This is the one that is the hardest to write about. Because guilt and self-doubt are so much a part of my anxious self, and there are still times when I question myself about my experience, especially as I move on and do better. This is also the most important of my entries, because I absolutely believe that it is this same mindset that is one of the many reasons that people don't seek help. I'm not THAT bad, am I? I know that this is not right, but I'd be making a big deal out of it, surely?
Yet there are moments when the memories are evoked in a powerful way, almost breathtaking in their rawness and intensity, and they upset me to my core. Last week I watched a movie called Still Alice, with Julianne Moore, about a woman who is diagnosed with early onset Alzheimers. Light viewing, right? Although the subject of Alzheimers is disturbing in itself, it was the early part of the film that I related to in such a vivid way. As I watched Julianne Moore's character, in the very beginning, start to lose her words during a lecture, or forget where she was on campus, I was taken right back to those months where I could just not get a grip on my ability to control my mind.
The main character is a linguistics professor. Her currency is words. Much like me. I was not the sporty kid or particularly confident in my own body (those tall and gangly teenage years), I have always felt incredibly uncomfortable in the spaces where I am not in my element or in control. But creativity and words, these were MY territory, and still are. When I was standing in front of the class or on stage doing a speech, or when I pull together that kickass report conclusion, or I present to big room of people, I feel powerful and capable and respected. I am articulate.
Going back to February. After a few months of therapy I had felt as though my anxiety were basically under control, but SOMETHING was still not right:
1. My sleep patterns were a mess
My sleep had deteriorated to its worst point of nightmares and waking up to five times a night with a massive fright each time. Never underestimate how crazy prolonged lack of sleep can leave you feeling.
2. Loss of concentration and focus
I had completely lost the ability to concentrate for more than a few minutes at a time. I was taking forever to complete the smallest tasks, faked attentiveness in meetings, and started becoming obsessively structured in noting big and small tasks and ticking them off one at a time, in order to regain some semblance of control. If you know me you will understand how counter-intuitive this was - I absolutely hate routine. Grocery shopping became distressing as my senses would overload very quickly and I could not concentrate on what I needed to buy. There was a day when I almost burst into tears in the nuts section (the irony is not lost on me), because I felt completely overwhelmed by the sheer choice and kept forgetting what I was looking for anyway.
3. Loss of short term memory
My short term memory was so compromised, that I kept leaving behind my shopping, I would stand in the bathroom with my asthma pump each morning and night and have to ask Alistair if he had heard me use it, and worst of all, I had completely missed a presentation because I forgot that the time had changed to an hour earlier. Everyone was in a state of worry, convinced something terrible had happened to me. I began to panic regularly, thinking I had forgotten to do something or had left something behind and would frantically check the contents of my bag, repeatedly throughout a shopping trip. One day I left a folder of important documents on the counter at the bank teller and had to hare back through the mall to fetch it once I realised this, ten minutes later. Thank goodness it was still there.
4. Loss of words
But the worst was that I forgot my words all the time, and with increasing frequency. I, the words-girl, was no longer articulate. I would often scramble for the word and say it, only to find I had picked a completely wrong one, or I would stop mid sentence, hoping that the other person would understand my half thoughts. I would become annoyed and irritated with Alistair when he couldn't understand me, because I was just Too. Damn. Tired. to correct him, and then I would feel like a terrible wife for expecting so much of him, when he was being so patient and understanding with me, not quite the person he married.
5. Not present in my own life - a numbed-down state of self
And then there was the constant state of being a spectator in my own life. I had gone from the grey bubble of anxiety, where a grey film separated me from my surroundings, to leaving my body entirely, and watching myself, in a completely numb state, pretending to participate in my life. I would watch myself pretend to be happy, pretend to be sad, pretend to get irritated, pretend to get excited, all the while feeling absolutely nothing. Alistair and I spent a week in Cape Town visiting wine farms, having dinners with friends, taking walks along the promenade or in the Kirstenbosch Gardens, eating the most amazing food..and all I wanted to do was go back to the apartment and curl up with a book or go to sleep. The guilt! Five weeks of holiday in three months had done nothing to lift that heavy fatigue.
So I went off to my therapy session, having not gone for a few weeks, and related all these things to my therapist. She looked at me and said, "I'm sorry to tell you this, but you are depressed, perhaps due to burn out, perhaps not".
I burst into tears, because a small part of my mind had suspected this, but I did not want to be the depressed person. I had come to terms with being the anxious person; the patient to a Psychologist. Now I had a new label to wrap myself in. I had a new uncomfortable word to roll around on my tongue until it would no longer stick in my throat.
But she had also said 'burn out', so I went home, read up, took all the online tests and convinced myself that my adrenal gland must be shot, so my cortisol levels are down. I went off to a homeopath and she sent me away for blood tests, armed with a stack of natural antidepressants (GABA, 5-HTP to add to my Biral).
Blood tests came back. Cortisol levels were fine. Thyroid was potentially a problem. I read up on Hypo-Thyroidism. That was definitely it. I went off to my GP, and he sent away for more blood tests. Blood tests came back. Thyroid was fine. So was everything else he had tested for.
He phoned me and told me that it was time I accepted that I had depression and it originated in my head, not my thyroid, my adrenal gland, my vitamin D levels or anything else that can set off depression. I did not want to accept this, because how was this possible without something physical being wrong? So he asked me to answer a question without hesitation.
"Are you generally happy?" he asked.
I was about to say yes, then I stopped. "Well," I said, "no I am not happy. But I am also not sad. I am...nothing. I don't feel anything at all."
"And there is your answer," he said.
But how on earth could I be depressed, just like that? Surely I had no right to claim such a diagnosis? Would I not be diminishing the experience of those who were 'properly' depressed? And anyway, I have a good life. No, a flipping great life. What is someone like me doing owning and accepting depression? It did not matter to me that the GP, the Homeopath and the Psychologist had all concurred, I felt like I did not deserve to associate myself with an illness loaded with associations of suffering and dysfunction.
I went home, read up on depression and discovered that not all depression is the same.
You do NOT need to feel sad all the time.
You do NOT have to struggle to get out of bed in the morning.
You do NOT have to want to kill yourself.
You could be feeling numb, lacking vitality, lacking energy, out of your body, loss of concentration, loss of memory, loss of words, struggling to sleep, and you would most likely be depressed. If you left it untreated, however, you could very well end up in the darkest hole imaginable. Fortunately, though, I had inadvertently landed up in therapy in November, and as I started slipping down into that blackness, I had someone there to grab my hand. Someone who had suspected a low level depression underlying all that loud, shouty anxiety, right from the start, and who was already working on it with me.
As it turned out, a combination of therapy, a prolonged period on natural antidepressants, cutting out most sugar and refined foods, managing work stress, regulating sleep and deliberately removing myself from some ongoing family drama, meant that I pulled out of the dark space very suddenly (although it's taken a few months to settle), without needing the prescribed medication. That in itself brought on a lot of self doubt and questions around if I had a right to get depressed in the first place.
But if I take a step back, I was prepared to be very honest with myself, took action across a number of measures, was in therapy for eight months, and worked damn hard to pull myself back to the air. I also now know that I have the propensity for mental illness and I will have to watch myself for the signs, or the denial, very carefully.
All I can say is that I do have the right to be depressed, because it is something that happened to me, just like any physical illness. And I own it with a deep gratitude for what the experience has taught me about myself.