Living with mental illness can be challenging to say the least.
There are about, say, around 500 psychological diagnosis codes in the DSM-IV. Some are subtypes of general illnesses so, when a patient with mental illness seeks medical attention, we are looking at maybe 200 or so potential diagnosis the treating physician must consider.
As you can probably deduce from these numbers, knowing you are some kind of loony tunes and figuring out what your actual disease is, are two completely different beasts. Add to that co-existing conditions, instigating events, trauma, other disease induced depression, PTSD, postpartum, well you get the point.
Often just reaching a proper diagnosis takes a lifetime. Frequently accepting you suffer from mental illness takes a lifetime. Finding treatment; can be next to impossible.
Currently, I am in the process of both exacting my diagnosis and finding the appropriate treatment.
While I have always been moody, prone to bouts of sadness and anxiety, it never really affected my daily life. Sure, it was a tad annoying if say, I was in one of my “states” and there was a family event to attend and would hide in a bathroom for as long as my absence could go unnoticed. Or if I suffered a panic attack at the school dance. Those events were so rare I simply dealt with them.
I made friends, great, supportive, fun-loving friends. Did well (enough) in High School and got high enough SAT scores to land me in a top State University. New, dear friends were made. I spent a semester abroad in Australia, traveled to Europe two consecutive summers. I got decent grades. Not amazing grades, but on par with the amount of effort I had put in to my coursework.
Following college I got an administrative job. It was simple, menial, it paid the bills. They loved me.
I am not saying that in this time there weren’t long nights I did not cry myself to sleep because the guy in the office I was sleeping with, the one with the girlfriend backed out on plans we had made, again, at the last minute. I don’t know a chic on earth that hasn’t done that. There were those weeks, sometimes months I would not go out. I’d hunker down, spent hours at the gym or the library. Where I struggled most was in forming relationships with men. I still do. What’s the problem? Well, that is still something I am working to figure out and hopefully fix.
It was not until I began attending Graduate School that I had my first flirtation with Major Depressive Disorder and severe social anxiety. Psychiatrists were seen, Zoloft prescribed, side effects made me crazier than being crazy. Zoloft dismissed.
A year or so later, I left Washington, DC, where my program was located, I returned home to New York to serve a year-long internship as an AmeriCorps volunteer. Being back in my “natural habitat” I was naturally better. I had my friends and made new ones too. However, I did not want to stop the work on enhancing my overall state of being I had begun in DC. So, more doctors were seem more meds prescribed. Adderall and Clonazepam this time round.
When I returned to Graduate School I noticed a significant improvement in my experience. The medications helped me focus on my schoolwork and alleviated some of the anxiety that made going to class seem like I was going into battle, leading me to frequently skip. My grades improved. My mood somewhat uplifted, the depression moderately alleviated. I felt empowered again.
After I finished my coursework in DC, I returned to New York once again and began furiously searching for work. In any field. Mainly, because I had just spend $80,000 on a degree a realized 1/4 of the way in, I didn’t really want. C’est la vie.
After three or so months of searching I landed a consulting position as a project coordinator of a Business Operations PMO within the Investment & Advisory Department of a major global company. Yah, I had no clue what any of those words meant either but I definitely knew what $35/hr, 40 hours a week meant. Cha-ching!
Sometime in December I revisited seeking treatment. I began seeing a wonderful therapist and a thorough psychiatrist. I was prescribed a different anti-depressant, Wellbutrin.
Wellbutrin is an SDRI, a Selective Dopamine Re-Uptake Inhibitor. Unlike Zoloft and most anti-depressant’s which are SSRI‘s Wellbutrin prevents the brain from absorbing dopamine, a feel good hormone – or neurotransmitter our bodies naturally releases. The medication blocks receptors in the brain thereby preventing re-uptake creating greater availability of the hormone in the brain. The intended result: good, happy feelings. Or in the case of people with depression, who, physiologically, are not naturally producing enough of the substance in the first place, make you feel, be, normal.
Most anti-depressant’s, like Zoloft, block the re-uptake of a different neurotransmitter in the brain that affects mood and feelings of well-being; serotonin. These are referred to as SSRI’s. Now there is a new class of anti-depressant’s which affect both serotonin and norepinephrine (a fancy word for adrenaline). These drugs are aptly called SSNRI‘s.
From personal experience, my own background in psychology, health and bio pharmaceuticals I know I have adverse reactions to any medication, herb or supplement that stimulates serotonin. So, SSRI’S and SSNRI’S are a no-go. The side effects are more vile than the disease itself.
Jump a year into the future. I was offered and accepted a full-time position with the well-paying global corporation I had worked as a consultant for in New York. All my hard work had paid off. A stellar reference from my manager, who was in what you would call the “big leagues”, my natural/learned aptitude for being charming during interviews, love of excitement, challenges and new experiences all played in my favor. I moved to San Francisco because that was where the role was located and tried to settle into my new life as a Californian.
Then, the seizure happened. Monday, September 12th, 2011, at approximately 1:12pm PT, I suffered a Grand-Mal seizure. Right there, in my new office, for everyone to see. I convulsed, jerked, bit my tongue then passed out. Of course I don’t remember any of this. I came to confused on a gurney in the walkway of my office. The paramedics explained what happened. I felt nauseous and wet, my body was covered in sweat and every muscle ached. My blood pressure dangerously low, I couldn’t be moved. My confusion and shock morphed into the fear I saw in the eyes of the paramedic strapping the oxygen tube through my nostrils, slipping and IV into my left hand.
