Big Shiny New Year: how a party about new beginnings set the tone for a spectacular collapse into depression

The last few months of 2013 were a horrible, terrifying slide into Major Depression. I tried all the tricks, followed my treatment plan, and still nothing. I wasn't eating, I wasn't smiling, I wasn't even able to laugh. It was pretty darn bad. So imagine my surprise when my friend P from church invited me to a dinner party on New Year's Day. He said no one would pressure me and I could hide in a corner if I wanted to, but that we would play games, and I would have fun. So, for the first time in my life, I went to a New Year's party. I was really looking forward to it!

We played a super hilarious game called Braggart (I think that was it, anyway) with cards where we made up stories and then stole the good bits of other people's stories. Everyone was so entertaining, and I had fun. I felt like I hadn't had the chance to even pretend to be happy in so long.

It was a very cold day, thirty below freezing or so, but the condo was toasty from cooking and company. While I was doubtless the boringest, wort guest ever (hello crippling depression), I was happy to be there. It was especially nice to be out of the house and away from my parents on the first day of the new year. New starts and all that.

As a thirty-year-old paying rent, I knew I had every right to go and and do whatever I wanted to do, even if I was still living with my parents. But, in some sort of bizarre quest not to be a total bitch, I did try to be considerate of them. So I told my mother that if I didn't call by the 9:00 train I'd be taking the last one of the night. I'd also arranged with a friend that if something went horribly wrong I could stay at his place. I had this shit under control.

Because I think it's rude to have telephone conversations while you're at a dinner party, I turned my phone off and left it in my bag by the door. To be honest, I also didn't want to risk having everyone find out that my mother still checks up on me - that my own family doesn't think I'm capable of running my own life, that my mother still treats me like a child. Even though I was sick, it's not like I didn't have my shit together on this one.

But I hadn't counted on my mother waking up at 10:00 pm and deciding it was too cold for me to walk home, and single-handedly scrapping my entire plan. She texted me a couple of times, and of course when I didn't answer because my phone was off, she started calling and leaving messages. Not one to be put off by the fact that I was obviously still having fun with my friends, and was an adult fully capable of taking care of myself, my mother put her detective skills to good use and somehow located the phone number of the place I'd gone. She then proceeded to call them and ask for me. The second I heard their phone ringing, I had this cold feeling in the pit of my stomach, and started feeling lightheaded and disconnected, like a deer caught in the headlights. I knew - I just knew - what was happening. And I so wasn't prepared to deal with it.

Once our host figured out that the person on the phone wanted to talk to me, he handed over the phone. It was obvious that he was as taken aback and embarrassed as I was. Since there was nowhere for anyone to go, everyone got to listen to my half of the conversation.

Like talking to a two-year-old, I kept my voice calm and level, speaking clearly and simply. I told my mother that everything was fine, and reminded her that I'd already told her about my plans and there was no need to be calling. But it was no use. My mother was already in a full-throttle fit, yelling at me that I should have answered my phone, and insisting that I had to take the metro home immediately so my father could pick me up in Laval and drive me home - it was absolutely too cold out for me to walk home from the train the way I'd planned. Never mind that I've spent my whole life weathering cold winters, or that I was capable of making my own decisions, or even that being a renter in my parents' home didn't give them the right to control my life. She'd made a decision and wasn't about to be mollified or dissuaded or derailed.

So I gave in. I 'okayed' and 'fined' until I finally got her off the damn phone. Then, of course, I had to explain to my hosts that I was leaving because if I didn't give in to my mother's irrational demands she'd be having a fit for hours - maybe even days - before I'd finally be able to calm her down. That I'd spent my whole life hostage to her moods and didn't know how to stop giving her what she wanted, even though I knew that just made things worse in the long run.

Everyone was incredibly nice about the situation, telling me that it was alright, but for me it absolutely wasn't.

I felt completely humiliated. My mother had embarrassed my in front of everyone by treating me like a child in public.  I felt ashamed that people knew that this is my family, this is my life, that I wasn't allowed to be a grown-up. I felt deeply ashamed at having allowed this to happen, at not having kept my phone on because I know how my mother is. As I bundled myself up and left I felt so small, and so hurt, knowing that my mother would do that to me just to make herself feel better, that she'd cost me a chance at friendship and that I'd probably never be invited over again (and, of course, I haven't been).

As I rode the metro, the shame started to fade and be replaced by anger. Rage, even. How could she do this to me? It was completely inappropriate! I felt so, so angry! By the time I got to Laval, this too had faded, and I just felt weary. Weary of the life I was living, of the way people treated me, of being depressed. When I got to the car, my brother was there, too, and it turned out that everyone in my family thought I was wrong and should have had my phone on, and needed to do what my mother said. I felt so betrayed: I felt like no one in my family ever protected me from anyone else in my family, and I was all alone. I wanted to cry.

The next day, I went to work and realized that someone had to make the first step in repairing this mess, since my mother had decided she was still pissed off and not speaking to me. On my way out of the office, I texted her to say that, while I understood her perspective, what she did was unacceptable and I wouldn't tolerate it, and that she was never to do that to me again. She totally flipped out, telling me that I  was the wrong one, and everyone knew it, but that I'd find a way to save face with my friends, probably by lying to them and saying that she had a serious mental illness.

I couldn't take it. I just couldn't. It was such a hurtful and personal attack. I saw that she didn't understand how I was feeling at all, and didn't want to. She didn't see that there were boundaries, and I apparently wasn't able to enforce them. I was so unhappy, and so sad, and I didn't want to go on struggling so hard against my pain for nothing, just to be shot down. So I went straight to the store and bought my favorite cutting knife. I hadn't owned a serious knife like this in years, intended only for this, to hurt myself, to open my skin, to cut myself wide, to end my life with precise incisions. I felt like, even in this, I was giving my control over to someone else, and I didn't know how to get it back. I just knew that this was one straw too many - one weight too much - and I couldn't stand against the tide anymore.

When I told a shorter version of this story in my DBT therapy group as an example of an invalidating environment, there was an audible intake of breath and one 'eiiigh' when I got to the part about my mother phoning the party host to make me come home. In the back of my mind I'd always been thinking that I'd overreacted, that the situation wasn't that bad and that, really, I was the one in the wrong; since I'd made a mistake, I deserved to be punished by being humiliated. Sharing this story, I felt for the first time that maybe the way my family treats me, and has treated me, is not okay. It's really not okay. And maybe it's not my fault. And maybe that makes it okay to stand up for myself.

The Music Man: Prescription Amphetamines and the Worst Date Ever *trigger warning*

In the Fall of 2009 I was beginning my second year in Graduate school (thesis writing year) and my depression was still getting worse. I'd taken one seminar final paper deferral the Fall before, and three in Winter semester -- yes, that would be all of my courses. I didn't get as much research done over the summer as I'd hoped, even though I worked at it every day. I felt like I was sliding, falling, slowly suffocating. Everything was getting a little too difficult, a little too beyond my capability. Although I begged him to let me try ECT, my psychiatrist was unwilling to consider it as as option for me. I was maxed out on Wellbutrin XL and feeling like there was nowhere to go when my psychiatrist and I made the decision to try augmenting it with Ritalin.

On the face of it, Ritalin was actually the best antidepressant I've ever taken, at least for the first few days. I'd had consistent problems with tiredness, low energy levels, and an inability to concentrate, and Ritalin fixed that right away. I was able to focus on my research, to cut through the fog enveloping my brain and put ideas together, to understand what I was reading. I felt alert and awake, and had the energy to walk from one side of campus to the other, to get through my daily activities of worship and study. I took two doses of Ritalin a day, once in the morning and once in early afternoon, and suddenly I was feeling the way I'd felt when Wellbutrin SR had worked: I was feeling like myself. While I didn't really feel any better mood-wise, I could be productive; I felt I had a shot at maybe living my life the way I wanted to, the way that mattered to me. I believed that my mood would stabilize over time back to baseline if I could keep from destroying my life and my goals and my dreams in the meantime by being able to string words together into sentences.

The Ritalin crash was brutal, though, and ultimately an unmitigated disaster. For some reason I was taking regular Ritalin rather than the sustained-release kind, so it was all dumped into my body at once rather than evenly over time. I was fine while the drug was in there, but when it would wear off at the end of the day with no third dose to take its place, I found myself completely immobilized by exhaustion. I couldn't get up if I wanted to. After thirty to forty-five minutes the effect would be gone, but the initial come-down was crushing. In retrospect, I regret never agreeing to try Adderall, which does come in sustained release-form and has less overall drug interactions, but the times it was offered I still overwhelmingly blamed Ritalin for what had happened to me.

At the same time as my depression was worsening, I was coming to the conclusion that my relationship with MM had run its course, if I was being honest about what I wanted my life to look like long-term. I also, perhaps out of pride, had no desire for someone who hadn't committed to me to see me at my mood-worst, crying all over the place and unable to smile or laugh or take pleasure in my life. Sure, Ritalin promised me I could go on with my daily activities, but it wasn't going to make me into the person I was without Major Depression. It offered me a way to maintain a normal level of activity, but in terms of the depressive low, it seemed like the only way out would be through. So I decided to end it, even though I knew I'd miss him and wasn't sure that we'd still have a friendship after this second time around.

