jakebe: (Mythology)
One of the earliest memories I have about my mental illness is breaking down in the middle of lunch in sixth or seventh grade. Things were not going well for me. I was a shy and awkward kid who loved reading fantasy books. I was really sensitive, so I didn't hold up to bullying very well. And I had gotten into trouble enough that in addition to homework and everything else, I had to write a sentence "I will not...something something something." 1000 times.

I was sitting alone, trying to think of what impossible task I should do over lunch and how I could justify putting off the others, when I just needed to put my head down. It didn't help. Tears welled up and I let them fall. My entire body locked up. All I wanted to do was curl up tighter. Someone found me, stood me up, and asked me if I had eaten anything. Then they marched me up to the lunch line.

It felt like my entire body had fallen asleep. I didn't have full control over the way I moved, so I just lurched around like Frankenstein's monster. I couldn't stop crying. There was no way I could eat, or speak, or open my mouth. When the lunch lady asked if I needed anything, all I could do was sob and shake my head and lurch back to my seat.

To this day I have no idea what to call that episode. A panic attack? A nervous breakdown? Who knows. But it happened again when my sister ran away from home, and again shortly after I dropped out of college and moved to Arkansas.

I've been dealing with depression and anxiety for my entire life. Most of the memories I have of my childhood are unhappy ones, where something in my brain just snapped and a response rose from within me that I still don't understand. What's more, I can remember similar things happening to the people around me; my father's mind going after his divorce, retreating further into himself; my mother disappearing for hours to sleep off depression; my sister's mood swings; the strange rumors that dogged certain neighbors. When I was growing up, our understanding of mental illness was little more than being able to identify "crazy" behavior; if someone did something "crazy" once too often, then they were branded. And there wasn't anything they could do to shake that off.

Even now, knowing what I know about my family history and the struggles that my siblings and I face, I see that for the most part that understanding hasn't deepened much. My sister is on medication that makes her incoherent or sleepy. My brothers still do things they don't understand. And, now that she's reaching the end of her life, my mother is beginning to forget things and become confused.

It's taken me a long time to come to grips with my mental illness, to accept it and learn how to incorporate it into my self-image. But there are so many black Americans and others in the diaspora who either can't or won't for a constellation of reasons. Most of us simply can't afford treatment for mental health issues, and wouldn't know where to begin even if we could. There is a stigma, even now, around therapy and medication that makes it difficult to encourage folks to seek out. There is still this narrative that those of us with mental illnesses are just "weak" or "whining" and only need to "get your mind right" to overcome them. We know so little, but we have such strong opinions.

Talking about my personal struggle with these things is still frightening to me, even though I do it so much. But it's important that I do. Within black circles, and geek circles, and even Buddhist circles, there is so much misinformation about mental illness and what people who deal with them are like. If being open about them can help to dispel that, then that's what I have to do. For my family, for my friends, and for my community.

If you are dealing with a mental health issue, please know that you're not alone. There are more of us than you know, willing and able to lend a hand. If at all possible, do what you can to lessen the stigma around these issues -- especially in minority groups. There is no shame at all in having a chronic mental illness, or in seeking treatment for it. There is no shame in doing what you need to do in order to be the best person you can.
jakebe: (Mythology)

Chronic depression is one of those things that can be very difficult to deal with, mostly because those of us who suffer from it exist in two states. When things are fine, we might think that we've rounded the bend and things will never be as bad as our last valley again. And then, when we find ourselves descending towards another crash, we have no idea how to stop it or make the cliff feel any less steep. I think most of us have an "out of sight, out of mind" attitude towards things that are big problems; when we're not actively battling our depression, we prefer to forget we have it.


But the fact is that chronic depression is a disease; an invisible one, one whose symptoms might not show up for days or weeks or months, but a disease that most of us will have to cope with for a major part of our lives. When a diabetic has his glucose levels under control, the diabetes isn't cured -- it's just managed so that the symptoms aren't making it difficult to function.


I think it's useful for those of us with mental health issues to think of our illnesses like that. The symptoms might not be bad enough to prevent us from functioning most of the time, but it's still doing its thing under the surface. There are things that we can do to help ourselves manage it; taking care of ourselves can make depressive episodes less frequent and less severe. I can't guarantee that we'll ever be completely free of it, but we can develop a number of coping mechanisms to help.


Learning how to live with depression is a process. Sometimes it might feel like we're making no progress at all; sometimes it can feel like we're sliding backwards into our worst places. But it's important to have patience with the process and with ourselves. There is nothing fundamentally broken about us; there is nothing that we can't handle. There are just a lot of considerations we must make that most others might take for granted. This can be a gift of practice; learning how to appreciate many aspects of our life that we wouldn't even notice otherwise.


Here are some of the things I've learned to do over the course of several years. You might find that different habits work better for you, and that's fine. It's not important to do every single thing that people recommend for you. It's important to find your own way of managing your mood and getting to a place where you feel comfortable and capable within your own skin. Take my advice, or discard it and forge your own path. But please try. It's worth it, I promise.


