anecdotes and reflections on life with depression and anxiety
As I mentioned in a previous post, I’ve been in a bit of a slump the past couple of weeks. I wouldn’t call it a rut, not a downward spiral, but definitely a downturn in my mood and energy. I’m not talking about the kind of desperate, gnawing sadness that I’ve described before, not a string of really terrible, hopeless days, but more of just a low-level, doing-the-bare-minimum, getting-by kind of depression. The low moments are not as painfully low as they are on a truly awful day, but the high moments don’t feel as happy and carefree as they should (and do) when I’m completely well. I’m a little more able to get out of the house and put a smile on my face, it’s just still hard to feel like I’m glad that I’ve done so.
It’s impossible for me to tell when a slump is coming. It just happens, as I slowly realize that I have been stringing together days and days of “blah.” My body might ache a bit more; I’m more prone to headaches and stomachaches; and I sleep a lot. (For example: last night was the first night in two weeks that I was not in bed before dark.) Over the weekend I slept and slept and slept. I got up for a few hours and then went back to bed after dinner, finding it difficult to think of a reason to stay up. If I couldn’t sleep, I escaped into a crime novel and read until my eyes closed. And then I slept some more.
Sometimes I sleep like this because I’m genuinely fatigued. I took a day off from work, using sick time to try to sleep off the misery and exhaustion I was feeling. It didn’t help, but back to work I went the following day. I fought my way through the rest of the week, doing my work, taking moments here and there to check in with my husband about how I was feeling. I tried to just let the depression sit with me through my days; I was functioning but feeling a constant, dim kind of melancholy. Sitting with even just that faint sadness all the time is really, really tiring. So I sleep.
Other times, I sleep like this because I just don’t feel like there is anything more important or more interesting to do. I let the pile of clean laundry sit unfolded. I let the dust gather around the jewelry and toiletries overcrowding my dresser. I notice that the shower curtain liner is starting to mildew. I just let it all go. None of it feels more important than being horizontal, in my bed, away from the nagging world. So I sleep.
Slumps like this can last for days, weeks, even months, for me. I function, get through work, cook some occasional meals, but mostly I just use my energy to get by. Socializing is hard, even with my closest friends and family. I want my husband home but when he’s nearby I get irritated with him for no reason. As soon as I push him away I want him back in the room with me (I’m sure this is maddening, but he takes it all in stride, thank God). I cancel plans so I can rest, or sleep, or hide, and then I feel guilty about canceling plans, so I spend energy using positive self-talk to remind myself that I’m not well and I need to take care of myself. That’s exhausting too, so then I go to bed. Again.
If you see me during a slump, you might not even know I’m having one. Upon starting this blog, several people close to me let me know that they would have had “no idea” that I suffer from depression if they weren’t told. I guarantee they have all seen me during a time like this, probably not on a horrible day, but during a bit of a hard time. I have learned to smile and, if not engage, at least quietly observe what’s going on around me and try look interested (rather than grimacing at the negative thoughts in my head, or muttering under my breath for the monster to pipe down). The good thing about slumps is, while they take a lot of energy to get through and they are damned persistent, at least they don’t suck all the happiness out of a moment. I can still get in a genuine smile here and there. I’m learning that it’s better than nothing.
So, slump or no, I try my best to be present for the important moments in life. I can name birthday dinners, reunion trips with college friends, weddings, even parties that I have hosted myself that have all occurred during a rough patch. I show up. I look the part. It’s okay. I can acknowledge happy occasions and wonderful people. The deep, sustaining joy in knowing that God is good and life is beautiful is not gone from my mind and my heart; I just am less equipped during these moments to fully experience and express happiness in all its shapes and sizes. I have still made the memories, still witnessed the events, still been present in the moment. At the time, I might feel like all I’m doing is mucking my way through the swampy waters of depression, the exultant world around me hazy and out of focus; but I try to remember that what I’m doing is being here. I’m living. Maybe the happiness won’t be as big, as uproarious, as full in my heart as I want it to be; but I’m here, where the happiness is, and that’s more than worth slumping through.