MM picked me up and brought me to his place for our usual date during my first few days on Ritalin. In his car on the way there I told him about what had been happening when it wore off and he remarked that, when he'd taken the drug, he'd experienced the same thing. I felt relieved knowing that someone understood what I was going through.

When we got up to his bedroom, I told him that I didn't want to have sex because I wasn't feeling well, and he said he understood. I'd intended to go home pretty much right away, but he suggested we take a nap, and since the Ritalin was wearing off I thought this might be a good idea anyway. And besides, I'd always liked napping with him because he was a good cuddler.

I got into bed and lay down on my side and he lay down beside me. My limbs were already so heavy that I knew I'd never have made it home anyway: if I hadn't stayed, I'd be sitting on the floor somewhere waiting for the near-paralysis to be over. I'd miscalculated my timing, I suppose. Falling asleep with someone snuggled warmly against my back and wrapped in someone's arms isn't the worst way to spend an early evening, after all.

I was confused at first when he started stroking my belly, but he knew I liked it, and I appreciated that he knew I was feeling bad and wanted me to feel better. I was confused when he pulled down my pants and underwear because I couldn't figure out what he was doing that for. But when I heard him taking off his underwear and realized he'd removed his pants even before getting into bed with me, after I'd said I didn't want to have sex, I felt a cold stab of fear deep in my belly, and I understood.

As much as I tried to move, to kick at him, even to open my mouth and scream, my body didn't do any of those things. I looked at my hand and couldn't will it to move. I felt so violated, and so ashamed. I didn't understand why he was doing what he did, knowing exactly that this isn't how I behave, that this isn't how I act. I couldn't understand why he would destroy our friendship over something as stupid as sex. 

I knew that I would never see him again, and I was so, so sad. I knew that I could never tell people that this had happened, because they would look at me and wonder why I didn't do anything to stop him, how this could happen to me again, what it was that I was doing to bring this on myself. I knew that no one would believe me, and that it wouldn't seem important, when we'd already had sex countless times. I wondered if I'd ever be able to forgive myself for climbing into the bed beside him, for going to his house knowing my drug would be wearing off, for not just telling him we were done over the phone, or over coffee, or any other day of my life but this one.

When he was finished and I was alone, I looked at the ceiling for what seemed like hours, and lost myself. I left knowing we'd never speak again, and it was the worst date ever. 

The Music Man: Of Course it Continues *trigger warning*

After I stopped seeing him, MM and I kept in touch sporadically, exchanging emails every once in a while and occasionally chatting on Facebook. I'll be honest, even though we didn't meet up again, we did flirt a little sometimes. A girl needs to practice her sexy, you know? And even though I found myself conflicted about the nature of our relationship, over the time we'd known each other I'd come to care about him a great deal, and wanted to keep in touch. I'd read drafts of the early chapters in the book he ended up publishing...I wanted to know how he was doing, know the general outlines of his life. I wanted to know that he was happy.

In 2009, I ended the most emotionally difficult intimate relationship of my life, and I wasn't quite sure how I was feeling. Although I'd loved my partner, I'd struggled for over a year-and-a-half with the dynamics between us that made me feel deeply unhappy and unhealthy. I'd always felt a little bit controlled and restrained by the way he seemed capable of taking over my life and my affairs; he didn't do it on purpose, but I ended up feeling incapable and small. After I had behaved particularly badly, my partner told me that he would feel better and trust me more if I dropped MM from my friend list on Facebook. So I did. For the first time -- and I hope the last -- I allowed someone else to determine who I could and couldn't be friends with.

When we broke up, one of the first things I did was get back in touch with MM. Part of it was revenge, I'll admit it: I wanted to do what I hadn't been able to while I was with my ex-partner. Part of it was a feeling of expansive freedom. Part of it was wanting to feel desired and desirable after feeling sexually unworthy, unattractive, unwanted, and messed up. And part of it was just wanting to be able to talk to MM again, about all things psychological, about our lives, about the parts of ourselves that people keep hidden for fear of being judged. I wanted to be vulnerable and have someone accept me.

As it turns out, MM had recently been missing me as well, and we quickly struck up a flirtation. We ended up meeting for hot chocolate soon after getting back in contact, and I was pleasantly surprised by how things went. We talked about our lives, our recent relationships, and what I'd learned I wanted. I found myself very different with him than I used to be: I was shy and deferential, but now I found I was expressing myself with confidence and behaving more like who I really am, instead of like a student trying to impress her teacher. He remarked on the change as I, too, was noticing it. I was older. I was more sure of myself. And I knew that, if I liked him, it wasn't because I was star-struck but because I knew him and I knew myself.

I often wonder what exactly it is he saw in me. I know he liked that I was smart and we could talk about a range of topics. I know we found each other insanely attractive. But, more and more, I think it was that I simply wasn't impressed by all the crap he usually impresses people with. I didn't care that he was the equivalent of a psychology rock-star, because I'd known him before that was true. I didn't care about his house, or his cars, or his clothes, or his job, or his money, although I knew that those things all represented success to him. And he knew that I didn't give a crap. I think what he liked most about me was that I looked at him and saw him with all those things stripped away, and was interested in him anyway. I got the feeling that he was surrounded by people who focused on what he could do or what he had and was, and I was part of a smaller number of those who took him for who he was. We seemed to give each other something we were both missing, along with a lot of desire and tenderness.

I 'dated' him from late spring through to early fall, meeting up once or more a week. I invented a fake graduate student working in a psychology lab so my family would know I was seeing someone and wouldn't constantly be asking where I was going. I wasn't sure exactly what our relationship was, but we were having a lot of fun, and I was getting to know both of us a lot better. I met and had dinner with one of his friends from out of town, and actually went to a block party with him. We had a lovely and memorable day trip. I knew I had feelings for him, and him for me, but it didn't seem important to try and define what we had or where it was going. I was much happier and more fulfilled dating him this time around than I had been the first.

But, as time went on, it started to bother me. I felt like, in a way, I was letting myself get comfortable in a relationship that would, in the long run, keep me from pursuing what I really wanted. I was still young and I knew I wanted children, and that he didn't. I knew one day I wanted a life partner, but I didn't think that was in his plans. Ultimately, I started feeling like I was selling myself short and allowing myself to be less than I hoped to be by choosing to be with someone who couldn't give me the kind of commitment that I wanted. I felt like we were both settling for less than we deserved.

I knew it would hurt, but after crying it out all over a friend in Dio's basement after a Friday morning Eucharist, I decided I needed to stop seeing him and re-evaluate what it is I needed in a relationship in order to feel like I was growing, like I was a real partner, like I could be fulfilled.

Montreal Walks for Mental Health

This year was Montreal Walks for Mental Health's sixth year in existence, and my second year participating. I'd seen a segment about it on the news three years ago, and immediately began following the event on social media so I could join the next one. I sincerely hope I'm able to participate every year, and not just because they give walkers these truly awesome hats!

This year, I was able to double the number of people I convinced to walk with me. Double! On the surface, this sounds impressive and speaks wonders of my charisma and persuasive skill. This would all be true, except for the fact that the number of people who came out to walk with me was two.

Two.

I posted extensively on social media about the event, and about other mental health topics in the weeks leading up to the walk. I posted mass invites on facebook, and personally asked a couple of people I feel really close to if they would come with me. The posts where I told everyone I was going and invited them to come with me got only 8 'likes.' None of the people I singled out came -- some because they couldn't, others because they didn't want to. While I did have an encouraging number of private responses, most of those who were trying to make it ran into personal conflicts and ultimately weren't able to attend.

I have 402 friends on facebook, all of whom have seen my re-posts about mental health over the years. Of those 402 people, 1 person said the walk wasn't worth going to because we wouldn't be spending any time alone, 3 planned to come and couldn't make it, 1 wished she could come so much that she shared my invitation with all of her friends (with my permission!), and 2 actually came. 

Two.

The point of the walk is to stand up together against the stigma surrounding mental illness. We all know the tangible effects that stigma and discrimination can have: unemployment and underemployment, lack of adequate housing, fragile and non-existent social networks, loss of opportunity, loss of friends and family, food insecurity, looks of disdain, refusal of service...the list goes on. As for me, I am fortunate to have never experienced life-shattering stigma, to have never run up against that wall. While I've had my fair share of people tell me they don't believe in medication (including my mother who habitually refers to it as 'a crutch' and a graduate thesis supervisor who approved my leave of absence specifically so I could stop taking pills), or who believe that I will get better if I just try harder, the way that stigma has hurt me the most is actually in its silence.

I feel stigma in the silence of other people surrounding my illness. Over the years, my depression has been dismissed by family members as 'not that bad,' even though we've never spoken about what it's like for me. In the decade since I first became acutely ill, my mother has not read any literature on depression, suicide, or trauma. Depression, and its ongoing effects in my life, is never discussed, except in the weekly complaints that I kept a prescription light box on the family's kitchen table so I could use it every morning. 

