Remember back in October 2019 when Modern Love came out on Amazon Prime, and for a moment there it seemed like wholesome, pure things like romance actually existed in the world? Yeah, me either. If you watched the Amazon Prime series, you definitely remember the episode with Lexi (played by Anne Hathaway), a young woman who was struggling with bipolar disorder. That was based off the Modern Love essay by Terri Cheney, a NYT best-selling author and former attorney to the stars, whose new book MODERN MADNESS: An Owner’s Manual is out September 8.

In the middle of a pandemic that has worsened a mental health crisis in America, Cheney offers an honest, poignant work of nonfiction that discusses all the ways her battle with bipolar disease has affected her life, and offers lessons to be learned. Whether you struggle with mental health or care about and want to support someone who does, MODERN MADNESS is a necessary read. But don’t just take my word for it: Anne Hathaway, who blurbed the book, says, “Terri Cheney’s unflinching commitment to telling her own truth on her own terms moved me into a new place of compassion. Hers is an unparalleled—and deeply necessary—voice.” And now, Betches readers can get a first peek at MODERN MADNESS. Check out the excerpt below, and be sure to order your copy today.

Back when I was still a practicing lawyer, I developed a lovely bad habit of dropping out of sight and reemerging in Santa Barbara. I didn’t tell my friends or my bosses where I was going. I just disappeared into the sunset over Pacific Coast Highway, listening to Joseph Campbell’s Follow Your Bliss audiotape and scheming how I could quit my job. I was usually manic when I did this, or on the brink of becoming so.

I remember pulling into the sweeping driveway of the Biltmore Hotel one time. The pink bougainvillea that draped the entrance rustled in the ocean breeze, welcoming me.  “Aaaah,” I sighed, as the valets and bellhops swarmed my car. A disturbingly handsome young man, dark-eyed and deeply tanned in a spruce white uniform, opened the car door for me. Mindful of his gaze, I extricated myself slowly, holding his hand for balance. I felt like a princess making an entrance—until I gracefully tripped, landing splat on the cobblestones. My purse flew open and all its contents went sprawling out over the drive.    

The valet did his best to recover my things, even scrambling under my car to retrieve my lipstick. Despite his efforts, a few papers were lost to the wind.  They were probably just related to work, I thought. Good riddance. I tried to tip him, but he refused. “Please,” I insisted, but he shook his head. “It’s my pleasure,” he said, as he ushered me into the lobby. 

“You’re awfully kind,” I said, feeling that old familiar risk-taking tingle. “Can I buy you a drink when you’re free?” (I’m so practiced at asking men out for drinks when I’m manic, I could lecture on it at Vassar.)

“I’ll be off in an hour,” he said.

“Terrific!  I’ll meet you in the lounge.”

I went to my room to unpack. Something was missing, but I couldn’t say what. Perfume? Check. Mascara? Check. Stilettos? Check, and check. I slipped them on with a sexier dress and some racy new lingerie. But the feeling continued to nag at me: what had I forgotten? Was it important? Would I need it? Oh well, I shrugged. Whatever it is, I can buy it in the gift shop later.

I went to the lounge, ordered myself a tequila sunrise, and settled in to wait. The bar was busy—lovers and tourists cooing over the magnificent view of the ocean. I glanced in that direction: a sunset. Pretty, but I’d seen it before. I was more interested in the view of me. I took great care to arrange myself on the stool—a little leg, a glimpse of shoulder, just indiscreet enough to be noticed.

A man at the bar came over to me. Another dashing devil, only this one had blue eyes, and was wearing a crisp white shirt with epaulets. Having dated a pilot once, I knew what those four bars meant: a captain.

“Quite a view,” he said.  

“That?” I waved my hand at the panorama.  

“That, among other things,” he said.  He looked down at my empty glass. “Can I buy you a sunrise?” he said, and I giggled. It sounded salacious to me, but then most things do when I’m manic.

“Maybe,” I said. “What’s your name?”

“Dan,” he said. “And you are..?”

I put a finger to my lips. “Incognito,” I whispered. “So tell me, which airline are you with?”