I have a confession to make. When I talk about my therapist, or going to therapy, this is a recent development in my life. I struggled through years of depression, thinking that I was managing it well with medication, check-ins with my psychopharmacologist, and self-care, until I finally realized last fall that the illness was taking things from me, from my life, that I wanted back. And so finally, after talking about it for years, I started seeing a therapist regularly for the first time since graduating college.
One of the worst things about depression is that it’s a disease that so desperately needs treatment, so critically requires care from others, and yet, during these all-important times of need, all the sick person wants is to be alone, to stay in bed under the covers where it’s known to be safe, and not to reach out to others in an uncomfortable search for help.
But I made the leap, and yes, it was uncomfortable. I’ve had to face some things about myself, about who I am and how my mind works. I’ve had to cry in front of this stranger-turned-therapist, reaching for tissues as I ponder the grip depression has had on my life for the past few years. But slowly, I’m gaining insight into myself and my life, and this (while painful) has been helpful. Here’s a peek at what exactly I’m finding out.
I care about what others think. My therapist has been telling me this since day one, and I struggled to believe her. I’m pretty happy to do my own thing; I’m not striving for prestige in my career or trying to appear more successful than I am; I don’t spend hours trying to show the outside world how together my life is. (Obviously, someone who writes in her blog about the days she doesn’t shower is not trying to pretend she always has it going on.) But there’s another way to care about what people think, and that’s to be afraid of disappointing them. Maybe it comes from growing up as a pastor’s kid in a small, microscopic town; maybe it comes from being known as a goody-goody and a straight-A student in high school. Maybe it comes from an internal drive to please others. Who knows? Part of it is just in me. It’s been hard for me to admit that this is true (and isn’t that, in and of itself, evidence that I care what others think?) but acknowledging that no, I don’t want to disappoint my loved ones, and yes, I do want them to think highly of who I am and what I do, has been helpful in my process of understanding where some of my negative thoughts and self-doubt, two driving forces of depression, have come from.
I have a strong tendency to self-isolate, which only continues the cycle of depression. “I worry about you being alone with your thoughts all the time,” my therapist said to me the last time we met. “You spend all day working from home while your husband’s out at work, and then he has his coaching jobs, and you’re home that whole time just thinking. That’s not good for a person with depression.” I protested, saying that I love working from home, that I’m an introvert by nature, that I would be exhausted trying to be “on” all day for co-workers. I explain that working from home allows me to save energy for weekday afternoon plans with friends and weekend socializing. Then, quietly, I admit that on bad days (or sometimes on fine days) I cancel those plans and just stay home. I don’t wander out to the coffee shop a block away, I don’t go sit on the beach and read my book when it’s nice out. I stay home. With my thoughts. A desire to isolate oneself from all outside surroundings is a normal part of depression; but it’s also responsible for causing that depression to continue. There’s a fine line between taking down time when it’s needed as a part of caring for myself and isolating from loved ones because I don’t feel worthy of them when I’m at my lowest. I need to seek better balance.
I’m not lazy. Okay, well, first: of course there is a part of me that’s lazy. I like to sleep in. I like to lounge on the couch and read, and I can binge-watch TV with the best of them. I’m not particularly a go-getter. But as I explained to my therapist all the things I could be doing with my afternoons and weekends in my bustling, quaint suburban town in New England, and then told her how I had no motivation or desire to do any of them most days, I bluntly told her, “I think I’m just lazy. It’s not like I couldn’t do those things if I really wanted to.” She looked me square in the eye and told me, “I don’t think you’re lazy. It’s the depression.” I started to cry. It’s something I’ve believed about myself for so long, and blamed myself for, and felt so much guilt over, that I felt an overwhelming sense of relief to have someone affirm that this is not who I am at my core. The depression monster, as I am starting to refer to him, is the one driving that piece of my behavior right now. To know that this could change, that this is a symptom of illness and not a personality flaw, took pounds upon pounds of weight off my shoulders. Learning to congratulate myself on the hard work of getting through the day, of recognizing that I am spending my energy fighting the monster and not just sitting around in my house, has been enlightening and rewarding. I’m not lazy; I’m just using my energy trying to get and stay well.