Sleep. This is single biggest piece of advice I would recommend for people dealing with mental illness: sleep well. I can't overstate the importance of rest in helping yourself to get on a more even keel. If you don't have a sleep routine, or you're having issues with getting regular or quality sleep, I really do think this should be a top priority. Sleep allows us to settle our emotions and builds our ability to cope with fluctuations in mood or changes in our environment that would cause anxiety. It is one of the best things we can do to care for ourselves.


Building a good sleep habit takes time and practice. The chemical imbalance that can lead to depression also impairs sleep function, so we end up sleeping too little or too much. However, keeping a regular sleep practice is a great foundation for routine that we can use to help us weather those times. Listen to your body; notice when you start to feel tired or your brain tells you it's time to get to bed. Notice when you're most likely to wake up without an alarm clock. If at all possible, build your sleep time around your own circadian rhythm. If it's not possible, determine when you need to get up and count back nine hours -- start getting ready for bed at that time.


It's not easy, and it's not quick, but it is effective. Once you're sleeping regularly, your body can begin the work of stabilizing itself.


Eat well. I know in a lot of situations this can be exceedingly difficult. Even for those of us in the United States, we might live in a food desert where fresh produce or lean meat might be hard to come by. Many of us simply don't have the money or time to make our own meals. I get it. But making sure we at least eat food that gives us a good balance of proteins, fats, carbohydrates and fiber will give our body its best shot at managing itself.


If possible, eat three squares a day that includes lean protein, unsaturated fat and complex carbohydrates. Think a turkey sandwich on whole wheat bread, multigrain chips and fruit. Try to limit caffeine intake after 2 PM; we all know that caffeine plays havoc with the ability to sleep and too much of it will definitely exacerbate anxiety issues. Drink more water, and cut back on sodas and sugary drinks.


You hear this kind of advice all the time, and I know how much of a drag it can be to try and follow through. But it's definitely important. The better fuel you give your body, the better it will be able to function. That's the simple fact. And I know that the instant you begin to control your diet it feels like you're swimming upstream, and we just can't put in the effort all the time. But try. And keep trying. Notice how you feel -- how you really feel -- after you eat. Does the food sit heavy in your stomach? Do you feel gassy or bloated? Greasy? Light? Satisfied? Focus on the foods that make you feel good -- not just emotionally, but biologically. The more you listen to your body, the more it will tell  you what it needs. To be a god-damn hippie about it.


Exercise. I know, I can hear the groaning from here, but trust me -- being active when you can really helps. Just going outside or getting the blood flowing helps just about every part of your body, including your brain. When you find the activity that works best for you, your brain learns how to release endorphins that tell you that you're doing a good job. And again, pushing yourself to pay attention to your body will help you recognize how it speaks to you -- how it tells you that it's in pain, or needs food or water, or what kind of shape or mood it's in. Learning your body is the first step to being comfortable with it, realizing and accepting its limitation, and appreciating the things you like about it.


Most people think of exercise as a slog; huffing on the street during a grueling run, or sweating through some terrible routine that you can't begin to keep up with. But it really doesn't have to be; it can be any activity that gets you moving and makes you happy. For me, it actually IS running. I get a wonderful high and a sense of accomplishment after putting in my miles. But for you, it might be anything from playing tennis, basketball or football to playing Dance Dance Revolution or Rock Band on your XBox. If it gets your heart rate up and your body moving, it's fair game. Do it as regularly as you can without hurting yourself.


Therapy. This is another suggestion that takes on almost limitless forms. For you, it might be therapeutic to write your feelings down in a journal or talk to the spiritual leader of your congregation. It might be reading, walking in nature, talking to a therapist or taking medication. Whatever works for you, seek it out and do it; develop a self-care routine, arm yourself with coping mechanisms, engage with the world and community around you however you see fit.


Again, I understand how difficult this might be for some of us. We might live in places where mental health professionals are hard to find or prohibitively expensive; we might not have access to an understanding or capable support network; we might not know where to begin to develop a framework of self-care. But if you're reading this, you probably have access to the Internet and that gives you a leg up. Research things that might help you and try them out; describe the results when you use them, and determine if it would be useful to keep doing them. Seek out communities online if you can -- there are a number of websites and forums for those of us dealing with depression and anxiety. Don't be afraid to ask for help if you need it. Try.


Sleeping regularly, eating as well as you can, doing active things you find enjoyable and engaging in a therapeutic practice are all basic things we could all do to help stabilize our mood as much as possible. Again, these are a lot easier said than done for many of us, but please -- do what you can when you can. Seek out help and support where you can find it. And keep trying. What helped me most with my depression is seeing it for what it is. It allowed me to engage with it, really understand it. And by doing that, I understood myself a lot better. Self-awareness is perhaps the most powerful tool we have against our mental illness. It helps us learn how to cope with it and to live happy, full lives even while we struggle.


If you have depression, anxiety or another mental illness difficult to endure and tough to make people understand, I see you. I'm with you. I want to help. And I'm not the only one.


