My Mental Health Issues Have a Name: Bruce
And like Mr. Springsteen, I have resolved to release the shame.,
I’m probably not going to make the strongest case for my mental soundness by telling you that Bruce Springsteen lives inside my brain. But here we are.
Since being diagnosed with depression in my 20s, I have been candid about my mental illness. To counter the stigma, I share that I go to therapy, and that via daily medication I am in the Better Living Through Chemistry contingent. But over time, the diagnoses have added up: depression plus generalized anxiety disorder. After I got my third diagnosis, inattentive-type attention deficit hyperactivity disorder, which I came to suspect I had while supervising my young daughter’s remote schooling during lockdown last spring, I was still honest about my mental health, but it was harder to discuss without a term that encapsulated everything.
I was not only “mentally ill,” nor was I merely “neurodivergent.” “Serotonin-deprived with executive dysfunction rising,” while a clever description, was more likely to be taken for an odd diagnosis than for the joke that it was. For expediency’s sake, I gave the whole bundle a nickname: “Bruce,” in homage to Springsteen, who has been open about his own struggles with mental health. The nickname allows me to efficiently keep people apprised of my status, as in: “Bruce has really been bringing me down this week.” The nickname helps me lighten up about my own darkness.
I am one of many Americans whose emotional well-being nose-dived during the pandemic. The glitchy chaos of my daughter’s Zoom classroom frustrated me endlessly. The juggling of schoolwork, house work and my own work overwhelmed me to the point that my mind would skate into blankness, like my system had been knocked off-line, as it has been many times in my life.
Because my husband is a veteran, I get my health care through our local military hospital. During a consultation with the Army psychiatrist on staff, I checked almost every box on the diagnostic questionnaire for inattentive A.D.H.D. — including siblings with the disorder (it has a strong genetic component).
A.D.H.D., anxiety, depression: I’d hit a comorbidity hat trick. “Comorbidity,” the ominous-sounding term for simultaneously occurring conditions, is common. Many people with A.D.H.D. have another mental health condition; and according to a 2017 article in the medical journal BMC Psychiatry, in adults, depression and anxiety are among the most common comorbidities.
I’m not surprised my A.D.H.D. diagnosis came last. Research shows that women are underdiagnosed, improperly diagnosed and diagnosed much later in life than boys and men, as women tend to have the inattentive type of A.D.H.D., rather than the garrulous, constantly-in-motion variety often equated with the disorder. Underdiagnosis is even greater among Black girls and women.
After my A.D.H.D. diagnosis, I was overcome with emotion — relief, yes, at having an explanation for why my mind pinged between daydreaming, emotional overload and obsessive hyperfocus, but also shame, anxiety and grief. Shame around feeling abnormal and difficult. Anxiety around finding effective treatment. And grief for opportunities lost.
Had I been diagnosed in childhood, when the symptoms first appeared, I might have had an easier time calming the tides of negative feelings. I might have finished high school. In a culture hellbent on productivity as a hallmark of success, and even individual value, it can be difficult to accept that my square-peg underachiever status is a matter of faulty wiring, not personal failing.
Finding the proper medication, or medications, to treat overlapping mental health conditions is more often a wavy course than a straight line, as exhibited by my own trial-and-error. Eventually, I found I function and feel best with daily Lexapro, extended-release Adderall and the occasional Klonopin for intense spikes of anxiety. I cling to these pills like the lifeline they are, traveling with my meds in a tote bag clutched over my shoulder, pills rattling in their plastic amber bottles, marking each step like psychopharmacological maracas.
With vigilance, plus medication and regular therapy, I feel mostly OK, most of the time. My work gets done, my obligations met; the black-dog days stand stark in their rare awfulness. One important part of the journey is identifying how mental illness and executive dysfunction manifest in my life, so I can address them when they reappear or worsen. My signs of depression and anxiety are agitation, exhaustion and, at the extreme end, a lacerating feeling of self-loathing and futility. Springsteen, by contrast, has referred to his own depression symptoms as a cloud of “toxic confusion.” There’s no one-size-fits-all in this scratchy suit.
It was likely A.D.H.D. that spurred me into buying a last-minute ticket to “Springsteen on Broadway” in July while evading sleep at 1 a.m. This particular form of executive dysfunction is known for impulsivity, after all.
I took my Adderall the morning of the show. Attending unmedicated would have had my mind wandering as I watched Springsteen perform: I wonder what song he’ll do next. You know what song is great? “Candy’s Room.” Oh, man, I should’ve gotten some candy at the concession stand before the show started. Does he need to wear orthotics in those boots, standing for more than two hours every performance?
But once the show began, I was fixed on the legend in the spotlight unfurling his life story from peak to vale and pealing out songs. Nothing else, save for the woman next to me silently weeping, diverted my attention. (I’d have cried, too, but Adderall and Lexapro dancing cheek to cheek in my bloodstream make it all but impossible.) Fully absorbed in the mystical significance of live performance, this was, in a way, the first show I’ve ever completely seen.
The next morning, I was left feeling inspired by Springsteen’s honesty, to continue being open about my struggle, to normalize the process of discovery, diagnosis, treatment and adjustment. Some people can’t disclose their mental health challenges for practical reasons — work, cultural bias, unsupportive family. Some people simply don’t want to. But my mission has been made clear: to extend the hand of hope to anyone who is suffering the way I have.
As I count out my pills, I count my blessings. Isn’t it funny how a cluster of diagnoses can rob with one hand, and, once managed, grant you purpose with another? And isn’t it funny how an entire constellation of thoughts, and an entire way of being, can spin out from a single star?
Lily Burana is the author of four books, most recently “Grace for Amateurs: Field Notes on a Journey Back to Faith” (W Books/Harper).