anecdotes and reflections on life with depression and anxiety
So -- where were we? Ativan. Lorazepam. Pills. Right.
An “as-needed,” or PRN, anxiety medication is the newest addition to my pharmaceutical arsenal, and at this point, it isn’t really new at all. I was prescribed the Lorazepam after some intense physical anxiety had cropped up -- unexpectedly -- for the duration of a tortuous, squirmy plane ride, throughout which the only therapeutic advantages I had at my disposal were Dramamine, squeezing my husband’s hand really hard, and stealthily sipping from a nip bottle of flavored vodka I had in my carry-on (I was desperate). I also tried cell phone games and counting backwards from 100.
As I have begun to think of myself as a person in recovery from a depressive episode, rather than a person who is presently depressed, I’ve had to start looking at how my days and weeks come together and what the pacing of everyday life looks for me in recovery.
Through this process I have somehow taught myself to recognize what a “good day” looks like and to take full advantage of it. You never know how long a good spell might last, I tell myself, so you’d better get in all the things you’ve been wanting to do before the clouds drift back over and cover you in shadows again. As a result of this (somewhat misguided) “carpe diem” attitude, these good days have begun to look a little frenzied, sometimes socially but often just around my household, and generally, for whatever reason, in the form of cleaning.
I work from home, so when I feel well and have energy and motivation to get things done, I not only perform my work tasks ably and efficiently, but feel spurred on to get things done around the house as well. I appease my Fitbit by pacing around the house as I pick up clutter, make the bed or dust a shelf or two. I use my lunch break to wash the dishes in the sink and then, as if by magic, feel antsy with desire to continue “being productive” as I finish out my work day. I might go for a walk and then come home to continue cleaning and make dinner. Once I’m in this zone, it’s hard to make me stop; I want to make sure every room in the house is straightened up before I relax. I have been known to straighten throw pillows or refold the blanket behind my husband while he sits calmly on the couch, looking at me with a bemused expression.
If you know me personally, you likely know that my home is most often in a state I like to call cheerfully cluttered -- we live here, and it looks like we do, which I think makes it comfortable. I am by no standards a neat freak. The tea towel hanging on my oven door (thanks, Mom!) proclaims, “Anyone who has time to clean isn’t reading nearly enough!” and this is a fairly apt description of my attitude toward housework. Cleaning and keeping house tend to be the first things to fall off my to-do list when I’m depressed -- where would the energy for that come from? -- so when I actually feel like doing it, and like I can do it, I make sure to do as much of it as possible, as quickly as possible. That way if tomorrow comes and it happens to be not such a great day, I have at least accomplished something in my brief respite from depression.
The problem with this kind of frantic pacing is that, often, it more or less guarantees that a good, accomplished, productive day will be followed by a listless, self-doubting, exhausted day.
Why, I asked my therapist recently, could I not expend all my positive energy in one day and wake up restored after a night’s sleep, ready to do the same thing again? Why could I not spend a day working, exercising, keeping house and cooking like a “normal” person without experiencing an almost crushing fallout the next day?
The answer she gave me, which depression often seems to give us, is simply, “because.”
Because I have an illness that impacts my energy levels.
Because my energy, despite all my efforts, does not operate on a 24-hour cycle that kindly resets each night for the following day.
Because when I allow my mind to become a whirlwind of things to do at work, things to do after work, things to do around the house, things to do over the weekend, things to do before a friend stops by -- I become exhausted.
And because exhaustion -- sometimes even productive, proud, elated exhaustion from living life -- simply creates the perfect toehold in my mind for depression to sneak back in and say, “You silly woman. You didn’t think you could actually keep up with that type of pace for more than a day or two, did you?”
So, my therapist suggested helpfully and cheerfully, maybe you clean the bathroom and straighten up the living room and then sit down and read your book or watch a show.
Maybe you leave the kitchen floors for tomorrow.
Maybe you prioritize your energy and well-being over the course of days, weeks, months, instead of cramming a week’s worth of responsibilities into a single day.
I sigh and roll my eyes and sit back, looking at her. “Is that really it?”
Yes, she says, that’s really it, and you have to look at it as a form of self-care, recognizing that treating a good day like it will be the only one you have will cause you to spend so much physical and emotional energy that then it really will be the only one you have that week.
This kind of retraining is really, really hard. But I’m trying to think of the good days as an opportunity to enjoy life, in a combination of productivity and recreation and relaxation, rather than a race to get everything done before I feel unwell again. Because the dishes and the grimy stovetop will still be there tomorrow, but this day -- a day of motivation to walk in the sunshine, of the capacity to enjoy a good book in the warm company of my husband and my cat, of unfettered gladness to be alive -- is happening now, and I’ll be damned if I don’t spend some of that precious energy learning and practicing how to enjoy that too.
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.