But the best way to get help is to help yourself. We can support you, but we can't "fix" you. There's nothing to be fixed. You're a human being, wonderful and complete just as you are. You deserve to live, to be happy, to be loved. For people like you and me, it takes more work and care. But it makes the results of that work so much sweeter.
jakebe: (Mythology)

Last Monday, I posted a quick primer on what happens physically and chemically to the brain when depression strikes. On Wednesday, I talked a little bit about what that feels like for me. I wanted to state (again) that depression and other mental illnesses are incredibly varied and complex; there's not a single cause or expression of it, and everyone's experience and struggle with it will be different. However, I'm hoping that talking about it will give people a better idea of what it's like to live with it.


Today I want to talk about how we can help loved ones who are depressed, especially when they're in the middle of an episode. It's fairly common for people living with depression to have periods where they're managing OK and things are at some kind of baseline, then fall into an abyss when chemicals or external factors shift. Even when they're doing everything possible to manage themselves, this can happen. It's no one's fault when it does -- that's just the nature of this illness.


It can be exceedingly difficult to watch someone you're close to go through that. You can see them start to think horrible things about themselves and the world around them; to sink down into a hopelessness that causes a complete negation of who they are; to watch them say or do things to make the situation actively worse. Because we're a social species, and because we genuinely care about these people, their despair can frequently become our own. And because most of us don't know exactly what's wrong, any attempts to fix it at best do nothing and at worst only pushes the person further down that pit. Helplessness becomes frustration, and frustration can become anger.


As someone with depression who've also dealt with a number of loved ones going through the same thing, I get it. I've been on both sides of this equation. I know what it's like to be in the mental space that says I'm a terrible person living in a terrible world and nothing will ever get better. And I know what it's like to speak with someone like that, to try to make them feel better, to feel the panic and maddening frustration when everything in my bag of tricks simply doesn't work.


So this is as much for myself as it is for anyone else in these situations. It can be hard to remember a few things that may help us relate to someone in the grips of depression a little better. If you have your own recommendations, or would like to share your experiences, or would like to offer feedback on mine, please feel free.


First, please remember that your friend is in the grips of an illness. This is an actual disease that affects the way your loved one thinks; those thoughts can lead to words and actions that are difficult to deal with. Most of the time, all we're going to see is what our loved ones say or do. As with most invisible diseases, that's just the tip of the iceberg. There are a host of interrelated thoughts, experiences and body processes that lead to that result that we're not aware of. It's important to keep that in mind -- your loved one is having trouble coping with what is happening with them, and that often leads to behavior that doesn't make sense or can be outwardly intensely aggravating.


In times like these, I've found it helpful to try my best to keep in mind that this person is effectively disabled and treat them as such. We wouldn't expect someone in a wheelchair to just grab something off the top shelf, and we wouldn't expect someone who's diabetic to just eat something that would send their glucose through the roof. During episodes where our coping mechanisms fail or we enter the depths of our illness, please don't expect us to just behave normally or think differently or be something else. It's exceedingly difficult, if not impossible.


When we talk about everything that's gone wrong in our lives, it's often not that we have no idea how to solve these problems (though that may certainly be the case). It's that depression or anxiety looking for a reason to exist, latching onto anything it can find to take root and become more permanent. I don't want to say that a depressed person complaining about their lot in life has nothing to complain about; what I am saying is that what's going wrong feels insurmountable and unsolvable when we're at our worst, whether it's true or not. For us, that perception is reality. Life is fundamentally broken, and it can't be fixed.


I think this is what lies at the fundamental disconnect between a depressed person and a loved one. There is that seemingly unbridgeable gulf between our perception and theirs. To someone in a depression, no one understands just how awful things are, how wretched and permanent. To someone watching depression from the outside, this loved one doesn't understand just how much they are loved and have people willing to help them if they would just get up and try.


I believe the best thing we can do for our depressed brothers and sisters is to accept them as they are, in that moment. When I'm in that valley and I talk about how terrible things are, I'm not necessarily looking for a fix; I'm looking for understanding, for the comfort that comes with connection, for someone to take my hand and say "I hear you, and I know that you are suffering."


That can require an extraordinary amount of empathy. So many of us don't like sitting with difficult emotions, even if we're the ones feeling them. We look for ways to stop being angry or sad or uncomfortable as quickly as possible, and because we've never developed the patience or compassion for ourselves to allow these emotions to exist within us when it appears in others we simply cannot tolerate it. We want THEM to stop it as quickly as possible, too.


So when a depressed loved one comes to us with their difficulty, we treat the situation like we would treat it in ourselves. How can we fix this? How can we distract from this? How do we stop this? The short answer is that we can't. We must simply accept it, be in that difficult space, find a way to bear it, however we can.


That load is lessened so much when there is someone willing to be with us in those moments. Just hearing someone say "I know this is awful. I am here for you." can make an unbearable, permanent situation feel like something that is "only" difficult. Hearing someone try to offer solutions to my problems can have a paradoxical alienating effect; I know that they're only trying to help, but the attempts to offer solutions only underscores the fact that they don't understand me. Sometimes, it forces me to admit that I don't understand myself at those times.


