By July after my college graduation, I had a job and an apartment about an hour and a half away from my parents in one direction and my now-husband in the other. I met good people and enjoyed my work in a residential facility for teenage survivors of complex trauma. Most of all, I liked having the freedom of my own space. I found a psychopharmacologist who could continue to manage my medication, but I did not feel I needed a therapist. I was managing my fatigue and wasn’t, to the best of my memory, really experiencing other symptoms of depression at that time.
During my first meeting with the psychopharmacologist, she asked what my biggest depression symptom was and I answered promptly, “fatigue and exhaustion.” She looked at her notes and shook her head. I looked at her curiously, and she asked, “You were fatigued and they put you on Celexa?” I nodded. “Well, that’s interesting, because Celexa makes you tired.”
I remember raising my eyebrows and saying simply, “oh.” It hadn’t occurred to me to do any research on all the different medications available to me and their side effects, benefits or disadvantages. I took what I was given and went on my way. Looking back, I realized I had continued to feel tired, but my frame of mind had improved to the extent that I was able to manage the fatigue better. Lauren-on-Celexa was better than Lauren-on-nothing, but not as good as I could be on something else.
I don’t think I realized at the time how daunting it would be to spend months, and ultimately years, trying new medications on varying dosages (this continues to be part of my story, and I imagine it always will be -- more on that to come in a future post). However, I think this conversation did help me begin to realize that something better could be out there. If the wrong medication helped me feel a little better, how much could the right medication improve my condition? My condition -- there it was. After meeting with the psychopharm once every couple of months for awhile I began to see my situation for what it really was: an illness that required me to manage and attend to it in order to keep myself healthy.
I remained optimistic; this was a good time in my life. I really did love my job, and met one or two lifelong friends there, as well as several people who would shape my understanding of the social work field and of mental health in general. I was learning and growing, planning to become engaged soon, and aside from frequent bouts of fatigue, I felt well. But at the same time, I made frequent trips back to see my parents and visit the psychopharmacologist near their home; I took my new pills and contemplated the implications of living as a person with depression. I began to use my newfound understanding of the disease as a way to relate to the world around me. I no longer counted my depression as a passing phase of life; I planned to treat it with medication and self-care for the foreseeable future. This is not to say I had any clue what would come in later years (hint: it’s not pretty) but I at least was becoming aware of the need to adjust my expectations, however slightly, to include depression in my plans.
I want to make sure to note that I did not immediately come away from my first therapy appointment with a diagnosis and prescription. This is important! It took a several visits and lots of talking, as well as a couple of inventory-style tests, to determine that I was, indeed, depressed, and not just sickly and feeling down in the dumps.
After a couple of visits, my therapist had me describe the past year or so to her. I recounted the sudden ending of a serious relationship; a back injury that had caused me to drop a magazine internship and left me more or less lying in bed for a month; the recent theft of my laptop (and, as a result, the loss of the digital copies of all of my pictures from my semester in Madrid). I’m sure there was more. When I had finished, she said kindly, “I’m hearing about a lot of loss.”
I sat back and said, “Huh.”
I was happily in a new relationship (hello, husband!), my back had healed after some physical therapy, and I had a better, new computer -- and with most of my pictures on Facebook, I hadn’t really lost them all. In my mind, all of these losses had been resolved. Plus, they weren’t earth-shattering things -- they were normal life things that happen to everyone. But this wise woman explained how sometimes our minds and bodies can catalogue these losses, absorb the shock and sadness of them, and hold on to them, creating a kind of “circumstantial” depression. In her opinion, I was trying to recover from all these “life” things and just needed some help getting over the hump, as it were. She suggested medication to help with that, which I was open to, but I made her aware that I did not want to be on antidepressants for the long-term. “Am I on these for the rest of my life?” I asked nervously. She assured me that she didn’t see that being necessary in my case. I had every reason to believe that this was a temporary state of being for me, and I would come away healthier, happier, and ready to live my life again (without wanting to nap for an hour, every hour, on the hour).
I made an appointment with the doctor at the adjoining health center and she, without asking the specifics of my symptoms or what I hoped to gain from the medication, prescribed a smallish dose of Celexa to be taken daily. She told me it was a “middle of the road antidepressant” and I assumed she had conferred with my therapist (as I had given her permission to do), so I didn’t worry. I filled the prescription and began to take it.
