Footnotes

A Collection of Thoughts

Tag: Mental Health

World Mental Health Day 2018

I have Major Depressive Disorder (clinical depression), Generalized Anxiety Disorder, and Seasonal Affective Disorder. I have also been previously diagnosed with an unspecified “mood disorder”—most likely a symptom of my other three disorders.

Today is World Mental Health Day, and I’m writing because even though transparency and mental health have come a long way during my lifetime, it’s important to constantly remain open and supportive about mental health problems.

It’s okay not to be okay. It’s okay to seek help. You are not weak. You are enough.

My mental health journey finally began in January 2013, the spring semester of my junior year in college. It should have started several years before, when I was in high school, but my disorders remained latent enough that I could essentially ignore them or let them “resolve” on their own. To this day, I still don’t know exactly what triggered the coalescence of my disorders, but as the spring semester of my junior year at Mary Washington began, everything fell apart. I fell into a horrible, deep, hopeless depression, and it was accompanied by an utterly crippling anxiety. I couldn’t eat more than half of a snack bar or sandwich because of the knots in my stomach and tightness in my chest, and that half-bar or half-sandwich was what sustained me throughout an entire day. There were several days where if I ate more, I vomited because there was simply “too much” for my anxiety-riddled intestines to handle. I had horrible insomnia—so much so that I slept only about 20 minutes each night for at least a month. With endless depression and crippling anxiety, sleeping was all I really wanted to do, but even sleep was no longer a respite for me. Sleep, my “safe place,” became an object of severe anxiety for me.

A deep, helpless depression, crippling anxiety, and unending insomnia turned me into a completely different person. I wanted to drop out of Mary Washington. I couldn’t function at a basic day-to-day level, so I couldn’t even see how I would make it through a week or month, let alone a semester, and a semester filled with challenging, upper-level coursework. If I wasn’t going through the day as a zombie, I was constantly sobbing and wishing that my condition would end. I remember walking downtown several times to meet friends for coffee, and I remember thinking how easy it would be to just step off the sidewalk into the path of an oncoming car. I remember looking at my bottle of ibuprofen, after days and days of no sleep, and wondering how many pills I would need to take before I would die. I remember burning myself on the stove in our kitchen and burning myself on a curling iron because I wanted to feel something—anything—other than despair and hopelessness. I knew that these actions of self-harm and suicidal ideation weren’t healthy, but they also seemed like the only way out for me. I truly felt that my anxiety and depression were so crippling, so unmanageable and so incurable, that suicide was the only way to truly end how I was feeling and bring me peace.

I remember my parents coming to pick me up two weeks after the semester started—a dark, cold, Friday evening in early January—because I couldn’t function. I remember my mom feeding me at home, lifting forks full of food to my mouth as I sat listless at our kitchen table. I remember her giving me baths at home because I was incapable of doing so myself. I remember feeling so ashamed about all of this, but also feeling utterly powerless and incapable of changing it. I remember sobbing on the phone to several of my close friends, calling them every two hours every day as my brain failed to escape its depressive and anxious cycles. I said the same things over and over again to them because my brain couldn’t process the solutions that we’d talked about two hours before. I remember Taylor, my roommate, getting in the tiny twin bed with me on multiple nights, coaching me in deep breathing and snuggling me as I struggled to fight anxiety and insomnia to get just a couple hours of sleep. I remember her stroking my back as I sobbed each night because I was so exhausted but still couldn’t sleep.

I remember my dear friend Jenny telling me, as I finally revealed my suicidal ideations to her, that “Suicide doesn’t really end your pain. It just gives your pain to somebody else.” And I remember the profound effect her statement had upon me. As much as I was struggling, and as much as I felt that suicide was the only way to solve my problem, I couldn’t imagine all of the pain and suffering from my mental health disorders being put upon someone else because of something that I had done. If I couldn’t handle what was being thrown at me by life and mental health, how on earth could I force that upon someone else? Or upon multiple people?

So I kept going. It was never enthusiastic, but it was the next best option for me, and it was the option that would spare all of my loved ones from suffering. My mom took me to the doctor, and the doctor prescribed me an anti-depressant (a generic of Zoloft). I started going to the counseling center at Mary Washington, and I requested a graduate student because that was the only way I could see someone as frequently (every 2 weeks) as I needed to. I talked with all of my professors about how much I was struggling, and most (if not all) of them seemed shocked to find out that their friendly, bright, capable student was struggling to just live.

Finally going on medication and going to regular therapy changed my life. Sertraline, the generic for Zoloft, is an effective anti-depressant and anti-anxiety medication. It’s a class of medication known as an SSRI, or selective serotonin re-uptake inhibitor. Essentially, it helps your brain take in more serotonin (the “happy” chemical), so it can help correct the chemical imbalance in your brain that is believed to cause depression. When serotonin breaks down, it becomes melatonin, which is a natural part of the sleep cycle, so the medication helped tremendously with my insomnia as well. The transition to being medicated was extremely difficult for me for a couple reasons. First, the side effects were difficult. I had horrible dry-mouth, but even worse, I had the “worsening depression or suicidal thoughts” that every anti-depressant commercial warns about. The 3 days of first taking medication, and then the first 3 days of upping my dosage, were even worse than my “normal” days. But after those 3 days passed, it was like coming out of a thick, dark, hopeless haze and entering into a bright, new future. It wasn’t necessarily going to be easy, but I felt “even,” and I felt like I could finally begin to manage my mental health problems.