Like a cold, or a bad flare-up of arthritis, or some other chronic disease, depression is not necessarily something that can be fixed. When it happens, we can only manage it as well as we can. Because it affects the way we think, speak and act, those of us in the thick of it are often unable to do what we need in order to manage it. As part of the support network, sometimes it falls to us to find ways to make that happen.


Empathy, patience and understanding are necessary for this. I understand that so many of us have that in limited supply, mainly because we're dealing with our own issues. Taking on the suffering of someone else is not easy, even in the best of times. But whatever we can offer to someone else has a tremendous effect.


Finally, please be sure to take care of yourself. I know how difficult I was on the people around me during my worst depressions, and I know that a lot of these people burned themselves out giving and giving and giving without making sure they were OK as well. Do what you need in order to be OK; get good sleep, eat well, talk to someone about your experiences and difficulties, if you can. It's impossible to care for someone else if you don't care for yourself first.


Wednesday, I'll offer advice on what we can do, as depressed people, to care for ourselves. All of this is first drafty, but I hope it's helpful anyway. It's important that we at least begin these types of conversations.
jakebe: (Self-Improvement)
On the weekend before last, I walked all night to raise money and promote visibility for suicide prevention and related issues. There were more than a thousand people with me, all dedicated to this cause because they had been touched by mental illness and the havoc it can wreak over the lives of people who cope with it and the people who form their support network. It was a sobering thing, knowing just how many people were directly affected.
Walkers wore honor beads to show their connection to suicide. Green meant you had a personal struggle or attempt. Gold meant you lost a parent; white meant you lost a child; orange meant you lost a brother or sister. Red is for losing a spouse, purple is for losing a friend or other loved one. There was a rainbow of colors over a sea of blue shirts that day, and the sheer variety of people wearing green beads really blew me back. There were old hippies, young video game nerds, intellectuals and business-people, homemakers, people of color, couples and whole packs of others. I could look at someone, see their green beads, and know that I'm not alone in what I survived. So many people from so many different walks of life also deal with depression and the suicidal ideation that can be a part of it. It was inspiring, but also surprising.
We don't talk much about suicide or the conditions that lead to it -- namely, deep depression and anxiety. I can understand why. Mental illness is something that can be very hard to wrap your brain around; one can understand it logically, or have an idea of what it's like through metaphor. But when you're dealing with a loved one who feels like they're only burrowing deeper into a hole you're trying to pull them out of, it can be exasperating, confusing and make you feel hopeless.
Why do we do that when we're depressed? What's actually going on when people like me are in the worst of those troughs? I wanted mainly to try and explain things on a few different levels -- what physically or chemically happens to the brain; what it feels like to me personally when it does; how it looks to our support networks; and what the depressed and their loved ones can do to help manage their condition before, during and after episodes. This might take me a little while to do, and it'll most certainly take multiple posts. I want to make sure that my information is correct and any recommendations made are helpful, but also please keep in mind that I'm not a mental health professional. I have intimate knowledge about this, but I'm not trained to deal with it any way.
Depression (or major depressive disorder, or chronic depression) is a mood disorder often characterized by deep feelings of sadness, hopelessness, numbness, loss of interest and lethargy. People within a depressive episode can appear sad or empty to the point of near-catatonia; angry or irritable; entertain irrational thoughts or worries that leads to catastrophic imaginings; be unable to sleep, or sleep too much; appear tired or "slowed down", so that thinking and speaking are noticeably delayed; appear distant, aloof and/or unable to explain what's going on. There are a lot of other symptoms, of course -- depression isn't a "monolith" illness, and everyone's relationship with it will differ depending on physiological and environmental factors.
So what's going on in the brain that depression manifests with such different symptoms? Why do some of us get really sad and still while others get agitated, angry or paranoid? Why is it so difficult to treat depression with medicine or lifestyle changes, like so many other illnesses?
That's a difficult question to answer, simply because so little is known about the physiology of the brain and how it relates to mood. The brain is a frighteningly complex organ that is really a bundle of inter-related systems working together to do amazing things -- if any one of them runs into a problem, it can cause changes that are hidden through some dependencies and rise in others. The simple fact of the matter is we can't pinpoint to one part of the brain and say with certainty that this is the part that causes mood disorders.
What we do know is that there does seem to be a genetic component, and parents can pass depression and other mental illnesses to their children. For example, my biological mother was schizophrenic and the children of schizophrenic people are at a higher risk for chronic depression. There is also a physiological component that might take a bit to explain.
So, our moods are actually electrical and chemical messages that travel through our brain. What happens is an electrical message is sent from a neuron, travelling down the long trails called dendrites to the end of the branch. Think of it like a rural family walking down a long dirt road to put a message in a mailbox. That message can be anything from "This thing you're touching is very hot." to "You are getting sleepy." That message changes from an electrical stimulus to a chemical when it reaches the mailbox, and that chemical is called a neurotransmitter.
Receptors at the end of dendrites for other neurons are specially formatted for any of the 30 (identified) neurotransmitters; when those receptors pick up the neurotransmitter, it converts the chemical message back into an electrical impulse which races along the dendrite (that dirt path), into the cell body, and then to the axon -- which changes the electric impulse back into a chemical -- and the whole process starts all over again. We have anywhere from 10-100 billion neurons in our brains, and they can communicate with each other in less than 1/5000 of a second. It's amazing stuff; our brains are processing incredible amounts of information at astonishing speeds, converting electricity to chemicals and back again.
