“I suffer to live.” This is the response I received once, when I asked a friend how he is doing. At the time I thought “Don’t you mean I live to suffer?” But I write it down, anyway, stick it on the fridge and ponder it for the next 25 years. Gradually I came to understand its meaning and appreciate the candor with which it is spoken. How true these words are for so many. We had already bonded over our mutual affliction with depression.
I first noticed something was wrong as a six-year-old child, though I am too young to understand it is anything more than just an overwhelming feeling of shame and despair. I am sad but have no idea why. Though I am indeed a lonely, shy only child I do not recall having any serious issues in my childhood. Unfortunately, a few years later, I experience a sexual assault by an older female friend from school. At that time, I do not recognize it for what it is- sexual assault. It will be decades later that I realize this. I am still trying to process it. Other than that, I grew up in a fairly “normal” middle-class family. Looking back, I realize my parents are not the greatest parents. This could be the start of many people’s problems later in life- poor parenting. However, I can see how my parents might have struggled raising a happy child- they were practically children themselves (24 and 27) when they had me and know very little about parenting. Plus, I have met all four of my grandparents so I can understand why my parents are clueless.
Nevertheless, they could have done better. Both are very poor communicators. My mother either ignores me or yells at me. She does not show affection and often teases me. My father also ignores me when I try to converse with him. He plays games with me, takes me to the beach and attends my tea parties but remains aloof. Verbal and emotional abuse is something present in my family, but I have yet to identify it. My father was also extremely overprotective of me during my childhood. He does not allow me to drive after dark (even in college). He forbids boys from calling our house. On the one date I had in high school (to see “Dances with Wolves”) he decided to come along. This is at 17! Having grown up in a strict ultra-conservative fundamentalist Baptist church household, he does not allow drinking, cursing or MTV. No rock music on the radio. Even “The Facts of Life” sounds sketchy to him so I’m forbidden from watching. Yes, they could have done better.
I am not exactly sure why I feel depressed, but I do feel ashamed of myself, like I have done something wrong. It is probably my parents’ treatment of me that contributes to this. When “The Breakfast Club” comes out I become obsessed with Ally Sheedy who plays The Basket Case. I can relate to her sentiment that her life sucks because her parents ignore her. Back in the 70’s and early 80’s, psychotherapy for young children was not as prevalent or advocated as much as it would later become. Plus, my parents had grown up with parents who thought psychiatry was not a real science. It is almost taboo to discuss and certainly heavily stigmatized. Being depressed is all in one’s mind. My grandparents had grown up in THE Depression and psychiatry was not something they had the luxury of indulging in. My grandmother even tells me to just “get happy”. My family members all seem to be early gaslighters too. It is exhausting enough to fight depression, but to also have to constantly defend yourself against the stigma really wears you out. Southern suburban towns are not as advanced as bigger cities and towns in the North, or other areas of the country, when it comes to psychiatric mental health. This is my perception, anyway, as a sheltered child growing up in a small South Carolina town.
Since it is unheard of in my family to seek psychiatric help, I just live with depression and anxiety, not really understanding either until I get to high school and take a psychology class. High school is also when I first experienced suicidal ideation and engaged in self-harm, which I do not even know is an actual thing until years later. Then, right after high school, I was diagnosed with a painful chronic illness that definitely contributes to my state of mind. I experienced an episode of acute pancreatitis (non-alcohol-related) that later became chronic. Since pancreatitis is so painful, I have to be on painkillers for much of my life. Being on painkillers, then having to wean off them after each episode, only makes my depression and anxiety worse. This is called “comorbidity”- when a person has more than just one diagnosis, and instead, has two or more that affect mental and/or physical health.
When I head off to college in Alabama in the Fall of 1992, I take advantage of the free student counseling services. By the late 80’s and early 90’s, I believe mental health services for kids and college students have become more prevalent- at least in the South, which is the Bible belt. That old way of thinking that mental illness is controllable is starting to fade. So, I began seeing my very first of many therapists to come. This therapist begins by asking me to count backwards from 100 in increments of seven. I have no idea how this relates to therapy, and, since I am terrible with math, do not return out of embarrassment. But, at the very least, it is the beginning of my quest to understand and combat my mental illness. It helps to understand your enemy if you hope to beat it.