The next few months are a blur, not because of depression but because I was entering the last two months of my college career. I think I did better. I took my medication and continued therapy. I finished and defended my thesis, which ended up being long enough and, I was told, good enough to have been an honors thesis as I had originally intended (too late). I attended all of the senior events -- my eating house formal, myriad college-sponsored celebrations, senior week at Folly Beach -- and had a fantastic time. I graduated cum laude and felt excited to see what was next. Saying goodbye to my friends and professors was hard, but I was content to move back home to Massachusetts with my family and figure out my next steps. By all appearances, I had made it over the hump of whatever circumstances were dragging me down, and in my mind, I was done with this “depression” thing.
I wasn’t done, or maybe it’s better said that depression wasn’t done with me. Now I understand that it likely never will be. I don’t say this with pessimism or hopelessness; just with the comprehension that depression, like most mental illnesses and many physical ones, is a chronic condition. With treatment, self-care and lots of attention, I can help it recede to the outskirts of my life on occasion (and hopefully, eventually, for longer chunks of time). But I’m learning to accept that my depression and I will never be done. Learning to live with that fact is another step toward a healthier life -- and so is cutting myself a break when the disease forges its way back into the center of my existence and takes hold. Depression may not be done with me, but I am most certainly not done with it.
Seven years ago this month, I found myself trudging up the hill and across the campus of my beloved, small-town Southern college to the local CVS. After browsing listlessly, feeling so exhausted I could hardly think straight, I rudely dropped a bag of peanut butter M&M’s down on the pharmacy counter and told the pharmacist I was picking up a prescription. She avoided eye contact and said, typing into her computer, “Celexa?” I nodded and wondered, vaguely amused, how many customers came in and wound up buying chocolate along with their antidepressants. Surely, I thought, I couldn’t be the only one.
As I dragged my aching body back across campus toward my apartment, I called my mother and my boyfriend (now my husband), tears in my eyes, to tell them that I had been diagnosed with depression and was starting medication, per the recommendations of the warm and reassuring counselor at the student health center. I felt simultaneously relieved and anxious; matter-of-fact and embarrassed; hopeless and yet at the same time, considering whether that might be a tiny blink of optimism I felt somewhere inside.
The diagnosis came after months of physical fatigue and malaise, vague aches and pains, a mind-numbing inability to concentrate, low-grade fevers, migraines. I thought everyone was tired all the time until, when I tired after about 30 minutes of shopping over winter break, my oldest childhood friend said to me: “Lauren, I don't think I ever feel tired like you do. Have you gone to a doctor for this?” This was a novel idea to me (Not everyone feels tired all the time?), and so I did as she suggested. My nurse practitioner tested me for lyme disease, mono, and the like -- nothing popped. She sent me to a rheumatologist to rule out fibromyalgia and an infectious disease doctor to eliminate the possibility of anything, well, infectious, and still: I got no answers.
Word of my mysterious ailment spread across our small senior class as I dropped my Spanish honors thesis, after several tearful sessions with my dear advisor, down to a regular one. “Tú tranquila,” he said to me. Calm down. “Sometimes life is more important than school.” I missed classes and passed on social events I would normally have looked forward to. Facebook recently dug up a post in my “Memories” in which a pre-med acquaintance who had heard I was sick asked if I had been tested for typhoid fever: “your symptoms seem to fit.” I was so very, very tired, and starting to be convinced I would never know why.
My roommates, friends and family did all they could to help. They organized a group of everyone I knew to write me encouraging letters (this was thoughtful and kind, and yet as I read them, my eyes stung with tears and my face burned with humiliation as I grew aware of how public my illness had become). They signed up for a farm share so we could enjoy healthy meals together. They encouraged me to exercise, to volunteer, to not just “sit around,” to which I said, fighting off tears, “I just can’t.” My mom came to visit, making the trek from Massachusetts to North Carolina just to be with me. Finally, two friends who had previously been helped by sessions with a counselor suggested I make an appointment so I could get help “dealing with not knowing what was wrong.”
That first visit marks the beginning of my journey with depression, in the sense that I was slowly becoming aware of what was really happening in my mind and body. I’m incredibly grateful (not to mention blessed!) to have had family and friends who supported me through such a stressful, frightening time; without each of them and their love, care, compassion and guidance, I may not have been diagnosed when I was. Seven years later, the struggle is realer than ever, harder than ever, and more painful than ever, but I have begun to learn that my personal moments of transparency and honesty -- with friends, with family members, with people in my social media network -- have allowed me a measure of peace, feeling that I am doing what I can to help my little corner of the world understand what it’s like to live with mental illness. That’s what I’m doing here. I’m going where it hurts, so that you can too, so that maybe one or two of you will better know how to approach mental illness when it touches someone you love. Because if it hasn’t yet, it will -- and they need you.