I AM the kind of person that got to the other side...and learned a few lessons along the way

And so we come to the end of this story.  It's been nine months since the start of everything and two months since I made the return to myself.  The lessons have been many.

I think it is important to acknowledge that, although I had a very sudden sensation of vitality and energy, signaling a definite end to the depression, there has been an adjustment period that has been surprising, encouraging and unpleasant in equal quantities.

Being devoid of emotiona for months, only to have them flooding back is comparable to the peace and muffled silence of being under water, to suddenly finding yourself in the golden circle of a Rammstein concert.  On the one hand, I had a real sense of transcending any level of emotion, empathy and understanding of myself that I experienced before, however, it also occurred to me that perhaps I had just forgotten what emotion felt like, and now I was enduring a bit of sensory overload.  Sometimes productively and sometimes less so, I was overly sensitive for a while, and had to take a step back for some perspective from time to time, to avoid overreaction (some days more successfully than others).  If I felt hurt or hard done by, it was deeply so.  If I were happy, I was overjoyed and intensely grateful.  I thanked the friendly car guards profusely (some of them were just so NICE to me) and despaired for the homeless person and was in awe of the hard working recycling collectors on their homemade trolley thingies (okay, I am still in awe of them, they are superhuman).  I spent a lot of money for a bit there, handing out excessive tips whenever I believed they were warranted.

More unpleasantly, after suppressing the manifestations of anxiety for some time I was prone to something called the feedback loop (or so I read), where you get sucked into a vortex of emotions, and one emotion loops back on itself, causing another emotion, which triggers another emotion, until your head completely runs away with itself, and you are a bit of a wreck at the end of it.  This only happened a couple of times, and once I was aware of what was happening I was able to disrupt the pattern pretty quickly.

I continued seeing my therapist through this time, which helped me greatly to remain aware of what was happening, to maintain perspective, and more importantly, to cut myself some slack.  Then one evening, the night before another session and a few weeks after I had begun to feel better, I realised that I no longer needed that kind of help.  Just like that!  Karolyn had told me, right at the start, that I would know when I was done.  A full seven months prior to that evening.  The next day, before I had a chance to tell her of my epiphany, she asked me: "Do you still feel that you need to see me regularly?".  Damn, she's good!  We had a wrap up session about three weeks ago and I am incredibly proud to say that I have made it back to myself.  A much better version of myself.

Reflecting on those eight months, it was such a tough time.  A confusing and upsetting time.  This will, however, be remembered as one of the best years of my life, for these reasons:

1. I have a level of self awareness and understanding that I never had before.  To change the way you see yourself, see your role within your family and friendships, to learn how to disrupt and challenge the way you are hardwired to think and feel and react - how utterly enlightening!
2. I have connected with others in such a meaningful way.  Thank you for the stories you have shared, thank you for the dialogue that you have started and thank you for relating to what I have spoken and written about.  This has helped me, too.  Tremendously.
3. I have rekindled my love for writing.  I have wanted to write for such a long time, but felt that it had to be meaningful and something that others could relate to.  I have loved the process of forcing myself to be as raw and honest as I have been, and finding ways to verbalise what is sometimes terribly complicated and not always immediately tangible.  This is not the end of writing for me, the proverbial bug has bitten, watch out for my book one day (insert smiley face).
4. Becoming more appreciative of your vitality is a great motivator.  I like to think that I am a creative person, yet work and life and technology and TV makes me very lazy.  My senses are heightened so I am seeing and hearing and tasting and smelling on a much more acute and appreciative level, which makes me want to create.
5. I wanted to share to create awareness and challenge some of the misunderstandings.  I wanted to play a small part in destigmatising this thing that every second person seems to be enduring on some level.  I did not realise the extent to which my experience could provide comfort and insight and reassurance.  If this is the reason I needed to go through what I have, then this has, in fact, been a gift to me.

