My Sick, Sad World

I am not very good at writing and that frustrates me. I have a lot of ideas that I think are cool or important or otherwise worth sharing with other people but when I try to transcribe them from my mind into words and sentences so that those ideas can end up in other people's minds I'm never satisfied with the result. Writing is an endeavor in vulnerability. Even on the least personal or most benign subject matter, writing is an act of creation and letting others read your writing entails opening a part of yourself to being judged, rejected, or hurt. I'm not good at being vulnerable. That risk is daunting and I have a few persistent internalized voices that try to steer me towards easier, more comfortable pursuits. But vulnerability is important to writing and I want to be a good writer.

In addition to my fear about being hurt, there's another, more significant hurdle to my being vulnerable: I'm not sure who I am so I don't really know how to open myself up. Identity is a common topic of discussion in society today and it's not rare for people, particularly those my age, to be questioning what their identity is. Beyond that though, I'm not even sure I have an identity. When I hear others talk about identity it's always in terms of groups or categories: race, gender, orientation, religion. But that never feels right to me when describing my own identity. Those aspects, for me, are not the core of my identity but merely descriptors. I'm not a white person. I have pale skin. I'm not a man. I'm male. I'm not a straight person. I am attracted to women. I'm not a Mormon. I believe in Mormonism.

It's possible I'm missing the mark with the entire concept of identity. But, there could perhaps be something deeper at work. The one aspect of my identity that colors every other part, the piece of me whose tendrils reach into every thought and moment of my day, is my mental illness. I have depression and every experience, every relationship, every feeling is filtered through that lens. My brain is wired incorrectly and I think that is what stops me from feeling connection to any sense of identity. In a way, illness is my identity. This is, perhaps somewhat obviously, not the identity I want to have. But I've spent nearly a quarter of a century dealing with it so it's a part of me.

I don't have the answers on how to deal with mental illness. I can barely handle my own and everyone has unique brain chemistries so I'm in no way qualified to be giving advice on anyone else's illnesses. What I am going to do here, though, is write about my own. I hope you'll read it, keeping in mind that I'm not good at writing but I'm trying. I'm trying to get better at it. I'm trying to be vulnerable. And I'm trying to make connections—with a sense of identity within myself, and with you.

I was diagnosed with depression about five years ago. The specific diagnosis I received is actually double depression, a combination of two disorders: dysthymia and major depression. (In my case these are accompanied by a host of other mental problems including anxiety, insomnia, eating disorders, and obsessive-compulsive tendencies. We'll get into more specifics, but in layman's terms I worry a lot, can't sleep, sometimes eat too much and then make myself throw up to feel better, and have specific things I feel compelled to do to prevent or deal with unwanted thoughts.) Dysthymia is like a constant low mood and major depression involves long episodes of even lower mood on top of that. In short, my baseline emotional level is pretty depressed and sometimes I get even more depressed.

I think a lot of people assume that with my depression, there's something that "triggers" it. I imagine they think I'll be completely normal and then I read a story about an orphanage burning down and none of the orphans' puppies surviving and I'll fall into an emotional hole until I climb back out. That's not really how it works with me. I'm not depressed about something. I don't get depressed. I am depressed. I've been in that hole for as long as I can remember. I'm not sure I know what it'd be like to be out of that hole, which is part of the reason I have such a hard time describing what it's like to be in it. But I'm going to try.

For me, depression doesn't equate to sadness. I get sad a lot, sure, but it's more than that. There's an emptiness, a hollowness to it. It's a feeling throughout my whole body that something is wrong. It's not that there's something wrong with me or that there's something wrong with my situation; there's something wrong with my existence. My soul feels like it doesn't fit into my body properly and it's unsettling. More than that, this feeling is crippling. Depression is often described as a lack of something—a lack of energy, a lack of motivation, a lack of interest, a lack of self-esteem. For me, it's all of those. There's a lack of feeling to it, as well. My normal emotions are dulled and it's hard for me to recognize and understand my own feelings. Am I feeling happy? Am I feeling annoyed? Am I feeling at all? Most days my entirety of being is stuck on the couch, neutered by my illness.