I’m only scratching the surface of what I’m learning in therapy, of course; that relationship is private and no one needs to hear the nitty-gritty details of those behind-doors conversations. But I wanted to share some of this because I think it’s a valuable reminder that there’s no substitute for finding an objective, distanced person to talk through your “stuff” with. What I’m learning will stay with me and help me as I change, grow, and heal, and the thought of trying to white-knuckle my way through this disease without professional help now sounds impractical, never mind painful. Discomfort is a small price to pay for learning to practice self-awareness and treat myself with kindness.
I’ve been quiet on here for the past week, and while it’s partly because I’ve been in a bit of a slump -- missed a bit of work, fought off a lot of headaches, took a lot of naps -- it’s also because I’ve been thinking about what to write next.
You know what my depression is like on a bad day. You know how it has affected my marriage. You know how my diagnosis came about, what my major symptoms are, how I feel about medication. Prior to beginning this blog, I pretty much knew all of those things myself.
What I didn’t know, and what you therefore can’t yet know, is how writing posts for this blog has brought me to feel about owning the labels of depression, anxiety, and most of all, mental illness. Whether we want them to be hard-and-fast labels or not, that’s what they are. Being the person of words and language that I am (once an English major, always an English major), I’m generally a fan of labels. I like things to be defined, to be clearly delineated, so that everyone can be on the same page about whatever they’re talking about. It makes for more efficient, productive conversation, and to me that’s always a good thing. Even and especially regarding mental health.
But how would I feel once I defined myself as mentally ill?
It’s one thing to admit to “having depression.” I’ve been owning that one for awhile now amongst friends and family, and it doesn’t bother me. While I never know how someone might react when they hear this for the first time, I generally don’t think much more of making this admission than I do about telling someone that I have high blood pressure, or that I wear glasses for near-sightedness. But to own up to that depression as a true mental illness -- how does that feel? I’m still not sure.
At times, in previous entries, I have referred to my depression as an illness, and I know intellectually that’s true. But how I feel about that personally -- that’s a bit of a different story. Sometimes I feel unworthy of the label: am I truly mentally ill? Isn’t that term reserved for people in a psychiatric hospital, or with more severe diagnoses, with something worse than “just” depression? I don’t self-harm; I’m not suicidal; I can work most days, and see my friends and family, and generally live my life (with some exceptions, naturally). Does my condition really warrant the label of “mental illness”?
But yes, I have decided, it does. People who are not mentally ill do not spend days on end in bed, avoiding sunlight, feeling too tired and too worthless to shower or brush their teeth. People who are not mentally ill do not miss the wedding of two close friends because they feel too low to leave the house or too anxious to fly. People who are not mentally ill do not go out to their favorite restaurant, eat their favorite meal with their favorite cocktail, and shrug, indifferent, because they don’t even feel a glimmer of enjoyment.
Society has taught us a lot about which people we label as mentally ill. People who are mentally ill (or mentally “unstable,” that’s a good one, too) are crazy; they hear voices, act irrationally, do things that make no sense to the people around them. The label is a catchall to explain behavior we don’t understand, to reason away instances of inexplicable violence in our communities, to dismiss people on the margins of society. It’s a way to push people who are different into a category, to force them into a box we can stick a neatly printed label on and put on a shelf, gathering dust and staying safely contained away from everybody else we love and want to keep safe.
This is not okay. This is stigma, and it’s a reason I am writing openly and honestly about my own mental illness here and now.
Who are the mentally ill, really? We are not people sitting in corners, crying or holding our heads in our hands or staring into a dark room. We are not aggressive or violent; we are actually more likely to be victims of violence than perpetrators of it. We are not a punchline, a joke to make your friends or coworkers chuckle.