I feel stigma in the way that people avoid talking about mental illness. The informational posts I share are the kind of thing people seem to skip over in their newsfeeds. Perhaps, like me, they worry that if they display too much of an interest people will begin, on that basis, to assume they must be mentally ill.

I feel stigma in the way that inappropriate language and misinformation about mental illness is silently accepted. Over the past few years, I've occasionally scattered my speech with ridiculous mental-health terms, hoping that someone will call me on it. A thing can be 'psychotic,' 'schizophrenic,' 'bipolar,' 'crazy,' or 'retarded.' I have never, not even once, had anyone tell me off for using offensive and discriminatory language (though I've certainly done it to others!). When I complain that news media have reported a story in a misleading and discriminatory way, people respond by changing the topic, with non-committal sounds, or by defending the newscaster. We have come to accept the misuse of words and misinformation as part of our social fabric, in the face of which we, as a society, are largely silent.

I feel stigma the most in my own personal silence. Although I was quite outspoken about my struggle with trauma and depression years ago, and was able to use those experiences to help other people, over time I've become hesitant to share these details about myself. When I began a new university degree, I decided to tell as few people as possible about my history of mental illness. Part of that was wanting to make a new start after having tried to kill myself again. Part of that was related to taking on new roles in church leadership and preparing for a more public ministry within my Christian life. Part of it was shame that, after years of helping other people with their illnesses, I could no longer convincingly tell a story of my own recovery.

In terms of employment, my manager does not know I have depression. My absence was coordinated with disability and HR, so none of the people I actually report to are aware of the circumstances of my medical leave. While negotiating flexible hours to accommodate group therapy (which should be starting soon!), I implied to my manager that the group is about my chronic headaches. I write this blog, all about my experiences living with depression, but the link is not posted anywhere on my social media because I'm afraid it might get back to the office inadvertently through friend-colleagues.

I feel like a hypocrite because, while I talk about ending mental-health discrimination, I keep my own illness wrapped in a carefully guarded silence. I do it because I'm afraid to ruin my career in a competitive, target-based work environment where failure to succeed is not tolerated. I do it because I am afraid I'll be seen as a liability in an office where taking your full 10 sick days in a year is tacitly considered unacceptable, unprofessional, and detrimental to the team. I do it because, on my very first day of employment, I asked about using sick days for mental health reasons and was told that for mental health days we have to use our vacation. And I do it because, as someone who longs to dedicate her life to working with other people as part of her church ministry, I understand all too painfully that disclosing my mental illness makes it unlikely that I will ever be entrusted with authority; depression makes me 'unstable,' and my honesty has meant that I am not considered a good candidate for ministry.

So yes, I do feel the stigma. I wonder to myself if people skip over my profile posts about mental health because we are more comfortable not talking about it. I wonder if I would have gotten more likes or more participation if I had asked people to join me for Light the Night. And I feel the stigma in the relationship of my own speech about mental health awareness to my silence about my own illness.

I went to Montreal Walks for Mental Health and I was proud to stand with people who are fighting stigma by speaking out, hopeful that one day I, too, will no longer feel the need to protect myself with silence. 

Ye Olde Homestead (or, a post composed entirely of rant)

Yes, I know, I am a terrible daughter. Or at least I feel like one every time I put off going home to visit with my parents. It's difficult to find an excuse not to go over when some of my things are still living at their house. I'm just so much happier here, in my own space, in my own little world, with no one intruding on my privacy, my routines, my emotions, and my life. I'm so much more at peace.

It isn't that I don't love and appreciate my family: I'm pretty sure that I do. But when I see them, when I'm in their house, I just feel so...unhappy. I feel like the familiar walls are crushing me. I feel numb and anxious at the same time. I find myself slipping too easily into old patterns of behavior. My mother encourages me to eat my feelings, maybe because she does it too, and when I visit with her I do -- even though I know sticking to a proper diet is crucial to maintaining my equilibrium. I feel terrible now, tearful and uncomfortable the way too much food always makes me feel -- heavy and suffocated. I'll feel heavy and bad for the next few days until it wears off. 

I can't afford to do this right now. 

I don't want to do this right now.

It isn't always possible to cut the people and things that make you unhappy out of your life. I'm not an island alone in the middle of an ocean. I'm connected, intimately, with people I have no desire to hurt. They would never understand it if I said I didn't want to hear from them for a while, until I can hold onto the person I want to be when I'm with them, the person I know I can become if I let myself change and grow. Change is slow and fragile, and it would certainly be easier if I wasn't surrounded by people who, in one way or another, rely on me being the same as I've always been. They would never understand if I said that what I need is time to be completely alone in the world, without a family and without a home: no phone calls, no emails, no visits. 

I understand how people can go into a fugue and find themselves in a new place with no idea of who they are or where they come from. The mind is powerful, and Lord knows it's easier to build a new life without the old one following you around. It isn't possible for most of us to leave the past behind us and begin completely again: you can't erase your memory and your connectedness like a chalkboard.  

But I feel like I can't breathe. I feel an unnameable dread. I feel alone when I am with them, and uncomfortable in their space. I need it to be over, but I will never be able, or willing, to bring myself to do that to my own family -- to walk away without turning back. Maybe I would heal. Maybe I would be the same. I struggle constantly with the boundaries I need to keep them out of the space I am trying to build for myself. It is so familiar for my family to take over my space and my life, like a fog seeping into unguarded corners. 

I just need a lot of space right now. Maybe too much space, more than is really reasonable, or possible, or fair to demand. I need to figure out who I am, and whether or not I can accept this person or this life. I've never had the chance to be alone. I've never had the chance to put myself and my needs before what everyone else needs or wants or requires from me. I have thrived on giving myself away in relationships with others. I have been consumed by other people and the worlds they've created for me to live in.

But today I am tired. Today I want to be alone. Today I want to be free. I'm like a child demanding the impossible: leave me alone, but be there when this is over. Don't try to come into my life, but let me love you in yours. Don't make me be the person you love and want, but accept me however I feel like being right now in this moment. Don't demand or expect anything of me, but let me give you what I am able to. 

Nobody could accept that, most certainly not family. But I really, really, really don't want to see them, or hear from them, or think about them, for a while. I want to get the hell away from that place. I don't want to set foot in that house, and I can't quite put my finger on why.

I came back to my home today and cried, couldn't get off my couch for hours, after I visited my parents and they dropped off some more of my things that I don't want or need...more pieces of their house that I don't want in my life but that are, slowly but surely, shaping my new home in the image of my old one.

I want it to be over. I want it to be enough. But you can't outrun your family any more than you can outgrow the years spent loving them, trying to weave and unweave a life together that everyone can live with.

A Slow Awakening: An Early Spring Photoessay

You might know that I've been having something of a difficult time. Part of that is probably due to my brain settling into an old, familiar groove as the rTMS treatment I received moves further into the past. Part of it is undoubtedly due to therapy -- engaging with trauma, or any difficult issue, often results in feeling worse over the short term.

Obviously, what we're most concerned with is the long term: will I survive this illness? If so, for how long, and with what quality of life? But the short term matters immensely, too. After all, I live in the here-and-now, not in the future. And anyway, what with the Morlocks and the Eloi, it isn't as if the future looks like that awesome of a place to hang out.

One of the first things I noticed during rTMS is that the color green was brighter.

Spring was the ideal time for me to receive this treatment, as it turns out. My senses were awakening at the same time as the world burst into riotous growth around me. From a landscape laden with dead, bare branches and hard, barren earth sprung up buds, and new plants, and the beginnings of life. 

I felt like things I had all but forgotten were growing within me: humor, and lightness, and hope. Like a seed dormant in the ground, I had not lost those things whose absence I felt so keenly and with overwhelming pain. They were only sleeping. I couldn't feel them, or remember them, or reach out and touch them. I felt like I would never feel happy again, that nothing would ever change, and that there was no point to struggling on in the midst of lifelessness. But, when I believed I couldn't take it anymore, not even for one more day, the world around me burst into life and reminded me that feeling like I could live was hidden, but not dead.

Under a layer of dead leaves slumbered a field of flowers. And under the darkness of my despair crouched a hidden sunlight. I began to have hope -- hope that I could get better, hope that I could feel differently. Hope that, one day, I might even recover. I looked at the world around me with hungry eyes and an open heart, amazed at the way my own mind could take me by surprise. I had been afraid that I couldn't get better, that it wasn't possible, that this was going to be my life. In the onslaught of vibrant color, I was caught unawares by the possibility of change residing even in me.

I felt an openness, an expansiveness, like a body of water in the breeze. I began to see that life could be beautiful. Life could be beautiful emerging from death, and going into death. Maybe life is beautiful too when it lies in stillness, dormancy, a dreamless sleep. If I can remember this, hold onto it, when I feel like I'm dead and wish to be dead, maybe I can hold the beauty and the suffering in my two hands at once, cradling and cherishing both. Both can be tended to, and both frame the boundaries of my experience.