So what happens to the message once it's been received by a neuron? Well, it's released from the neuron that started it and floats in the synapse -- the space between neurons in our brain. It's then either taken back by the neuron that started it (that's called reuptake) or broken down into another chemical called monoamine oxidase (MAO).
There are three neurotransmitters that have typically been focused on when it comes to depression -- serotonin, dopamine and norepinephrine. Any one (or more) of the three have been shown to have unbalanced levels in people who are depressed. Basically, the chemicals that tell our brains to regulate our mood, sleep, appetite, stress and sexuality are in short supply or the brain has trouble actually knowing what to do with them.
While at first we believed that it was the level of these chemicals that were the main cause of the problem, there has been research that indicates it might be the connection between neurons in certain parts of the brain -- like the amygdala, thalamus and hippocampus, all of which have been shown to be physically different in people who deal with depression. Anti-depressants target certain processes in our brains to elevate the level of these neurotransmitters and to improve the number and quality of connections in the areas of the brain associated with them. SSRIs, or selective serotonin reuptake inhibitors, basically prevent one of these neurotransmitters from being called back to its parent neuron. So there are more of them floating in the synapse, waiting to be picked up by other ones and pass along the appropriate messages. MAOIs, or monoamine oxidase inhibitors, are drugs that prevent these neurotransmitters from being broken down if they're not doing the reuptake thing.
So, to sum up, depression can be caused by an imbalance of three neurotransmitters -- serotonin, dopamine or norepinephrine. This imbalance could be caused by an overly efficient reuptake process that calls back these chemicals before the job is done; it could be caused by bad connections between synapses in certain parts of the brain; it could be caused by the brain's inability to form these chemicals properly to begin with. Each possible medication treatment targets one aspect of this problem, and possibly only one neurotransmitter. That is why it can take some time for medication to work in the first place (because physical and chemical changes to the brain don't happen overnight) and some time for your psychiatrist to find the right medication (because the problem might not be that your serotonin is too low, it's that your dopamine can't attach properly to synapse receptors).
Even though our brains have a "post office" that passes along literally billions and billions of messages between neurons every single minute, sometimes something goes wrong with the system and we lose the ability to send and receive postcards that say "Having a great time, I hope you're doing well!" Sometimes, it's not even something in the brain -- it could be hormones that are causing different physiological responses in the body that ultimately end up affecting the brain. There are no quick or inexpensive tests to pinpoint exactly what's going on with the chemicals in the brains and bodies of us depressive people, so medication is often our most educated guess.
There are, of course, different kinds of depression. Major Depressive Disorder is what most of us think of when we talk about depression, but there is also Persistent Depressive Disorder (where depression lasts more than two years), Bipolar Disorder, Seasonal Affective Disorder, Postpartum Depression, Psychotic Depression (which is accompanied by hallucinations, delusions and paranoia) and others. A proper diagnosis can lead a psychiatrist towards one or more medications, but most often treatment will happen on multiple fronts; while looking for a chemical solution, cognitive behavioral therapy can help us identify and manage thoughts and emotions that come from depression.
What's important to realize is that depression is a distinct physical illness -- as real as diabetes, AIDS or Parkinson's Disease. There is a real chemical and/or physiological disorder in our brains that affect how and what we think, our levels of energy, our ability to manage conflict and stress in our lives.
During depressive episodes, our brains are going through changes that make it much more difficult to manage our moods, sleeping patterns, appetites and other things. When we're depressed, we may literally be physically incapable of being happy, maintaining a balanced perspective, sleeping or eating as we should, or even getting out of bed. The chemicals that allow us to do that are simply not present or active within our brain.
That is what those of us who manage depression have to face. While many of us are lucky enough to have access to mental health care and responsive treatment, many more of us are unable to visit a therapist or psychologist; have no means to seek help; or are in an environment where mental illness is poorly understood, stigmatized or completely ignored. Those of us trapped within those situations often have no recourse but to suffer alone and helpless.
So many of us who have this illness recognize that there's something wrong with us; that we can't feel happy or motivated or interested the way most people can, or that we feel empty and hopeless even though we have no reason to. We know that our inability to do everything that might be expected of us can be a real burden on those around us, and that it can be difficult or impossible to explain just what's happening to us. When we're in a place where getting out of bed and just taking a shower is all that we can do today, it can be extraordinarily alienating for even the most well-meaning advice to miss the mark of our experience, to offer ideas or solutions that the depressed person is simply incapable of imagining.
It's an awful thing to be in that place. We can often be unable to think of times when we didn't feel this way, or imagine a future in which we won't feel this way. This is going to sound lame, but U2's song "Stuck in a Moment That You Can't Get Out Of" was a revelation for me; it really captured the major problem of depression for me, that idea that this is something ugly and permanent that I will have to bear for the rest of my life.
For those of us with this illness, there are a number of things that make our manifest symptoms and internal experience unique. Specific brain chemistry, personality traits, environmental and social factors, hormonal imbalances, life experience and so many other factors contribute to how we express, cope and view depression. And I know how difficult that is to help with, but trust me -- it's not any easier for those of us trapped inside of our own heads.
On Wednesday, I'll talk more about my personal experience with depression. But for now, here are a few links that offer further information.