Sure, sometimes we sit in a dark room and cry. Sometimes some of us can act aggressively when we are hurting or scared. Some of us hear voices. Many of us can handle a joke at our own expense. But essentially, we are just people. We are writers, thinkers, students, graduates, professionals. We are the person sitting in the park, playing with our dogs or reading a book. The person serving you coffee with a smile at your local cafe. We are probably even your doctor, your accountant, your child’s teacher. We are your parents, your children, your siblings, your friends -- and we are sick. That’s all. We are people, who happen to be sick in a way you can’t always see or expect to understand.
Yes, I am mentally ill. No, I don’t need you to sympathize or try to fix it. What I need you to do is keep me out of the labeled box on your dusty top shelf, and keep me in your life the way you hold the rest of your loved ones dear.
I’m mentally ill, and I can own that. Can you?
for my husband, with gratitude, on the eve of our fifth wedding anniversary
From our bed, under the covers, I hear the front door to our apartment open. It’s around five in the evening, and I’m in some semblance of pajamas. I have not showered. Maybe I didn’t shower yesterday, either. I have no makeup on, or else it’s remnants of mascara from days ago, transforming my bleary eyes into dark smudges reflecting the chaos I feel inside. You are home from work and I have not worked all day. I have not touched the piles of laundry scattered across the floor, sorted during a more ambitious time. I have not thought about dinner, let alone made anything for you to eat. I have not even pulled the curtains open in our bedroom.
Upon hearing the door creak open, I instantly feel relief that you are home and I have a vague idea that it is good you are here, combined with shame that I am not dressed and have not done anything productive with my day. I roll over to face the bedroom door and you appear, greeting me with a gentle smile. You come to sit on the edge of the bed next to me, reading my body language to make sure it’s okay. You brush the hair away from my face and kiss my forehead. You might say that you’re sorry it’s a “dumb day” -- our lighthearted way of referring to the monster in my head that takes over at any given moment, seemingly, at least temporarily, stopping my life in its tracks. You ask if I have eaten or what I want to eat. You ask what we can do to make me feel better. I shake my head, hovering somewhere between distressed and wildly agitated. I want to tear my hair out and scream, but instead I sink into you, hiding my face in your chest, wishing tears would come but knowing they won’t.
You kick your shoes off and crawl into bed next to me, holding me if I let you and just being there if I won’t. After a little while I might pick up my phone or my Kindle, seeking distraction, or else I might just sort of stare into space. You browse the Internet on your phone and sit quietly with me. I’m sure you’re hungry, or could be working, or maybe catching a game with the guys, but instead you sit. If I talk, you listen. If I don’t, you don’t force it. You might ask if I want to watch something on Netflix or offer to get some dinner for us. More likely I will fall asleep with my head nestled against your shoulder, and you will refuse to move because you know that I need you there. You will do everything you can to let me sleep, because you know there I will find peace. You will be quiet and still, you will pray that tomorrow is a better day, and you will be there.
In the morning, you wake up ready to see who wakes up beside you -- will it be the woman you married, who lives with joy, and loves to cook and plan meals and entertain friends and spend time with family? Or will it be this woman who fell asleep on you last night, who was broken and devastated by the voices in her mind who convince her that she is not okay? Whichever one awakes, you will love and protect her, making sure she feels safe, with no demonstrable bewilderment, confusion or frustration at how you came to be married to both of these people.
Our wedding vows were traditional ones, and I doubt either of us thought that “for better or for worse; in sickness and in health” meant days like this. I know it wasn’t in my rosy, optimistic, newly-wedded vision for our marriage. And while I’m sure neither of us would choose for me to experience this kind of sickness, you are able to tenderly remind me, when I need it, that the what-ifs won’t change the reality that is my illness or our marriage.
“I love you,” you insist when I question how you live with the uncertainty, the volatility of who my depression makes me. You almost laugh when you say it, because to you it is so obvious, how you live with it. It’s because you love me. Everything you are for me, to me -- your patience, your flexibility, your calm, safe presence next to me -- all falls in line because that is the fact that precedes all the rest.
