We live in a world in which people are constantly judging us on how we look. Sometimes, the effects of mental illness are overtly obvious, like when hygiene goes flying out the window, or when eating pattern changes produce major weight loss or gain. Things like weight gain can also be very visible side effects of some psychiatric medications. So how does one handle living with visible side effects?
I have a tremor as a side effect from lithium, and it’s been surprising how often people comment on it. My tremor is worse with intentional movement than at rest, and people often notice this when I am paying for things in shops. Clerks may come out with a condescending “take your time” or a concerned “are you ok?” If I’m at a coffeeshop and carrying a wobbly mug to my seat, this will sometimes elicit comments, either from staff or other customers.
I’m not sure why it’s anyone’s business, but it makes me feel very conspicuous. I have a mostly invisible illness whose treatment has visible side effects. I’m lucky that the antipsychotic that’s worked best for me (quetiapine) has a low potential to cause movement-related side effects like tardive akathisia.
Yet it’s hard sometimes to remember that I’m lucky. One of my nursing jobs involves administering injections and teaching clients how to self-inject medications. My hands are very much on display. My tremor is worse with intentional movement than it is at rest, and I worry that clients will think I’m either nervous or incompetent. I don’t really like either of those options.
I usually take propranolol before doing this kind of work to put a damper on the tremor, but if I’m tired/stressed/caffeinated, the propranolol doesn’t do a whole heck of a lot. I’ve seldom had clients comment, and if they do I brush it off as too much coffee, but the rest of the world seems to feel quite free to comment.
Another way I’m lucky is that I’ve never experienced a disordered relationship with eating. I haven’t always been happy with my body, but it hasn’t impacted my relationship with food. I’ve written before about illness, meds, and weight, but what comes to mind now as I’m writing this is questions about pregnancy. My meds have caused the weight to pack on disproportionately on my lower abdomen.
The proportions have shifted around over time, but one particular summer, multiple different people asked about my non-existent pregnancy. I’m of the opinion that you should never ask a woman about being pregnant unless it looks like she’ll probably give birth tomorrow. When others commented on my “pregnancy”, I felt like I had totally lost control over my body. I felt really offended, less because of the very real psych med baby I was carrying around and more because others felt they had the right to talk about my body.
No, I didn’t get Botox for looks
There is some evidence that Botox can be helpful for depression, and I recently made the decision to add it to my treatment plan. When I told a friend about it, she shifted the conversation to how she’d thought about getting it cosmetically. For some reason that made me feel icky.
And it’s not (at least I don’t think) so much that I would judge someone for getting a cosmetic procedure; it’s more that I don’t even care enough to wear makeup, and the thought of doing something to my body for cosmetic reasons seems utterly bizarre. Maybe the issue is that I worry others will judge me for getting Botox. My non-crinkling forehead is a sign of desperation to try anything for my illness, not a sign of vanity.
This post has been a bit all over the place, but I guess my point is that people are judging us. No matter what we say, what we do, or what we look like, others will judge us. We can’t stop the judging, much as we might wish to, so all that’s left is managing our own reactions. And sometimes that’s much easier said than done.
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