After this incident I was forced to stop taking Wellbutrin. While it is one of the few antidepressants with minimal side effects, it did have one rare risk: it severely lowered the threshold for seizures. Oops.
I was back to square one. Now I was living 3,000 miles from anyone I knew, family, friends, my pet Quaker Parrot. I was alone, socially isolated. I was lonely. It felt like DC all-over. I continued seeing a psychiatrist but only kept taking the Adderall and Clonazepam, both sparingly. I also started an herbal supplement called SAM-E, which affected the brain and dopamine similarly to Wellbutrin. Things were okay.
I met a guy, I made some friends, I joined a ski house in Tahoe. Work was difficult at times but soon I grew to love the fast, ever-changing, always code-red pace of Investor Relations. I was content. Things were not ideal, there are always problems.
Then, there was a REAL problem. My job became obsolete and subsequently so was I.
That day my world changed. Over the next six months, events, both unrelated and stemming from my dismissal continued re-traumatizing me over and over again until what was left is what we have here today. An image of my former self viewed through a broken mirror.
I am trying. Now. I began seeing a therapist twice a week. Visit my psychiatrist twice a month, agreed to try a new medication. A mood stabilizer this time. These affect the brain in ways beyond the scope of my understanding of neuroscience. I do know there are a few varieties, all originally developed and used as anti-seizure drugs for epileptics until doctors noticed that at lower doses they witnessed positive effects on people suffering from manic depression. It helped treat bipolar disorder and other less severe forms of mood disorders.
Most of these medications have some fairly awful side effects, worse than the SSRI’s I had refused to take. However, one, lamictal, exhibited limited side effects and a high rate of efficacy. The skies parted and hope shone down upon me once more! At this stage in the game I am damaged. I am fragile, anxiety ridden. I couldn’t take an interview if I somehow managed to get one. My confidence is gone and my charm has gone with it.
There was only one potential side effect to lamictal. It is extremely rare, affecting approximately 1 in 10,000 people. A rash. A simple skin rash. A simple skin rash which in the course of a day can turn into a number of severe syndromes all of which the end result is disfigurement and almost always shortly after, death.
Twelve days in to taking lamictal I noticed slight itching. Then, I saw it. Very light, barely noticeable, but definitely there, tiny red dots covered my forearms, hands and upper thighs. I fell apart. My great white diamond-shaped hope of a pill was gone. I mourned the loss of being one of thousands who reap the benefits of this wonder drug for emotionally unstable folk like myself.
I reached out to my doctor and she demanded I stop taking it immediately. I did. For one day. The rash disappeared. But, I was already lost in hopeless and in a self destructive state and continued taking it the medication against medical advice. The rash came back. Spread to my torso, feet, upper arms. It was so minor, I didn’t care, I talked to my doctor. She agreed to continue to prescribe it as long as I stayed on a low dose and saw a dermatologist immediately.
I have an appointment in two weeks. Till then I have a rash, when skin starts peeling off in chunks I’ll deal with that then.
So, we have medication and therapy. I began acupuncture; which I am finding to be the most effective of all treatments so far. I take about five vitamin supplements and herbs. I light incense, attempt to meditate and recently was introduced to DBT. All things to get myself, get my mental shit together!
Dialectical behavior therapy (DBT) is the “new thing” in psychotherapy. All the rage. Small groups of emotionally sensitive individuals meet once a week for two hours, learn how events in our lives and our reactions to them are not mutually exclusive. Identify triggers, learn coping techniques when faced with these situations, and each week homework assignments are given, our experiences shared. It is people learning from one another.
I am not sure what else I can do. What action to take in my efforts to “get better”. I have begun volunteering with the American Red Cross. I jog, I blog. I have not given up just yet.
Still, today, and everyday since I was laid off, there isn’t a moment I haven’t felt the words, “I don’t wanna die, but I ain’t keen on livin’ either”, Robbie Williams crooned on his number one hit “Feel”.
The number of times I have been asked if I am suicidal or have suicidal thoughts is sky-high.
My answer always the same. I do not want to die, but I want to live. I will never kill myself. At my core I am an optimist, a fighter, a romantic. I have lived long enough, seen enough, experienced enough to understand; you never know what is waiting for you just around the corner. Can never tell what’s behind door number three and I would hate to miss out on something amazing. So, I keep trying new things, searching for “my cure”, my survival mechanism.
Ultimately, two things in life bring happiness; meaningful relationships and fulfillment through being a contributing member of society. Whether these are achieved through romantic relationships, friendships, family, a job, volunteer work, none of that matters. At this time, and, looking back, while I was in DC – the only other time this strong debilitating onset of sadness occurred – I do not have any of the aforementioned necessities for happiness. I am not surprised or think “something is wrong with me” for feeling badly. It would be ABNORMAL if I didn’t.
However, the cycle of events, the loss of the only close people in California. Door slamming in my face at nearly every turn, eventually, it can do a number on ya. The therapy, the medication, it all “kinda” helps. I lived 25 years without needing either to be successful. I also had a very strong social circle, school or a job I was working hard at to get what I wanted, even if I didn’t know exactly what that was, I knew a good reputation can help you get there, whenever you find out what it is.
What I need now is a life coach. I need to dig deep within myself and figure out what I truly want my life to mean. What I want to accomplish, only THEN can I start working towards achieving it. Only after I begin working to achieve it will I be the kind of positive fun-loving person others want to spend time with, befriend.
Until then Robbie, I could not have said it better myself;
“I don’t wanna die, but I ain’t keen on livin’ either”.