Right, Oscar speech aside, it's time to wrap up this story, with ten lessons I have learned, that I feel are worth sharing:

1. Anxiety, in particular, and depression are not unique, but the stigma and shame is alive and well.  Often very much self-imposed.  We are everywhere.  If you dip your toe into the scary sea and start talking about it, others will talk back.  You will feel less alone.
2. People are so very kind.  There is support everywhere.  Make use of it.  If you don't let the people you trust know what you are going through, you can't expect their patience and understanding when you are not yourself (big love to Alistair for all his support).
3. This is all very confusing, because very little is defined in narrow terms.  There is a lot of misinformation out there about what makes an anxious person or a depressed person.  In addition, physical things like hormone imbalances and burnout and deficiencies can cause similar symptoms.  Just know this, if you are not feeling quite right, it is well worth exploring why.
4. Get help.  You are not weak, you are not overreacting. We all have stuff we could deal with anyway.  I was so embarrassed at first, but now I am pretty proud of myself for swallowing my pride.
5. Therapy is not a quick fix, and if you are not fully on board, you are wasting your time.  Don't expect to feel 'better' before you feel a lot worse.  But don't give up, give it a chance.  Not every therapist or type of therapy is right for everyone, so find the solution that you think will give you the best chance possible.  Give it time before you give up.  It took me eight months, and I was totally on board.
6. You can't force anyone else to acknowledge their issues or seek help.  Just be there for them.  If they want your help, they will let you know.
7. Everyone is responsible for themselves.  I am responsible for myself only, and the effect of my choices and behaviours on others.  The world is not going to fall apart if I don't try to fix everything and every situation.
8. Anxiety makes you question your responsibility in another person's negative mood and behaviours.  You won't be able to help it, but that's not your fault.   The golden rule is to always counter 'what if' with 'what if not'.  Or just ask and put your mind at rest!
9. Sleep holds everything together. Even now, a couple of months on, if I don't sleep well for a few nights consecutively, my memory, words and concentration desert me.  I suspect that this will continue to challenge me for the rest of my life, but if I am to be philosophical about it, my sleeping patterns are a barometer of my stress and anxiety levels, which will always provide me with an indication of how well I am doing.
10. There is nothing wrong with taking meds.  My preference is for something more natural, but I was quite prepared to take the 'scary' drugs if I had needed to. Therapy, diet, supplements and exercise are as important as natural or chemical medication. 

This may well be my final entry on this blogpage.  If it is, thank you so much for reading and sharing.  Tomorrow is an exciting day for me, as I have been invited to The South African Depression and Anxiety Group to participate on a TV talkshow called Mental Health Matters.  What a great opportunity to continue the conversation.  If there is anything in particular that you would like me to explore and write about on this blog, please drop me a mail on carolastewart1@gmail.com.

Health and peace to you all
Carol x

I'm not the kind of person that has a right to get depressed

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.

I'm not the kind of person that has an anxiety disorder

Okay, that probably wasn't the most surprising conclusion.

I just thought I was one of those people that simply worries more than other people.  I worried a lot, about a lot of things.  I'd worry that family birthdays wouldn't be remembered, and would text everyone to make sure no one forgot.  I'd worry who would be around for Christmas, to make sure that my parents would feel like enough of their children wanted to spend at least some of the day with them.  I'd worry if friends were careless with other friends, in case anyone's feelings were hurt.  I'd worry if people didn't queue properly, if waitstaff weren't thanked correctly, if I were going to ruin everyone's fun by being the slowest runner or cyclist in the bunch or the worst at tennis.  I even remember, as a child, absolutely hating the flower my mom appliqued on a Sunday School dress she had made for me (the centre of the flower was blue instead of yellow - it just was not right!) and every Saturday night I would work myself up into a state, in the event that my mom would suggest I wear the dress the next morning, but not wanting to hurt her feelings either.

This went hand in hand with a pessimistic, fatalistic way of thinking.  I would imagine a disastrous outcome to anything - for example, I'd imagine dropping a sharp knife and stepping on it every time I unpacked the dishwasher, or that a car would pull out and knock me over if ran past it, or that someone would jump the traffic light and drive into us if I, the passenger, did not pay close attention to how everyone else was driving.

My head was also filled with negative dialogue.  I was stupid, I was ugly, I was slow, I was useless, I was not liked, I walked funny, I talked funny, I stood funny, I was a fraud, I was going to be found out, I was not like everyone else, why was I not like everyone else, what was wrong with me?

So this chronic worrier decided to take up mountain biking.  I should point out that I am also painfully clumsy and very easily distracted.  Call me brave, call me daft, but the inevitable happened and I hurt myself in quite a bad accident (or as a friend described it, I stuffed myself up proper) and after six months I had not recovered mentally.   As my therapist explained, after six months PTSD sets in and it starts becoming impossible to unravel rational from irrational thought.