 Spring is not all beauty and new growth and sun reflected off water. Spring unearths muddy ground, trees that have not survived the winter, stagnant water overflowing with the detritus of decay. Plants that greedily take more than their share of water come back to life, dominating the fragile seedlings around them. It isn't all easy, it isn't all pretty, it isn't all what you're hoping to find in your foray into new beginnings. But it is there -- an undeniable part of what it means for life to come charging back in.

In its own way it is beautiful, because it is true. As I started to feel better, I began noticing painful truths about myself that had been buried under the agony of suicidal, backbreaking depression. I had opened the door to hurting myself again, and the longing plagued me. I have difficult relationships that take up a large place of my life, that have contributed to my illness and that I don't know how to manage. I have enduring trauma and recurring memories that flow through my mind. I hate myself, and wish I didn't. I live with a lot of shame. I am somewhat obsessive. I have difficulty understanding my own emotions.

These things were hidden under the blanket of winter. But now I see them again, reappearing, taking up time and space in my life. There is a layer of decay that fomented under the snow, and it needs to be reabsorbed into the life around it; changed into life, it can once again bring forth goodness and color and meaning and strength. It's good for a tree to fall in the forest and be reclaimed. But it isn't easy when you first see it lying there, tumbled across your path.

It will be hard. It will be painful. And it may cause me, sometimes, to forget about the springtime. But I have to look hard at myself if I want to reclaim the parts of me that have been damaged by depression -- the parts of me that have fallen under the unbearable weight of ice and snow -- and integrate them into a healthy life.

As I struggle, it is too easy to focus on the bark of a decaying tree rather than on the seedlings springing up in its midst, drawing their nourishment from it. I'm writing this post to remind me of how I felt when I saw vibrant green and new flowers. And to remind me that spring is a coming into being that enfolds both the remains of winter and the beginnings of new life.

How to Get to Your Happy Place: Visualization in the Face of Difficult Emotions

Like many people who live with chronic and major depressive disorder, as well as trauma (lucky me!), I struggle with intense sadness, anxiety, hopelessness, terror, helplessness, and a host of other difficult thoughts and feelings about both myself and the world I find myself inhabiting.

I haven't always dealt with these feeling productively. That probably goes without saying! Before you can begin to process and resolve painful feelings and memories in a therapeutic setting, you should probably have better coping skills than cutting yourself with knives or trying to kill yourself. Probably. I mean, I'm taking a guess here, but I think that's the general idea. I seem to have somehow skipped this step in my previous decade-long attempt at therapy, which might partially explain why, in crisis, I return to harming myself, sometimes severely.

Anyway, this time we're approaching things a little differently. One of the tools I learned in therapy this week is called visualization. It involves thinking back about a time in the past when you felt completely calm, safe, and at peace. You then immerse yourself in the memory by recalling it through the five senses: sight, touch, taste, hearing, and smell. You try and find as many aspects as you can for each of these senses, which helps to really activate the memory and give it depth. Once you've put yourself in that space, you rest there until the sense of calm starts to suffuse you and you find the difficult emotions you were experiencing begining to subside. This will keep you from doing anything rash and stupid, like eating all the dish-washing soap thinking that will stop the memory from endlessly replaying itself in my head while I run the scanner at work: problem solved!

For me, my happy place is hiding in the snow.

From the time I was a young child to the time I stopped wearing snowsuits -- so around the start of Junior High -- I loved to go outside and play in the snow. Of course, I had snowball fights, and built snow people, and forts, and went sledding and cross-country skiing, all with other people, but I regularly played by hiding by myself.

Due to the fact that this happened in the past, we used to get a lot more snow in winter than we do now. (Also, everything was uphill both ways, but I digress) When we shoveled our front walkway, the snow would pile up to the living room window where we dumped it against the side of the house: it was so high! It was also perfect for building a tunnel. I'd dig with my hands in the center of the pile, beginning at the driveway and working my way into it parallel to the window, digging myself a Kat-sized hideaway. Once I could burrow all the way in, I would make my way head-first into my snow tunnel and hide there for as long as I could, usually until frostbite started to set in or my mother called me inside. I liked to take naps in there. It was warm enough from my body being in such a small space that the cold didn't seem to work its way inside me so much. I loved the solitude, that no one could see me, that I had created a world for myself that was only mine and where I could be safe. I used to think about what it would be like to go to sleep in my tunnel and never wake up. It was just so peaceful.

Inside my space, I could see the dark outline of the snow around me, its closeness to my body. I could see the darkness in the middle of the day where very little light penetrated. Sometimes I could vaguely see an icicle I'd brought in with me from off the eaves-troughs, and the outline of my woolen mittens. I could see the inside of my eyelids as I began to nap, and the patterns of light and color from squeezing my eyes shut.

I could feel the rough wool of my hand-knitted mittens, and the string pressing against my back beneath my coat so I wouldn't lose them. I could feel the cold of the snow on my mittened hand, and the icy smoothness of my snow hollow when I took my mitt off to lay my hand against it. I could feel the end of the tunnel pressing gently against the top of my head through my hat. I felt the warmth of being enveloped by warm clothing and snow, and the chill of crisp winter air on my uncovered skin. I could feel my scarf against my mouth, and my breath against my skin, the dampness of my scarf where I had breathed on it in the cold. I could feel the length of my body supported by the packed snow, and the closeness of my snow walls around me.

On my tongue, I could taste the coldness and sharpness of the air, and the lingering coolness of an icicle if I'd eaten one. I tasted the inside of my mouth, and my lips where I had bitten them. I could taste the dampness of my scarf pressed against my mouth, and the anticipation of hot chocolate with marshmallows.

Inside my tunnel, I could hear the silence of winter, and the distant sounds of children playing. I could hear the muffled footsteps of someone walking by my hiding place. I could hear the slow deepening of my breath as I grew sleepy, and my soft heartbeat. I could hear the snow gently settling, and the sound of the breeze. I could hear my own movements against the snow, the swish of snowpants and the scrape of boots. Sometimes, I could hear the soft wisp-like falling of gentle snow, or the scrape of a shovel against pavement, the short thump of snow being thrown on snow.

I could smell the winter in the air, that smell you grow up with in the cold and never forget, and the way that it freezes inside your nose and smells clean and new and pure. I could smell the woodsmoke from fireplaces in our neighborhood, and the distinctive smell of packed snow. I could smell the dampness of my scarf from my breath, and the snow-dampness of my woolen mittens.

Inside my snow tunnel, I felt safe, and peaceful, and alone. I felt enveloped, enfolded by a space I had created that seemed like it could last forever but was really quite fragile. Enough snow piled on top of it, especially heavy damp snow, and it would collapse. But I knew I could always build it again after the next good snowfall. I felt content. I felt the closest thing I can remember to an uncomplicated happiness. I believe I was happy.

When I bring this memory vividly back to mind, I feel all these things again, and as I stay in the space, recalling it, I start to feel calmer, and the chaos and pain inside me ebbs away to where it becomes bearable. It also gives me back a vibrant piece of my childhood that I had all but forgotten, because I almost never take the time to sit and think about it, though declaratively it is always there. That's the magic of visualization.

I hope that the next time you're anxious or depressed or scared or homicidal you take a moment to find your happy place, go back there, and spend some time visiting with your own precious memories.

Observing Your Thoughts With Curiosity: It Turns Out I am a Total Bitch

One of the key components in practicing mindfulness is non-judgmental observance, or learning to pay attention to your thoughts as they arise. As my psychologist put it, my homework for this week is to approach noticing my thoughts with an attitude of open curiosity. Oh, isn't that interesting! And then letting them go. The mind, after all, is a fascinating place if you just pay a little attention to it. We're so used to thinking thoughts all the time that they become a kind of static we don't hear any more.

But they're there, influencing us. And if we don't know what they are, how can we begin to unravel the complex ways that our mind behaves during periods of depression to reinforce our mood, to dig us deeper into it, to make us think that the things we're saying about ourselves to ourselves are so automatic that they must be true?

I saw my therapist on Tuesday, so it's only been a few days, but already I've noticed a disturbing pattern in the way I talk to myself. I call myself an idiot an awful lot of the time. Like, a lot. I insult myself, say I should have known better. I am very sarcastic: when I do something wrong, like pushing the elevator button for the wrong floor, I say 'good job' in an obviously demeaning way.

These are things I'd never say to anyone else, certainly not in this way. These are things that are unacceptable. If I was my own wife, I would call myself verbally abusive and tell us to get into couples' counselling right away!!

The hardest part of the assignment is not to judge myself -- or the thoughts! I can't help but feel disappointed in myself when I notice the way I self-talk. I can't help but feel like an idiot for calling myself an idiot. So I notice these patterns, too, this tendency to spiral off into a cycle of self-abuse that leaves me feeling worse and worse.

And then I put it aside.