“I fly corporate,” he said. I’ve never once dated for money, but still: visions of Lear Jets and Gulfstreams flitted before my eyes. At the slightest whim, we might be off to Acapulco or Paris or wherever for the weekend. Imagine all the art I could see, the tales I could tell, the glitz and the glamour of a jet-setting life…

“Yes, you may buy me a drink, Captain Dan.” I heard the rhythmic lilt in my voice, and for a moment, I felt uneasy—but I wasn’t sure why.

He drank Glen Livet, as all men should. I kept to tequila, but switched to shots on his dare. Probably not a wise idea: alcohol is trouble enough on its own, but it instantly kindles my mania, as if a match is being held to my brain. I downed another shot, and fire exploded inside me: oranges and violets and flamingo pinks, as if I’d swallowed the sunset instead.

I felt a hand on my shoulder and turned around: the handsome valet. The two men immediately started sizing each other up. I got in between their glares and said, “This is my old friend, um—I’m sorry, I don’t know your name.”

“David,” he said.

“Dan, meet David,” I said. Or should it be “David, meet Dan”? It was getting awfully hot in there; droplets of sweat snaked down my back, and I was suddenly flushed and confused. Why were they both wearing white uniforms? Should I be wearing one, too?

“Give me a minute to change,” David said. “Hotel policy.”

“Ooh, are we breaking a rule?” I said.

“Not yet,” he said, and he winked. I laughed, but Captain Dan didn’t seem amused.

I watched David leave, and wished I could go with him. His eyes were so dark, they looked like they were rimmed with kohl. They were the eyes of an Arabian prince. I pictured myself swathed in colorful silks, riding bareback with him across desert dunes. Pretty boys were feeding me sweet fresh dates and waving palm fronds across my body to keep me cool…

A jazz combo started playing, annoying and loud. The music inside my head was so much nicer. “It’s suffocating in here,” I said. “Let’s leave a note with the bartender so David can find us.” I scribbled two words on a cocktail napkin and handed it to Captain Dan. He looked at it quizzically. “The ocean?” he said.

“Yes, let’s go for a swim. I need to clear my head.”

“But I don’t have a bathing suit.”

“Neither do I.”

It didn’t take him long to settle our bill after that. When we stepped outside, the night had turned cool and windy. “I need to get my pashmina,” I said. “Back in a flash.” It didn’t occur to me how absurd this was—as if a small, silky shawl could keep the chill off my wet, naked body. Captain Dan leaned against a pillar and lit a cigarette. I spotted David coming up the path behind him. I wondered if I should stay and soothe the tension, but then I figured it would be so much more fun to watch the sparks fly.

I hurried to my room and grabbed my pashmina. A paper came fluttering out from its folds—a page from a legal pad.  I’ll deal with it later, I thought, and was starting to put it back into my suitcase when I saw the title, in red ink and all caps: “WARNING!  READ IMMEDIATELY!” Uh-oh, I thought. This can’t be fun. But I sat down on the bed, smoothed out the well-worn paper, and read:

If you suspect you’re getting manic, you probably are. You MUST obey these ten sacred rules:

1. Don’t change into something sexier. Wear granny panties and flats.
2. Don’t make friends with strangers. They’re strangers.
3. Don’t drink anything but iced tea—Lipton’s, not Long Island.
4. Don’t get naked, except to shower. Alone. And don’t shave your legs.
5. Don’t try to beguile attractive men. Or attractive women. Or cops.
6. Don’t pull out your credit card for any reason, except if necessary to post bail.
7. Don’t call or text or email ever—except, as noted, for bail.
8. Don’t cut your hair short. You aren’t Audrey Hepburn.
9. Don’t quit your day job.  
10. Don’t follow your bliss.

My manic cheat sheet. I kept multiple copies of it with me at all times—in my glove compartment, my suitcase, my briefcase, my purse. That must have been the paper that flew away when I fell. I’m supposed to read it every day, but frankly, I forget to when I start to feel high. Or more likely, I don’t want to. But those rules had saved me countless times, from danger and improvidence and self-sabotage and worse. I carried them for a reason, and I reluctantly admitted that I ought to heed their advice.  

Thinking wistfully of the two men waiting for me, I kicked off my heels and slipped off my dress, and put on the thick white terry cloth robe provided by the hotel. How perfect: my very own white uniform. Was I being rude? No, I was being safe. I locked the door and shut off the lights and pretended that I hadn’t done any real harm—or at least, not too much. Maybe—but it was also safe.

