A NEW OUTLOOK AND CONTINUED DIAGNOSES.

Is this over for me? Did I have a terrible experience, get through it, and manage to learn something from it to help make me a better person? Yes, no, and maybe to all of the above. I did have a terrible experience. I think that I am through it. I do feel like I’m a somewhat better person for it. I have no idea if it’s completely over. My psychiatrist has talked of a potential bipolar type 3 diagnosis. From what I understand, bipolar type 1 is extreme mood swings in a very short amount of time. You wake up in the morning, feeling great, but arrive home at the end of the day feeling the exact opposite. Bipolar type 3 is similar swings, but they happen more slowly – over periods of years. Type 2 is somewhere in between. I’ve greatly over-simplified, and mostly due to my own lack of knowledge about Bipolar, but the idea is there. (Maybe one of my awesome Twitter friends will help me with this part.)  Bipolar type 3 is very difficult to diagnose, but if that is the best description of my issue then it means that there is a cycle to it and that I will likely go through the cycle again.

“Alas, the litmus test for depression and related disorders still eludes us and so I am left uncertain as to the reasons for my experience.”

The cycle can often be seen with periods of high productivity, either at home, at work, or both. These are followed by the periods of depression. As I mentioned earlier in the book, I was feeling very creative and being very productive leading up to this ‘crash’. I was writing, building, raising my family, being husband, working on my guitar skills, my swimming skills, and working out to a point where I was no longer enjoying any of this. I also remember this from ten years ago when this happened before. Through discussions with my psychiatrist I have also identified at least two other similar cycles between these two depressive episodes. In these ‘intermediate’ cycles, the highs and lows, were not as pronounced, but I can certainly identify them and link them to similar feelings, such as health anxiety.

Alternatively, maybe it was a reaction to the antibiotics. Perhaps that was the trigger. Perhaps it was also the trigger ten years ago when I went through something so similar.  I don’t remember being on anything back then, before it happened, but it is certainly possible. Maybe the cause was negative life experiences and stressors? Environmental? Dietary? Genetic? Developmental? Maybe it will never come back. Hopefully.

Alas, the litmus test for depression and related disorders still eludes us and so I am left uncertain as to the reasons for my experience. I’m left listening to the expert opinions of others and ultimately arriving my own conclusions. I wonder if, in years to come, we will have many more ‘names’ for what we currently describe as just a few related conditions? Maybe what has happened to me is an as yet undiscovered/named disorder with a specific cause and cure? Time will tell? Hopefully.

A COMMENTARY ON THE ROLES AND PERCEPTIONS OF OTHERS.

Whether or not we believe any of the inaccurate viewpoints about brain health issues, we still know that they are out there. It makes it hard to admit to others that this is happening to you. Heck, it even makes it hard for us to admit it to ourselves.

“We need our friends and loved ones to believe in us.”

We need our friends and loved ones to believe in us. We need them to do their absolute best to understand and help. We need them to believe that one of the organs in our body is having trouble right now. It’s the most complicated organ of them all.  It’s the one that affects the way we perceive ourselves and the world around us. They have to understand how authentic this is for us. They have to know that this is not something that we can think our way out of. They have to understand that this is more than merely feeling lousy. This is feeling like there is no point to anything. This is the feeling I’d feel if my entire family were killed before me in a gruesome car accident. I don’t want to go on living… I’m sure that everyone’s experience of this misery is a slightly different shade of grey, but in each case, it is real beyond real. And, in the absence of any external issue (such as the family car accident) our minds may turn on ourselves, destroying our self-perceptions, ripping open our souls, and possibly removing our will to live. We are in serious trouble. Depression is a potentially terminal illness.

A COMMENTARY OF THE ROLE AND PERCEPTIONS OF OTHERS.

Boy oh boy, do us humans love to critique other humans. We make sweeping judgments about the actions and decisions of each other with only a superficial understanding of the reasons behind them. We arrive at arbitrary conclusions about other motorists based on a brief snapshot of their driving skills. Some people that have never felt depression love to make far-reaching appraisals of those with it. I used to be one of those people. I thought of sufferers as people who had let things get on top of them. “They have so much negative in their life that they have become very, very sad.” I thought it was something that could never happen to me. I was wrong. Either it can happen to anyone or we lack the science to figure out who it can happen to. One way or the other, no one knows if they are truly safe from it. Chemicals in your head, combined with electrical activity in certain areas of your brain can make you feel a sadness like never before. Trust me. Sad beyond the very pit of your stomach. Sad enough that you might consider killing yourself. Many do. It happens to celebrities and non-celebrities alike. Some are saved in time, while others succeed in taking their own life. Many never even ask for help.