If I saw a beautiful flower, I wouldn't say to myself, 'You are a wonderful person for noticing it there, its soft petals and its delicate fragrance.' I didn't put the flower there on purpose, or create it, and it isn't mine, though I did choose to notice it. It was fascinating. If I saw a hideous flower, I wouldn't say to myself, 'You are a terrible person for noticing it, its ugly color and sickly scent.' I didn't put the flower there on purpose, or create it, and it isn't mine, though I did choose to notice it. It was fascinating. These things tell me that I am the kind of person who chooses to notice things, as they are, and tries to let them be an experience without judging it, as best as I am able.

It's fascinating to choose to pay attention to your own thoughts. I knew I hated myself. I was aware that I didn't like myself, that I don't think well of myself, and that this would be surfacing in my thoughts. But I had no idea the extent to which I was doing it. I am going through my days surrounded by this great cloud of words. It's...fascinating! I was like, wow, I had no idea it was like this inside my head all the time!

I don't know what to do with all of this yet. But it's interesting. After 31 years, I keep being surprised by my own brain: how cool is that?!

I Can Has Internet!!!! (Or, rejoining the land of the living)

Well, I finally moved out of my parents’ house into my own place, which was a milestone for me not only because at the age of 31 I’ve never had the opportunity to live on my own and be truly independent, but because I’ve never moved in my life. Ever. Yes, that’s right, lived in the same room in the same house, always.

I meant to blog about this whole process, but in the upheaval and overwhelmingness of all that was going on, I totally forgot that the internet can’t be magically and instantly delivered to your dwelling. A shame, really.

It was a long, drawn-out process because I hired movers for the first day I could take off work – July 11^th – but really wanted to move in before. So I had all my Ikea furniture, including a bed that was a nightmare to put together (apparently), delivered the Saturday before, and my family helped me build it. Well, my family built it while I washed dishes and then lay helplessly on the floor, curled into a fetal position when faced with the enormity of what I’d done. I mean, I made my family build a crap-ton of Ikea furniture together: it was a nightmare.

I’m the kind of person who hates change. My life is carefully structured into tiny and large routines that govern my days, everything from what coffee cup I use any given morning of the week to how I do my makeup, what I eat, what time I get up in the morning, to how and when I pay my bills, the kinds of jobs I apply for, and the rhythm of my days. I like routine, and structure. Sure, I make allowances for when things inevitably don’t go as planned, but when I’m facing huge adjustments I’m an absolute nightmare to be around. I run the gamut from sobbing hysterically, to withdrawing and shutting down, to hiding under the kitchen table only to be bribed out with jars of peanut butter.

When I was about to start kindergarten, my stress drove my brother so batty he moved out of our shared room and into his own space in the basement.

Anyways, this whole moving-into-my-own-apartment thing was a really, really big change. I spent every night the first week crying. The first day was particularly distressing because, even though I had a bed, I didn’t have a table or chairs, so I ate dinner sitting on the hardwood floor balancing my plate on a stepping-stool. I admit, the thought ‘what in God’s name have I done?’ crossed my mind a few times.

I had a difficult moment in my first week, when the Douglas hospital called me to say I was eligible for maintenance treatment one week a month, every day, for six months, the thought being that I would benefit by seeing an increased duration to the effect of treatment and a possible delay of recurrence. Unfortunately, none of this was included in any of my return-to-work medical papers, so I had to turn it down because I can’t afford the two-week exclusion period that comes with a new claim.

To be honest, I’m lucky my health insurance is so good that I don’t have to choose between food and medication. Please remind me not to lose my job!

I struggled in the middle of the first week when I unpacked a bottle of Remeron that I’m not taking anymore (but, of course, I hoard medication I’ve stopped taking). When I cried at my desk at work Wednesday morning, I reflexively dumped them all on the desk and counted whether or not I had enough to kill myself with if I needed to.

I know that having my own space, my own independence, control over my own life, is a stepping-stone in the direction of changes in myself that I need desperately. But, for today, I’m still battling to live with my dragons.

Sometimes Your Brain Thinks Thoughts

The brain is a truly complex and amazing organ. It does some pretty unbelievable things that we never have to think about, like regulating the pace of our breathing, our heartbeat, some reflexes, vasomotor activity, plus the obvious stuff like generating our emotions and thoughts. The brain, in conjunction with the nervous systems, reaches out to tell our organs what to do, and to make our bodies move around. Our brain allows us to see, to hear, and to feel. Our brain is so sophisticated that it does what no other parallel processing computing device has ever been able to replicate: it allows us to have consciousness.

Kinda makes it sad that the machines are wasting our potential by using us as batteries, right?

I joke, of course. This isn't the Matrix. Whatever you do, don't take the red pill.

Sometimes, our brains think thoughts. If you think about it, we're thinking thoughts all the time, possibly as an outcome of linguistic capability (it might also be the other way around but, really, who cares). It seems obvious that we think thoughts when we're trying to solve a problem, or planning, or listening, or having a conversation, or learning. We think little thoughts all the time as we ask ourselves questions like, I wonder if I'm hungry? What should I have for dinner? We think little thoughts as we keep up a running commentary on things going on around us. Our brain thinks little thoughts to remind us of things, sometimes by interrupting something else that we're doing to tell us something completely different, like if we're doing the dishes and our brain tells us that we have to go to the drugstore tomorrow and buy more cottonballs.

We think thoughts so often that most of the time we don't even notice them; they're part of the background noise of being human. We take them for granted. In retrospect, part of what I find most terrifying about severe acute depression is the moments where the pain gives way to a nothingness where there are no thoughts. People tell me later that it's like I've frozen staring off into space. Subjectively it feels like time has stopped and then picked back up again, except that it turns out there was a gap with nothing in it. I'm lucky that this tends to last only moments at a time. But the idea that it might be possible for my brain to stop thinking thoughts, even temporarily, is chilling.

But I digress.

Sometimes I have thoughts that I don't feel like I'm in control of. Sometimes these thoughts follow moods, but sometimes they just float into my mind like a passing breeze with no obvious genesis.

I wish I was dead.

I should jump in front of that metro.

I want to stick a carving knife into my wrist and pull it up to my elbow.

Do the thoughts bother me? Yes. Partly because anything I don't control bothers me, and I hate not being in control of my own mind. Partly because the thoughts are scary and bad, and I'm afraid that if they start to hound me I'll end up being powerless against them. Partly because it divides my attention away from other things, like data entry, or looking at pictures of cats, or obsessively replaying my rapes in my mind.

I talked a little bit about the hurting-myself thoughts with my first psychologist, whom I will henceforth refer to as Dr. Radio, because he had the best voice I've ever heard in my life. I could listen to him for hours, even if he were just reading copyright information, because the sound of his voice was so relaxing. Anyways.

When I started to get more depressed in the Fall, one of the things that happened is these thoughts about suicide and self-harm reappeared. I was terrified: I hadn't had these thoughts for years. I wasn't suicidal at all since 2006. I hadn't harmed myself at all since 2009, and not seriously since 2006. When these thoughts came back, I felt scared. I also felt like I'd failed. I felt like I was failing God, Who had given me the miracle of healing me from these ideas. I felt like I was failing myself. I fought against the thoughts for months, by the winter for most of the day, constantly. Both the feelings and the thoughts were painful and overwhelming. I was scared I'd have the thoughts forever, and I was scared because I both did and didn't want to do what they were telling me. I knew that at one point I wouldn't be able to stand the thoughts any more and would give in just to get a moment's peace.

When I was released from the hospital in March, I'd had weeks to think about it, and I knew something would have to change in the way I was dealing with the thoughts, especially since my mood was still pretty low. In a way I was also better off than before I went in, thought-wise, because trying to kill myself did work in the sense that it released a lot of the pressure. It was like taking a cork off a bottle of champagne: Ahhhhhh. Suddenly not so crammed-in and tight-feeling, crushed, unable to breathe. I think that's what they call catharsis.

Over the years, I'd taken steps to try and mitigate the potential impact of the thoughts. I don't keep Tylenol in the house because acetaminophen is shockingly hepatotoxic (that shit will destroy your liver). I don't have a gun, and wouldn't have a gun, because shooting yourself in the head is very bad. I keep stainless-steel blades specifically for self-harm because I can sterilize them with alcohol and, at the very least, avoid cutting myself with anything stupid like a rusty nail or a broken bottle I found in the street. At times, I've had my prescription medication locked up so it was inaccessible and gotten it dispensed weekly.

Obviously, these are attempts to control my environment rather than attempts to regulate the thoughts. Leaving St. Mary's, I knew it wouldn't be good enough because it manifestly hadn't been good enough.

The main thing I decided I would do is that I wouldn't chase the thoughts. It's natural, when you have a thought, to have the corresponding emotions. When a thought is powerful, either in the force of its suggestion or the tenor of its emotional implication, it's easy to get trapped in a cycle of thoughts. One thought follows another in an endless train, pulling along emotions that fuel the thoughts running on and on, a conflagration running like wildfire through the kindling of your mind.

You chase the thoughts, following them, fueling them and, ultimately, allowing them to burn uncontrolled. If you ever do stumble across a wildfire - which I sincerely hope you don't - the way to put it out is really to have it run into barren ground where there's nothing to burn. Chasing a difficult thought around is like throwing barns at a fire while you run away, hoping that it will eat the barns instead of you, all the while making it bigger and angrier and more uncontrollable.