As a result, over the next few years I developed a fear of losing control that affected so many aspects of my life.  I would lie in the bath or in bed and have these flashbacks of the feeling of losing control of my bicycle.  I was terrified of hurting myself by falling down the stairs or a balustrade coming loose and falling to my death or going too fast in the car and ending up in a terrible accident.  It was utterly exhausting!  You'd think it is possible to talk yourself out of the panic, but I could not, because there was always that slight possibility that the worst outcome could conceivably occur, so I became absolutely obsessed with these thoughts of disaster, but tried to hide my distress by squeezing my hands together and digging in deep with my fingers in a drumming motion, grinding my teeth and breathing quickly and shallowly as inconspicuously as possible.

I knew I had a PTSD issue by the time I started seeing my therapist, but had not realised that the behaviours and thought patterns so deeply entrenched from as far back as I can remember were not normal.  Oh and I tried my utmost, in the first session, to explain myself.  After all, this is my role in my family.  If I am not there to make sure my dad has eaten dinner the day my mom has back surgery, who will?  What if he became ill from not eating properly?  Who would look after two sick parents?  And of course I had to organise Christmas Eve dinner or my parents' anniversary dinner.  Who would if I didn't?  And what if my brother in England hadn't received an Amazon delivered gift on his birthday?  What if no one else gave him a present?

About a week after that session the realisation dawned on me - I did not have anxiety because of PTSD.  The PTSD was an inevitable outcome of my propensity for anxiety.  This was devastating to me because, for the first time in this journey, I was faced with the truth this was so much more complex than I had anticipated, and I was not going to be 'fixed' quickly in two or three sessions.

What amazed me over the course of the next two months of therapy was that, if you catch the triggering thought, as it originates, you can challenge that thought and stop your brain from running away with itself.  You can learn this new way of thinking pretty quickly too and make it habit in no time at all (my throat-constricting panic attacks disappeared immediately and I've not had one since!).  Also, dumping your worries in a journal at night clears your mind and assists sleep.  Countering 'what if' with 'what if not', even if you don't believe it, slowly unravels logical from illogical thought.  And finally, learning that, even if you believe it to be, holding everything and everyone together (whether they need you to or not!) is not your responsibility, is so utterly freeing.  Because really, what IS the worst that can happen?  And if you don't, someone else will probably step up.  Or not.  But that would not be your problem either.

Freeing myself from the loud, glaring, obvious shoutiness of anxiety has been lifechanging.  I know what to do about it now.  I am not just a worrywart and I don't have to make excuses.  I have an anxiety disorder.  I have so much more peace.  No one has minded and nothing has fallen apart.  Who'd have thought it?

I'm not the kind of person that goes to a Psychologist. Repeatedly.

I didn't really mean to in the first place.

In October last year I was sucked into the End Of Year Rush.  I'd taken on far too much work.  I'd done it before.  Repeatedly.  Sandra, my business partner (and one of my best friends), warned me that I was stretching myself dangerously far and was going to snap, but I guess you don't have any concept of your limits until you are faced with them.

Unsurprisingly, I got sick. The doctor, a new GP I was seeing, confirmed I had a sinus infection and asked if there was anything else bothering me.  Feeling a little like I may be overreacting, I mentioned that, recently, I kept feeling like there was a wind stuck in my chest when I went to sleep.  This was causing me to wake up feeling panicky, just after I fell asleep, often triggering a nightmare (more like a night terror) that I would to die if I breathed in or swallowed.

The doc reacted with a lot more interest than I had expected him to.

Him: How long has this been going on for?
Me: About three or four months now.  But (trying to downplay it all) I have always had nightmares.  My whole life.  Spider nightmares mainly.  You see?  Nothing to worry about.  My mom used to have spider nightmares too, it's probably just a genetic predisposition, right?
Him: Let's just worry about you for now.  Do you wake up just once, or more than once in the night?
Me: More than once.  Maybe four to five times on a bad night.  But I have episodes.  It goes away.
Him: And how long do these episodes last?
Me: Probably two to three months at a time.
Him: How many of these episodes do you have in a year?
Me (realisation setting in): Probably two to three
Him: And for how many years has this been going on?
Me (starting to feel somewhat embarrassed): Um, probably for the last six to seven years?  Maybe longer?

What I did not tell the doc is that going to sleep had become an ordeal.  Something I had come to fear.  Several times a night I woke up, fighting breathing in, convinced I would die if I did, and on occasion would resign myself to having already died, panicking about what Alistair was going to do when he woke to find me lying dead in the bed next to him.  Absolutely terrifying - pounding heart, shaking like a leaf, sweating - night after night.  I suppose I did not want to sound melodramatic.

The doctor smiled.  So are you telling me, that for the past six to seven years, you've spent up to nine months of each year not being able to sleep through?  Often causing you significant distress?

