Resourcing myself

This winter was really rough for me. I wrote about my depression a little bit but mostly I didn’t have the mental energy to write a lot here since November. The short version is that the combination of the bleak political situation with the record rain and dark, long days we’ve had in Seattle forced me to confront the fact that my depression isn’t just situational. There are definitely things that make it worse but it’s clear that it is a bigger problem than just something wrong in my relationships or at work. My personal life is objectively better than it ever has been and yet I barely had the energy to get through the day most of the time.

But I did what I’m best at – I used my resources and courage to look for solutions. And luckily, I didn’t just look for a simple quick fix. It took a combination of a lot of factors to bring me out of it. I’m recording them here partly for my own sake so if/when this happens again I can recall what worked, but also to hopefully inspire others to take some steps towards radical self care.

First off, I have been seeing a great therapist since the beginning of last year who has helped me find ways to break patterns of anxiety and recognize my triggers early enough to help get out of the cycles. But even the best self soothing and awareness only seems to work for me when I’m dealing with the “normal” amount of mental health challenges for me. When I add the layer of depression on top of my anxiety, ADD, and PTSD, I get stuck.

So I found myself a psychiatrist (well technically an ARNP) and started working on finding the right antidepressant for brain. The first try with Lexapro was disastrous – I had a bunch of side effects including worsening anxiety. And even with the second try, Zoloft, it took a long time to find the right dose. But now things seem to have leveled out and I can tell there is a huge difference in my ability to self manage my mental health.

Another important factor was (re)engaging heavily in my core relationship building. Being depressed can take a heavy toll on the people around you and I know I was much more irritable for a long time and my libido was way out of wack. Things aren’t perfect but now I can confidently say I’m feeling a sense of secure attachment and I can see the growth and evolution of my relationships instead of stagnation. I have two romantic relationships that have passed the two year mark and I’ve built a chosen family around myself that can weather a lot of change.

One aspect I didn’t anticipate being such an important key was my physical health. I tend to be pretty good about going to the doctor but I had stopped going to the chiropractor last year due to money and schedules. My back and neck clearly weren’t ready for that though because as I was trying to track my mood for medications, I noticed an unusual pattern. My anxiety was peaking shortly after I arrived at work and again at the end of the day. It turns out that was when my neck pain was worst and it was so bad that it was breaking down my ability to manage my mental health. So I found a new chiropractor who I’ve been seeing weekly and it is making a world of difference.

Finally, at my therapist’s encouragement, I took steps to bring things back into my life that ignite my creativity and passion. I am starting a trans acapella group and even though we haven’t met yet, I can tell the excitement of that is giving my mental health a big boost.

The weather and longer days are of course helping too but between all these factors, I am radically better than I have been in months. My energy has returned, I don’t need to constantly take time every day for pain management, and I can be myself finally. This in turn gives me motivation to do more things that I love like open myself back up to new dating opportunities and see friends more. The positive feedback loop of well managed mental heath sure takes a long time to get going but I’m glad it has finally kicked in.

Antidepressants

Yesterday I did the big scary thing and met with a psychiatric nurse practitioner to explore antidepressants.

I’ve known I had an anxiety disorder since at least puberty before I knew about psychology diagnoses and medication. In my early 20’s it was clear that depression was part of that mix. I show signs of adult ADD and OCD as well but to what degree those are independent of the rest, I don’t know. For a sense of what that is like for me, see my previous post.

Despite knowing all that, I have avoided even thinking about medication for years. My mom has always tended towards naturopathy and pharmacophobia even though she shares the same mental health issues I do. I think because of that I have been scared to approach a medication that would put me in any kind of dependency even after I’ve seen how much it has benefited her to be on SSRIs. I guess it felt like admitting defeat to use a “crutch” like meds. I’d rather keep battling through on my own and try to find coping mechanisms.

But it has become clear recently that I’m not doing myself or the people around me any favors by holding out. It takes so much energy just to get through the day trying to be myself that I often don’t have the stamina to do the relationship building and activism that I want. And I have been around enough people who are on medications without shame now that I have broken down some of the phobias and misconceptions.

So today I took my first, very low-dose of Lexapro. It helped a lot to sit down and have a specialist really explain it all to me in a thoughtful way. The way he tells it, frequent depressive episodes train the brain pathways to be better at repeating that way of being and feeling, right down to modifying the epigenetic code. The reason antidepressants work is because they help you retrain those neurotransmitters into healthier patterns. It takes time but knowing that it doesn’t need to be permanent and there is actual hope for stopping someday really helps.

I was surprised that by the end of the conversation and even today as I took the first pill, I didn’t have fear around doing so. I’m actually rather excited about the possibility of feeling some relief and knowing for the first time that I can remember what it is like not to constantly fight my anxiety. We’ll see what happens now.