Excerpted from MODERN MADNESS: An Owner’s Manual by Terri Cheney. Copyright © 2020. Available from Hachette Books, an imprint of Hachette Book Group, Inc.

I have bipolar II, so I knew, even before I got pregnant, that I would have postpartum depression. It was a foregone conclusion, like your iPhone slowing down as soon as the new one’s announced, or y’know, a depressed person getting postpartum depression. This was not going to be a shock.

When I did get pregnant, it was ON. My therapist and I started to prepare for my inevitable transition from Depression Classic™ to Depression New—Now With 100% More Child™. We trained for it like a depression marathon, only there was zero exercise, but still a whole lot of carbo-loading. We talked about medication, self-care, and building a support system. We talked about how our sessions would work in the first few weeks and maybe there could be a few home visits too. But we never talked about it being anything other than PPD. There were mentions of postpartum psychosis and anxiety, because PPD was the goal—it was the darkness at the end of the tunnel. 

Throughout my pregnancy I was reminded to “watch out” for signs of postpartum depression. The problem was, I didn’t know the difference between PPD and regular D. I’ve lived with manic depression for years, one could say I was quite the depression maven, but that would be extremely weird and unhealthy, but I was! I assumed the key distinction between the two would be the amount of crying.

When it came to postnatal mental health, the main focus during my appointments was the “Baby Blues” and how it makes you cry a lot. But what we really should have been talking about is how the term “Baby Blues” is bullsh*t and should be renamed to “The Crying Out All The Moisture In Your Body Oh God Please Make It Stop Reds.” It felt as though most of these materials and classes were aimed at people who didn’t have a mental illness or had never experienced clinical depression, both of which I find deeply disturbing. The point is, as an already severely depressed person, I didn’t know which “signs” to “look out for.” That’s like telling a nineteen-year-old me to look out for red flags in the men I dated. How do you expect me to do that when they’re all one giant red flag?!

I went off my medication for my pregnancy. I regret it now, but at the time I was scared and confused. There were no official guidelines for lithium during pregnancy, and every time I thought I had a handle on what to do, a new study or classification would come out and rip the handle out of my hands. The medication goalposts kept changing, so I decided to wean off under the careful monitoring of my psychiatrist. I fell into a deep depression early on. From there it just kept getting worse, and as my stomach grew so did my feelings of guilt and shame—how could someone LUCKY enough to get pregnant now be DEPRESSED and NOT WANTING TO BE PREGNANT? 

I felt confused and ridiculous, but more than that I felt lonely. There’s not a lot of information about pre-natal and during-natal depression. And when it came to discussing PPD, the most I’d received during my entire pregnancy was a one-sheeter and a leaflet. I also took a childbirth prep class where the instructor played a video on postpartum depression, but before doing so, polled the class on whether they wanted to watch it because it may be a “bit of a bummer.” The issue with PPD isn’t the lack of information, it’s the distribution. 

I’m lucky to have a therapist who I’ve been with for years, who understands my mental state and manages my medication. And I’m lucky I made it through most of my pregnancy without anything dangerous happening. I spoke to my therapist a week before giving birth—by that time I was experiencing suicidal ideation and we agreed I’d get right back on my meds after birth, maybe even a higher dose. This seemed like a solid plan as it was clear PPD was on its way. But we’d been training for the wrong thing and I was in for a shock.

The first day back from the hospital I cried. I cried more in that day than I’ve ever cried in my life. I cried so hard I gagged. It felt endless, and at some point, I thought “I guess this is my life now. I will go through the rest of my life suffocated by tears and overwhelming grief.” And that was all perfectly normal. Two weeks later, it all went wrong.

I woke up feeling wired, like I’d already had a gallon of caffeine. The baby was crying so I fed and changed her. I put her in her (now massively dangerous and recalled) rocker and watched her from the sofa. I’d only left the apartment once for a short walk with the baby and my husband. I couldn’t bring myself to leave alone. I felt safe inside. Outside was evil. People were outside. I had started to develop agoraphobia but everyone, including myself, put it down to “just being a new mom.” My husband would drive me to a postpartum group every Tuesday and I’d ask him to stay and wait outside because I was vibrating with anxiety. Every moment in that group was torture. The other moms and babies with their talking and crying, I hated it and them. It’s important to note here that this venomous behavior is not my modus operandi. I am normally a kind, funny, generous person and you’re just going to have to take my word for it.

