Saturday, April 21, 2018

My Struggle With Mental Illness

Let's cut to the chase. About 8 weeks ago I was medically diagnosed with a mental illness known as moderate to severe depression.

Mental illness has a negative stigma in our society. So in order to help reduce this stigma, and perhaps to help anyone reading this who may be in a similar situation, I want to share some details about my own illness.

In The Beginning

Looking back on my life I think I've had bouts of depression all my life.  I can recall having strong and prolonged feelings of despair and not being good enough at several points in my life,   These waves of feeling down would come and go, but the most recent bout of depression started a couple years ago.

It is important for this story to understand what was going on in my world.  What was going on was the status quo.  I had two kids that were, aside from normal kid things, pretty easy to deal with.  The relationship with my wife has remained as it always have - strong and drama free.  My job, which I have been doing for 10 years at that point, pays well, is relatively low stress, mentally interesting, has a flexible schedule, excellent management, and in general a wonderful way to spend a career.  In short, there have been no major life changes, and no real reasons to be unhappy with my life.

Despite all that about two years ago I started becoming disgruntled.  I'd have days where I didn't want to go to work, and when I got there I didn't really want to do anything.  Of course every one has these feelings now and then. However they were starting to get more and more frequent.

Slowly over time I wasn't enjoying any of the activities I used to enjoy, or they would be more stressful then they used to be.  Road trips, which I love, would not be as enjoyable, and exhaust me.  I would get more irritable at minor inconveniences. I'd have trouble finishing projects, and picking up my camera.

However it was easy to explain away.  I have allergies (I live in a high allergy area), which are affecting my energy levels.  My project at work is not as interesting as others.  I am an immigrant in Trumps America.  Lots of easily explainable little things were not going as smoothly as they should have been, and were bringing me down.  Little things that were masking the demon lurking deep down inside.

The Downward Spiral

About 6 months ago it really started to intensify.  I really started to lose ambition, and it became harder to get motivated to be creative, especially at work.

I was also getting increasingly cranky.  I mean I've always had a cranky side, but it was starting to kick in at the most minor of things. I was more sensitive to the slightest inconvenience, criticism, or change in direction. I'd have a short temper with the kids, and get easily annoyed with my wife.

The rare moments I could get deep in thought and be creative were wonderful, but if anyone interrupted me, it made me incredibly and irrationally irritable.   More than once my wife was met with what must have seemed absurdly angry and bitter response to a simple announcement like "supper is ready, dear."

I  mean, how dare she feed me now... doesn't she see I'm creating something over here?

I did have a series of sinus infections, which served as a handy excuse. "My sinuses are messed up which makes it hard to think. Thats why I'm not motivated, and cranky. Obviously!" was my thought process.   When I went to see the doctor about those issues, my wife, wise to the fact that something was off in the behaviour of her oblivious husband, encouraged me to talk to the doctor about it.

To be fair I was diagnosed with sinus infections and did go thru several rounds of antibiotics, so thinking it was the cause wasn't entirely unwarranted.

I did bring my crankiness up to the good doctor, but it was mixed in with my other symptoms, and could be explained away as other things. "If you stop exercising you can feel down." was one excuse I hung on to.  I had stopped biking to work every day - mainly because the local bike shop closed and my bike needed repairs.  It fit tho, so I went with it. Another excuse was "You don't go hiking alone like you used to, perhaps you just need some alone time."  Also true.. also held on to.

It is just bad sinuses, and not getting enough exercise and alone time, I was satisfied with that explanation, and started treating those issues.  I was a victim of circumstance,  so just leave me the fuck alone, OK?

Fortunately, aside from my super crankiness, my reaction to all this stress was not to cause harm to be or anyone else, but to run away.  I started to day dream about quitting my job, packing up the family, and moving back to Canada.  Problem was I didn't have anything lined up job-wise back home, and I didn't want my wife and kids to suffer without a regular paycheque, so I soldiered on.

Rock Bottom

So after a very trying Christmas break spent with family back in Canada, I returned to work in January.  I got no real joy out of that vacation - in fact I had a bit of a nutty overreacting to a New Years Eve party (which I crazily tried to sleep thru despite a party, planned well in advance, happening in the living room).  My incredibly understanding wife talked me thru it, but still something had to change. I knew it did.  I just didn't know what, and I was grasping at the straws I had previously clung to, desperately seeking solace.