All About Depression -- A website that offers information and resources about what depression is, how it works and manifests, and treatment options.
What Causes Depression? -- A page from the Harvard Medical School that talks about what we know (and still need to learn) about the physical and chemical roots of depression.
Antidepressants (Wikipedia) -- Wikipedia, of course, has an extensive article on antidepressants and how they work chemically. What's interesting is we still don't know exactly WHY they work; but the data gathered over the decades prove that they do.
National Alliance on Mental Illness -- NAMI is the leading organization in the United States dedicated to mental illness and improving the conversation about it within our country. They also have tremendous resources, information, and outreach.
See you folks on Wednesday. If there are any questions about depression or comments about information I've presented here, please let me know!
jakebe: (Hugs!)
No Shame Day was last week and I completely missed it, so I thought I would take a bit of time to open up further about my mental health issues. I believe that the more we discuss these things openly, the more people understand the nature of mental illness and the more we destigmatize those suffering from them.
I manage chronic depression, and I'm pretty sure I've had it all my life. Depressive episodes have been really bad a few times, and it was only recently (when I moved to California) that I finally got the help I needed. Now, I cope with a mixture of medication, cognitive behavioral therapy, and Zen meditation. For the most part this does the trick -- my thoughts don't run away from me nearly as often because I can recognize when something is being driven by depression and have tools to engage that.
However, things aren't perfect. One of the reasons I identify with rabbit so strongly is because it's a creature whose life is ruled by wariness. They're constantly on guard for potential threats, and so much of their communication is about worry and the lack of it. The less they worry, the more their personality comes through; it can be hard to "get to know" a rabbit, but it's a delight when you do.
I'm a high-strung person; most of my effort goes towards the managing and alleviating of stress -- in myself and others. At work, I sweat the small stuff as much as I can, though it gets exhausting to do so and I end up dropping a lot of the details because I just don't have the capacity to deal with them. THAT can stress me out, knowing that I'm inconsistent with my attention to detail or the ability to get things done. And since I'm stressing about that, I have a reduced capacity for new stressors in my life.
The cycle completes when I get overwhelmed. It becomes impossible to concentrate on the things I need to do. The more I try, the more my brain just seems to slide off the task and I look for anything that can provide a distraction. Sometimes I'll end up just clicking on the same three websites over and over for distraction's sake, not taking in anything, just doing something so I don't have to think.
But that's no way to live your life, much less spend your career. I'm trying to move into a position of more responsibility at work, but it's difficult when you struggle to manage the responsibilities you have. This obviously isn't something I can talk about my superiors with; I'm not a bad worker, I just have trouble dealing with certain aspects of my work. Still, something had to be done.
So I went to a psychologist to see if I had ADHD; the lack of concentration and focus, the excitability, the tension all seemed to point to that. After a test and a consultation, she determined that yes, that was a likely possibility as well as Generalized Anxiety Disorder. GAD is characterized by excessive worrying about various aspects of daily life (in my case, writing and work) with physical symptoms that include fatigue (yes), muscle tension (yes), twitching (yes), difficulty concentrating (yes), irritability (also yes).
So now I'm embarking on a new front for my treatment: group therapy classes for GAD and ADHD, with a round of medication possibly starting up today. I'm hoping that the coping mechanisms learned in these group therapy classes can help me cope with anxiety, and the medication at least puts me on an even keel for long enough to make those mechanisms habit. We'll see how the rest of the year goes, but I'm optimistic that it'll at least help me deal with my reactions to stress.
I know that mental health issues are difficult to speak about. You have celebrities and various seminars and self-improvement courses trying to tell you that it's "all in your mind" and medication is never a good idea. You have the media promoting the idea that when something terrible happens (like say, Dylan Roof) it's because the perpetrator was mentally ill. Well-meaning friends and associates tell you to suck it up or get over it without properly understanding just how difficult (and sometimes impossible) that is -- like people who suffer haven't tried that already.
But mental illness is a real thing with real causes; sometimes those causes need medication to be resolved, and sometimes developing a mindfulness program is enough. Sometimes the condition is transient, brought out by extraordinary stimuli. Sometimes it's chronic, without any cause but chemical, and you'll have to work to manage it for the rest of your life.
All of this is OK. We each have our own burdens, and sometimes we need the help and wisdom of people better equipped to deal with them. It takes a while to find a therapist we feel understood by; it takes a while to find the medication that makes us feel even without feeling emotionally restricted. Learning just how to handle mental illness is a journey that can be long, lonely and frustrating. But like getting to know a rabbit, the end result is very much worth it.
It's important to me that people know mental illness is a real affliction, and that it can be managed. People who have them can live productive and meaningful lives. And most importantly, that there's help out there. If you feel there's an issue that you can't manage on your own and need help, mentalhealth.gov is a good place to start. Reach out to friends and/or family you trust; a support network can be tremendously helpful. And know that you're not alone. There are those of us who are fighting the fight with you, all the time, every day. We see you, we understand you, we love you.
jakebe: (Hugs!)
Imagine your willpower as a car that you drive to get from place to place, and that your destinations are anything that you might want to do with your life. Something simple, like making a sandwich or getting dressed, is a quick jaunt to the corner store. Something a bit more involved, like training for a marathon or writing a novel, is a cross-country trip. If you need to do anything, no matter how trivial, it's going to involve getting into your car and going for a drive. Why? Because for the purposes of this metaphor, life is one big Los Angeles freeway.