That's a hard truth for me to admit so I'm going to write it again: I spend the vast majority of my time on my couch doing nothing aside from thinking about how I want to be doing something and distracting myself from beating myself up for not doing anything. This worries me. I find myself questioning if depression is simply my excuse for laziness. I don't believe that they're the same things but unfortunately in my mind I often conflate laziness with depression which can then lead to guilt and deeper depression in turn. Despite my anxiety over this distinction I believe, at my core, that I am not a lazy person. I like working. Some of my happiest moments are when I'm completely lost in my work and the flow kicks in and I lose track of time and everything outside of tackling whatever issue I'm dealing with at that instant. I can't be depressed when I'm in that flow and so, like a parasite fighting to survive in a host, my depression tries to stop me from finding it.

When I'm on the couch I hate that I'm not doing something else. There's an inertia that keeps me there. The weight of my body feels like too much to lift up and move somewhere else. Even when I do get started on something, my depression has trained my internalized voices to tell me it's not worth it, I can't do it, it's too much. All to keep me from breaking its shackles. So I try a different route. Distraction. I turn on the TV. I don't have the energy to focus on a show I actually care about so I fall behind in my DVR recordings and tune to whatever syndicated reruns are airing. "Great," I think. "I'm so depressed I'm watching The Big Bang Theory." I can't motivate myself to start watching a show I've previously binged several episodes of on Netflix because I know I won't be able to pay attention. So I try video games. But even Mario Kart is subject to the law of diminishing returns and some days I'm too depressed for Nintendo. (Surely I'm not simply lazy if I can't even bring myself to play video games, right?)

I have other escapes. Junk food has been a big one. Something about eating garbage that I didn't have to work for takes me out of myself long enough where I don't feel bogged down by the weight of not feeling. But the crash is hard. I had a few months where I was addicted to Pizza Hut and I would order it, already feeling sick to my stomach before I took a bite. It's an expensive habit, too, and I've fortunately been able to cut back a lot. I used to go to Chick-fil-A and order fries, a milkshake, and two sandwiches to eat at home but I'd throw in some nuggets to snack on the drive back. That's like, upwards of $16, and sometimes that wouldn't even be the only time I ate out that day. I'm not good at listening to my body's hunger signals and I usually ended up eating when I was bored or lonely or anxious. And aside from eating mostly junk, I ate way too much of it. Then I would sit and stew, hating myself for spending money on something that was causing me to feel sick. At some point I realized that throwing up made me feel better. And I also knew I could make myself throw up. I didn't consider binging and purging to be an issue in my life because it was infrequent and I actually felt better after it. Fortunately I talked with a friend and my therapist about it and was able to stop that habit before it got more control over my life. I still have a rocky relationship with food. Now I'm on a medication that has appetite loss as a side-effect and I have to drag myself to eat throughout the day or else I'll get sick when it wears off at the end of the day.

I don't sleep well at all. I spend hours laying in bed, but nothing happens. Sometimes my thoughts race and anxiety keeps me up but most days it feels like I just don't know how to fall asleep. My mind is calm and I feel tired, but not sleepy. And sleep doesn't come. I started taking Unisom and it helps. If I take it around 8 PM I can usually fall asleep by midnight instead of 3 or 4 AM, when I would normally fall asleep without it. Recently I've noticed myself drifting to sleep quicker than in the past but I'm very aware of it. Recognizing that I'm drifting to sleep immediately resets the progress I made falling asleep. I now sometimes get to the point where I feel my mind doing what I think is it slipping from consciousness to unconsciousness but right at that instant, instead of surrendering to sleep, my body panics. I think it's an involuntary response to what my body interprets as dying, but right as I'm on that border to the dream world, adrenaline surges and I'm fully awake.

Most nights I do eventually fall asleep. I know this because I wake up, usually to my alarm. I'm still tired. My depression prods me to hit snooze or if there's no alarm, just not get out of bed. This cycle repeats itself usually until midday or early afternoon but sometimes earlier. If I'm lucky I have the willpower to drag myself out of bed while it's still morning and take my medication that's prescribed to help me stay awake. It usually does its job. After I get up, my body feels gross. I feel like my skin is sticky and dirty, even if it's not. This lasts until I shower. I imagine this seems normal for most people that shower every day, but it's a persistent, nagging feeling that pushes itself to the forefront, driving me to shower. It's an obsession that compels me to do something.

