Opinion

Depression: Me, you & all of us

Hi, my name is Erin. I live with depression, general anxiety disorder, and PTSD. Last year, I was hospitalized twice for nearly killing myself.

Sorry, let’s start a little slower. I guess I should begin by saying why I’m writing. In no small way, I owe a lot to Ross Boehme and Judy Syrkin-Nikolau for coming before me, as well as everyone behind Mac Voices on Mental Health and their heartwarming cover of Mary Lambert’s “Secrets.” I did not know either before their Weekly articles, but all three sources helped give the extra nudge to talk about my experiences with mental illness.

I’ve wanted (and tried, with limited success) to talk about living with depression before, but wasn’t sure I wanted to even embrace this part of me, let alone be open about it. I’m not sure there was any one thing I can point to that helped me cross that bridge. To be honest, I’m not totally sure I’ve crossed it yet – this article may join a long list of impulses that leave regrets in my mind like a black-purple bruise. It might just be too close to home or awkward for you. Read with me for a while, and let’s see if we can’t dispel those fears.

I’m writing in part to be ‘out’ about my condition and my story, in part to lend my voice to the brave few who have already led the way, and most of all with the hope of sharing what this is like. It may sound oversimplified or trite, but one of the most critical challenges I believe we face together is how to include those of us on the fringe (in virtually any context, whatever the spectrum). I do not believe that inclusion is possible without first having a better understanding of what it’s like to live in someone else’s shoes.

My main goal here is based on that belief: I want to share my story to help hold better spaces for all of us, for those of us with or without mental illness. I’ll start with my story, and then talk a little bit about a few things I think would help foster that space.

If you are uninterested in reading my story, or careful about being triggered, please skip ahead (I’ll make clear where to start again if you’re so inclined*). I completely understand.

So, where to start? Judy Syrkin-Nikolau started her piece last week with highly appropriate confusion about whether to talk to her disorder in past or present tense. Like her, I don’t know where to begin my story. How much does all of Macalester need to know about my pre-teen abandonment issues, or intense fear of barnacles (or other sea creatures) growing on me? You probably don’t need that much, though they are more relevant than it might seem at first glance. I’ll try and cut right to spring 2013, my junior year, and my first diagnosis.

Before getting there, it might be worth mentioning that my parents had a sense something was up before I got to junior-high. I was tested for ADHD and proved negative, but (so I’m told) I was positive for emotional hypersensitivity. Basically this is relevant in that I (like many of us at Mac) was separated from many of my peers. Unlike many of us, not only did I have an overactive mind but I received emotional signals stronger and with less regulation. I guess you could say it was hard to make, and keep, friends.

The other half of my life pre-2013 relevant to this story is that I am a Third-Culture Kid (TCK), raised mostly in the Philippines by my Turkish mother and American father. TCKs, for those who don’t know, are a demographic with a lot of associated advantages but no shortage of common problems. As a group, we tend to have fewer adjustment issues with new cultures but a much harder time finding a permanent home, with all kinds of confusion of identity bundled in. This is a big part of why TCKs have some of the highest suicide rates of any demographic in the world.

Feeling out of place, and prolonged stretches of trauma, marked a difficult childhood that formed memories for my PTSD. Whereas (as many of us already know) depression and anxiety disorders are more biological and genetic, PTSD comes from experiences. Unlike the public perception that PTSD is mostly just military veterans having flashbacks about a particular battle or day, PTSD is actually formed over prolonged exposure to trauma/violence. This includes, for example, the inhuman stress our soldiers endure patrolling for IEDs even if nothing happens on that particular day. The sheer stress of being constantly alert for a physical danger builds the traumatic memories behind PTSD. In my case, enough violence both in and out of school pushed my mind to where I developed PTSD by the time I graduated high school.

Depression, on the other hand, has always been in the family. As far as my docs and I know, I’ve always been depressed. Growing up the knowledge that we are all going to die drove me to obsession, causing complete physical breakdowns for as far back as my memory goes. I also have a history of self-harming behaviors stretching back until I was 13, 14. My symptoms only grew to be unavoidable in 2013 however, when I was so severely depressed I slept more than 14 hours per day, lost interest in almost everything, contact with almost everyone, and eventually was unable to function even on a life sustaining day-to-day basis. Under an agonizing amount of internal pressure and external concern, I finally caved to see a therapist in March of 2013.

Before things got that bad, I had never really seen anyone except for briefly relenting to on-campus therapy my freshman year when my then significant other threatened to kill herself if I ended our relationship. I moved on however, determined to see that event as an isolated extreme – the end of my first serious relationship, surviving (I only realized two years later) what was sexual assault but I thought of at the time as just a really, really bad night, and the first class I had ever failed, not to mention the pressure of being another American white guy at Mac when I’d never lived in the US before and felt like I was anything but that. Had to be just a really bad year, right?