Some people have souped-up roadsters that are just a pleasure to drive. These are your go-getters, your Type A personalities. They have no problem with getting things done; they just get into their cars, listen to it purr and suddenly they're at their destination. These folks are rare, and most of us have no idea how they do what they do because their cars are so awesome it just doesn't register. Most of us are in Fords and Toyotas. These guys are in Ferraris.

But even for those of us in econo-boxes, it's not so bad. As long as we give our cars enough fuel and take care of them, we can get most of the places we need to go. A particularly arduous trip might tax our reserves if we hadn't prepared well, or it turns out to be more difficult than we anticipated. But running out of gas almost never happens. When it does...you know how much of a hassle it can be.

Suddenly the car that you use to get everywhere has become this two-ton burden that you have to look after. You can't leave it on the side of the road, unlocked and vulnerable. So you have to push it to the nearest gas station and that's no picnic. It takes all of your energy just to move it, and the moment there's even a small obstacle, like a bend in the road or an upward incline, well that's it -- it's just impossible.

This is what happens when you're depressed. Your brain, the thing you rely on to get things done, suddenly runs out of fuel and forces you to drag it along with you to accomplish anything. When it's really bad -- when your mood is completely depleted -- just getting out of bed and making yourself presentable enough to go outside is a massive undertaking.

For most of us this only ever happens once or twice, and usually after a traumatic event that saps us. You're already running dangerously low, and it's easy to get caught on the road when your fuel just runs out. For those of us with chronic depression, though, this is a constant worry. Let's look at it this way: there's something wrong with the fuel lines in our cars, so a full tank of gas doesn't get us nearly as far as it does most people. Our gauges are faulty, so we're never quite sure how full our gas tank is. And as a result, we get caught on the road on the way to somewhere, suddenly empty.

There are ways to manage the issue. We patch up the holes with duct tape and sealant, but it's not a perfect solution. We need to re-apply it every day, and watch for times when the solution we've found is not working as well as it once did. If we think we can go a few days without re-applying the fix, the chances that we find ourselves stranded dramatically increase.

Just in case you're wondering, I'm talking about drugs here. If you're anti-depressants, take them. If you think you'd be fine without them, talk to your doctor before doing so. You might think you're fine, but remember that your gauge is faulty; it helps to have a mechanic come in to verify that the 'trouble' light really should be off.

This is what happened to me, and why I've been suddenly incommunicado for the past several weeks. I thought I was all right, even with a number of stresses piling up on me, and stopped taking my anti-depressants for a while. And before I knew it, all of those destructive loops, anxieties and mood crashes hit me again. I wasn't prepared for it, and just like that it was all that I could do to deal with work and other obligations. Things like blogging and writing were completely out of the question. Fuel was gone as soon as I got it.

So the car's been in the garage for a while; I've been steadily bringing it back to health, and taking it out on short runs to work or to a role-playing game I run a few times a month, but that's it. Gradually, as I grow more confident that I can take it places without it leaving me stranded, I'll be trying to do more again. But I'll have to be careful. I don't want to push myself too much and get myself into trouble.

So if I'm a little irregular around these parts, or I drop an entry or two, that's likely why -- I'm saving my precious willpower for something that's a bit higher on the necessity scale. But I'll definitely be trying to update as regularly as I can, to fill this space with my thoughts on movies and storytelling, with bits of fiction here and there.

If you have a faulty fuel line like me, please make sure you stay on top of its maintenance. It's so easy to get yourself in trouble, especially when you feel like you're fine. And if you know someone with a faulty fuel line, please be patient with them. Not only is there an issue with their brain, there's an issue with their brain monitoring; things can look awfully distorted in the middle of a problem, and it's not always easy to navigate. Just point us in the right direction, support us where you can, trust us to eventually figure out that our gauge is steering us awry.