Back in the US in January, going thru the motions in the new year, I was getting lost in my head.  At work I had a project assigned to me - nothing super complicated and nothing I hadn't done a dozen times before.  However I couldn't seem to make any progress on it. I could do some small tasks here and there, but digging into the creative problem solving of software engineering took a force of will.  A force of will I was rapidly losing.

I did get my bike fixed, and I was biking every day again... which helped for a day or so, but the effect didn't last.   It seemed harder than before as well.  A lot harder.

By the end of January I was just stewing in my own fog.  I actively hated going to work.  I had to force myself every day to leave the house.  I was being cranky to my co-workers - nothing they did.  I actually have really friendly and cooperative team mates.  We've been working together for 10+ years, and we have a great rapport. Still, I was reacting with anger and annoyance to things that didn't come close to deserving negative reactions.

My personal live was suffering too.  Especially my photography.  I still had a flood of ideas for shots I wanted to take, and special effects I wanted to try, but I simply couldn't get the energy to get out of my easy chair and go to my studio in the basement.  That was true mental pain - the spirit was willing, but the flesh wouldn't cooperate.  Creatively I felt trapped in my head - it was the closest I ever came to a personal hell.

The first week of February I hit my wall.  I simply couldn't go on with things as they were going.  My project at the time was writing software code.  However I had to force myself to simply open up the editor - actually writing the simplest line of code was beyond me.  All I wanted to do was leave, pack up the family and run away.  However I was in no position to hunt for a job, and I still didn't want to leave the family without support, so I felt trapped.  I felt incredibly trapped.  There was nowhere to run to, nowhere to hide.  I was miserable beyond all reason - crying inside every day. Sometimes crying outside in the middle of the night.

I also felt like I was about to be fired for poor performance, and really I couldn't blame them.  I was sucking at my job. I'd have wanted to fire me, too.

Fighting back physical tears (I didn't  want to attract attention and try to explain myself to my team mates), while sitting at my desk, for the 4th day in a row of having accomplished absolutely nothing - not even being able to open a text editor, I finally typed in "signs of depression" into my browser.

The first hit was a questionnaire about depression, which I filled out.  It came back with the result  of "Moderate to Severe Depression".


Light In The Darkness

The moment I saw "Moderate to Severe Depression" on the screen, I actually felt a little better. Just a little.  Instead of having no idea what was wrong with me, I had a possible diagnosis.  Perhaps there was a reason for my insanity.  It was something to focus on. Something specific to fight.

The first thing I did was text my wife: "I just took this online quiz and I think I have depression".  She responded "Yep, most likely.".  I suggested I should get help, and she agreed.

As an aside, you may wonder why my wife wouldn't bring up her suspicions that I had depression before.  I think this was a smart thing for her to do.  If she had suggested it before I was ready to hear it, I would have likely raised my defenses against it, and made it much harder to come to the realization myself.  I think thats the key - I needed to face it myself. Now that I was facing it, she was behind me 100%.  Bless her for that.

The second thing I did was write my manager an email, and tell him I was having issues.  I did this simply because I figured I'd need some time off, and there may very well be a medical reason why my performance and attitude at work was crap lately. Fortunately he was amazingly supportive. Another monkey off my back, at least for now.

Finally I made an appointment with my family doctor.  It was going to be a week before I could see him.  So I kept showing up to work, and not being productive.

Diagnosis: Depression

When I saw my family doctor, we talked about my issues, and he asked a lot of probing questions. I live in a small town, and my doctor is also an elder in my church and teaches my adult Sunday School class, so it got a little awkward when the questions became personal.  However the one thing I really knew about mental illness is that locking things inside is not helpful, so I threw caution to the wind - if I needed to talk about how things are with my wife, damn it I'm gonna talk about how things are with my wife (fine, BTW, she's remains amazing).