“Some people that have never felt depression love to make far-reaching appraisals of those with it. I used to be one of those people.”

Friends and loved ones are real life savers in all of this. However, not all are created equal for this task. They may love you very much, but life experiences, beliefs and personality traits all affect how prepared and how well-equipped they truly are to help you through this.

Perhaps you used to have your own misconceptions about depression and other brain health issues. Perhaps you saw sufferers as weak? Perhaps you felt that they had brought this on themselves by making certain life choices? Perhaps you thought this only happened to the uneducated or those that pursued illegal drug use? Those with tough upbringings in which they were neglected or abused? Maybe you had none of these misconceptions. Either way, if this is happening, or has happened, to you then you know that it is gut-wrenchingly awful and that it does not discriminate.

Coming Soon… Chapter 9: Part II

10 Things That I Felt/Thought as I Recovered from Depression:

1. I felt fragile, like I might relapse at any moment.
2. I had been taking my health and happiness for granted for way too long… life is to be appreciated.
3. Depression sucks more than I ever realized. I had my own misconceptions about depression, but they have been put firmly in their place.
4. Many things that I did as I healed felt strange/different. Certain things felt like it was the first time I’d ever done them. Grocery shopping felt daunting and new.
5. I spent a lot of time hoping that the depression would not come back. A fear that it would return lingered, but faded over time.
6. I used to think that this could never happen to me. It can happen to anyone. I felt passionately about this point as I was recovering.
7. I must use my experience to help others. I must share what happened and talk about it to those that were willing to listen. Of course, I still feel this way and hence I sit here typing away at night.
8. Wouldn’t it be terrible if a child had to go through this… which lead very quickly to point #9.
9. What is being done to help children that go through this?
10. I was relieved that my suicidal thoughts had stayed passive and that I had never taken my own life.

WILL THOSE FLAKES EVER SETTLE?

So, my counsellor suggested a gratitude journal each night before bed. I would climb into bed, pick up my journal and write down three things that I was grateful for or happy about that day. Eventually, this became a habit and the moment I walked into my bedroom at night I began thinking about things I was grateful for.

“I had become nervous about going outside.”

I had become nervous about going outside. This happens to many people when they have been depressed or suffering anxiety. So my counsellor gave me weekly homework. This included things like going for a family hike in nature, getting groceries, or going on a date night with my wife.

“One by one, the flakes settled. It took a couple of months, but eventually most of the flakes were back on the ground. I could see clearly again.”

One by one, the flakes slowly settled. It took a couple of months, but eventually most of the flakes were back on the ground. I could see clearly again. One or two snowflakes still hovered around, but that is a normal human state. One of the problems with depression is that you spend a lot of time scrutinizing your moods and feelings. As you recover, this continual analyzing carries on. The reality is that everyone has good and bad days. We don’t experience a consistently happy and care-free mood 24/7 for the whole of our lives. If you’ve never experienced depression, then it is easy to dismiss the bad days as just that and wake up the next day ready to start again. After depression, you will question those bad days. Is my depression coming back? Is this a sign that I am not ‘cured’? You want to feel 10/10 everyday, but this is not realistic. Remind yourself that ‘normal’ involves good and bad days. It involves being able to deal with the highs and the lows that life throws at us.

If this is you, notice this point in your recovery and congratulate yourself. These feelings mean that you are getting better. You are travelling along the road back to health and you have made it far. You will never quite be the same again, but in many ways you will be better than before. You will have a new found appreciation for your own feelings and for the feelings of others. You understand brain health in a way that you never could have without going through it yourself. You are now better equipped to help friends and loved ones who may go through their own similar illnesses. Welcome to the club. We are glad to have you. Let’s change the future of mental health stigma.

WILL THOSE FLAKES EVER SETTLE?

So for me, my cure came in the form of a daily SSRI medication (Prozac). It took about four months to really get me back to anything resembling normal. I also took a non-addictive sleep pill to help get my sleep routine back on track. I went for weekly counselling to correct negative thinking patterns and I saw my amazing psychiatrist once every 2-3 weeks.

“Everything negative that I’d ever done or felt about myself had been stirred up, chewed over, added to, and digested as facts.”

In the months of January and February, when my depression was at its most severe, counselling had a very minor impact on me. However, I’m still glad that I started it at this point. It helped a little and I would recommend that a depressed person goes to counselling ASAP. When I say ASAP remember that you may need to shop around because the relationship between you and your counsellor is extremely important and a good match for one person may not be a good match for someone else. In my experience, counselling had its biggest impact in the third and fourth months of my depression.