Stop. Take a breath. Acknowledge that you're having a thought. I am having a thought. Okay.

Then let it go. You don't have to hold onto it. You don't have to dwell on it, or try to puzzle out what it means, or let it fill you up. It's just a thing that's happening, and it passes.

Talking about the thoughts with Dr. Radio, we discussed the ways that I felt badly about myself for having the thoughts. I felt like I was a sick person, a weak person, like I wasn't ever going to get better. I felt abnormal. These thoughts, these are illness. But he pointed out that, in reality, people with psychopathology and people without psychopathology both have random thoughts like, I wonder what would happen if I stabbed that person, or, I wonder what would happen if I jumped in front of that train. The research supports the fact that everyone is having these stray thoughts. The difference is what people with mental illness say to themselves about themselves because of the thoughts.

I have a thought about killing myself, and I tell myself that I am sick, that I am a bad person, that I am not capable of getting better, and that I am afraid I won't be able to resist the thoughts. So what I have to learn is not to judge or label myself because of the thoughts. Essentially, this involves noticing that a single thought is actually triggering an entire thought-sequence about yourself that really has nothing to do with the original thought and everything to do with your self-conception. So when my thought-train starts up, I take notice, stop, take a step back, and remind myself that the thought doesn't mean any of the things I'm saying to myself about myself, because the thought is just a thought. It takes a lot of time, and a lot of work, to interrupt thought patterns, but I'm sticking it out.

Recently, after rTMS, I've been feeling a lot better and doing the thought-work is easier, but I'm still having the thoughts sometimes, out of nowhere. It doesn't bother me as much as it used to. I do feel disappointed sometimes that they're not completely and miraculously gone, but then I remind myself that it takes a long time to undo thought patterns. Thoughts, like flowing water, carve grooves in the mind so that future thoughts more easily follow the same path. It's not easy to change the course of a river, and it's not easy to change thoughts, either. You definitely end up with two competing thoughts at once where you're telling yourself, gently, that you're wrong. So, at least while you're relearning, what you're having is not so much different thoughts as more thoughts, as you pile new thoughts on top of the old ones to divert them. I had to decide to be patient with myself.

Talking about my thoughts with my new psychologist, she mentioned that I didn't seem very distressed by the fact that I was having them, so I told her what Dr. Radio had told me and how I was trying to learn not to judge myself. She suggested that I take it one step further and, instead of saying to myself, 'I am having thoughts,' to say, 'My brain is having a thought.' This makes sense on multiple levels: it creates more distance between you and the thought by decoupling it from a sense of personal agency; it creates a gap between the thought and the emotional reaction by framing the experience in the most objective way possible; and it interrupts the thought-pattern by adding a new thought about the thought, namely that you are not the same as your thoughts. This last idea is actually pretty radical - the suggestion that you and your thoughts are not identical, or that you, as a person with personal worth and value, are not made out of your thoughts.

So, if you're looking to change the way your thoughts are running around in your head, I hope you find my tips helpful:

Don't chase the thoughts.

Don't judge yourself for the thoughts.

Be patient with yourself as you learn a new way.

Remember that the thoughts are not you, and don't define you, and will never define you. The thoughts are something that is happening, and that you are living with, and that are giving you an opportunity to change. 

If all else fails, just turn yourself over and look for the little button that you can poke with a pen to force a system reset.

The Difficulty with a Difficult Recovery

Sometimes people get confused because I'm a chronic optimist despite living under the cloud of depression for so many years. Admittedly, this confusion is understandable since it only makes sense that an illness which robs you of a hopeful perspective of the future would make a person - well - less than hopeful about the future. Lack of rose-colored-glasses and all that. But I feel like looking on the brighter side has, for me, been the natural consequence of spending years searching and searching (and searching!) for the light even when it doesn't appear to be there.

If there's a problem, I think it'll be all right. My life is on fire? Oh, it's not that bad, I can make a new one. Oh, my academic career has been destroyed by my illness? That's okay, I'll find something else to do with my life. Oh, I lost my job? Well, that's not ideal, but I've been meaning to make a change anyway.

Having said that, if I smudge a freshly-painted manicure, nothing will ever be okay again because this is the end of the universe, so I think I'll just sit on the floor and sob hysterically for 20 minutes. I think what I'm mostly lacking isn't a sense of optimism so much as a little perspective.

Anyways, when I heard that having rTMS was a possibility, I was already thinking we are trying something new, and it will work. I was fully prepared for it to work spectacularly well. And it did: it gave me moments of clarity and feelings of well-being that were beyond even my expectations. I feel truly blessed that it worked so well for me. And when I had the opportunity to try adjusting my medication levels to try and alleviate some of my lingering exhaustion and bursts of inexplicable sadness, give me back a little pep-in-my-step, of course I jumped on it. It is a great plan, and this time we are going to go all the way and it will totally work, especially while I'm still in the consolidation period following rTMS.

Well, as it turns out, not so much. Of course, there's always a period of adjustment while medications are being changed, and that's only to be expected. But it might be that more of a good thing is sometimes just too much. I hate to admit defeat, in anything, but sometimes it just has to be done. I was wrong, universe: it is not a smooth line upward - though I do believe that upward will be the ultimate trajectory. Sometimes, it's just hard when the direction is more sideways than you were hoping for.

It's easy to tell people you're doing poorly - that you need their visits, their prayers, their support, and their offers of fresh fruit - when you are so sick that you're an inpatient in a psychiatric unit. It's another to tell people you're struggling when you're doing so much better. You, as well as everyone who has rallied around you, need the story with the happy ending. You need the recovery story. You need to tell it to yourself, and so you tell it to everyone around you. I am doing so much better. I am recovering. I am in recovery. Even, I am better. It's so, so easy to leave out the second half of those sentences: I am recovering, but I am still struggling. I am doing so much better, but the truth is that it's still really rough. I am in recovery, but the road is uneven and I am afraid of falling, and I have fallen.

The logical part of my mind reacts to setbacks as setbacks. I tell myself that this is part of the recovery process, that it will take time, that it will not always be smooth. The part of my brain that is still depressed tells me that this is just like before and I will never, ever be better. The truth is that when you live with an illness in which your brain tries to convince you that nothing will ever be okay, you're going to spend a lot of time arguing with yourself. It takes patience, and self-compassion, and determination to tell your brain that it is wrong. Your brain is saying two contradictory things at once, the one which you encourage and the one which you struggle against.

And it's hard. It's so, so difficult. And part of that difficulty lies in not knowing how to say that this is a story about recovery and also a story of learning to live with not being completely well all of the time, of learning that recovery is a process requiring you to learn and to grow and to stretch your fragile wings, and that you are not quite all the way out of the nest and ready to fly.

Short-Term Disability (Or, the Insurance Policy I Didn't Even Know I Had)

I went into the hospital at the beginning of January to get some stitches, because I knew that I literally couldn't do my job with a gaping hole in my forearm. Oh sure, there were some other reasons. For starters, I'd actually been making incisions in my arm in an attempt to locate my artery, because I was convinced it would look really beautiful when I sliced it open...luckily, my lack of stamina as well as my apparent lack of basic anatomical knowledge meant that I eventually gave up and decided to go to church instead, where a friend helped me get to the emergency room.

For another, I knew I needed some sort of help that I just wasn't getting. I was both relieved and devastated when I was finally admitted to the psychiatric ward at St. Mary's. I was relieved because I knew that I was incapable of doing my job, and this would save me from destroying my fledgling career. I was relieved because I'd been having an incredibly public breakdown all over social media and being unplugged from the internet would keep me from posting any more cartoons about how I wished I was dead, and generally humiliating myself any further (P.S. it's really hard to look people in the face after you've had a complete meltdown in public view for a few weeks). I was relieved because I didn't have to spend any more energy trying - and failing - to pretend that I am perfectly fine, goddamit!

But I was also kind of a little crushed inside, in the part of me that cares, the soft squishy vulnerable part of me that I have to shield at all time because weakness is a liability that just isn't acceptable. Weakness means rape, and pain, and all sorts of failure. I just can't stand it. Every time a doctor talks to me about allowing myself to be vulnerable I want to punch them in the face and throw myself off the nearest building.

But I digress.

It was crushing to call my boss every day during the first week and tell her that I was still in the hospital and wouldn't be coming into the office. It was humiliating to be so...I don't know...a terrible employee. I knew that I was protected from being fired because it's against the law to fire someone for being in the hospital, but I still felt pretty shitty. You've got to be thinking you've made the wrong hiring decision when your employee goes AWOL less than a year into the job; it wasn't fair to either my manager or my team for me to so completely drop the ball. I felt like someone had thrown me the ball, it was busy season and they needed everyone to be on their A-game, and I was like 'Oh, this ball? I think I'll just throw it back in your face.'

I hadn't been hospitalized at all since 2006, and my last significant stay was in 2002-2003. I felt like I'd wasted all this time and all these years only to find myself back in the same shit-hole. I was so disappointed in myself, in my failures, in all the things I should have done to get better but somehow didn't manage to get around to doing.