I knew how depression felt, I knew how mania felt, but I couldn’t quite grasp what was happening to me. I felt different but I couldn’t describe it. A couple more weeks passed. I had quit the group and spent all my time indoors. But in a few days my husband would be returning to work and every time I thought about it, I cried. These weren’t hormonal, “normal” tears, these were terrified tears. I knew something wasn’t right, but I’d also convinced myself this was just a “new mom thing” and that everyone had fantasies of murdering or being murdered by someone trying to kill their baby. I was filled with so much anxiety and paranoia it felt like I had electricity for blood. I was deathly afraid of being left alone with my baby for fear of something bad happening to her, and for that something to be me. 

I cried and begged for my husband to not go back to work. I told him I couldn’t look after our baby and I was scared of myself. As much as he sympathized and understood he still needed to go back to work because, money. I don’t have any family here and we didn’t have any childcare, so I decided to join another postpartum group; this one was a fifteen-minute walk away. Before my husband went back to work, we decided to do a dry run of the fifteen-minute walk. I still hadn’t left the apartment by myself with the baby and, unbeknownst to me, was deep in the throes of agoraphobia. But once again, I assumed this is how every new mother feels and acts – like they want to rip their skin off and carry out a murder-suicide on every person who walks too close to them. For me, if it wasn’t PPD then it was “just mom things.” The only mental illness I’d been somewhat “educated” on for postpartum was depression, so if I didn’t have depression, then I didn’t have an illness. 

We did the dry run and I was ok. Sweaty, but ok. The overwhelming anxiety had me sweating profusely. Once again, you’ll have to take my word for it, but I’m usually not a sweaty person. When the day came, I felt stable but nervous. I asked a friend if she could talk to me on the phone as I walked there because I needed to think of something that wasn’t dying defending my baby’s life or bursting into flames. My friend had a five-year-old daughter and had been to postpartum groups. I panted at her down the phone “did you hate the other babies when they screamed because it would disturb your baby?” She said, “My baby was one of the screaming babies.” I made it to the group, drenched in all the moisture in my body. Everything was going fine, but towards the end I felt it, a madness, surging through my body. I grabbed my baby, who was sleeping in her car seat, put her in the stroller and bolted. I was so panicked I didn’t even buckle her in. I ran, jostling my tiny baby from side-to-side. I prioritized getting home over her safety, and as I ran, I thought (and I don’t say use this word lightly) “I’m fucking crazy.”

Going to doctors didn’t help because they’d see “bipolar II” on my chart, and it was easy to dismiss my erratic behavior as a hypomanic episode. But I knew what those felt like and this wasn’t that. I cried and begged doctors to see me. I was told it would be a month before the next appointment, “I don’t have a month, I don’t even have a day” I cried down the phone. They said there was nothing they could do. I had now been in, what my therapist diagnosed as, a state of high-functioning psychosis for seven months. I finally saw an endocrinologist, a very old, white man who had previously claimed my issue was that I wasn’t taking my meds because I was mentally ill and prone to that behavior. He’d made this assessment before he’d even met me. I didn’t want to meet him in person, but I had to. There was no one else. After several blood tests and neck scans, it turns out I had a relatively rare postpartum thyroid condition that was set off by Hashimoto’s disease which apparently, I also had. And there was no cure. I just had to wait for the psychosis to go away on its own, which is the wildest sh*t I’ve ever heard. Waiting for PSYCHOSIS to go away on its own like it’s a wart, or hopefully the spider that’s currently chilling in the corner of my bedroom. 

After feeling literally insane for seven months all while being gaslit by doctors and looking after an infant, I decided to do my own investigation. I borrowed a book from the library called The Thyroid Solution by Ridha Arem, an endocrinologist based in Houston, Texas. In it, Arem talks extensively on how this postpartum thyroid condition affects people’s mental health. There were countless stories of women who, like me, had lost their minds and not been believed. Women whose husbands had left them because they were “crazy” or because their personalities had changed, and they weren’t “the woman I married” (side note: why are men?) These women had no idea what was happening to them, they’d just given birth and now they felt completely out of control. It was heartbreaking, but they only knew about postpartum depression and maybe postpartum anxiety, so in their minds, this was them. And that was me. 