It's not the only obsession. When I touch certain things—garbage bags (even brand-new, empty ones), animals, people I don't know well, and plenty of other things—my hands will feel different afterward, like they're someone else's hands that have been switched with mind. This feeling dominates my mind until I wash my hands. I don't necessarily feel gross while touching whatever sets off this feeling. For example, I had a pet guinea pig I would hold and play with. I loved her and let her climb on my shoulder and sit on my head. But even if I just patted her head in passing, I felt the urge to wash my hands afterward. It's also limited to my hands (and occasionally my forearms). I have frequently let friendly dogs lick my face and haven't had any lingering urges to clean my face following the encounter. There are other, weirder obsessions, like sitting on my hands and biting my lips so I don't blurt out something inappropriate, but I haven't spent as much time thinking about them so they're harder to describe.

A lot of people equate depression with crying but I actually don't cry that much. The last time I remember really crying hard was in high school when my guinea pig passed. I came home from school that day and my mom pulled me into her room and told me. I took the news calmly, but when I went upstairs to where her cage had been I fell to my knees and broke down and wept for I'd guess around an hour. Sometime soon after that the movie G-Force was released and I couldn't bring myself to watch the trailers when they played on TV. I don't cry like that anymore and that's frustrating. A lot of times the depression makes me sad to the point where I want to cry. There's a pain that's present and I feel like crying would be cathartic and let me release it. Sometimes I try to make myself cry because I wish I could in that moment. At most I get a little misty or my face scrunches up and my breath becomes slightly erratic, but I never cross that threshold into full-on crying. The tension stays in my face and chest, waiting to be set free into tears and sobbing but my body never reaches that point so I have to sit with the feeling until it passes.

Anxiety is an interesting demon. Some days depression stands alone, on others it takes anxiety as its companion. For a large part of my life I held my anxiety as a captive workhorse. I in some sense thought I had control over my anxiety because it served a purpose. The internalized voices nagging me about failure and my self-worth would do their job and get me to do things. (My depression during this time was predominantly existential in nature but could rear an ugly head when it came to socializing and human interaction.) This arrangement with my anxiety worked because I wasn't looking at it too closely. Then one day, on my mission, I went to the doctor because I had been throwing up and couldn't identify the cause. (I was being well fed in Idaho but I wasn't binging and this wasn't connected to purging.) The doctor told me I had anxiety but I didn't want to believe him. He said something along the lines of, "Look, before you even told me what symptoms brought you in, I came in this room and saw you biting your nails and nervously shaking your legs. You have anxiety and the stress is causing you to throw up." He was right, and like a quantum system, observing my own anxiety caused a change in my relationship with it. From then on I wasn't bound to do things to deal with my internalized perfectionism but the freedom came with a cost. I began to lose the ability to get things done using that same perfectionism as the instigator. This led to a sharp drop in my self-esteem because those voices seemed to have some credence in my observations of reality.

About two years ago I started having panic attacks. It's possible I had had one or two before then, but the attacks becoming a regular part of my life seemed to be caused by a combination of the natural progression of my relationship with anxiety following my realization years prior on my mission and a new medication my physician was having me try. When I stopped the medication the frequency declined but they still happen on occasion. Since panic attacks are a relatively new part of my mental health, they still seem a bit foreign when I talk about them and I have a hard time describing them. They're scary. It's almost like being scared by being scared. For me, they start with one of those thoughts about failure, but that thought gets out of control. The train it's on starts going down very dark corners, faster and faster, until my thoughts are zipping by more quickly than I can process them. At that moment I lose connection to my body. I have to consciously control my breath but the rate of inhalation and exhalation feels wrong. My feet no longer feel connected to the ground. I clench my fists and slow my breathing and after a few minutes it passes. Most of the time. A few times I've had to call the on-call campus counselors and am able to talk myself down with their help.

