to lose track of time?
- Is travelling just a form of ‘escape’ [i.e. fight or flight response], and not an actual problem-solver for a psychiatric patient? It is, in some way, but I would argue that there is always a deeper meaning and definitely a learning outcome.
- What happens if you end up in a situation where you feel suicidal, where you need to be in the hospital?
- How to adjust to “tough situations”? – i.e. getting lost, experiencing something with a ‘suffering element’, just hearing tough stories and the associated trigger effects?
- Who can help you in these situations (is there that need – probably yes, we all need a ‘community factor’)? How can you help yourself in these situations?
All of these questions and hypothetical situations can evoke intense anxiety, and so while I think that people may not think about travelling as a “psychiatric recuperative” option, these are likely (from my perspective) the reasons why. And obviously, why my pipe dream has probably not been realized; and also, there’s always the fanciful detail that while the pipe dream might work for me, it might not for others (and I already noted other issues that stand in the way, like income disparity, and severity of sickness, etc. etc.). But, I want to take the next while (not this post obviously), to think through how to deal with the thoughts above because there may still be a niche group of people out there who are like me. And so, I want to actually want to tackle all those issues; not all today obviously, but some day.
My trip to Afghanistan was short, but there were a few important take-aways, that I think can provide some of a meaningful contribution to that “some day” above for now.
- The Harder to See and Do: Be Open -> Breathe and live for the conversations (i.e. embrace the pain to get to the good) – More often than not, I found myself listening rather than speaking, and in some ways, it arose feelings of maybe not belonging, or even identity issues. I am in a WhatsApp group with the Afghanistan people back at home now, and sometimes I still feel like an outsider. And that’s something, someone with a mental illness will need to be cautious, yet open-minded with when it comes to travelling – especially with solo or group travelling.
- There were even a few instances during the Afghanistan trip where I felt slightly internally ostracized just by statements that were made – for example, “I think it would be probably difficult to travel with someone with mental illness” (I was sitting right next to the person who said this, and I felt like crying afterwards, but maintained myself), and then in a conversation about dating, some stories were told about seeing someone with bipolar disorder, or someone taking multiple medications (for mental health reasons), with connotations in both instances of those people being ‘crazy’.
- At the end of day though, not all that differently from at home, I found that I needed to remember that everybody does not know all that much about mental health and the associated experiences, and those were opportunities where I could have opened up to educate and leverage my capable voice. Learning to educate (without being a pushy preacher) is something I need to do, and in time, be more comfortable with if I actually want to break stigma and be an actual “voice” for mental health.
- I did not have to tell my life story, and if I had more time, I might have or I might not have – I do not know. But, my purpose there was not to dwell on my own problems (even up against the “voice” point above), but to be completely open-minded, curious for knowledge, and to listen and take away perspectives that could potentially help me. As you have already read, in many ways I did. I think that had I been gifted more time, I could have taken those perspectives, framed them against my existing situation, and been able to open up in an applied manner. This is kind of a similar to a support group, but I think with more magnitude -> once again, tying back to my point about the interactions between the privileged to the privileged (even if it’s less privileged).
- Even if my support group consisted of individuals who were of lower-income (which my last one did – and I felt really privileged against some of the addicts I met who live in subsidized housing), the privilege of living in a place with Toronto is that you can access a queue for OHIP-funded resources and professionals (I can enter the 17th floor queue at St. Mike’s hospital on a certain severity level just the same as a homeless addict with schizophrenia that is experiencing a certain severity level). That’s not the case all the way around the world; in some cases mental health resources do not exist. Mental health is taboo; but that does not mean you cannot talk about and share experiences. So, it’s always a different interaction, and scenario of learning when it comes to experiencing the world.
- The Easier to See and Do (also in some ways can apply to people without mental health problems): To ease the loneliness aspect, try to travel with others. (I am in a lonely state to begin with, which I am used to, as I laughed about casually with my psychotherapist today; but let’s assume you are trying to solve a loneliness problem). I was morbidly afraid of group travel prior to this first experience, but after Afghanistan, I realized how powerful community can be when you are billions of miles away from home. If you cannot stand being with others all the time, try at least to make moments away for yourself (whether with a nap or away in your room after activities are said and done). But, you might find yourself in a surprising situation (like I did) where you want to sit at a table with others for hours laughing about everything that happened that day -> especially where some ignorant lady at your guesthouse greets the one African guy in your group brazenly with “I study monkeys”, before even saying hello first or asking where he was from.
- Bring comforting things from home – I accumulated pictures of Jon and my cats on my phone, and I brought a squishee cat (to act as a stress ball).
- Plan ahead of schedule to talk to a loved one at home – I messaged or talked to Jon frequently even with the time difference.
- Rest properly and eat healthy – I am not young anymore, so there are no urges in me whatsoever to stay up past 10PM wherever I am in the world, but I do let go of diet when travelling because I want to try everything I see in front of me (including Afghan hash). Surprisingly enough, I always find that when I get home, I have lost a lot of weight. And, it makes sense, you eat a lot, but you are also not sitting in front of a desk all day, so movement makes a difference.
- Logistical items that can help with the mind mess –
- Register with your embassy. For Canada -> Link here.
- Get the proper travel insurance. For Afghanistan, I focused more on kidnap and ransom (and, at the advice of Inertia, went with First Allied), though in hindsight I should have also been thinking of covering hospital treatments, as well as potential emergency repatriation in the case that I became actively suicidal.
- Things I should do (but have never done in the past) –
- Find out if my meds actually exist in the countries I am travelling to.
- Prepare prescriptions and doctor’s letters explaining my need for medications.
- Prepare a medication schedule. I just took all my meds at night.
And so, while the range of ways that travel can aggravate a person’s mental health needs to be addressed and considered, I would never consider any of them obstacles to achieve all that I outlined above in what I could only describe as an immersive global support group experience – once again, – the pipe dream. How I can put that all together into play with other issues I may not even fully be aware of (i.e. cultural sensitivities, patient differences, income disparities etc etc), I just do not know right now. And so, maybe that’s why I need to experience more ‘on-ground’ before I can put things down on a white board and structure it all together, probably with people who are way smarter than me (from travel, tech, and mental health perspectives). But, as you are all aware, I am struggling through some personal obstacles first before the path to a pipe dream can even start.
Anyways, as always, the story just drones on. I am just glad though that Afghanistan has helped me to write again. I feel a sense of relief each time new (or even a reorganization of old words -*ad-hoc smiley face*) words find their way onto paper. If nothing comes out of this, and I remain the basic and useless human being that I currently am, at least I have learned to voice my opinion more, even if it’s behind a screen.