“For at least two months I had gone to bed thinking terrible thoughts and woken up thinking even worse ones.”

By this point, my medication was starting to work. It was a surreal and confusing time. The anxiety attacks had stopped completely. My mood was generally pretty good. But in the two months that I’d been severely depressed, I had developed some very undesirable patterns of thinking. Everything negative that I’d ever done or felt about myself had been stirred up, chewed over, added to, and digested as facts. It was as if all these negativities were the snowflakes in a festive snow globe. For years, they had sat motionless on the floor of the globe. They were there, but largely ignored by my conscious self. During January and February, the globe had been shaken violently, causing the flakes to swirl uncontrollably in my head. Now, the globe was no longer being shaken, but the flakes were still floating around. Counselling helped the flakes to settle back down. It helped to correct the bad thinking habits that I had acquired. For at least two months I had gone to bed thinking terrible thoughts and woken up thinking even worse ones. This had become habitual. Thanks to the medication, I was now at a stage where I could begin to correct these patterns.

Coming Soon… Chapter 8: Part II…

TEN HELPFUL THINGS THAT FRIENDS DID WHEN I WAS DEPRESSED:

1. Assumed that I was generally feeling worse than I was letting on (this was nearly always correct).
2. Checked in on me frequently.
3. Answered messages from me the moment they got them – their response was more important to me than I cared to admit.
4. Reassured me that the feeling was being caused by biological problems. It was real, not imagined. Many people experience it. It can be cured and it will pass. They told me that one day I would feel like myself again (they were right)
5. Reduced my stress. Stress sapped my brain’s ‘feel-good’ chemicals. My friends picked up groceries, helped cook meals, and even tidied the house. I’m not saying a friend should do it all, just that they can help out and reduce your ‘load’.
6. Ensured that I was not left alone any more than was absolutely necessary. This was especially true of going to bed at night and of getting up in the morning.
7. One friend became my ‘Interweb Buddy’ (the helped research symptoms etc. while protecting me from too much negative information which my mind would have totally focused on while ignoring anything positive).
8. Helped organize medical appointments and counselling sessions.
9. Helped get me to my appointments and kept me company when necessary.
10. Did their best to understand how I was feeling.

When you have a toothache, you get yourself to the dentist as soon as possible, even if you hate going there. The clue is big and clear – your tooth hurts. You know that the early discomfort will continue to get worse and, if left untreated, could even kill you (just ask the Ancient Egyptians who often died from the infection of a decaying tooth). Yet, for some reason, we tend not to do this with depression. We try to struggle through it on our own. We don’t want to admit that something is wrong with this particular organ of our body. Is this the fault of society’s stigma? Is it our own fault for caring so much about how we are perceived by others? We often wait months before seeking any medical help. Why? Something is wrong with my tooth – I get it sorted right away. Something is wrong with my brain – I wait months without even telling anyone? Something is seriously wrong here. I brush my teeth twice a day, avoid too many sugary treats, and rinse with mouthwash before bed. I have been explicitly taught this by parents and teachers. In the grand scheme of things, our teeth are relatively unimportant (sorry dentists) and yet most of us take better care of them than we do our brains.

“In the grand scheme of things, our teeth are relatively unimportant (sorry dentists) and yet most of us take better care of them than we do our brains.”

My parents and teachers never explicitly taught me to look after my brain. I’m sure this is because they didn’t know we had to.  We need to stop thinking of our brain as this mysterious organ that will just take care of itself… a hinge that never needs oiled; an engine that never needs maintenance. We need to start looking after it, just like we look after our liver, kidneys, and intestines.

Let’s throw this into the mix… there are people who believe you should be able to reason your way out of depression, without seeking help! Years ago I was one of those people! “C’mon, snap out of it!” “You’ve got nothing to be sad about” Well, that’s what depression often is – sadness with no reason (although the depressed person’s brain often tricks them into finding false reasons for the sadness). We are talking about our brains! This is serious! Maybe we can talk our way out of that toothache while we’re at it. Or heal our broken leg with some positive thinking. Perhaps I wouldn’t have asthma if I had a rosier outlook on life? Hey, I’ll throw away those antibiotics for my kidney infection, and take this bottle of optimism –one teaspoon, twice a day and I’m sure I’ll be just fine.

“We need to stop thinking of our brain as this mysterious organ that will just take care of itself… a hinge that never needs oiled; an engine that never needs maintenance.”