Me and the hospital. I was like 'Please, please, help me. Please save me from myself,' and also, 'I don't deserve to be here, and I don't have what it takes to get better, so you might at well give me the boot and make room for someone who will.'

Anyway, in one of my many conversations with my manager, she mentioned that we'd been using up the two weeks of sick days I had in my bank, and then we'd be contacting HR to get started on a short-term disabilities claim. I was like, 'short-term what in the what now?'

I'd been thinking that I was really fortunate not to get fired, and that I'd saved up money for years so that if I was ever too sick to work I wouldn't end up homeless and completely bankrupt. But, instead, it turned out I had an entire short-term disabilities insurance policy that would pay 75% of my salary. It had come with my job, and I didn't even know it. I work in the insurance industry, and I knew the insurance they were giving me as part of my compensation package was outstanding, but I didn't even know short-term disability was a thing.

I felt so, so lucky. But, when week three of my hospitalization rolled around and it was time to fill out the complex paperwork, I also felt deeply conflicted. I was basically saying, to my employer and to myself, that I was a failure. I was incapable of working. I was worthless, a financial liability. I couldn't even do my job. I have always tried so hard, worked so hard, kept going no matter the personal cost, and here I was giving up. I mean, why couldn't I just make myself go in to the office? I'd been doing it before, hadn't I? I felt so overwhelmed and incapable. I'm not sure I've managed to work out all the things I was feeling.

When I finally did go back to work on a progressive return, and started to struggle with working four days a week, I wondered if I would ever be able to work a full week again, if I would be able to manage it. I was doing the best I could, but I was failing. And then, I went back on full disability benefits to receive rTMS treatment at the Douglas. I realized, 'I am disabled.' It wasn't something I thought I'd ever have to say about myself. I am disabled.

I still struggle with what saying that means. I was disabled. The part of me that's trying to learn self-compassion tells me that it's okay, that it's not my fault I was sick, that this is something that just happens. I was lucky to get through it. I was lucky that rTMS treatment worked well and I could get back to my old activity level without distress. I was lucky. I know that having been disabled doesn't say anything about my character, or my strength, or my worth as a human being. But I still feel somehow less than I did before. I still wonder what value my life has when I can't be a functioning, productive member of society. Sure, everyone needs a little help sometimes, but not everybody ends up disabled because they just can't handle their workload.

I am so, so lucky to be employed at a place that gave me such great insurance, because not everyone has that benefit. I am so, so lucky that my team and managers believed in me, and welcomed me back so seamlessly. I am so, so lucky that HR and my short-term disabilities case-worker were so compassionate and willing to work out a solution that would get me back in the workforce without making me sick again. But I also feel broken. And I'm not really sure when I'll feel whole again.

Clipping My Face On: Getting Back to Work

Every day when I leave for work, I'm secretly afraid that I've forgotten my ID at home. Not so much because I wouldn't be able to get into the office - I'm sure someone would let me in eventually - but because all the women's bathrooms in the building are pass-key enabled to make us more secure. I just can't hold it that long.

But I digress. 

Now that I'm finished rTMS treatment, I've started back at work full-time, though admittedly without the ability to control all metal objects in my vicinity with magnetic superpowers like I was promised. 

I was thinking about it on the way to the train Monday morning, and I realized this would be my first five-day work week since I went into hospital in January. I was nervous, to be sure, but also excited. Not disabled any more!!!  I felt like shouting! Of course, that would entail that people in my office knew why I'd been out...presumably they've been thinking I was kidnapped by aliens? 

The week seemed especially long and insurmountable from the perspective of Monday because I knew I'd be working late on Friday, every week, to make up the time I miss on Tuesday to go to my psychologist appointments. I discussed taking the time unpaid, but my manager made it subtly clear that it was either the opportunity to give the time back every week or using up vacation time. Given that I've spent, like, twelve weeks on sick leave this year (holy crap!!), this seemed fair.

I was all set to make this a post about look how awesome I am, I'm completely better, I went back to work full-time and it was great! There are ways that this is true: I was tired, but it was a normal tired. I'm moving at a normal speed. I'm making good production statistics in my data handling jobs, and I didn't do too badly my first day back on the industrial scanning machine. I was all like I am a success story!! Haha psychiatrists who thought I was pinning too much hope on neuromodulation! I was still having mood fluctuations, but I was so, so much better.

This is true.

But there are ways that this is not true. 

Today was my second day using the scanner this week, and my day started out poorly. I had an insurmountable system error at the first machine I tried to work at, and I couldn't manage to fix it using the process notes. In the end, I had to change machines and ended up beginning to scan late. As I tried over and over to fix my machine, I felt like putting my head down on the desk and weeping, or walking out the door and never coming back. The machine I moved to is not built for someone as small as I am, so I couldn't reach anything. The stacker door slammed on my hand as I was retrieving a document that got lodged in the gears of the machine. Everything was slowing me down, and I knew I'd never make my production target for the day. I was near hysterical tears. I was all like, everything was going so well, and I'm messing it all up, with my moods and my failures. I was thinking, thank goodness I have those xacto knives in my bag, I can go slice up my arms during lunch, or maybe I'll wait until I get home where all my bandaids are, because I shouldn't get blood on people's documents. 

And I was thinking, why aren't I better?

I've always been...something of an extreme person when it comes to myself. I'm very forgiving and flexible with other people, compassionate even, but I just can't tolerate my own failures and weakness. Maybe because I just have so darn many of them. I need to be the fastest, the smartest, the best. And, for a lot of my life, I have been. I expect nothing less than perfection. And isn't my recovery just one more thing to be perfect about, all in one swift go? I want a gold star on my exam, goddamit!

But maybe I'm wrong. Maybe it's not all one thing or another, but a shading and blending of both. I am a lot better. The right treatment has broken depression's crushing grip and I feel like I can breathe again. I am better. But I'm still fragile. My emotions are out of kilter. Sometimes things are too bright, and I feel that edge that comes on when everything is going too fast, when I'm thinking too fast, and moving too fast, and I feel like any moment it's going to spin out of my grasp in a million different directions, and all I want is to stand still. 

I've been sick for at least twelve years. I've accumulated ways of thinking and behaviors that are fundamentally maladapted to living a healthy life. I'm not sure I know how to live a healthy life. There are things I need to learn, and things I need to unlearn, and it's going to be a lot of work, and take a lot of patience, and demand a self-compassion that I still need to discover. I am finally in a place where I am well enough to start doing that work, instead of just treading water or trying to dig myself out of crisis. 

Just because I almost burst out crying at my work station doesn't mean I am not better. It doesn't mean I should give up on moving toward wellness. In the end, no one else could fix the machine either, and my manager had me switch stations with somebody taller so I wouldn't hurt myself. My day got better, and so did my mood. I left the office exhausted and hopeful. 

I am frightened by how much I'm affected when things go wrong. By how fragile my mood is, by how weak and vulnerable I feel. And that's okay. It doesn't mean I'm hopelessly sick. It means I'm human.

And there is so much more that I can grow.

Why Yes, I Bought Myself a Card

One of the things I occasionally do which some people might find a bit on the odd side of the spectrum is that I buy myself cards. Sometimes. Sometimes it's because I like the picture or sentiment but don't have an occasion that matches the card. Sometimes, like yesterday, it's because I feel like the card is giving me something I need: it throws a challenge in my face about something I need to own up to, focus on, or just plain acknowledge. The card speaks directly to my soul, like some kind of voodoo psychic. It's watching me.

The card I picked up yesterday has this message in it:

I know it must be hard

having to stop

everything for awhile

and just focus on getting better.

But whenever you

find yourself

worrying about

the million and one things

you think you should

be doing instead

just remember...

This time is for you.

Your time to rest.

Your time to heal.

And nothing's more important than that.

Because you're important.

I've been pretty focused lately on trying to figure out some way to coordinate all my medical appointments with my upcoming return to work. To be honest, I feel like time is one of the things I don't have on my side. I was thinking I still had a week of 4 days left on my progressive return-to-work plan, but because of the way the director of my clinical trial filled out my medical certificate, my short-term-disability plan is requiring me to return to work full-time as soon as the treatment is completed. And, let's face it, it's not like a single day off would have made that big of a dent. It would have been more like a polite society lady nibbling a cucumber sandwich, and less like the way I tackle an ice-cream sundae. By which I mean a small, ladylike bite rather than an all-consuming bite of humongous gluttony. Beware my ice cream eating mouth of DOOM!!

It's just all so...overwhelming. I have at least two appointments with the psychiatrist at the Douglas once treatment is over so we can do an assessment; with the travel time, I know I won't be able to make up all the hours I miss work. I have to see my St. Mary's Psychiatrist at least once to adjust my medication levels, and probably a few more times for follow-up, which is time I won't be able to give back, either. This all strikes me as annoying, but ultimately manageable, as they are once-in-a-while things.