At no point during your pregnancy does someone tell you there is a chance of a total personality change; they do but only in terms of like “you’ll be born a mother” to which I give a hearty Logan Roy style “f*ck off!” I’d spent seven months getting gaslit and scrambling for answers. I knew this wasn’t postpartum depression and I knew it wasn’t my mental illness, but I also knew this birth had changed me on a cellular level .

We will always need a wider and more honest conversation about postpartum recovery, both physical and mental. And even though PPD is the most talked about postpartum illness, it’s still not talked about enough. There’s more to postpartum than depression and anxiety, there’s psychosis, OCD, bipolar, PTSD, Hashimoto’s, and a lot more. We need just as much care and attention put into postpartum recovery as we do during pregnancy. The pain doesn’t go away after we’ve given birth—for many of us, it’s only just begun. We need better access to maternal health services, better maternal mental health care, and most urgently, better black maternal health care. We need medical professionals to give us more information and options for postpartum recovery, but most of all, when we tell them we’re unwell, we need them to believe us. Especially black women who are three to four times more likely to die during or after pregnancy than white women. 

My child is now thirteen months old, and while I may not be as sweaty or paranoid, I still have agoraphobia and, of course, still have depression and hypomania. I get regular blood tests to monitor my thyroid and haven’t had any flare ups since. Some days I wake up scared that that switch will flip again, and I’ll have to walk around out of my mind for god knows how long. But even if that did happen, at least I have a diagnosis and this time I’ll know that that’s not me and that I won’t be like that forever. 

Images: Alex Pasarelu / Unsplash

Seeking out a therapist to help with any number of mental health issues is something every functioning adult should know how to do. But, unfortunately, a lot of us don’t even know where to start when it comes to checking in with a feelings doctor, where to find one, or how and when to make an appointment. And it makes sense. Once you get over the stigma (that shouldn’t exist) of seeing a mental health professional, finding one isn’t exactly easy. And if you’re already feeling intimidated about going to a psychiatrist, psychologist, counselor, etc., the daunting process of finding the right one for you could turn you off completely. So that’s why I wanted to break the process of how to find a therapist down.

In the words of the coolest president ever, Barack Obama, “Too many Americans who struggle with mental health illnesses are still suffering in silence rather than seeking help, and we need to see it that men and women who would never hesitate to go see a doctor if they had a broken arm or came down with the flu, that they have that same attitude when it comes to their mental health.” Well said, you BAMF. So whether you just want to talk through some stress at work (because Tracy is driving you up a damn wall) or need to revisit the eating disorder your school bully prompted at age 8, or whatever other reason, here’s how to find a therapist in your area.

What Type Of Therapist Do You Need?

Knowing what you’re actually looking for in a therapist is the first step. According to WebMD:

Psychiatrists: “Doctors who specialize in the diagnosis and treatment of mental or psychiatric illnesses. They have medical training and are licensed to prescribe drugs. They are also trained in psychotherapy, or ‘talk’ therapy, which aims to change a person’s behaviors or thought patterns.”

Psychologists: “Doctoral degree (PhD or PsyD) experts in psychology. They study the human mind and human behavior and are also trained in counseling, psychotherapy, and psychological testing—which can help uncover emotional problems you may not realize you have.”

In other words, psychiatrists have medical training and can prescribe medication. Psychologists can’t prescribe you stuff. You might not need to see a psychiatrist, depending on what you’re going for.

Mental Health Counselor: Intimidated by a psychologist or psychiatrist? There are other options out there. Mental health counselors usually hold at least a master’s degree and can help guide you through a sh*tty job or relationship. (Just make sure the person you’re seeing is licensed and ask about their education.) They’re also required by state law to have at least 3,000 hours of post-master’s experience related to counseling, so it isn’t just, say, someone like me with no formal schooling giving you life advice that may or may not be terrible.

Social Worker: Yeah, so, social workers aren’t just the people who come to take people’s kids away when CPS gets called, as Law & Order: SVU help people copemay have led you to believe. They can also with issues in their lives, including—you guessed it—mental health issues.

