World Mental Health Day 2016

Today is World Mental Health Day… I am not okay, but that is okay.

Earlier today, I read an article discussing high functioning anxiety and depression. Towards the end there was a description that resonated very strongly with me, so I wanted to share it.

Sarah Graham, a journalist living in London, has mixed depression and anxiety, but says she can still get on with day-to-day life for the most part.

“A friend of mine once described it as ‘coping privilege’ which I quite like as a way of looking at it, because I’m lucky in lots of ways that it’s obviously nowhere near as debilitating as mental illness can be for some people,” Graham says.

“That said, it does make everyday life more of a struggle – everything from forcing myself to get out of bed and into the shower, to leaving the house on time or taking the tube (which triggers my anxiety) when I don’t have time to take the bus – all of that is a constant day-to-day battle with my own mind, and I do sometimes wish I could just give in to it and stop ‘functioning’ quite so well.”

On the surface, high-functioning depression or anxiety appears to be easier to deal with, but this is not the case. There are dangers associated with keeping feelings bottled up, such as failing to seek help when it is desperately needed.

“I’ve said in the past that people think that high functioning depression is better than low functioning depression, but the problem with high functioning depression is that a person is not getting access to help,” [Carol Landau, a clinical professor of psychiatry and medicine at Brown University,] says. “Many of the women I see are perfectionistic and therefore have difficulty asking for help.”

Sarah says she didn’t seek help for years, because of the prevailing stereotype of what depression and anxiety should look like.

I definitely struggle with this. Constantly fighting the thoughts that it’s not bad enough to warrant the help I truly need. So I avoid talking about it. I pretend I am okay when I’m really not. And no one sees it. No one knows how bad it really is. Even those closest to me.

I sat here, staring at this blank text field for quite some time, Pirate of the Caribbean marathon on Space, in the background.

I feel very passionately about mental health awareness, but when I’m in the middle of a battle, it’s a lot harder to feel safe opening up.

When I’m not in the middle of it, I don’t mind talking about it. But right now, I’m at one of the lowest points of my life and saying that out loud, or even writing it, and posting it publicly on the internet, is absolutely terrifying.

I’ve mentioned it a little recently, but I don’t feel like I’ve explained it accurately. Probably because I was scared and each time I do, there’s always something I seem to be holding back on.

Anxiety has usually been the more prominent struggle in my life, moreso than depression, but the two have always been present in my life. Even though it was diagnosed quite late in my life, I know now that I’ve had anxiety since I was a young child and depression since my early teens, maybe even before that.

Until recently, my depression had always been on the mild to moderate side of the spectrum. Generally, when my anxiety was higher, especially my social anxiety, my depression increased. Stress increased both, causing major irritability and agitation, and when I was particularly overwhelmed I would have thoughts of ending my life or wishing I was dead so I wouldn’t have to face the things that were causing me distress.

I had never felt afraid that I would actually try to kill myself. Anxiety over what would happen to my dog and how my family would respond usually prevented it from ever getting that far.

When I moved, a little less than two years ago, and got a new doctor, my anxiety was more prominent, but the overwhelming emotions I felt had caused my depression to get quite bad. At the time my doctor felt that the anxiety was the main problem that needed to be dealt with. At the time, he was probably right, but in my head, I knew my depression was worse than anyone actually thought.

After several changes in medication, many sessions with a mental health social worker, and group CBT, my anxiety had calmed down a bit. I had just started a new job that I was enjoying. I’d paid off all my credit card debt and started building up some savings. I decided to participate in the CHMA’s 2016 Ride Don’t Hide event. It was around that time when something started to change.

I began riding my bike quite frequently, and even bought a new bike. I was feeling pretty good. My meds seemed to be working, after adjusting them so they didn’t make me so tired all the time. For several months, I was actually okay.

In the weeks leading up to Ride Don’t Hide, I started losing my motivation to ride, but I kept going because I knew that I needed to. I was riding at least 5 times a week. After the event, I gave myself permission to take a day or two off from riding. I kept trying to keep myself going regularly but slowly my riding got down to twice a week, once a week, once or twice ever couple weeks, and then not at all. It wasn’t intentional. The days just sort of got away from me. It was always, oh, I’ll go tomorrow. Eventually, tomorrow stopped happening.

I had noticed I was frequently having intrusive thoughts while driving to and from work about driving my car off the road or into oncoming traffic. I would see the entire thing play out in my head. The crash. My car smashed up so bad that no one should have survived. Sometimes I wouldn’t survive and sometimes I would. When I did, I imagined being in a coma for a while. Eventually I had to explain that it wasn’t an accident, that I did it intentionally. That’s usually where I started crying, and the images dissipated. When I realized how often this was happening and how often I was thinking about suicide outside of the intrusive thoughts, I actually began to fear that I would actually try to kill myself.

Some days, it was so unbelievably overwhelming that all I wanted to do was numb the pain. I would take pills. Too many pills.I didn’t really want to die, I just wanted the pain to go away. I often hoped that I wouldn’t wake up the next morning, but I always did. This wasn’t exactly new for me. Before I was diagnosed, I often took several Benadryl and/or night time cold medicine, because they made me drowsy, trying to make myself fall asleep so I wouldn’t have to listen to all the noise in my brain anymore. But by this point, I had a prescription for clonazepam and a few different sleeping pills that hadn’t really helped me feel rested in the mornings, so I would take more of those than I should have.