Between the chaos of freshman year and finally actually engaging with the medical help I needed, things actually got much better. People with mental illness, including depression, can actually function and feel happy – deceiving friends, family, and even ourselves, sometimes for long periods of time, sometimes for a lifetime. I had a pretty great sophomore year, and tore into the 2012 elections and the start of my junior year with reckless enthusiasm. Between exhaustion, my unsustainable lifestyle, and years of shame quietly brushed under the allegorical rug, I reached a point where collapse was inevitable.

After meeting with my therapist from March to May of 2013, I eventually agreed to a series of appointments which led to my being diagnosed with depression and general anxiety disorder. At the time, PTSD was suspected but not formally added until just a few weeks ago in early September. Over the course of the summer, a few things happened. My medications were adjusted a number of times in search of the right balance – anyone familiar with psychoactive meds knows how much fun that can be. The adjustment period to changing your dose can last between one to three weeks, depending on the person and the drug, and is more severe if this is the first time the particular drug is given let alone if a negative reaction occurs.

On top of changing my meds, starting a new form of therapy (that actually proved immensely helpful) called Dialectic Behavioral Therapy (DBT), and navigating the first, of two and a half ends to an intimate, codependent relationship I also landed myself in the hospital for the first time in connection to depression. In July of 2013 I was hospitalized for three cuts – two deep cuts, one of the two all the way to the bone – I had given myself while suffocating under an especially bad panic attack.

I had been subtle with my self-harm most of my life, but these cuts are, unsurprisingly, hard to miss. Until that night, I had always cut (or burned) in places I knew I could hide the scars, and had done so after hours of feeling unable to resolve my inner pain any other way. That night was different. I felt trapped, actively chased by my demons and like there was nothing I could do but punish myself – and cut deep. Instead of calculating how to hide my shame, instead of walking myself through my reasons, instead of meticulously planning the preparation, execution, and cleanup I walked right into the kitchen, grabbed a knife, and attacked myself.

There were a lot of signs I probably shouldn’t have returned to Mac without a break. There are a number of wonderful people in my life who, with caring intent and good reason, tried to convince me to take a break. I’ll talk more about the importance of listening to these kinds of folks later. At any rate, I came back. Unlike the last two semesters, when I could fake enough of being a student/human being to get by, I had nothing left. I could turn in no work all semester – not even leaving it until the last minute and loading up on 5 hour energy and panic could get me going. Predictably, I failed my classes. Equally predictably, I then concluded that meant my life was meaningless, and that there was no point in living.

December 23 of 2013, I was the closest I had ever been to suicide. My previous therapist called it an attempt, as did the staff at the hospital where I was institutionalized afterwards, whereas my current psychiatrist describes it as a near attempt. Whatever it technically is, had I moved my body differently, and there been a wind, had I slipped and fell, had any number of possibilities occurred, I would have died that day.

Reconnecting after coming so close to death was (and indeed remains) surreal, and I avoided all contact until eventually my therapist told me I had no choice – I needed to admit myself to an ER for a full psychiatric evaluation and emergency treatment. After admission and an evaluation, I was placed in a psych hold and escorted (under guard) to a locked mental health ward. I was stripped, searched, placed inside a mixed ages ward, and checked on by staff every 15 minutes. It was, by far, the most humiliating and terrifying experience of a life by no means easy or carefree. This was an extreme, even by my lows, and the sensation of being locked away is a memory that has yet to fade in intensity.

At the time, I felt forced and enraged that my therapist and the doctors at the hospital had concluded I needed to be placed in a hold. I hated that I had walked away from suicide only to be “punished” for dropping off the grid and coming close. In reality, though I had walked away from death that time, getting shocked with the seriousness of my condition remains the first step of many to saving my life, and a new beginning.

I like the phrase “in reality,” because what is real versus what is only real inside the mind is a subject critical to understanding mental illness. My greatest hope in sharing these scars, both literal and metaphorical, is what I’ve been through – though by no means normal – becomes more normalized and open to discussion in day-to-day conversation.

If you or people you know are going through something similar, my hope is that both they and you know that these experiences are not isolated. There are others, many of whom even live with us on campus in conditions that might appear privileged or fortunate from the outside, who face a struggle much, much worse than mine. Though only a relatively brief summary of some of the lowest moments of my struggles with my condition, the daily uphill climb of every single day living with a brain that fights us is worthy of time and attention.

*[SKIP TO HERE]

“If you know someone who’s depressed, please resolve never to ask them why. Depression isn’t a straightforward response to a bad situation; depression just is, like the weather.

Try to understand the blackness, lethargy, hopelessness, and loneliness they’re going through. Be there for them when they come through the other side. It’s hard to be a friend to someone who’s depressed, but it is one of the kindest, noblest, and best things you will ever do.” – Stephen Fry

To those of you brave souls still reading, or those of you who have skipped ahead, I’d like to talk about what to do next. I must confess that “conversations,” is too often code at Macalester for coming together about something difficult then going back to our own spaces and thinking really hard about it, usually alone if at all. Patience is not one of my strong suites, but I know that I am not alone in being skeptical of our campus’s “conversation” spaces in response to one crisis or another. To challenge that, and hopefully keep up the momentum of opening up about mental health, I will end this piece with a few thoughts on what we can do living with mental illness, we can do as friends of those with mental illness, as a community, and why.

