Mental Health Awareness Month

It has not gone unnoticed that May is Mental Health Awareness Month. Apparently, this has been in place since the 1940s and I think about all of the the progress that has been made in reducing the stigma around mental health over the past 60 years, even 30 years for that matter. I am part of a family that is wholly accepting of mental health issues and something that we can talk about when things are tough. Never a judgement. Only acceptance. How fortunate am I?!!?

I have noted in my Facebook feed that several of my friends have taken the opportunity to talk about their specific experiences with sensory disorders, depression, autism, anxiety and panic attacks. I have an infinite amount of compassion for mental health concerns.  Even in the most difficult of circumstances when mental health symptoms are at play, I try to have compassion because if you ask the person that is struggling, they often would not choose to experience the world the way that they are. Mental health is often invisible, misunderstood and judged more harshly than most other medical conditions.

I thought I would follow the lead of my friends and be a little more open about my personal experiences with mental health. I believe my diagnoses are major depressive disorder - severe, persistent, generalized anxiety disorder and avoidant personality traits. I was officially diagnosed with MDD and GAD back in 2004. I was never honest with my doctors about how much I was drinking so much of what I was experiencing in those days was enhanced by my alcohol use. Let me tell you, the frustration I felt about the depressive and anxiety symptoms not abating when I stopped drinking, was pretty profound. Good grief, the symptoms got worse in a way. Not only was I depressed and anxiety, I experience anhedonia which is this lovely inability to find or feel pleasure in anything. That lasted for a year after I stopped drinking. It was seriously painful. Fortunately, I had more wherewithal to get help instead of trying to end it all after I stopped drinking and was in treatment. That was the most major complication of being dual diagnosed: Every time I would drink, I would get relief from paralyzing anxiety and dark depression for about 15 minutes. Then the my view of the world changed at minute 16 and I started planning on ways to end it all.  Most nights, I would be too drunk to make a move. A few times the courage broke through and I would land in the hospital.

If you were to look up the symptoms of depression and anxiety, you could make a check mark next to just about every symptom for me. I have experienced them all from the lack of energy, excessive sleep, thoughts of being better off dead, irritability, restlessness, crying excessively. Again, most of these symptoms were exacerbated by my use and lead to some bad decisions. Therapy was not super helpful back then. I wanted to whole world to be wrong and for me to be the victim. I didn't want to change anything about my life. I would convince my therapist of all the horrors I experienced on a daily basis including bad coworkers, people being "after me", changing jobs because people were after me, etc. I continued to go though, because someone was listening to be even if I was full of shit.

Fast forward to today. It took 3 years and a lot of adjustments, but I finally found the right medication combination to give me some relief from some of the most debilitating features of my depression and anxious. I have tried over the past 8 years to reduce to stop certain medications. It never goes well and I am finally in acceptance that I will have to take antidepressants for a lifetime. If I don't, depression takes over my whole world, leaves me listless, anxiety ridden and wondering what is the fastest way out. I would be highly likely return to drinking. I believe to this day that if I return to drinking, I will not make it out again. I have another drunk in me, I don't know that I have another recovery.

I have no problem talking about the fact that I see a therapist. There are a few very important things that he helps me with in regards to my mental health. He helps me to understand what is symptoms vs efforts to self-sabotage myself.  He reinforces (regularly by the way) to show myself the same compassion that I show others with mental health issues. He challenges my thinking when I am in a lost place and wondering what the next steps are. This is my 1 hour per week that is all about me. How was the week? Am I feeling burned out? Am I anxious? Did I have some really cool things happen? I can get out of my head because it can get pretty busy in there. I have a conversation about my mind without judgement. I can process decisions and situations. 

My therapist is currently helping me work with the personality traits that I have developed over the years. I was unhappy when we talked about my tendencies to avoid a lot of things in life. This is how I know he has hit on something. He told me once that I am quick to get defense which my response was "I am not defensive, how could you say that?" Ahhh, the irony. We worked on that for several session too. If it hurts my ego a bit, it's something to look at. So, back to avoiding, part of my issue with depression is feeling like I am incapable or lack mastery in getting through my day. By avoiding, I don't allow myself a voice. I create additional anxiety by not taking care of things. I will start to sleep more so that I can shut off the internal conversation about how stupid my own avoiding is. Thanks to working with a therapist, we have changed the direction of most of this. I still avoid some things but I am able to see my patterns. By seeing patterns, I am empowered to change them if I so choose. 