At this point the good Doctor agreed with the online test - I did have moderate to severe depression, and I needed treatment.  However that is not always as easy as it sounds.  Brain chemistry is not well understood at all, and a lot of it is still guess work, and anecdotal evidence. My doctor said that medical science can explain down to the molecular level how the heart works, but the brain is still largely a mystery.

However there were many things to try, and some likely causes. The most common cause is a deficiency in the neurotransmitter serotonin.  Serotonin is thought to regulate, among other things, behaviour and mood.  So it is not a stretch of logic to realize an imbalance there can cause depression.  So it would be an experiment. We would try a drug - if it didn't work, we'd try another, and another, until we came across the right combination that worked for me.

I was put on an SSRI - Selective Serotonin Reuptake Inhibitors - which is a fancy way of saying I was given a drug that slows the bodies absorption of serotonin, leaving more in the brain to do its thing.  (fun fact:  Learning the brain drugs work is my favourite part of this process).

Luckily the first drug we tried, which works for the majority of people apparently, seems to have done the trick (spoiler alert). Luckily I'm not that special, and the more common solution worked for me.

Side Effects

So I started taking an SSRI pill every day - something I call my brain candy (cause a sense of humour is important when one is suffering depression).  Not much of a burden really.  However the side effects are intense.  It takes 3-4 weeks for the body to get used to the effects of the medication.  The side effects basically made me alternately tired, and energetic.  It really threw me for a loop. I felt mentally fuzzy for weeks. (I feel physically fuzzy all the time, so maybe I just achieved some sort of symmetry?)

Interestingly enough the only day of work I missed due to depression (at least directly) was the day I started taking my brain candy.  The side effects were that severe.  After that I went to work every day.  I felt staying in a routine was important.  However I gave myself permission to not be productive for a few weeks.  I'd attend meetings, and try to do some work, but if I didn't have it in me that day, that was OK. If I needed to take off in the middle of the day to decompress, then I took off.  My boss was OK with it, so I was free to adjust to the meds relatively stress free - which is another true blessing.

Eventually the side effects became less and less intense, and my energy levels increased.  By March I was able to start doing hours of productive work at a time.  By the end of April I was able to finish that software coding project that previously I couldn't even open the editor for.

I no longer hated work. I didn't feel dread every time I left the house.  I was less irritable, and even downright happy.  In fact there have been several times where I remarked to my wife that "I feel frustrated. I want to be cranky, but I'm not!".

My photography seems to have been helped, too.   I've since managed to get a lot of shots done that I've been sitting on for moths.  That feels amazing to have accomplished.

As a side effect I noticed that I take less pain killers than I used to.   I don't think I had a real problem here, but because I bike to work I sometimes get muscle pain in my legs, so I'd take some Tylenol or Advil.  I was taking them before bed 3-4 times a week.  Now I may take em once a week (normally on a Friday after 5 straight days of pedaling).  One of the effects of depression is that it saps energy from the body, so it is harder to deal with things like mild muscle pain.  Everything seems amplified.  That is also what makes it harder to deal with people, and cause crankiness - social graces take work, and I was being drained of energy.

Status Quo

For the time being I am taking daily medication for my depression, which seems to be working.  I need to take it for at least 6 months.  Apparently my brain is being trained to deal with higher levels of serotonin.  After 6 months they may try to ween me off of the meds, or I may end up taking them every day for the rest of my life.  However thats a small price to pay for not having to feel the way I felt.

So that is my story so far. I really don't mind talking about these things, so if you have questions, please feel free to ask me.  Also don't be surprised if I talk about my depression in person.  I don't feel the need to share all the details (I suspect most people don't need/care to know anyway), but I am not above using it as a reason why I need to take some alone time, or avoid a social engagement to get some rest.  I really feel that being open about this is important both for my own health, and to reduce the social stigma of mental illness.  I mean, if I had a bad leg and I said "Sorry, my leg is acting up, I can't go with you, I need to rest", no one would bat an eye.  There is no reason why "Sorry, my depression is acting up" shouldn't be equally acceptable.  So I am making it so.  Deal with it.

Anyhoo, If you feel you may be suffering from depression, please take this free online questionnaire (which is a standard medical assessment form actual doctors use): (PHQ-9) and contact your doctor if you need it. 

Thanks for reading.