The D Word

I’ve been away awhile, trying, trying, trying to fight off a nagging sense of depression’s lingering presence in my brain. I couldn’t keep the Deep Dark away this time, so as I wait out these weekend hours until I can reach my psychiatrist and get some medication to send my serotonin levels back to “normal” I thought I’d take the time to share a bit of how depression feels.

As I was telling J last night, I haven’t been posting on here because 1) I haven’t felt well enough to write and 2) I long for this blog to be a source of optimism. Nonetheless, I think I can talk a bit about what I am feeling without taking an entirely pessimistic view on life.

If you’ve read anything about depression, I’m sure you’ve read that it isn’t just “a bad day.” I cannot emphasize strongly enough how true this is. Everyone has bad days, bad weeks, even. Depression is a different beast.

Take a second, if you will, to study this picture of brain activity scans of a depressed person versus a not depressed person. Pretty major difference, huh?

Brain of a depressed person on the left, vs the brain of a non-depressed person on the right

Brain of a depressed person on the left, vs the brain of a non-depressed person on the right

My first warning sign is usually a decreased interest in everything. There’s a clinical term for this: anhedonia. It means you lose interest in all those things you used to love doing. Previously, I’d found pleasure in cleaning and decorating the house: no longer. I love taking walks in early spring: no energy. Everything around me loses its color and vibrancy.

Second sign? My brain feels like it’s muddled in cement. I can’t think clearly. I have trouble explaining myself. I catch myself staring into space, staring into my coffee, wondering how long I’ve been “gone.” Every action seems to require a tremendous amount of concentration and energy. I’ve found I have to practice simple, non-verbal mantras to myself. Lying in bed this morning, realizing I’d been there for 12 hours… “Get up, Holly. Get up. Get out of bed and make coffee. You can’t lie here all day. Get up and make coffee.” Repeat until I muster the strength to throw off the covers and put both feet on the floor.

And then, the crying. Random, unexpected crying. I remember a time I had a sob fest because a bouquet of flowers had died, and I had to throw them in the trash. Somewhere in my sad mind, the flowers represented all that is life and suddenly “we were all slowly withering on the brink of death.” Sounds like a real drama queen moment. It isn’t.

Bring in the feelings of guilt. Depressed people will apologize for all the troubles and ills of the world. It isn’t that we are being purposely selfish or ego-centric but that our brains are filled to the brim with thoughts of inadequacy or of being a burden. For my part, I experience immense guilt over the concern I cause others and for how needy I become. I am naturally a very independent person. I hate having to ask for help. But when I’m depressed, something as simple as a sink-full of dishes can reduce me to tears. I need help but knowing that I need help, that I am draining my loved ones of energy, compounds those feelings of guilt.

Next up, physical pain. By now I’m sure many people have seen the commercial for Cymbalta. “Depression hurts, Cymbalta can help…” And hurt, it does. I’ve noticed that I experience more physical symptoms with depression as I get older. My back will ache, I’ll feel like my neck is made of limp asparagus and cannot hold my head. My head will ache, or I’ll get strange stomach pains. It can become difficult to distinguish whether you’re depressed or if there’s something seriously wrong with your body.

Other common symptoms of depression include sleep and appetite disturbances, irritability and/or restlessness. I can go either way on some of these. I’ve had times where I didn’t sleep for days despite being exhausted and other times when I couldn’t seem to pull myself out of bed. Appetite is a confusing topic for me because of my comorbid (not sure I used that correctly, but it just means an addition of another disorder on top of the primary one) eating disorder. I’ve taken loads of online depression self-tests over the years, and whenever I reach the question about appetite disturbance, I always wish there was a “how the hell should I know” option.

As I wrap this up, I feel the need to clarify that my purpose for sharing these things comes out of a desire to dispel the stigma of depression and other mental illnesses by spreading the truth. Depression is a real, physical illness that severely affects an individual’s daily life and functioning. Later, if I can get my brain to cooperate with me, I’d like to address what to say and what not to say to someone who is depressed, possible suggestions and tips for caregivers and things I’ve learned over the years about surviving a depressive episode.

If you’re interested in further information, WebMD gives a nice overview of depression here. For a reputable self-test, PsychCentral offers a well-rounded quiz that covers the basics of depression but isn’t overly long.

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Eating Disorder Awareness Week: A Bit of My Story

As Eating Disorder Awareness Week comes to a wrap, I thought I’d share a little of my story and experiences with this disease. I have tried to be as non-triggering as possible without leaving out details I think are important. If you are struggling with an eating disorder, please read with caution and care.

xxx

It all began as a diet gone horribly wrong.

