“XO, Clementine”            

Scrolling Twitter late on Christmas Eve, 2020, and in a musing mood, I was captivated by a post bearing a picture of an unusual sculpture. The image showed a curled hand clawing clay from a plane and leaving tracks. Mesmerized, I clicked “retweet”, then read a little further. The image was in fact a prompt. Perhaps I’m too hasty when inspired? I jotted my first thoughts, a poem, and then clicked send. Suddenly, as I explored the prompt handle further, I felt some trepidation. Was my dramatic and poetic reply insensitive? The prompt I’d discovered was @MHealthPrompts, (Mental Health Prompts) which is run by Caitlin Miller. 

Of all the curious places I’ve stumbled into on social media, @MHealthPrompts is one of the most thoughtfully curated forums I’ve ever discovered for interactive writing prompts. Caitlin is Bipolar. Open about her diagnosis and even the medications she takes, she shows incredible bravery embracing an audience that may very well be experiencing volatile thoughts and emotions. Perhaps what is most admirable in Caitlin’s approach is the special care she has taken to ensure that visitors know this is a safe place to engage. The disclaimer she posts as a pinned tweet reads suddenly urgent and deeply caring. What presents as a passing twitter writing game, has led one toward greater awareness for the seriousness of mental illnesses in society and the potential for tragedy when we turn a blind eye. 

Early in January I wrote to Caitlin, expressing my interest in the project. I told her how I could imagine that many people who do not consider themselves to be mentally ill have mingled with those who do on the platform, perhaps unknowingly. These fortuitous encounters lend unique visibility to the prevalence of mental illness. Her efforts thus far are therefore a monument to the challenges facing afflicted individuals. By lifting the veil on long-held stigmas that might otherwise prevent meaningful exchanges, we gain an opportunity to jump head first into potentially challenging relationships and experience rewarding results. In an effort to better understand the true healing power of what Caitlin has created and her personal journey as she advocates for mental health awareness, Monologging.org has invited her to reflect on her experiences developing and curating the prompt. The following essay, compiled by J.T. Stone offers his reflections on, and includes a media excerpt from the interview he conducted with Caitlin this past Spring. Their in-depth discussion picked-up on a larger theme J.T. had been exploring throughout the “gap year” he took account of the pandemic; having deferred attending SUNY Albany where he is now a Freshman. Passionate about raising awareness for youth voices, J.T. had independently researched and compiled a series of remarkable interviews with diverse participants confronting mental illness in two episodes of his podcast series that originally aired on his WRFI Community Radio show and was published by the Ithaca Voice. 

– Jeffrey F. Barken

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How A Bipolar Diagnosis Fueled Transformative Action

– Reporting by J.T. Stone –

 

One in five American adults experience a mental illness every year, according to the National Alliance on Mental Illness. That’s over 43 million Americans a year living with conditions such as anxiety disorders, schizophrenia, bipolar disorder and major depression. I am lucky to say that I was not born with a mental illness and have personally had the resources, support networks and living conditions necessary to support my wellness. Many of my close friends, however, have not been as fortunate.

Throughout high school, I never had a clear understanding of mental illness and wasn’t well equipped to assist friends who were struggling. I used to believe I could cure, or fix, my friends’ mental health conditions simply by saying that things will get better. While I was sincere in my hope, I now know how naive and even harmful my approach was. As a journalist, I have devoted my work to amplifying marginalized voices in my hometown and beyond, not only to expand my own knowledge of the world but to help others become more empathetic and compassionate toward others. Similarly, Caitlin Miller never imagined herself providing a platform for people struggling with their mental health. Growing up in the southwest suburbs of Chicago with three older brothers, Caitlin’s background is in classical voice performance and she holds a degree in classical voice from Boston Conservatory. Her experience living with bipolar disorder, however, has driven her to become something she didn’t expect: a mental health advocate. “I consider myself to be a writer, musician, singer, composer and kind of unintentionally, honestly, a mental health advocate,” she says. 