The most common facet of my mental illness, though, I think would be loneliness. When my family and I moved while I was in grade school, I lost the connections I had with my friends and struggled to make new ones. I started to develop a defense mechanism to prevent myself from getting hurt. I'd tell myself, "I don't like people" or "We're not compatible as friends." There are a handful of people I let in—one at school, a couple at church, a few more later in middle and high school—but even those relationships my illness would taint with doubt and paranoia. "Do they really like me or are they just pretending? Do they like that other person more and are letting me join the group out of pity?" I would concern myself with whether or not I was annoying these people that I wanted to be friends with and often found myself excluded, many times because I withdrew myself so I wouldn't bother them. The people I consider my closest friends from before college are still extremely dear to me but I've only recently begun to let myself be myself around them and stopped trying to appease what I assumed their expectations for me were.

I did make friends in college that I felt I was being myself around. It's a group that I love but I was often the butt of the joke. I still enjoyed it, and embraced my position in that group. More often than not, I was the one making fun of myself. Spending time with these friends was exhilarating. It was unlike anything I could remember. I had fun and I wasn't as worried about what everyone thought of me. (To be fair, it took a while until I got to that point with these people.) Hanging out with them was like a drug. But after the trip, there was a crash. I found myself clinging to those interactions, milking every moment, because when they were over I would be even lonelier than when they started. My loneliness was a hunger that would not be satiated. I tried both ends of response to this hunger, on one, withdrawing further to minimize the amount of time I'd be crashing and on the other, stalking social interactions with the ferocity of a predator. Neither seemed particularly effective. I'm glad I have those friends but I often doubt that I'll be able to make new ones like that. The armor I developed in grade school is now much thicker. I'm extremely quick to reject people under the guise of not liking them or claiming we wouldn't get along but I imagine the real reason is my reluctance to open up. It's uncomfortable to open up to people face-to-face. That's one of the reasons I prefer opening up in a written format. I guess friend-making is an even more vulnerable endeavor than writing.

This next topic I'm more hesitant to write about. It's very sensitive and although it is a part of my life, I'm not sure I'm equipped with the language or experience to talk about it in a way that does it justice. The topic is suicide. Before I go further, I want to make clear that I have never made an attempt nor a specific plan. I have been fortunate enough to have had or to have reached out for help before I was in too dark of a place. To be honest, though, a big part of what kept me from going down that route early in my life was fear. Not the fear of dying, but the fear of being judged in the afterlife for it. As a kid I believed that suicide was a guaranteed sentencing to eternal damnation and before I started making plans I would get scared and run away from the thoughts. But in some shape or fashion, I've dealt with suicidal thoughts most of my life. The thoughts usually come in one of two flavors: ideation or intrusive. The ideation is probably the scarier one for me at this point in my life. Those thoughts last longer and I spend a lot of time wondering what it'd be like if I just didn't exist any more. What would people think? Would anyone care? Would the pain stop? How soon would the pain end? I didn't give much thought to them as a kid. I thought these were normal things to fantasize about. The intrusive thoughts scared me a lot more as a kid. They are quicker and more intense but also more fleeting. When the pain builds up a lot sometimes I have a sudden impulse where I see myself with a gun to my head. And then it's gone. In high school a lot of times it'd manifest as the sudden urge to drive out into traffic. I'd press harder on the brake, and the urge would pass. I was a lot more worried about this as a kid because I was afraid I would lose control. Both kinds of thoughts still scare me today. On the whole, I'd say don't want to kill myself, but sometimes I frequently visit the Amazon listing of an item I feel I don't want to buy and almost without fail that item will show up at my doorstep if I keep going back to that listing enough.