The second issue that made medication difficult for me was that I felt like being medicated meant there was something wrong with me—people might think of me differently if they knew. They might judge me. They might not like me. And I might become even more isolated and alone because no one would like me. My therapist at UMW help me overcome these worries and to think of my anti-depressant as more of a vitamin than anything else. To this day, that is still how I think of my anti-depressant, which I still take every day. I stay on a low therapeutic dose of sertraline (50 mg) to keep me at a level where I feel “even” and can then handle the rest of my mental health issues on my own. I’m no longer ashamed of taking an anti-depressant, and I hope that other people seeking treatment can also come to this realization. There is nothing wrong with taking medication that helps treat a disease or disorder that you have.

Along with medication, therapy has been a key component of my treatment and recovery. My therapist at Mary Washington did wonders for me, and I believe therapy is a crucial part of treatment for depression and other mental health disorders. While medication can address the chemical imbalance that causes depression, it can’t effectively address what is causing that chemical imbalance—and, more often than not, it’s our patterns of thinking and other mental activities that cause the imbalance. Cognitive Behavioral Therapy (CBT) is what all of my therapists have engaged in with me, and it’s a method that of therapy that can help re-track your brain, leading to better mental awareness and healthier patterns of thought, and thus help correct chemical imbalances over time. Since my therapist at UMW, I’ve seen several others. I don’t regularly do therapy because I find that I do well enough on my own, but when something triggers my mental health disorders, I seek out a therapist and go for several months to work through my issues. (This decision is largely a monetary one for me, but I also always get to a point in therapy where it feels like the sessions are no longer productive because we’ve resolved what I wanted to resolve. The unproductive sessions are my sign that it is okay to end a round of therapy.) Though I don’t go to therapy regularly, I cannot stress enough how much of a difference it has made for me over the years. Having someone who is trained to help you recognize your thought patterns and help you correct the unhealthy patterns is beyond helpful. If you are thinking about therapy, go. It can be a huge mental burden at first to find a therapist whose style fits well with your needs, but it is worth the time and effort. Going in with an open mind, in my opinion, is the best way to go. If you think that therapy won’t help you or that therapists are just “shrinks,” you won’t get much out of therapy.

The days of the onset of my depression and anxiety were easily the darkest days of my life. But in that time, with great effort and mountains of help, I was able to find hope. I found wonderful friends, old and new, who answered the phone no matter what time I called, who got in a tiny college bed with me and soothed me to sleep, and who commandeered classrooms with me to watch Battlestar Galactica and distract my brain for a few hours. I found a family who would come and take care of me, even though I was an adult, and do whatever they could to support me. I found professors who truly cared about my well-being and who wanted to be there for me and help me. Most importantly, I found an ability within myself to overcome the toughest of mental hurdles.

I also found many other people suffering from mental health disorders like my own, who I otherwise never would have thought had mental health problems. It may very well be that the people who smile at you most, who are the kindest to you, who give the most, who work the hardest, who seem to be thriving, are the people who are struggling the most. It may also very well be that the people who seem to not work at all or who are not particularly friendly are the people who are struggling the most. Mental health disorders and their symptoms affect people and manifest themselves in different ways in each of us.

What you are feeling and experiencing is valid. It is okay not to be okay. It is okay to seek help. Please seek help—do not be ashamed. There is nothing weak about seeking help to better yourself. Do not feel ashamed for taking medication or going to therapy. These are treatments for a medical problem, and there is nothing wrong with treating your problems and bettering yourself. You are enough, and your deserve to be better.

End the stigma.

Stress Awareness and Anxiety

Initially I thought I would blog about something completely different tonight (the working title is “Finding a Home for My Heart”), but after seeing that today is National Stress Awareness Day, I’ve decided to write about stress and anxiety instead. I think stress is easier to talk about because most people know what stress is–they’ve probably felt it in some way, at some time in their life. Anxiety is a bit different, although I’m sure just as many people have experiences it, whether or not they realize it. This is how the Anxiety and Depression Association of America differentiates between stress and anxiety: “…stress is a response to a threat in a situation. Anxiety is a reaction to the stress.”

For me, stress is a short-term feeling that I can pinpoint to a certain cause–an upcoming assignment, a job interview, getting a shot, etc. Anxiety, on the other hand, is much longer-lasting, and I have an extremely difficult time discerning where my anxiety comes from. Oftentimes it’s a symptom of my depression. Other times, I feel the anxiety first–it bubbles up to the surface when I least expect it. (Seriously, I can be doing something as enjoyable as transcribing and listening to music, focusing only on the letter, when I suddenly feel anxious.) There are certainly situations/thoughts that trigger my anxiety, but there are also plenty of times when it comes on unwarranted. But, that’s just how anxiety is for me.