After flunking out of college two years later because I am too depressed to get out of bed and attend classes, I transfer to a college near home. It is during this time that I experience the trauma of a date-rape, which adds to my feelings of low self-esteem. I began seeing a psychiatrist at the local psychiatric hospital who puts me on Prozac. This is the first of many medications I try over the next several years. The Prozac seems to help…until it doesn't. I read this can be common. Some people find a medication they like and stick with it. Others find they must switch it up every so often. I also learned a new word in my study of depression: “Anhedonia”- one of its symptoms, which means a loss of interest or pleasure in activities one formerly enjoyed. This is me to a tee. (I even start signing for things with the alias “Anne Hedonia.”)
I had spent a lot of time in high school engaged in youth groups, attending church, reading my bible, praying. I found these soothing to my soul, so I made an appointment to see my old pastor, who sheds some light on my depression diagnosis. He says he believes there are two kinds of depression: “black” depression, which is more of a chemical imbalance in your brain, and “blue” depression, which is more of a situational thing in your life. As my friend says “The s*** ain’t goin’ right!” This makes sense to me and I have an epiphany- I decide I am too young to want to end my life over depression, and I have too much going on for me to let depression rob me of enjoying my life. I find that idle hands or an idle mind are indeed the proverbial devil’s playground. I need to do something to get out of my head.
This will go on for the next several years. I lapse into some sort of depressive or stress-induced episode, get sick with a flare-up of pancreatitis, have to wean off painkillers, experience horrible withdrawals, followed by more depression and anxiety, then finally experience some relief that gives me enough hope and drive to get back in the saddle and give life another try.
Just before the new millennium I decided to go to nursing school. It is a two-year program. During this time 9/11 happens. Even though I do not know anyone killed, it affects me greatly. Watching the tragedy and trauma of those horrific events unfold on tv stays with me to this day. Life is difficult enough. How could anyone even think to do such horrible things to other human beings? This is just the first of many things I will witness that troubles me. I ask myself “why must there be so much hate instead of kindness?” This furthers my resolve to become a nurse since I want to help others who suffer.
I eventually graduated and got a job in the adolescent inpatient unit of the local psychiatric hospital. I enjoy working with the kids, as well as with the adults in the drug and alcohol inpatient unit two floors above, where I am occasionally floated. I find so much joy helping these people who suffer many of the same afflictions I do. It is better than therapy for me. Getting out of my head and into someone else’s is healing to my soul. I would have done this for free!
During this phase of my life, I also did a lot of shadow work. I journal, read several self-help books, attend work conferences on treating mental health disorders, and basically look for ways to battle depression. I read about cognitive therapy and how useful it can be in battling anxiety, depression, feelings of low self-esteem, obsessive thinking, regret over the past, or anything that negatively weighs down the soul. Battling everything life throws at you really almost does take a village.
Inevitably, the “salad days” of my nursing career come to an end. The way the healthcare system becomes so stressful it strains my personal and professional life, then eventually my mental, physical and spiritual health. I had heard nurses eat their young. Sadly, I find this to be true. The tides have turned, and I am sinking again. The enemy becomes too powerful to fight. I am drained.
I have always believed mental health and physical health are connected, each affecting- or infecting- the other. My poor physical and mental health start to affect my work so- long before covid- I experience what many other nurses will soon feel: exhaustion and burnout. Against my better judgment, I finally go under the knife to try to resolve my pancreas issues. I worry the surgery is going to be bad and it is. My worst nightmare becomes a reality. The surgery is so awful it leaves me traumatized with self-diagnosed PTSD. I developed an incisional hernia, causing me to have to go back under the knife for repair nine months later. In addition, I am left with a horrific physical dependence on opiates that takes over my life. It will be 15 years before I am able to get off them. I am horribly depressed now more than ever. I basically have one long nervous breakdown and feel like I am stuck in some hell dimension. I thought nervous breakdowns were supposed to be quick and only last temporarily. Mine drags me down like I am wearing cement shoes and drowning in a sea that envelops me. One thing about depression is you can easily find yourself marinating in self-loathing. It becomes nearly impossible to even get out of bed or find a reason to live. Once you sink so low you become too lifeless to even plan a suicide because that would take too much effort. It is not that I have ever wanted to die, it is that I just do not want to suffer anymore. I grow tired of wallowing in my own despair.