In January 2020, Caitlin decided to launch the Twitter page Mental Health Prompts, a prompt page centered around mental health awareness and expression that has transformed into an online community vibrant of acceptance, empowerment and education. The handle now has close to 3,000 followers.

Caitlin experienced her first depressive episode at age 14. She remembers feeling increasingly anxious about being awake and began therapy. Originally diagnosed with depression, she was first prescribed the antidepressant Zoloft. However, as Caitlin began high school, she experienced two more depressive episodes, the first one resulting in her admittance to a partial hospitalization program. The second depressive episode was so severe that she struggled to speak and lost fine motor function. She recalls needing her mother to put on her shoes to enter the hospital. 

“I definitely know when I went past the point of no return,” Caitlin says. “I tell people my brain broke when I was 14, the summer before high school.”

After being prescribed a stronger antidepressant, Caitlin experienced her first manic episode at 16 that led to psychotic symptoms including both delusions and hallucinations. Officially diagnosed with bipolar disorder, she was put on an antipsychotic that caused undesirable side effects and led her to stop treatment. She then sunk into another depressive episode. At age 18, Caitlin was put on another antidepressant that resulted in a six month manic episode and psychosis during her first attempt at college. Once more, she decided to quit treatment entirely, because she believed she was “cured.”  This is a common delusion people experience during mania. She resumed treatment at age 20 after a second attempt at college caused another severe depressive episode. “That was kind of the six-year journey to really understanding that what I have is real and valid and not exclusively depression or a behavioral issue,” Caitlin says. 

From ages 20 to 34 her health was relatively more manageable. However, in 2020 she was admitted to Northwestern Hospital after using a new medication that caused akathisia, a disorder that causes uncontrollable moving such as fidgeting and pacing, which can be a side effect of antipsychotic or antidepressant medication. (It should be noted that medication side effects always depend on the individual.) As the COVID-19 pandemic began to hit the United States, she managed to garner only limited information about the spreading virus and its disruptive ramifications. “They started sending home some staff, they started not allowing visitors to come in, and they kept telling us, ‘Social distance, social distance,’” Caitlin recalls. “We hadn’t heard of the term and we were like, ‘What the hell? And no, we’re not going to.’ We weren’t really informed because we were in the hospital.”

When Caitlin was discharged from the hospital in late March of 2020, she encountered further shock. She describes her transition from “being extremely ill to a pandemic” as: “objectively dark comedy.” Two months after being discharged, she was in an intensive outpatient program for four months that consisted of daily treatment lasting three to four hours. As soon as the intensive outpatient program ended, the social isolation caused by the pandemic set in.

Caitlin is now on a combination of antidepressants and mood stabilizers that work in tandem to treat bipolar symptoms, but says her medication will likely be adjusted throughout her whole life. She also has a professional support team including a therapist, psychiatrist, and dietitian who help ensure her stability and wellness. 

When she first joined Twitter in 2014, she mostly followed drag queens and posts within the LGBTQ+ community. In the fall of 2019, however, she stumbled on the writing community and several prompt pages. Finding a supportive online community and camaraderie with other people suffering from bipolar disorder has further enriched and enabled her recovery.

While learning to live with bipolar disorder, Caitlin has endured mistreatment due to her diagnosis. She was kicked out of her first college dorm in 2003 for telling a roommate that she was bipolar, and says she had to “fight” for her diagnosis because her parents thought she was making up her symptoms. 

“This is in the late 90s, when I first started having problems, and when the stigma was huge,” she remembers. “The subject was very taboo. So I told everyone and it was seen as a behavior problem. It was seen as attention seeking that I was telling people,” she continues. “Most people didn’t want to hear about it… I think the denial of my diagnosis has kind of led to being an advocate as my revenge. I’m transforming this energy into a passion to help others not have the experience that I had,” she concludes.