I’m not saying that positive thinking won’t help. Seeing the silver lining is something from which all of us can benefit, at any point in our life. It is certainly helpful in dealing with any aspect of human existence, especially the hardships. I also believe that it helps release the ‘feel-good’ chemicals that keep our brains operating well and increases electrical activity in parts of our brain associated with feelings of contentment. But it’s not enough on its own.

This is our brain we’re talking about. It’s just like all the other organs in our body, but way more complicated and we know less about it. We cannot assume that it will just keep ticking over nicely for the whole of our lives (I have had to learn this the hard way). Why do we assume it will take care of itself and heal itself when we don’t expect this of our other organs? Unlike other organs, when something goes wrong with your brain, it can alter your entire perception of the world. It can change anything about you, including your personality and temperament – just take a look at Alzheimer’s patients, or someone who is drunk (the alcohol can do a great job of changing aspects of our personality until its effects wear off). Our brain is a finely tuned organ full of chemicals and tissues that even the best of scientists don’t fully understand. Small changes to these chemicals and tissues can have dramatic effects. The good news is that in most cases they can be fixed. Look out for the earliest of warning signs. Seek medical help as soon as you think something might be wrong. Waste no time. Act now. It’s your brain for crying out loud.

LOOKING FURTHER INTO MY PAST TO FIND WARNING SIGNS…

On their own, I don’t believe there’s any way I could be expected to interpret these signs and figure out what was on the way. In my mind, I had a logical explanation for what was happening. But there’s more, it’s just that I have to go back further. About fourteen years further into my past.

Cue blurry vision and a flashback sequence…

I was 27 years old. I’d been in a stable, common-law relationship for 8 years. In the last eighteen months of it, I had started to have second thoughts about the relationship. I had started drinking heavily. Binge drinking, mostly on the weekends. Not exactly unusual for a Brit, but somewhat unusual for me. Though I had gone through other phases of heavy drinking during my life too, this one was somehow different. I’d started going out without my girlfriend and drinking until I was sick. I relished the excitement of going dancing, talking to strangers, and losing control. I developed a narcissistic confidence during these nights and acted in ways that I would not normally act. It was a unique unit of time in my life. I lived for these nights out. The rest of my life felt ‘blah’ and empty in comparison.

“The rest of my life felt ‘blah’ and empty…”

I remember some specific conversations with my then girlfriend in which I expressed my frustrations with the relationship. I remember saying that I was feeling ‘flat’ and that nothing in the relationship (and consequently my day-to-day life) was interesting me anymore… sounds familiar. I blamed this feeling on the relationship and I left her. She was confused and so were our friends and family (who I suddenly wanted absolutely nothing to do with). Nobody else seemed to see it coming and I couldn’t understand why not. I distanced myself from everyone. I didn’t even call my parents, sister, or brother to tell them what I’d done. I had a few more weeks, maybe months, of craziness and then I crashed. I didn’t want to get out of bed. I didn’t want to go to work. I didn’t want to go out drinking. I woke up crying in the morning. I cried in my car on my way to work. I cried in the washroom at work. I felt guilty for ending the relationship and believed whole-heartedly that I was a horrible, despicable person. I felt intense self-loathing. I began thinking passive thoughts. Close friends suggested depression. I was convinced that this was not depression. In my mind, depression was a deeper sadness that came for no reason. I believed that my sadness had a reason and that reason was the poor excuse for a human that was me (of course, I now realize that this itself is often a symptom of depression… it’s a cruel illness). At least that’s what I believed. Whether or not I was right is another matter entirely and not one I’m even sure I can answer. I remember that my girlfriend’s mother wrote me a very sensitive and caring letter in which she proposed that I might be depressed. Again, I dismissed this as her mistake.

“I never truly accepted that I was depressed.”

I’ll cut a long story short(ish) and say that I eventually ended up taking an antidepressant and going to counselling for depression. I never truly accepted that I was depressed. I always attributed the experience to breaking-up the relationship. While I don’t regret ending the relationship, I do look back now and believe that I had become depressed before the end. I see a cycle here in which this event closely mirrors what I found myself going through in the closing months of 2015 and the opening months of 2016. A cycle that may well have repeated itself between then and now, only with less extreme levels of melancholy.

Again, I’m not saying I should have seen this coming, or that anyone else should be able to see their own clues. I am saying that I now see these as signs as something that I can look for in the future. I’ve learned. I hope that these hints may now help me see this should it start to happen again. I know of them. My wife, doctor, family, and close friends know of them. Everyone will help look out for the cycle happening again and ensure early, maybe even preemptive, treatment.