One important thing to note here. If you or anyone you know ever starts on antidepressants, please watch out for suicidal ideation during the first few weeks or months. This may be common knowledge, but it is still worth mentioning. It is not that the medication makes a person suicidal, it is that before medication they were maybe too depressed to even carry out a plan, but once the medication improves their energy level, they may find they are still depressed enough to want to end their suffering and are now better able to carry out a plan. I met a woman once who lost her brother to suicide for this very reason. I explained this concept to her, and she said she wished someone had told her before. She would have removed his firearms.
So…that “blue” depression that I had learned to fight with my own resources becomes more of a “black” depression that is uncontrollable. I know there is some controversy over whether or not depression is caused by a chemical imbalance in the brain. I am neither a psychiatrist nor qualified to diagnose but, in my opinion, the brain, like other organs in the body, runs on certain physiological systems. Physiology courses teach about neurotransmitters such as dopamine, serotonin, norepinephrine or cortisol (the stress chemical) running things in the brain. When they are out of whack so are we. In simpler terms, feeling depressed (mood-wise) or being depressed (chemically) both take their toll.
Earlier in my life I would have described depression as a feeling of sadness brought on by my unfortunate circumstances. Taking action against this sadness is not easy but doable. I can try improving my eating habits, refrain from tobacco and alcohol- which contribute to depression- exercise, get some sunshine to help with vitamin D (20 minutes is enough and of course always wear SPF 50), volunteer to help people, do a bible study or attend a prayer group. Later, it feels like my depression has turned to black and, like the Pearl Jam song, has “tattooed everything.” It is no longer just feelings of despair but becomes a physically painful feeling of despondence that envelops me and sucks me under, while something frightening is crushing me. I am scared that suicide is coming for me, but it seems more like homicide. Then it progresses to the point that it is no longer a feeling but an actual place, like some creepy attic imprisoning me. I feel like I am being held hostage in the dark recesses of my mind. This place is suffocating and terrifying. Many times, I feel agoraphobic and claustrophobic at the same time. I often feel panicky but can think of no reason I should be. Even in my sleep I can get no relief. The darkness seeps into my nightmares. One of the many therapists I see throughout these years, a poor first-year psych resident-in-training and a volunteer at a local mental health clinic, looks at me wide-eyed and says she’s sorry but she doesn’t think she can help me- my depression is too severe.
I think to myself this must be what hell is like. There are plenty of times I convince myself hell is exactly where I am. Maybe I passed away on the operating table and this is my own personal hell dimension…or hallucination…or nightmare. It becomes debilitating enough that getting out of bed is impossible, and finding a way to function, a long-lost fantasy. I finally reached rock bottom with my dependence on painkillers. I tried for nearly 15 years to get off them, but the threat of painful flare-ups and the misery of unending withdrawal impeded my recovery. I finally found a helpful drug called buprenorphine that helps me get through withdrawal symptoms. I feel miserable for months and months, but slowly I start to maybe almost feel like I can finally see the glimmer of light and hope at the end of the tunnel. It will indeed take a village, but maybe I can get through this after all. There is no doubt that opiates and other drugs, such as benzodiazepines, wreak havoc on one’s brain chemistry, so getting them out of my system feels wonderful. This April (2024) will mark two years off them.
I wish I could say that I have found the magic cure for depression and addiction and all other afflictions. I wish I could say that I am all better from everything. However, some of us are still fighting out there. Everyone is different. All our brains, bodies, minds and souls are different. I have explored many many options, and it is always an uphill battle. Whether you get relief from medication, therapy, medical procedures like ECT- or electroconvulsive therapy- which, by the way, is NOT at all barbaric like it is portrayed in movies or television, reading self-help books, doing shadow work such as journaling, cognitive behavioral therapy, attending support groups, utilizing a hotline, praying, reading your Bible, listening to these blogs or doing anything you find helpful, such as just plain distraction, it is important to remember you are not alone. Try to have faith and hope in yourself, and do not be afraid to ask for help. Few people can battle depression or any affliction alone. And remember…that is what depression is- an affliction. You did not choose it and you cannot just turn it off.
The only good thing I can say right now is that I am glad I can be here to share with the many other people out there who also suffer with no end in sight. I do not find those memoirs helpful where folks suffer but then find redemption or whatever so they can brag about how life is now so great, and you will get there too if you only try! I have not gotten there yet, and maybe never will, but that means I am here for others who need encouragement to keep fighting. So let us work to reduce the stigma and support each other with kindness!