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.

Who We Are

Because of the nature of this blog - and in fact much of what I've written on the topic of mental illness over the years - I sometimes start to sound like a combination of broken-record and one-dimensionality. The truth is that I am so much more than this illness. I am not just depression. I am not just trauma survivor. I am not just chronic illness. These things have shaped the person I am today. These are things I have sometimes desperately concealed and sometimes spoken about in detail and at length. I think this is an important topic to open up about and, for me personally, a conversation that I need to have with myself and with others. But depression is not the sum of who I am, even when I am sunk so far in its depths that I can't move and can't breathe and can't feel anything else.

We are not just schizophrenics, or borderlines, or bipolars, or anoretics. We are not just antisocials, or anxious, or autistic, or alcoholics. We are people. People with hopes, and quirks, and struggles, and passions. We are people who love, who hate, and who are indifferent. We are teachers, and mechanics, and assembly line workers, and doctors. We are artists, and appreciators of art.

There are a number of art installations on the grounds of the Douglas, placed there for employees, patients, and visitors to enjoy. Here are some of my favorites. I hope you enjoy them as much as I have.

Choosing to Walk Under a Grey Sky

Well, my daily treatments of rTMS are almost done, and I've got a lot of competing emotions about that. This is good, because it means that I have more emotions than just crushing despair. Yay!

A few days a week, I walk from the metro station to the Douglas (or the reverse), both to avoid taking the bus and to try and get in some extra sunshine and exercise. Today, the sky was grey and it looked like it might rain. It's a pretty long walk to get from one place to the other, so I debated waiting for the next bus. In the end, I chose to walk and enjoy the refreshing breeze.

As I walked, I felt just right: it wasn't too hot, and the sun wasn't shining blindingly into my face. I came upon a grove of blooming crab apple trees, and stopped to smell the flowers. It was wonderful! I realized that I haven't smelled flowers in a long time, not even on my own pink tree. I began to notice the smell of fresh-mown grass, the sound of bees, the warm, dusty smell of the road. I felt like the world was opened up around me, as if I was suddenly seeing it for the first time, even though it's always been here.

I ate lunch outside on the Douglas grounds, and then wandered around smelling all their trees. I felt this lightness, this buoyancy within me, like air filling my upper chest and lingering there.

I realized that I was feeling...a lightness. A sense of calm. And something I think was happiness. I felt...happy. I haven't felt happy in so many years, this quiet almost-joy, unlayered with anything else.

When people ask me how my treatment is going, I point to the obvious cognitive and behavioral changes. I can concentrate and understand things better. My memory is improving. I am talking and moving at a normal speed. I am smiling more, laughing more easily. I am having an easier time following my meal plan. Colours appear brighter, my sense of taste has improved, my thought patterns have shifted. I even have less headaches!

It isn't perfect. I'm still tired a lot of time time, and I have less energy than optimal. I find being around people for long periods of time to be draining. I have trouble motivating myself to do things I know I have to do. And, of course, I have had to give up a significant portion of my time in order to pursue treatment and manage my illness. I still feel overcome by inexplicable waves of sadness and tears. But I don't expect to be happy all the time, or for everything to always go smoothly. That is unrealistic.

But all the weeks in hospital, and then in treatment, all the medication changes, all the anxiety over trying to change doctors and treatment strategies, all the time off work, and all the things I haven't been able to do...it was worth it, all of it, for this one walk on this one day, and the way it made me feel.

I will keep choosing to walk even when the skies threaten to open, because I'm starting to feel that the world is worth being in, and that life might be worth living.

My Pink Tree Is Pink

This will be my last year with my pink tree since I'm moving this summer, and I'm really going to miss it. Please enjoy these pictures!!

All Around Me: Travelling To and From the Douglas

One of the things that's true about living in a suburb on the North Shore of Montreal is that I'm really, really far away from pretty much everything I want to get to. This is especially true of my daily journey to the Douglas hospital, because it's in Verdun and itself pretty far away from everything else.

Luckily, the Douglas and its surrounding area are unbelievably beautiful.

The hospital faces some sort of body of water and the view is absolutely spectacular. This comes in handy if I've decided to walk either to or from the hospital. It's calming to look at the water while I wait for a bus, especially when the wait is a long one.

The Douglas grounds themselves are expansive and park-like. I can wander around, have a picnic, practice yoga in the shade. I love the smell and feel of the grass, the openness, the quiet, the chance to disconnect from a hectic, crowded, and noisy urban world.

I'm so grateful to have this space and this time, especially since treatment leaves me feeling incredibly drained and exhausted. I love looking at the beautiful trees and discovering the world around me. I feel like, in the middle of my days dedicated to my disease and its management, I have found a space just for being.

There is so much more to health than just the minimization or absence of illness. 

I get to the hospital much in advance of my daily treatments (because public transit is a fickle beast, sometimes), and it gives me an opportunity to be with the world around me. Over and over, I find myself thinking how lucky I am, which isn't something I've felt much of in the past years. It's amazing what impact being surrounded by natural beauty can have.

I'm not saying you should have all your future family picnics out on the grounds of the Douglas, but if you'd like to join me in sitting on the grass during my last week of treatment, you'd be more than welcome to share this time and space with me.