I've been dealing with chronic depression for my entire life, but I've only actually been managing it for about five years. My recent adventures in self-medicating tells me that I'll need to manage it for the rest of my life. Some days, this bums me out. I mean, who wouldn't want a Ferrari that purrs like a kitten and leaps when you tap the pedal? But the fact is, I have an econo-box with a busted fuel line, and it will require vigilance to make sure it performs as well as it can. The act of maintaining it teaches me patience, acceptance and to look for joy in the unlikeliest of places. With the right attitude, my broken-down little car can be the very thing that forces me to find new ways to get where I want to go.

A Few

Feb. 13th, 2009 04:53 pm
jakebe: (Default)
[livejournal.com profile] chris_sawyer linked to this, so I have to as well:

Feeling rejected has surprising psychological consequences. The thing that gets me is not exactly what those consequences are, but the sensitivity of the button that triggers. Even if you hate someone in particular, knowing the feeling's mutual is enough to produce these responses. We're very social animals, it turns out, and our desire for company can be taken to a faulty extreme pretty easily.

Another fascinating idea is how rejected people engage in behaviors that make it *more* likely that they'll be rejected in the future, anti-social and aggressive. It's interesting how this overcompensation is essentially hard-wired into our brains. Which of course makes me think if there's any wonder we have so many maladjusted, weird people out there; if you make it through high school being mocked by most of the people in your world, what kind of adult does that make you when you get through it? Does it work on an even larger social scale? Is it possible that a sort of 'societal rejection' is one of the reasons why the poor or minorities tend to have higher instances of mental illness, criminal tendencies and the like? How far can you take this?

Obviously, this isn't the one answer that explains why a member of a marginalized community might do something morally reprehensible, and it's not an excuse, either. But it's a significant factor, and if it's something we can do something about, then...maybe it means the difference between eventually learning to become functional in a social group and, well, not.

I'm taking a Psychology 101 class this semester, so expect a lot more obnoxiously naive rants about the basics of how the human brain operates. I'm warning you now. :)

*****

This week was pretty bad in terms of mood. I kept bottoming out to a deeper layer of bad mood, and Wednesday was the worst I've felt in a long time. I got so tired of everything that I just wanted to sleep forever, which is a disturbing thing to me. It felt like I was moving through a thick fog with everything I did. I just wanted to be still, and be alone, and not have to move or think any more.

One thing that I think it's difficult to get across is how...automatic this process is. I obsess over friendships and interactions and being able to connect with people, and I know a lot of the time if I could just get out of my own way, chill out and take things as they come things would go a lot smoother. I *know* this, but I can't *do* it when I get depressed and insecure. It's another reason the 'rejection' article hit me so hard; what sounds neutral to most people will more than likely sound like rejection to me. If anything as simple as a facial expression or vocal inflection *might* be construed as something negative, chances are I'll take it that way and run with it.

And of course, this is ridiculous. I *know* it's ridiculous but I feel like I can't do a thing to change this reaction. Most of the time I'm aware of these processes, I know how they work, and sometimes I can ride them out; some other times it turns me into this completely different person. I'll be fine, and suddenly I'll feel like I'm teetering on the edge of this cliff, and then I'm down. It feels like something in my brain is depleted. If I had it, I could feel better, but I don't. I feel like a stalled car in the middle of the road. I don't want to be there, you don't *want* me to be there, but I can't help the situation at all. I'm just out of gas, and I'm stuck where I am until I get more.

In Radical Acceptance, the advice given seems to be to make peace with this mood; to observe it, to let it happen without any kind of qualitative judgment for it. That's a really great idea, but impossible to do when you're in the middle of work and trying to do four things at once, and you can barely muster up the energy to do any of it. It's very easy to feel overwhelmed, to feel like you're trapped and the only thing to do is to quit so you don't have to deal with any of it any more.

That sounds a lot worse than I mean it to. I'm not suicidal. I'm just trying to explain all of this craziness; at the very least, so it makes sense to myself. And to other people.

I also don't want to be the guy who talks endlessly about depression, and bores people with all of the minutiae of every single mood. Just bare with me through a few more of these and I'll try to start posting about other things. This is just new and shiny and it helps me sort out my brain. Also, your input is tremendously reassuring. :)
jakebe: (Default)
It amazes me how missing a few hours of sleep can completely wreck things. The thoughts running through my head for hours are all about how boring and awful and completely unlovable I am. This isn't true of course, so on one level I can disconnect and watch my brain in its little wheel.

But on another level I know that I'm on this miserable little run and I can't seem to get out of it. It's just this moment, and it'll pass, but God it sucks while I'm in it.

I've been all but paralyzed by self-esteem issues for several months now. When I'm with friends I'd rather not say anything because I worry that anything I could possibly say would just sound really stupid and inane, and when I get up the courage to say it I end up stuttering or tripping over my words in my hurry to get it out and get things over with. I can't think of anything to say to people online because I'm constantly worried that I'm going to end up saying the wrong thing. So, I become boring and awful and nobody wants to talk to me, thus confirming the original view. It's a vicious cycle.

I really want off this ride.

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