In January 2020, Caitlin launched the Mental Health Prompts Twitter page to give people a space to journal their experiences and to find support. Early on, she would brainstorm a phrase and then find an accompanying image to serve as a prompt. Frustrated by the amount of time she’d spend puzzling over provocative phrases, however, she flipped the script. Instead, Caitlin now begins by choosing images that readily and naturally connote a worthy caption. She started with surrealistic paintings but now primarily uses sculptures, explaining they work best because “it allows for people to relate and feel connected to another physical body experiencing something that they can see.” 

“This was a place where I wanted to challenge people to not censor themselves. Write about suicide, write about your hospitalization, write about what twists in your head, write about something awful, go for it. Don’t be afraid. And it’s never been about writing good poetry or writing well. It’s about sharing and relating, and yeah, everyone, whether you have a diagnosis or not, your mental health must be addressed,” she says.

Caitlin believes Mental Health Prompts has given her a window into the lives of her followers. One person writes about losing their dad to dementia and another person regularly discourses about surviving domestic abuse. Others use it as a space to write beautiful poetry or as a tool to release their anger. “The really humbling part for me, which I didn’t expect, is I get people thanking me… The things that I remember are what it does for each individual. And again, those people who keep coming back, and how I’ve watched them grow through using it,” she reflects. 

Caitlin’s work on Twitter has not only given people a voice, it has helped teach others about the complexities of mental illness. Another Twitter project Caitlin runs is Bipolar Club, a website featuring original poetry and short stories by bipolar authors. Complimented by a dedicated Twitter page, the publication endeavors to create awareness by utilizing the hashtag #bipolarclub to promote content. Caitlin’s friend Devin Wellborn, who also suffers from bipolar disorder, originally came up with the idea for Bipolar Club. Together, they share a vision to “unite the bipolar community” and to educate others about what their condition entails. Caitlin loves seeing people get involved with both platforms. She is tremendously encouraged by how many patrons visit routinely and interact with both the prompts and content others have posted. 

Despite the perceived dangers of social media, Caitlin’s efforts online have brought joy and a sense of fulfillment. New relationships and the openness of her peers have helped her chart a course where she feels increasingly in control of her illness and comfortable expressing passion. “Someone told me once Twitter is exactly what you make of it. It can be completely toxic or it can be a place where you fall in love…. You can choose the community you want to be a part of. You don’t have to be a part of the gossip, or the sensationalist politics and crappy rhetoric. Find your tribe, find your people, make it yours, create boundaries, do your thing,” she reflects.

Caitlin is extraordinarily devoted to her followers, taking the time to read every post and to show her support by commenting “XO” followed by the orange emoji. (The orange is meant to approximate an emoji of a clementine, which is her online pseudonym.) “That’s about saying, ‘Hey, I see you. Welcome,’” she says. To weigh much further into the replies she receives would violate her own mission statement and risk destabilizing the discourse. This is a place for honest experimentation, hope and love. While empathy and community play an important role in treating mental illness, it’s important to remember that the site’s caretaker is not a mental health professional. Caitlin will give a visitor a careful and private nudge if she’s worried that someone is exhibiting dangerous behavior, but she is relieved to say that more often than not, an XO and a clementine are all that’s necessary to build a meaningful bond with newcomers and returning contributors, opening the door to a stigma free discussion of mental health in our society. 

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*The below recording compiled by  J.T. Stone combines excerpts from his interview with Caitlin, offering a chance to hear Caitlin tell her story in her words, and to elaborate on her perspective of mental illness.

 

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J.T. Stone is an Ithaca-based journalist, former teacher aide and freshman at the State University at Albany. During high school, he produced and hosted the five-part “Youth Voices” series on Ithaca’s WRFI Community Radio, in which he interviewed local students about topics they care about ranging from gun control to mental illness stigma. He hopes to continue his passion of giving others a voice through journalism during his time in college and beyond. His work can be found here.

 

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