There are times that I am happy to talk about my mental health concerns especially while I was drinking and in early recovery. I haven't talked about it directly in a while. I have eluded to it here and there in my writing but never really talked directly that I still have issues to this day. I realized during my session with my therapist today -- I carry my own stigma about my own mental health. By saying that I am having a tough time or feeling depressed, I assume that others will see me as incapable, compromised and/or not in a good place to do my job. I preach all about being compassionate to one's self when feelings of anxiety or depression are present. I really believe that. I really do. I just don't believe in extending the same compassion to myself. My self-talk includes a lot of "shoulds". I shouldn't feel this way. I need to grow up and get out of bed. I am too old to sleep all day when "I don't feel good." (This one really bugs my therapist.) I talk with my client frequently about shame and I go home and shame myself for being anxious for "no reason" or not feeling up to being around people. Somehow I hope that shame will get me to change. I keep getting the message that there is nothing "wrong" per se with me so shame isn't going to cut it. Intellectually I know this, but my heart is a little slower to come around.

I have been in depressive episode (more mild with times of being more moderate) since last fall. I upped the contact with my therapist since this time. He reminds me that I have made weekly appointments, religiously, since September of last year. Obviously, I am wanting to be better and be proactive in making changes if I continue to show up week after week even when he says things I don't really want to hear. If you think about it, having an avoidant personality, I don't avoid this. Success. Sadly, since last September, I have seen myself as weak, unable to cope with daily life and acting like a kid. In reality, I am doing a lot better than that, it just doesn't always feel that way. When I am in these depressive episodes, the severity can change rapidly - something I feel very annoyed about. I can have an amazing week at work and then do nothing for 3 days straight because the idea of getting out of bed is too overwhelming. I can spend my 42 minute commute wondering what I might have done wrong in the past 2 weeks because I have need to be prepared for something bad in my supervision. I can feel my irritability get the best of me and lash out in inappropriate ways (this one bother me a lot). I have adopted this as part of my personality to my co-workers because the idea of people knowing that it is because I am in a depressive moment and my emotions get the better of me is painful. 

The way I experience depression: black and white thinking, lack of self-compassion which results in a lack of self-care, irritability that quickly flows over into outright hostility and increased anxiety. The way I experience anxiety: racing thoughts about everything I have ever done wrong, ever, anticipating the worse case scenario, doubting my own decisions and thoughts and a total lack of desire to get out of bed because I am going to screw it up all anyway. Even as I write this, I am feeling like people will feel different about me, pity me, feel sorry for me. That is not at all what I am after in writing something like this. These symptoms I feel, the mental illness I have are things that I deal with on a daily basis. Most days, I do very well in managing my symptoms. I rarely miss my medications. I try to access my DBT skills. I reach out for help. I am getting help. I am remaining sober. I am working to find purpose and meaning in the activities of my life. I show up to therapy and go to uncomfortable places and say "I am not OK today" and no one loses their minds. Maybe it's worth saying how it really is to not feel right even when there is nothing wrong. I am a big "why" person. And I will be honest, I don't like the answer to "why" to be "because you are symptomatic of your depression" or "you anxiety is triggered and you are in too emotional of a state to be logical". It feels like I have to surrender control to things that upsets me. I don't like the idea that I am not able to control myself. Weakness, right? Excuses, maybe? Unhealthy, possibly? Incapable of managing, yeah, it feels a lot like that.

When I think about the years of drunkenness, my memories are often at night in pitch blackness. There is a cloud of gray that hangs over those memories. My mental health was so incredibly unstable during those years. In my mind, alcohol caused all the mental illness for me, so there is a mild sense of frustration that I am still dealing with the depression and anxiety all of these years later. However, I also remember being anxious as a kid. I was terribly avoidant for years and years. When I left home to study abroad in high school, I was in a severe depression for almost the entire time I was there. I was unable to put words to what I was feeling. I started with the negative self-talk back then "this is what you wanted, so be happy about it." Almost 25 years later, I am having the same conversation with myself, just a different topic -- becoming a counselor (this I am actually writing a book about, stay tuned.) 

Well, I guess that is what I wanted to say. I have thought about this entry for quite some time. Those who know me pretty well, know about me having depression and anxiety. I proudly wore the dual diagnosis tag when I first got sober and have slowly shied away from conversations about. I felt compelled by the strength of others in my life to step up and be honest. I have compassion for your mental health struggles and not for my own. It is sort of freeing in a way to be honest That kind of illogical thinking is something that I can change.

Lots of love,
J