Like many college students, I’d gained a few pounds during my freshman year. I’d been small my entire life, force-fed heavy, unappealing energy bars when, as a child, my doctor determined I needed to gain a few pounds. But, the juice, cashew and breadstick gorging over late-night study sessions had taken a slight toll.

I clearly remember the night I decided to start “the diet.” After the compulsory weigh-in at a doctor’s appointment, I resolved to get back down to the weight on my driver’s license, 93 pounds. Why I chose this number, I can only guess.

I took to eating disordered behaviors so quickly it would seem I’d been grooming for them my entire life. I cut back on foods, then started skipping meals altogether. I’d get up early each morning, take a bike ride then eat only a small bowl of grapes. At night, I’d lie in bed agonized with hunger and dream of all the foods I wanted to eat: muffins, corn on the cob slathered in butter, baked potatoes, chicken, oatmeal cream pies, glasses of milk, chocolate cake, pizza and (good god!) the newest Dairy Queen ice cream concoction I drooled over while watching television commercials.

Sometimes I’d stuff food in my mouth just to taste something and quickly spit it out, rinsing my mouth with water to avoid any food actually getting near my stomach. To anyone thinking of trying this, it works rather poorly. You’re bound to ingest some of what goes into your mouth and risk developing a bad case of TMJ in the process.

Occasionally, I would give in and binge, only to suffer the terrible physical and emotional consequences. Binges are not simply over-eating. Binges involve shoving as much food as you can tolerate into your body as quickly as you can. Though they certainly serve a purpose (whether that be psychological or physiological), binges are rarely enjoyable experiences. The food is eaten so quickly, it’s hardly tasted. Some individuals appear to dissociate during such episodes, meaning they are physically awake but mentally “turned off” or figuratively separated from their bodies. I’ve had similar experiences over the years, driving to the store completely numb and emotionally void, thinking only “food, food, food, must find food…”

Within the first month, I’d dropped 14 pounds.

The grocery store became a museum, a showcase for all the things I wanted but would not allow myself to have. I also developed a love for baking and a sadistic infatuation with feeding high-fat, high-calorie items to those around me. (I can now only assume no one will again accept baked goods from me without wondering about my intentions. Ha!)

I lost more weight. I stopped having my period. And in one alarming moment in the university library, I realized my heart rate was in the 40’s. Lying in bed at night, I’d press my palm against the wall, the cold, sturdy tangible surface holding me in reality, calming the chaos in my brain. The sad truth is these things did not alarm me. I was pleased. I was doing something right. I was, in my sick and twisted mind, a success. For most of my life, I’d felt mediocre, not smart enough, not pretty enough, not witty or sociable or blessed with some great talent. But now…now I had a “skill.” I could lose weight. If I willed it, it was done.

Having surpassed my initial “goal weight” I set a new one. This is one of the oft-held delusions among eating disordered individuals. We think, “I’ll get to my goal weight and then I’ll stop.” In reality, there is no goal weight, unless that goal be death. No weight is ever low enough. It is always “just a few more pounds, just another inch off my waist.” And when the logical mind peeks out from behind the disorder, one holds even tighter to the delusion. “I’m not sick. I’m not one of those girls. I can stop if I want to. I’m not addicted. I’m fine.”

Lies. You’re not fine. Your body is dying. I was in a never-ending battle between logic and delusion, reality and distorted perception.

From my journal, September 6, 2003:

“I have so many questions. I guess the biggest one is, “who am I?” I’ve spent so much of my life trying to be something I’m not, trying to fit in, trying to get people to like me. And where has it gotten me? It certainly hasn’t made me happy. Instead, I think it has torn me apart. So much so that I don’t even recognize myself anymore. I’ve allowed myself to be scattered, events in my life to remove pieces of me. And now I wonder how I can be whole again. I’m scared, scared to give up my control, my precious control, my safety net. That would mean allowing things to hurt me, allowing myself to be vulnerable. But I don’t even know where to begin. And I don’t really know how to find myself. Who am I anyway?”

xxx

I wish I could wrap my story into a lovely package, all the loose ends tied into one lovely bow. Isn’t that the way a story is supposed to end, with all the problems resolved and the handsome prince and the happily ever after?

Truth is, life is not a fairy tale.

And so I, all of us, forge on. Wake up in the morning, put both feet on the floor and begin the day. Some days are easier than others. Other days the struggle to remove myself from the safety of the covers feels monumental. But eventually, I always get up. Coffee and cigarettes and trying to find peace in the moment, peace in the freshness of a new day. Nearly eleven years after the onset of my eating disorder, I know that I am not entirely recovered, but I hold out hope that with enough hard work, I will win more battles than I lose. And that, in itself, will be enough.