I'm not sure I can go into much more depth on that topic. It's easier for me to talk about on a surface-level but I don't have the vocabulary to go much deeper. Beyond that, I'm afraid to dive into it anymore. Maybe I shouldn't let that fear control my decisions but for now I'm going to let it win on this specific issue. If you are struggling with suicidal thoughts, reach out to a friend. I hope that you have someone close that you can talk to about your feelings. I'm still not sure I have that kind of relationship with anyone, which might be why I'm still hesitating to open up more on this topic here. If you don't feel comfortable talking to anyone in person, call the hotline. You can also chat with someone through the suicide prevention website. Expect to wait, though. When I've called the hotline the wait time has been on average about 45 minutes. But if you're thinking about making that decision, please do whatever it takes to talk to someone first. I'm always willing to talk to anyone that is struggling as well, even strangers, but if you're contacting me because you read this be aware that I sometimes have periods where I feel too depressed to check my email. (I'm almost never too depressed for Twitter, though.)

That's pretty much everything. I could go on but I don't think I need to describe every visit I've ever had with a therapist and all the attendant revelations about myself. I think I hit all the major issues save one or two that are probably too personal to blog about. I hope that I've been able to convey some of what it's like inside my mind. I hope that it's felt honest and authentic because I tried to be those things. I hope that some of what I said will resonate with at least one person who reads this. But most of all I hope that it helps you to understand me a little better while also helping me to understand myself a little better.

To end on a slightly more positive note, I'm going to list a few things that have helped me to some degree. Nothing I've done has cured me entirely and I'm still pretty sick, but some things have relieved the pain a little bit. These things may not work for everyone, but they've been beneficial to me even if in the slightest.

  • Therapy. I first started therapy in middle school at the urging of my mom because I was having a hard time making friends and was shutting down a lot at home. Having a qualified professional to talk to is, in my opinion, the single most important aspect of treating mental illness. It doesn't make you crazy or weird to have a therapist. (Side note: In the interest of full honesty, I'm actually not in therapy right now. Not all therapists are equal and I've been lucky to have four amazing therapists in my lifetime and three I really didn't like and stopped seeing. Unfortunately my insurance is lousy when it comes to mental health so I'm trying to find a good therapist and might have to go out of network.)
  • Medication. I used to be afraid of any medication that was supposed to treat mental illness. I thought it would mess up my mind somehow. I guess I didn't recognize my mind was already messed up to begin with. Medication doesn't cure mental illness, but it helps. Just do it under the direction of a qualified professional. Despite not having a therapist right now I'm blessed to have an amazing psychiatrist who has been immensely helpful over the past few months when I've been possibly the most depressed I've ever been.
  • Exercise. The mission doctor for my mission would tell me that exercising 30 minutes a day was shown to be as effective in fighting depression as antidepressants. I disagree. For several months on my mission I ran 100 flights of stairs every single day and it was nowhere near as helpful as when I started taking Zoloft. Still, it helps a little.
  • Meditation. Meditation entered my life when I was in fourth or fifth grade. I didn't really understand it at the time but I thought it was cool so I tried it. I didn't really know what it was back then so I was really just imitating what I thought it looked like. In reality meditation is hard. Like really, really hard. But it's helpful in developing mindfulness which basically means the ability to quiet those internalized voices in your head (or at the very least, non-judgmentally acknowledge them).
  • Reading. Aside from getting into that flow with whatever I'm working on, reading a book that I really like is probably the only time I know that I'm safe from depression getting to me. That, and I feel like I want to plug some books that have significantly shaped my way of thinking and life philosophy which have in turn changed the way I think about and approach depression. Those books are: 10% Happier, Make It Stick, The Antidote, and But What If We're Wrong?. (I don't get anything if you buy them through that link. Also two of them are about learning, not mental health, but that's important to life and I just really like nonfiction and can be a bit evangelical when it comes to these four books. Also, unrelated, but comic books can be great and are often way better than normal books!)
  • Writing. I have a hard time understanding my emotions. The depression dulls my feelings and makes it difficult to know what I'm feeling, if anything at all. Because of this I don't have a lot of vocabulary to describe my emotions. Writing down how I'm feeling helps me to develop that vocabulary and understand my emotions better.
  • Socializing. I'm not sure I should include this one on this list because I don't really have any friends where I live now, but I've been told an active social life can help you deal with mental illness. I've definitely noticed I've been a lot worse off living in a city where I have no connections, even though previously I only had a few connections, so I guess I can vouch for it. My psychiatrist also seems to be implying that this might be my "big thing" currently, so I should probably try it.