But I'm worried about the psychologist I've started seeing at St Mary's. That's probably going to be a once-a-week-thing, with me missing at least an hour and a half each time. For me, that means I'll be working an hour and a half overtime on another day, or spread out over a few days, to try and make up the hours I've missed. Every week. Until we've accomplished whatever our goals are supposed to be. I'm worried about it. I'm worried about always getting home late, and burning out a new and fragile remission. I'm worried because I know what disruptions to my schedule do to my mood, and my sleep, and my ability to do all of the other things that are part of my illness management. I don't know how I'm going to handle it all.

If I could work part-time, just until I get some solid ground under my feet, that would be ideal. Financially, I know I can do it. But, realistically, if I decided not to make up the missing time, that would mean a significant rate of absenteeism, and I'm not sure I could pull that off right now after already having taken so much sick leave. I wish I could have had treatment while I was an inpatient. I wish I could have left the hospital and returned to work having actually been better. When I think of all the time this illness has stolen from me this year, I find myself wondering what the point of it was, what it was all for. I worry that I will undo everything we've been working toward.

There was a woman in the hospital with me who was there by court order, and I remember her psychiatrist yelling at her that it was her time to get better, that it was her time to be well. I wonder what that would be like, really having that time, having someone in my corner who wasn't looking for a fix that would prop me up enough to keep going. I wonder if wellness would be worth that sacrifice, the cost and the effort involved. I don't know, I've never really done it, just taken the time to get better, work on all my shit. You'd think I would have done it when I took 8 months of sick leave from graduate school, but sadly my psychiatrist was not interested in exploring all the shit that was coming up and out of me, so I ended up stuck in the same place as before - except that I recovered less functionality. Win?

What I'm trying to say, I think, is that I bought the card for myself because in my fantasy puppies-and-rainbows world this is how things would be. But reality isn't like a skittles commercial, and ultimately I come away finding that what matters isn't so much me as it is my capacity to contribute, to be useful, to fill the roles that I am supposed to fill. I think I can do it: I've done it before. I'm just worried that I won't ever have the chance to really be well, which is - after all - what I was so desperately searching for in the first place.

RTMS (Or, What I Do Every Day)

When I first started rTMS last Monday, I didn't know what to expect. I didn't have the stamina to research anything about the procedure, and when I had been referred by my treating psychiatrist, all we discussed was that it was an alternative to ECT. I'm writing this post so that anyone else headed off for rTMS has an idea about what to expect. I also don't want to forget my experiences, and I know I experience memory difficulties when I enter periods of acute major depression. Plus, it's interesting!

It's worth noting that I am participating in rTMS as part of a clinical trial, which means data from my treatment will be collected and possibly used for research and publication purposes. I'm quite happy with this, as I believe in scientific advancement. I was relieved to know that this is not a randomized double-blind trial, which would have involved the use of 'sham' coils in some of the participants (in other words, a placebo coil that replicates the external conditions of rTMS but without the application of any actual current). Although I believe these kinds of trials are absolutely necessary for scientific advancement, at this point in my life - and at this point in my current depression - I would have been unwilling to try anything that would definitively have absolutely no effect at all.

Moving onward.

The first thing that happens is I go to the Douglas and look at this awesome sign in the waiting room:

Of everything I've been through, nothing quite brings home the fact that there's something wrong with my brain more than this sign. It's both comforting and daunting to think in terms of brains as the problem here. I can't reduce this illness to a moral failing, to not having tried hard enough, to some sort of problem in the way I make decisions and the effects of those decisions. Those are all factors in what it means, for me, to live with depression. But, somehow, I am not responsible. Because this is my brain, my body, going wrong. In a way I feel like I'm being betrayed by my own body, which brings up all sorts of old and new emotions. In a way I feel helpless, because my brain isn't something I can control in the way I could take responsibility for, say, consistent moral faults. In a way I feel relieved, because I can lay down the burden of feeling like my enduring depression is my own fault.

So, after looking at this sign for a while, the technician administering my treatment calls me into a room. I sit on a comfortable, mostly-reclined chair with a pillow on my lap that I can rest my hands on. RTMS utilizes a biphastic magnetic stimulator (coil) to indroduce an electrical field in a targeted area of the brain. The charge is greatest at the edges of the coil, and drops rapidly to null as you move further away from the coil. Hence, rTMS is much more targeted than ECT, and much less targeted than what would happen if you inserted an electrode (or 'brain pacemaker') into the subgenual cingulate (BA25) and turned it on.

During my first-ever session, and once a week for the duration of treatment, the coil was positioned over my left primary motor cortex, which you can sort-of visualize the location of  by putting a headband on your head directly in front of your ears; the motor cortex starts above the ear and follows the trajectory of the headband. The technician moves the coil around about 7.5 centimeters above the ear, finding the area that causes the right thumb to twitch. This feels very weird, and very cool. Your thumb really moves without any volition, it's awesome! The minimum intensity of current necessary to cause the thumb to twitch is called the motor threshold, and this measure is used as benchmark throughout the course of your treatment. The stimulation intensity during treatment begins at 100% of the motor threshold and is increased by 5% each treatment until you are receiving pulses at 120% of motor threshold. This allows a consistent measure to be used across the sample and provides a means of standardization. It is, however, somewhat problematic to assume that motor threshold is an accurate indication of activity in the prefrontal cortex, but this strikes me as a minor quibble. 

Anyway, once motor threshold has been established, the coil is moved to the area of the brain that will be stimulated during treatment. The technician draws on your head to find the correct area, in my case the right dorsolateral prefrontal cortex. This is because we're using the alternative protocol: most people receiving rTMS for major depression will have the coil placed on the left side of their head. The theory underlying rTMS is that people suffering from major depression have lower levels of neural activity in the left prefrontal cortex than in the right. Ordinarily, rTMS uses 'fast' stimulation at a rate of 10 pulses per second (10Hz) for 4 seconds, with 26 seconds of rest between bursts. In my case, I am receiving 'slow' rTMS, at a rate of 1 pulse (1 Hz) per second for about 20 minutes. I'm not sure if this protocol was chosen based on my symptom profile, if it's because I also have PTSD, or if it was randomized. I hope I have a chance to ask!

'Fast' rTMS is excitatory, causing the stimulated left prefrontal cortex to 'speed up' to the same rate as the right. 'Slow' rTMS is inhibitory, causing the right prefrontal cortex to 'slow down' to the same speed as the left. In both cases, the aim is to synchronize the right and left prefrontal cortex. The DL-PFC is involved in executive functions like decision making, conflict or choice resolution, working memory, syllogistic reasoning, planning, and cognitive flexibility.

Because of the noise involved, I wear earplugs to prevent damage to the auditory canal. Because I have tiny, child-sized ears, I'm not able to wear things like ear buds, so I find the sensation of having earplugs in to be unusual and somewhat disconcerting. I think, for a normal person, this wouldn't be an issue. When the coil is active, I can hear the machine making between three and five sounds: I was also surprised that earplugs don't result in complete sensory deprivation! Of these sounds, I'm absolutely sure the machine is actually producing two of them. The first is the loud, hard-sounding sound make when a pulse is produced, and the second is the constant loud soft-sounding hum of the machine being on. Two of the sounds may be actually produced by the machine, but they might also exist entirely inside my head, either as reverberations or as products of my imagination. One follows the loud rapping sound of the pulse as a slight-delayed, softer, rounder sound that feels slightly fuzzy; the other is a constant low-grade high-pitched hum and may be a secondary sound of the machine being on. I find both these sounds to have a different timbre or texture than the first two. The third sound is one I only heard once, and it was a sort-of grinding or mechanical sound that happened when the coil was discharging. 

As some of you know, I'm sensitive to certain kinds of sounds, partly because I have difficulty filtering and tuning them out. This is one reason I'm glad we're doing slow rTMS, because the rapid-pulse-then-silence pattern to fast rTMS is the kind of sound I find acutely anxiety-provoking. Yay for alternative protocol!

When the coil pulses, it feels like someone is tapping my head, and the area around my right eye twitches a bit. It's not uncomfortable, just a little strange. All in all, the experience of rTMS is not difficult, and kind of relaxing. I like to spend the time focusing on my breathing and on the roundness and quality of the sounds I'm hearing. And of course cuddling with Puffy, my magical unicorn, who comforts me when I'm feeling stressed out and anxious! I hope this gives you an idea of what I do with my day. :)

In terms of whether or not I've seen any difference yet, here's the breakdown. One person has said I seem to be smiling a bit more. One person has said my online comments are more sarcastic, which he thinks is a good sign! Personally, I've noticed that colours seem brighter and more saturated, and I spontaneously decided that I wanted to start taking pictures again (wanting something! It feels so good to want something!!). I tasted a subtle flavor the other day: banana! I have an easier time reading fiction, although I still have attentional gaps. I feel like I have more emotional lability, and my voice is less flat. These are all good signs. I do have a lot of exhaustion, which might be a side-effect of treatment. I still have a lot of difficulty writing, especially posts like this one that involve recalling, synthesizing, and integrating technical or scientific information. All in all, I think it's going well.