Imagine how completely stupid I felt, having always believed myself to possess a healthy level of self-awareness.  Apparently not.

The doctor suggested that the level of reflux setting off these nightmares was as a result of something that was subconsciously bothering me.  I figured that it was mostly likely just a case of PTSD from two unpleasant cycling accidents, seeing that I still had flashbacks and had not been able to climb on my bike in over a year.

That was the first time I was wrong.  The first of many times.

The Psychologist at the practice was recommended.

Psychologist.

The word was foreign in my mouth and sat awkwardly on my tongue.  I am a verbal person and what I have noticed is that, when I struggle to identify with a concept, I struggle with the vocabulary.  Like when my dad had Cancer.  And, as I would later experience, the words Anxiety;  Disorder;  Depression; Anti-depressants.  Instead, I preferred the word Therapist.  Much less nut-job, far more easy to admit to.

I walked into the reception that Friday for my appointment.   I mumbled, I am here for Karolyn, the Psychologist.  I very nearly said, "Oh, but it's just because I can't sleep, nothing serious!".  I looked around the waiting room to see who had noticed me, the Psychologist's patient, and no one was particularly interested.  Then the shame hit me - I am a progressive woman, damnit!!  How dare I be embarrassed?  Except that I was.  Because I was now the kind of person that had a Psychologist.

The next day I went to dinner with three people, very close to me.  I decided to try out the word again and told them I had been to a Psychologist.  It turns out, all three of them had too, and still do when they need a bit of perspective.  They thought it was great.  Turns out I'm not so unique after all!

Karolyn has been a godsend.  Different therapists have different approaches and hers works for me.  We have a lot of conversation.  She gives me her opinion. She is a logical, rational sounding board and I could see the results of her influence as early as the second session.  I had experienced an approach that did not work for me in the past (during trauma counselling after an armed robbery) and if I could offer any advice I would say this: if you need the help, find the approach that works for you.  It could be a particular Psychologist's style.  It could be an alternative therapy even - Body Talk, life coaching, acupuncture even - I have friends who have all had their own successes with their chosen form of therapy.

I think we all suspect when something isn't quite right.  Finding the courage to scratch the surface?  That runny-nosed visit to the doctor could not have been more perfectly timed.

I'm not the kind of person that needs that kind of help

The two biggest lies I've always told myself:

1. I always handle it, no matter how much I take on ('cos I am Superwoman like that, right?)
2. It must be tough to be one of those people who needs medication to cope.  I'm so glad I'm not like that

Until the day I sat in my doctor's office, a few weeks back, and in response to his question of why I was so against taking something 'non natural' to help me return to myself, I actually told him, "This may sound really ridiculous, but I am just not that person.  The type that takes medication to cope".

As I said it, I realised that I did, indeed, sound ridiculous.  He apparently thought so too, from the amused (and slightly pitying) expression on his face.  What does that even mean, 'I am not that person...'?  What sort of judgement am I placing on the character and resilience of 'those' people?  At that moment in time, I had no right to draw comparisons and hold myself, inadvertently, to a higher level.  Because the truth is, I am exactly the type of person that is conditioned to push themselves so hard, take on so much (invited or self-inflicted) and worry so incessantly about everything and anything, that one day they break their brain.

And that's exactly what happened to me.

So after seven months of visits to the psychologist, blood tests, GP appointments, homeopathic treatments, I have decided to write about my experience.  I am fortunate to be on the way out of the black hole.  If not, I would not be writing today, on account of having lost the ability to string a simple thought together for a while there.  What this experience has made very apparent to me is that mental health problems are confusing, difficult to recognise in oneself, and often not very apparent to anyone around you either.  They can be caused by something physical or they could just be 'all in the head'.  I don't know which is worse to accept.  They are seldom 'textbook' and can vary in range and severity.  Whatever the manifestation, they are utterly valid to the person experiencing them, whether we perpetuate the stigma of embarrassment or denial or judgement ourselves, or if anyone around us does, by diminishing our experience in any way.

For sure, the self-imposed judgement is the worst of it.  Thinking back to seven months ago, I was not the type of person that went to a psychologist or had an anxiety disorder or got depressed.  Until I was.

Perhaps some of what I have experienced will ring true.  And if my experience can make this all feel a little less scary, confusing or embarrassing to anyone else, that will be great.  If it doesn't, well it's a bit of therapy for me.  For free.  My medical aid will be very grateful.

Now let's go back to the beginning of it all...