Not knowing

There will be a next time, another severe and major depression. 

by Nobody

[May is Mental Health Month. Every Friday at DXS is I Am Mental Illness day, and today’s essay comes with trigger warnings about suicidal ideation and suicide. Read on with caution.]

I have major depression, severe, recurrent. This diagnosis came 4 months after the best 18 months of my life where I had no depression. And it only came about 6 months ago when I was in the worst depression of my life.

“Let me ‘splain, no, there is too much, let me sum up.” 

I may also have some version of bipolar – that diagnosis is not fully agreed upon by my mental health team. Unfortunately, my manic stages are where I feel good and so I haven’t described them in such a way that they’ve been apparent to my team. For those of us I’ve encountered dealing with disabling mental illness, we read and ask a lot of questions of our health care team. We need to know.

When I read the description for my major depression, severe, recurrent diagnosis, I wondered how I was even functional. But, of course, I wasn’t. More on that later.

It is often said mental health is a spectrum. Personalities fall along any sort of spectrum, but I see bipolar as more of a bunch of broccoli. At the beginning of the stalk, you have an even-keeled person and close to the head you have someone who is super moody, and then you reach the head – the versions of bipolar branch out like the florets of the broccoli but they also interconnect, as do the florets at the very head of the bunch.

“When she was good, she was very very good. But when she was bad she was horrid.”

Whatever it is I have, I’ve had since adolescence. My family would allow no “pity parties” so I learned to hide my depression. It became very hard not to hide.. I first attempted suicide that I recall around the age of eleven. When talking to my health care team, they would ask “How many times have you tried to kill yourself?” And I can’t answer. A lot. “Once, twice, five times?” they ask. Over the course of my life, those numbers times 20.

For so many times, you’d think someone would have noticed or I’d have succeeded. Believe me, it only made my depression worse when it didn’t work because it was evidence I was too stupid and inept to take my own life properly. Others said I didn’t truly want to kill myself. When you have to hide what you are doing, you are limited in your tools. Stuck in my bedroom, I rarely had access to sharp enough items to break skin, no access to ammunition for the guns in the house (often stored in my closets or under my bed), no access to medications to take in sufficient amount to overdose, didn’t live near any bridges or huge water sources, and later no way to leave to somehow use the car to do it (though sometimes while driving I would think about how to actually get into an accident that would end it. I usually came up short since I mostly worried I wouldn’t succeed and didn’t want to face the consequences in that case.)

For those who don’t understand why a 11-year old would take her own life, let me only say that the bullying I endured my entire childhood (read: before college) combined with my home family life, sexual abuse, and brain chemistry contribute to it. Oh, did I mention? I also suffer from PTSD. I don’t fully agree, but my psychiatrist made that diagnosis on our second visit after the major depression, severe, recurrent.

I had learned to hide my depression so well that while my mother knew I had it (her work brought her into contact with many severe cases of people with mental disorders) and my spouse knew I had it, no one knew about my suicide attempts or how low I was at any point. It only took getting to the lowest I have ever been in my life and the spiral down for my spouse to see how terrible it can be. And he never realized how often I had gotten to a suicidal place, and even in admitting to go to the hospital, I made him leave the room when I had to tell the nurses. Hiding it is well ingrained.

And for me, my mood swings are normal. When answering questions about this or that, I give conflicting answers. One major symptom of depression is how well you are sleeping – too much or too little. I hate answering that. I don’t know. Sleeping has never been an issue for me. I didn’t understand what it was like to only be able to get 2 hours of sleep, until I spiraled down so low this past fall. But, I’ve also been an early riser, at least in my manic phase. And it turns out, “good sleeper” and “early riser” (in how early I rise) are not compatible. So I just learned this week that indeed I have the symptoms of mania to the point of being bipolar, and not extremely moody. (There’s that spectrum and the broccoli branch I follow.)

“I never asked you to understand me.”

I know there are people who don’t understand what it is like to feel this way. I know some want to understand because they want to help. I’ve always found the “how to tell when something’s wrong” seminars to be stupid because I would want to shout to the room that something was wrong but you couldn’t see it because I hide it so well. I would often speak up to say, don’t feel bad if something happens and you didn’t know. Sometimes people learn to hide it very well. And I would be admonished – there are always signs. And I would think, you can’t see my signs. Clearly.

I want to help you to understand. One reason my bipolar is in dispute is because the way I describe it doesn’t seem to qualify. You see, for a diagnosis and full-blown disorder, not falling on the spectrum because everyone does, it must affect your life in such a way that it somehow disables you. I saw counselors throughout my life. In adolescence, I think how I felt was attributed to normal teenage angst. Now that I have teenagers, I watch them closely for the difference between angst and depression – because depression saturates one side of my extended family.

But, back to the disabling part. I spent my much of my junior year of high school sleeping through the first two classes of the day. I didn’t fail only because I’m exceedingly smart (the one thing I can say is my only positive when I’m in full depression – because I have true evidence of it). I self-taught and managed to turn in homework. In college, I went to counseling, but my instability was chalked up to what would have been a bad month for anyone: my grandmother to whom I was quite close had died and my roommate’s boyfriend had shot himself to death outside our window, combined with the bullying, sexual abuse, and difficult family issues I’d had as an adolescent.