Anxiety is really difficult to describe to people who’ve never felt it before, and even now I struggle with giving a satisfactory description of how it feels for me. But, here goes: it’s an uneasiness, a dread, that creeps up out of nowhere, seeping from invisible places or cracks I thought I’d long ago filled. Once it’s present, it’s there to stay–it ramps up, snowballing, until it is a completely overwhelming and crippling feeling. My brain hurts from constantly being in an anxiety-induced hyperdrive, my heartbeat is much faster than normal, my stomach is in knots and I go without eating (because if I do, I feel extremely nauseous and occasionally throw up), I am incredibly tired but can’t actually sleep, and my body just feels off. What feels “off” is a sensation that I can’t put my finger on, and no matter how I try to describe it, there isn’t a word I can come up with (except for the completely unhelpful and vague “anxious”). It’s like drowning in the darkest waters, fighting to get to a surface that you can’t see, with no glimmer of light or hope, but somehow you can still breathe just enough to keep living.

That is just how anxiety feels for me. Stress is a much tamer version of those feelings. It’s important to remember that stress and anxiety manifest themselves in different ways in different people. Just because you can’t see someone else’s stress or they don’t voice it doesn’t mean that it isn’t there. And you should never minimize someone because they aren’t as stressed as you are or accuse them of never being stressed. The latter is something my mother does very frequently with my father, as a way of attacking him, and I hate it. It is a terrible way to attack someone and make them feel bad about themselves, in addition to simultaneously downplaying and heightening the other person’s stress. Please just don’t do it.

As part of National Stress Awareness Day, here are a few ways that I try to deal/cope with stress and anxiety:

  • Doing something I love–knitting, reading, watching a favorite TV show or football. I find reading and TV to be particularly effective because they allow me to enter another world and be mentally engaged with something else besides my thoughts.
  • Exercise. For stress, I find cardio to be the most effective. For anxiety, I prefer PiYo or some easy relaxation yoga.
  • Talking to other people. It’s so important to reach out to other people, especially when you’re feeling overwhelmed and disconnected (anxiety does this for me, not typically stress).
  • Deep breathing. Deep breathing is the most effective way that I’ve been able to slow down my racing mind and get some peace. It takes A LOT of practice and is not an instant remedy. But I’ve been doing it for long enough that it is a great coping mechanism for me. During periods when I’m feeling extremely anxious, I practice deep breathing when I wake up in the morning and when I go to sleep at night.

There are countless other ways to deal with stress and anxiety–it’s about finding the right combination of tactics that work for you, which takes some experimenting.

Falling into SAD

I’m blogging a bit later than usual tonight because I was debating whether or not I actually wanted to write about the topic I’ve chosen–at least for this week. It may be more appropriate once we really get into fall and closer to winter, but I decided that it’s been “fall” long enough for me to safely write about it.

Fall is a confusing time for me. On the one hand, it brings breathtaking colors and a reprieve from the sweltering heat and humidity of Virginia summers. The air is fresher, crisper, and I feel rejuvenated walking outside into nice fall weather. It also means I get to bundle up a little bit more–adding comfy scarves and sweaters (drinking hot drinks without sweating in the process!). And of course, it’s FOOTBALL SEASON! But for all of the wonderful things that fall brings, though, it is a mixed blessing for me. Because it is also a harbinger of terrible things to come. Of dark, dreary days where my eyes are constantly weighed down by exhaustion; of the quickening heartbeat and abating appetite as anxiety creeps back into life; of cold, cold days where I see my breath in the morning, and no matter what I do, I can’t get warm enough; of seeing green and beauty stripped from nature; of loneliness and sadness. And of SAD.

Fall means that winter is coming, and winter is a terrible, terrible time for me because I suffer from Seasonal Affective Disorder (as if regular anxiety and depression were not enough). The thought alone that fall brings winter is extremely anxiety-inducing for me. I have a very difficult time functioning normally during the winter because SAD dredges up my regular depression and anxiety, which I usually have under good control, and everything coalesces into the perfect storm of mental health issues. I don’t think it’s a stretch to say I’m a different person during the winter. The good news, though, is that I’ve made it through enough winters that I am slowly becoming equipped (hopefully, I think) to better handle SAD and lessen the effects it has upon me.

I have a sunlight lamp (seriously, it’s ridiculously and awesomely bright) that I turn on in the mornings when I’m getting ready to help my body get more of the light that it needs. I try to keep windows open so that any natural light can come in. I make sure that I stay on top of my medicine (antidepressant, magnesium, and multivitamins) so that my body and brain can get enough of what it doesn’t naturally have. I try to do as many things as I can that typically make me happy–reading, knitting, watching football, burning candles, doing puzzles, listening to MuggleCast and Jimmy Buffett. I try to keep things clean–I’ve found that the messier my things are, the worse my depression and anxiety get. This winter, now that I’ve been successful in my exercise regimen, I plan to continue that so my body will have more endorphins (and so I can continue to feel and be healthy). I hope I can force myself out enough to get the social interactions I need because I tend to withdraw socially and not want to leave my house when it’s cold and bleak out.

My battle with SAD (and other mental health issues) is largely my own to fight, but with these strategies, I hope this fall and winter may be better than others.

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