Yesterday was Mother’s Day, and Saturday night as I made preparations to celebrate the following day with my wonderful mom I found myself thinking back to Mother’s Day of last year. We had a big celebration with the entire extended family on my mom’s side -- each of her five siblings, most of their spouses, their children (my cousins), and even their children were there. We gathered around a long, long table in one of my grandmother’s favorite restaurants in Greensboro, North Carolina, and showered my Gram with cards and gifts and -- her favorite, I suspect -- a lot of hugs, kisses and family time with her kids, grandkids and great-grands.
Without context, this sounds like the kind of Mother’s Day memory that should make anyone smile; and yet, as I reminisced while driving home from dinner with my husband Saturday night, I caught tears running down my cheeks. I couldn’t make them stop.
The context is this: my grandfather, the patriarch of a family of six children, the husband of my grandmother for 65 years, had passed away in March 2015, and we held his memorial service on Mother’s Day weekend of that year. We celebrated my grandmother that weekend after we mourned her husband; and to say that “the whole family” was there is a half-truth, because my Papa was not there, and we felt his absence like none other (even and especially, perhaps, when the check came and he was not there to fight doggedly to take it away from my aunts and uncles).
And, for more context: in March of this year, my beautiful, strong, sarcastic and loving grandmother passed away as well. That giant family Mother’s Day lunch we all celebrated a year ago was to be her last. Mother of six, grandmother of 13, great-grandmother of 13 (I think? And with more on the way, and one already named in her honor): gone from us, with no warning. My mother, who was visiting, said goodbye to her mom at 9:00 in the evening and watched Gram make her way to the great hall of the retirement home to “say hey to the girls playing dominoes.” By the time my mom arrived to pick her up late the next morning, Gram had been found, quietly passed on, sitting in her recliner. There was still an indent on her pillow from having slept in her bed the night before.
At one point during the aftermath of my grandmother’s death, my brother asked how I was doing and I told him the truth: “Well… I guess I would say that grieving on top of having depression is like a pretty big kick in the crotch.” I stand by that description still. I told him I felt like I was wading through cement, like every tiny action of daily life took an enormous amount of energy to complete. What I didn’t tell him is that some days it felt less like wading and more like drowning.
Grieving while depressed is, I think, its own special kind of misery. You are already a person who, as my college therapist described it, “tends toward the melancholy” -- or more accurately put, who experiences chemical imbalances that cause you to feel sad, tired, empty, apathetic. Add to that a life-changing event, a loss that most mentally healthy people find difficult, or painful, or maybe even soul-crushingly awful, and it’s no wonder you begin to feel that you are drowning under the weight of grief and emptiness and loss. I try not to use any of these words lightly -- I don’t want them to lose their meaning -- but in the months following Gram’s death I really found myself fighting desperately to crawl out from under the weight that was pressing down on my heart and my mind. I certainly grieved when I lost my grandfather the previous year; but he had been sick and weak for a long while, and his hearty, soul-warming laugh had been absent for so long, that I had a chance to come to terms with losing him and I was able to say goodbye. This -- this sudden phone call from my mother, her quiet words: “Gram is… gone,” this sudden emptiness in a part of my life that had been so joyously full of love and support and gratitude: how was I supposed to cope with this?
I looked at pictures. I spoke at her memorial service. I reminisced with my husband, my brother and parents, my cousins; I did all of the right grieving things. I knew she was no longer suffering -- from skin cancer, from diabetes, from arthritis, from the depression that I think she too experienced during parts of her life -- but I could not make my own pain and sadness abate. I missed her; I wished I had visited her sooner (I had planned for this coming summer); thinking of losing her made me miss my grandfather terribly, all over again. I remember crying in my therapist’s office, telling her how bad my depression had gotten. I had been doing better over the past couple of months, but now I couldn’t get out of bed. I didn’t want to work. I was cancelling plans, avoiding seeing people I loved, trying so hard to climb out of the pit of despair I felt I was in, I told her, “and I just don’t know what else there is to do.”
While I believe I had gone through my five stages of grief and accepted that she was gone, really gone, and without a goodbye, I was still desperate for help recovering from this loss. When my therapist offered to add a prescription for Abilify to my current medication to help me “for a few weeks,” I eagerly accepted. But the medication didn’t help, and the side effects were, for me, intolerable. I stopped taking it as soon as I could and, slowly, in my own time, I began to come to terms with having lost two people who had shaped my life so deeply and meaningfully. I was able to feel more gratitude than sadness. I still waded my way through the cement of depression during that time, and some days I still do, but I’m going to choose to feel thankful that I am able to feel enough to grieve, rather than feeling completely empty of emotion. I’m going to make my way through the muck of grief with depression and try to be glad, because my depression will not take away my ability to grieve the people I have loved so profoundly. My mental illness may have taken many things from me, but it will not take that.
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.
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.