Medication for mental illness can be a touchy subject, and everyone is entitled to their own opinion. But I do honestly believe that some of us need psychotropic medication the way a diabetic needs insulin, the way short-sighted people need glasses, the way anyone else takes medication for a migraine or high blood pressure. Understanding that my brain is chemically imbalanced, and that I need medical help to balance it, has been a critical part of my illness and treatment. I refuse to be ashamed of that, and I’m happy to share my thoughts on it here.
You may recall from a previous post that I was started on Celexa by a college health center doctor who knew little about my personal depressive symptoms, and that I later learned that Celexa in particular can increase tiredness and fatigue (my primary, and most debilitating, symptoms). From there, I sought treatment from a psychopharmacologist who journeyed with me from Celexa to Wellbutrin, Prozac, and eventually Cymbalta, which I take now. At each visit she would ask how my mood that day was on a scale from one to ten. I’d answer as honestly as I could, tell her how the past couple of months had been, and we would discuss whether I felt good on the medication I was currently taking or if I was looking to make a change. As a person with depression, it’s always hard to know -- is this as good as it gets for me? Is there something that can help me feel even more like myself, with energy and passion and positivity?
But tinkering with medication is no joke. Each time we made a switch I would have to taper down slowly, sometimes adding in the new medication gradually, and take note of how I was feeling and what side effects I might be experiencing. I remember that Wellbutrin gave me a lot of energy, which was great, but when we bumped up my dosage I started to feel crabby and anxious, irritable and unable to tolerate even the slightest frustration. So we tapered back down. Some of the medications cause weight gain, or dry mouth, or hot flashes, so anything new that starts happening with your body sends up a red flag -- is this a side effect? My current medication (Cymbalta) causes hot flashes and excessive sweating, which is a lovely thing to deal with as a woman in her twenties. There’s nothing like being asked at a toddler’s birthday party if you’re crying, and having to wipe your cheeks and answer “no, I’m just sweating.” It’s a real self-esteem booster. But hey, at least I can smile while I answer. Cost-benefit analysis.
Other than that, I will sing Cymbalta’s praises (for me, and only me, as I’m not making ANY medical recommendations for anyone here). It has been a complete game changer for me. I was on a lower dose of it when I began to see my new therapist (who also now prescribes my medications), and she suggested going with the maximum dose to see how much it could help. And, you guys, IT HELPS! I went from feeling sort of okay some days to having REALLY GOOD days. My husband would come home from work in the evenings to find me having worked a full day, showered, dressed (these are bigger feats than I know how to explain) and cheerfully making dinner after doing several loads of laundry and cleaning some of the house. He said, on more than one occasion, “I haven’t seen this Lauren for at least five years.” I remember walking through my house one day, on my way to wash a dish or switch the laundry, and thinking to myself, “I’m just really freaking happy.” (Full disclosure: maybe my brain didn’t think the word freaking, exactly.)
Some people may argue that it’s unfair to simply take a pill and be happy, and to them I will say: this is not a permanent condition. There is no guarantee. I am not happy every day. I might not even be 50-50 on good vs. bad days. But my good days are so much better than the supposedly “good” days I have experienced in the past couple of years. More often, I am able to say that the highs of life feel as high as they should, instead of just moderately okay. More often, I am able to face the day without a mounting sense of dread or complete apathy. More often, I do what I need to do during any given day or week without missing work or canceling plans six different times.
Those who are against the use of medication to treat mental illness will say that the drugs are shortcut, a way of putting a bandaid on a wound that really needs stitches and professional attention to heal properly. They clamor that “putting in the work” (i.e., working through issues in therapy) is the only way to truly treat the disease. I will answer that while therapy may be the stitches and attention my wound needs to heal, the antidepressants are the ointment and dressing around the wound that keep it from getting infected, that make it livable, that make it tolerable and keep it safe while the healing occurs. I’m not choosing one or the other, but I will say that the meds help make this “wound” of depression tolerable while I’m working on healing myself in therapy -- and on some days, they’re the reason I can even get myself to therapy in the first place.
oh, hey --
My name is Lauren. I'm thirty-something, and I like to take naps and read good books and watch bad television. I love my husband and I love my cat, and I live with depression and anxiety, which is mostly what you'll read about here.