I’ve since run out of all of them and am terrified to ask my doctor to refill them because when I initially ran out, it was much sooner than I should have, give the number of pills I had with each prescription. Not because I was taking them frequently, but because I was taking a lot at a time. Moreso the clonazepam than the sleeping pills, but the sleeping pills only lasted maybe a month longer.

Around the end of July, the intrusive suicidal thoughts were happening on a daily basis. When I realized I was losing interest in playing with my dog, watching my favourite shows on TV, and hardly laughing at things I knew were funny, I was having an extremely difficult time concentrating at work, and I was crying myself to sleep almost every night I knew I couldn’t go on like this. I had even lost my appetite, which was especially bizarre to me. Part of me was hoping it was the meds, because my first antidepressant did that to me, as well, but this felt different.

Even worse, I was beginning to feel empty inside. I’ve always been a very emotional person, feeling everything very deeply. Now, I’m finding that I’m just not feeling at all. I can sometimes laugh, in the moment, when something is funny, as I’ve always found laughter hard to contain, but a part of me often wonders how genuine it actually is. About halfway through the laugh, the emptiness returns and the laughter ends abruptly. While I can still laugh, it’s not as strong as normal, and frequency in which I laugh is significantly decreased.

Here’s the kicker. I can not, for the life of me, figure out why I am feeling so shitty. In the past, there has always been something that seemed to be the cause, and once I figured it out, it would start to get better. I had noticed the changes earlier, but figured it was a normal mild, down swing, and in a week or two I’d be fine. More than a month later and it was still getting worse.

I saw my doctor the first week of August and he took me off of sertraline and put me on Trintellix. He had me remain on Wellbutrin. My symptoms continued to get worse.

About 5 weeks into Trintellix, the night before World Suicide Prevention Day, I found myself at the absolute lowest I’ve ever been. I wanted to die so badly, more than I ever have before, but I didn’t know why. I had been crying for hours, and at around 1am, I was lying there, in a slight pause between sobbing sessions, and I thought to myself, this is really bad. I might actually do something I’ll regret. Is this how bad it has to be for me to go to the hospital?

I knew I didn’t have any pills that could do any real damage and no alcohol worth drinking. I continued to lie there in my bed, crying off and on for some time, before I took a handful of Tylenol Cold Night Time, hoping it would make me fall asleep. A hour later, I was still wide awake.

I couldn’t work up the nerve to get out of bed to try and go to the hospital, so I decided, if I still felt this bad the next day, I would go.

I woke up the next morning to a World Suicide Prevention Day email from Wear Your Label containing a link to this video:

It hit way too close to home for me. I cried some more before finally getting out of bed. I felt pretty shitty, physically. It reminded me of the feeling my body has when I have a cold, which I decided was likely due to the cold medicine since I didn’t actually have a cold.

I managed to get through the day without any serious urges to do anything bad, so I decided I would call my doctors office on Monday and try to get in before my scheduled follow up. He was on vacation that week, so I had to wait another week to see him. That was the hardest week, trying to be “normal” at work and around my family, but at the same time hoping they would pick up on the subtle signs and actually ask me if I was okay. No one did.

I was also supposed to see my counsellor the following week but I got an email notification that his father passed away suddenly and he would be rescheduling appointments when he returned to work. I felt terrible for him, given that it was a sudden loss, but part of me was wondering if it was some kind of sign. Now, I don’t think it meant anything, because I got through it.

I saw my doctor on September 19th, and he took me off Trintellix and switched me to Cipralex. On the 28th, I saw my counsellor again, and we talked about how things were getting worse. He recommended a mood disorders outpatient program where they do consultations and multi-disciplinary treatment, uniquely tailored to each individual, to find the best treatment. It requires a doctor’s referral, so I got in to see my doctor again two days later. I’m still waiting to hear back.

In the mean time, things have calmed down a little. I think the sertraline and Trintellix both being completely out of my system has helped. I noticed a few weeks ago that my mind seemed clearer. I’m still struggling every day though. I have very little energy and completely lack motivation to do anything. I’m still getting up and going to work every day (although, I’m on vacation/stay-cation this week because I hadn’t used any of my vacation time yet and it’s been almost a year) but the whole time I’m there, I don’t want to be.

Last week, I had a completely random, out of nowhere, anxiety attack while at work. No idea why. My heart was racing and I suddenly needed to use the bathroom. I felt all weird and jittery for most of the day after that. I still don’t really know what caused it. I have a couple theories, but it wasn’t something that was making me consciously anxious, so I’m not entirely sure.

I’m still unsure of whether or not the Cipralex is helping. It’s only been three weeks. My mood is still mostly down, and I’m still finding myself suicidal almost every day, but not quite as severely as on September 9th. I have definitely been isolating myself over the past 5 months. No one really seems to have picked up on it though.

I did open up to one of my coworkers, because I know she’s struggled with anxiety in the past, so she gets it. She’s been very supportive and willing to help ease my workload as necessary (it is part of her job).

Right now, my anxiety is manageable, but it is not gone. I still deal with it on a daily basis.

Right now, my depression is raging through my body and my mind. Most days I just want to give up because it’s just so difficult to keep going.

Right now, I am not okay, but I know that that is okay. I am working through it. I am fighting.

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