In graduate school, I was diagnosed with anxiety. It wasn’t anxiety, it was my depression masquerading as anxiety. They offered me a prescription (I don’t recall to what.) I didn’t take it. I wasn’t ready for medication. I pulled myself up by my bootstraps and kept on walking.

My major depression, severe, recurrent was definitely fully disabling. I had spiraled so far down that I couldn’t hide it. I was crying, a lot. I could not drag myself out of bed. I had been able to do so in the past because I knew normal people got out of bed and coped, so I would pull myself out of bed and cope. Maybe not very well, but I think people just always perceived me as moody. Or, I wasn’t sleeping at all. And people don’t really know that unless you complain or you disturb your household. I can be very quiet.

How did I finally get the help I needed? I went to counseling because I had finally admitted after well over a month of being unable to work (I either stayed home or just sat in my office doing nothing. And really it started 4 months prior.) Anhedonia was in full force. I was in the middle of an extended plan to kill myself that would hide it from everyone until it actually succeeded. The intellectual part of me at least overruled the messed up brain chemistry so I could get help.

Every so often my depression would spiral down far enough I couldn’t hide it. At those times, my spouse  would use taking me to the hospital as a threat. To me, going to the hospital was scary. First, I’m not actually a fan of medical doctors for reasons better left to another essay. Second, I had no idea what a psychiatric ward was like. Someone happened to be describing what they are really like – where you usually self-admit through the ER and walk in with your suitcase and own clothing. And you get the care and treatment you need.

My counselor told me I was not allowed to kill myself. And I had gotten to the point where I didn’t feel I could keep that promise – and I wasn’t even going to hide it. I was going to walk right past my spouse to the kitchen and use the butcher’s knife to pour enough blood out of my body that I would finally die. So, I told my spouse I needed to go to the hospital. It was scary. I was doing this without any notification to anyone. I would go in and be cut off from the world (you could check email and the internet, but I chose not to.) You could make and receive calls, but only approved people on the list could call you. And my list had two people on it: my spouse and my mom.

Following a five-day stay in-patient, I attended 6 days of out-patient. And then I had to get on with my life. A counselor had tried to diagnose bipolar when I first sought counseling, but then I brushed that off because I didn’t want to have bipolar. (Again, that hiding thing is really hard to break out of when you’ve been doing it for over 25 years.) While in the hospital, I swung up. Seriously, 2 days after wanting to end my life, I was ready to walk out of the hospital, embrace all the everything that had been beating me down – I could take it all on, despite the fact I still wasn’t sleeping, etc. Yeah, that’s not the normal depression recovery. My doctor there diagnosed me with abnormal bipolar.

There are different types of bipolar. The public is most familiar with bipolar 1, where people have super ups and super downs. Where you live with instability, and you can’t keep relationships, or hold a job. I didn’t fit that (that’s why one doctor just thought I was extremely moody). I have been with my spouse for 17 years and have life-long friendships. I earned an advanced degree in one of the hardest of the hard sciences. I have a stable job. But when I read the description of bipolar 2, I could check everything off – with one exception.

I was discussing this with my counselor and she said she’s never heard me say anything about manic phases – but then she described one – and I’m doing exactly that right now.

Since I started on prescribed medications (the alcohol I was trying to do that with – called “self-medicating” – doesn’t work), I’ve been through a few difference anti-depressants and mood stabilizers. It’s a tricky thing. Your medication also can’t be disabling. Severe diarrhea and anxiety attacks caused by the medication become disabling. We’re still working through the right ones and levels. It’s a long and slow process.

“But wait, there’s more!”

I know this is long, and you probably don’t care (although if you’ve read this far, maybe you do or you’d have stopped already.) I’m wrapping up, I promise. But I have a few more things to add. This is long because this is the first time I’ve been able to put it all out there, in one place. Because writing this is hard. It’s a testament to how much better I am that I could write this and all it elicited was a few tears on my part – it didn’t cause me to start thinking about suicide (well other than the descriptions above.) But even how far I’ve come, I still am analytical about suicide for myself. On a run over a bridge a few weeks ago I caught myself thinking “the next time I feel like killing myself, I could jump here.” And then realized that’s not a normal thought. The scarier thing is that there will be a next time. I will relapse into another severe and major depression.

Besides medication, there is behavioral therapy I’ve participated in and things I can do to help myself. I’m working on those.

But, because I am that fucked up, the major depression, severe, recurrent/PTSD/(abnormal) bipolar isn’t all. I also suffer from disordered eating and body dysmorphia. As a teenager, I starved myself and since then have maintained disordered eating of some kind or another. Twenty years of that takes a toll. I get to start working on that over the next few months.

The last thing I want to explain is why this essay is by Nobody. I needed anonymity for this from the public. I cannot say this with my face. And that is the pseudonym I cloaked myself in when I was in middle school, trying to survive.

[Image credit: G Dallorto, use approved with proper attribution; image via Wikimedia Commons.] 

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One thought on “Not knowing

  1. Dear Nobody,

    Your relationship with others starts with your relationship with yourself. I hope you can see yourself as valuable and likable and worth taking care of properly — where bites of food are nourishment and steps in a direction you want to go, steps toward balance and health and away from fear and hate and revulsion and inadequacy.

    Good luck. See if you can change anything about your environment to reinforce positive thoughts — or not trigger negative ones. (Or read the book Nudge.)

    Can you implement one change per week to take your life/thinking in a better direction? Let those changes accrue.

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