“Conversations” at Mac, though slow and at times frustrating, are the first critical step towards being open an inclusive about a problem. To be as inclusive as possible in number and diversity is absolutely vital in practically all endeavors, but this is especially true of disorders of the mind. Illness that is visible only behaviorally, if at all, can easily be misunderstood as being something other than what it really is: a disease, much like any other. Those of us with the safety and ability to speak about their condition need to do so for ourselves but also for those without the safety, ability, or both. The fundamentally opaque nature of studying illnesses of the mind is such that no two illnesses are alike, even siblings with the same disorder from the same source suffer differently.

Though I am fairly familiar with my own state at this point, I have little personal experience struggling with (for example) sexuality, or living with bipolar disorder. Without open conversation and an effort to include one another in understanding mental illness, costly mistakes happen, and they happen far too often. I lost a close friendship when I was told that I was “hiding behind my depression; using it as an excuse” and the last words of a former partner (that are printable) were “I only have room in my life for people who make me laugh.” These aren’t anecdotes isolated to me, nor are they by any means the worst of what is directed at people with mental illness.

Not talking about or listening to mental illness has a human price tag, and frighteningly often it is someone we respect, care for, or even love who quietly pays the bill until, at worst, it becomes too much. If there is anything to be celebrating after Robin Williams’ tragic suicide, it is openness and determination to engage and discuss depression. We cannot afford to lose that energy and desire to engage such a complex and harmful subject.

In at least an abstract way, all of us understand what mental illness is by now. More than just sharing our personal experiences however, all of us need to do our best to engage with empathy and patience. We all know by now that depression isn’t an attitude problem, it’s a crippling illness. Having understood that difference it is equally important to acknowledge mental illness, which by definition causes irrational behavior, is met with understanding and time.

If presented with the opportunity to smile at someone in passing, do a favor, or be a good listener to a really bad day, practically all of us seize it. Human beings are predisposed to enjoy giving – we are social creatures, and this is basic evolution. We go out of our way to help people, with or without mental illness being a factor, because we personally stand to gain pleasure and fulfillment. If presented with the opportunity to do help someone struggling with a mental illness, please understand that the impact of your gift of kindness can be all the more meaningful. It is hard to say when you might be the one bright light in someone’s day, even with a small gesture made in passing. There are days that a smile from a stranger has nudged me just over the edge from self-harm. Cliché maybe, but true.

Patience is equally important, though so dangerously exhausting. As Stephen Fry said, it is hard – intensely difficult, especially the closer you are – to be a friend to someone with depression. It is exhausting, but please be patient with us. Chances are, those of us living with mental illness are just as if not more exhausted from a lifetime of living with a parasite that lives in our mind and eats our thoughts. I continue to carry with me a deep shame at burning many of the close friendships I had during the progressive worsening of my condition. I understand – we know – how tiring it can be to those of you trying to keep up with loved ones battling mental illness. Most of us have too many moments like “what did I just say? What did I just do?” to the people we know want to help. Patience is a must. It’s often hard to “get” the why and how of mental illness, but it’s the times when things seem most impossible that we need the most help.

That brings me to my final, perhaps most important, and definitely most difficult takeaway: knowing when to admit when the situation is beyond our control. This is easily where I struggle most, stubborn mule that I am, but applies to those with mental illness just as much as it does to those aware of or friends with someone who is fighting a losing battle. Patience and understanding are important every day, but knowing when to go to/recommend medical support can make the difference between life and death. I have every idea how shameful it can be to seek therapy, let alone be hospitalized in a psychiatric ward, but I also don’t know where I would be or what shape I would be in if I had not done so. It cannot be stressed enough that all of us must be willing to ask for help, whether for ourselves or for others.

I’d like to repeat my gratitude to the voices and people growing and shaping our community’s awareness of and response to mental illness. Voices on Mental Health is a phenomenal organization, one I would give almost anything to have had my freshman year (or sooner). They work to change the day-to-day conversation around mental illness on every level because, undeniably, mental illness is a part of our day-to-day lives on every level on campus. In the spirit of openness, October 16 and 17 Voices is hosting a “share your secret” event that is likely worth your time.

Last but not least, I want to leave on the note that all of us laboring under the smog of mental illness are not doing so alone. We can break the deafening silence together for good, and we can do it now – with even small changes in our lives. I’m hoping to continue blogging about mental health under the handle “The Depression Kid.” If ever you want to share your story, or just need a safe space and an understanding of what it’s like, please know you can write to [email protected] and I would be glad to help if I can.

October 3, 2014

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