There are also addiction counselors, religious counselors, family and marriage counselors, and more. Basically, no matter what type of professional you choose, make sure they have state licensing, postgraduate degree(s), clinical experience, and see if they have any published articles. That way you know they’re legit.

 

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Take Names And Make Lists

Some insurance may cover a few sessions with a therapist, but many won’t. But, either way, your insurance should have a list of accepted providers that you can look through which should help narrow down your search from just Googling “how to find a therapist in my area”. You can find that list of providers by either going online and logging in (if your insurance company has an online portal, which most should, given that it’s 2019), or by calling them and asking for it. You can also call area universities’ psychology and psychiatry departments and ask around. Ask for referrals from friends and family, if you’re comfortable; don’t forget to put feelers out to area hospitals and clinics, who know a ton of these people. The most important thing, though, is not to try and bargain hunt for a therapist via Craigsist or street flyers. (I don’t know if people actually do that, I’m just saying.) Also, even though it seems tempting, don’t just choose the cheapest person. Treat your mental health like you’d treat the health of any other body part. You wouldn’t go to some back-alley, part-time doctor with an online degree for a broken leg, would you? Probs not. So don’t do that with your therapist, either.

Know What To Expect

Once you’ve narrowed down who you want to see and when you want to see them, it’s helpful to know what exactly to expect during that first meeting. Are you going to have a miraculous breakthrough and never need therapy ever again? Probably not—and that’s fine (and also kind of the point of therapy anyway). Therapists of all kinds may employ different tactics depending on your issues. There are three common types of treatment your therapist may use:

CBT: CBT, or Cognitive Behavioral Therapy, is, according to Real Simple,”the most research-backed treatment for anxiety disorders and depression. It’s based partly on the idea that distorted thinking is a main cause of mental distress.” So basically, if you’re heading to see a therapist because you’re feeling down and generally depressed, a therapist using CBT will ask you about certain situations then identify the negative/sh*tty thoughts you have about yourself. If you’re thinking, “I don’t have a boyfriend because I’m fat/have adult acne” your therapist will pinpoint those thoughts and help you flip them into something like “I don’t have a boyfriend because I’M A STRONG INDEPENDENT WOMAN WHO ISN’T AFRAID TO INHALE PIZZA.” (I paraphrase; I am not a doctor.) If you’re dealing with anxiety, a therapist using CBT usually uses exposure therapy, i.e. making you do or face the thing you hate/are scared of.

 

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ACT: According to Real Simple, “If your therapist recommends Acceptance and Commitment Therapy (ACT) … you’ll likely learn various mindfulness techniques and exercises. ACT patients are taught to notice and accept challenging thoughts and feelings.” So instead of focusing on the anxiety/pain/substance you’re abusing, a therapist treating you with ACT therapy will have you use mental focus and exercises to accept that you think that way and adjust your actions accordingly.

DBT: DBT aka Dialectical Behavior Therapy is “an in-depth treatment that combines CBT with other approaches and addresses suicidal and self-harm behaviors, borderline personality disorders, eating disorders, and substance abuse problems,” according to Real Simple. This is obviously for more serious cases, but it works to have you focus on your specific problem—say, an eating disorder—then understand how your personal experiences have shaped/influenced you acting that particular way. Obviously, it’s a lot more in-depth and science-y than that, but this is me, your friendly Betches writer, trying to explain it to you, k?

More than likely, your therapist will use one of the above if you’re dealing with depression and/or anxiety. Of course, they’ll also be a sounding board for anything else going on.

After your visit, be sure to ask yourself how you feel. Are your comfortable with your therapist? Do you feel like they’re really listening? Are they asking lots of questions? Are they giving really good or really sh*tty advice? It’s important to know that finding a therapist is a lot like dating or looking for a job—you might not click with the first one you see. And that’s okay! It’s super important to have good chemistry with your therapist and feel like you can trust them. If you don’t like the first person you visit, don’t write off therapy altogether. Go back to the drawing board and find a different one.

No matter who you choose on your therapy journey, recognize that the most important part of this whole thing is you and how you feel. We’re rooting for you, we’re all rooting for you!

Images: Verne Ho / Unsplash; dietstartstomorrow / Instagram