I’ve written a number of blogs over the last several months and in each one I’ve written with such certainty: certainty that mental illness can be successfully managed with the right medications and the proper psychiatric care, certainty that a solid support system can go a long way towards fostering wellness, certainty that shame has no place in my life, certainty that a willingness to change old patterns and behaviors is the first step towards managing mental illness, and certainty that if I hold tight to these practices, I can attain a level of stability that will sustain me through difficult times. I’ve written all of these things because I know them to be absolutely true, yet as I sit and write today, I find myself in one of the darkest bouts of depression I have ever faced.
That’s the thing, isn’t it? That’s the thing that’s so easy to forget. There is no finish line. Our relationship to our mental health is not a finite one. There simply isn’t a beginning and an end. I know this. I talk about this. I live my life, holding this truth as a hard fought lesson. Things will changes and, like it or not, we will change with them. That is simply the nature of mental illness. We roll with the punches. Yet – even after all my planning, even knowing all that I know, even with all the safety nets I have put in place – I find myself sitting at my kitchen table at 5:00 am., smoking cigarettes and drinking coffee, thinking about exactly how I came to be here. Much to my surprise, even with all I’ve done to protect myself, I am teetering on the edge of the black hole of depression.
I understand that this kind of change can be organic, situational or both. In my case, I believe it is both. A catalyst nudged me towards my predisposed state. A change in insurance led to the need for a whole new medication cocktail. Titrating off and then on medication left a tiny crack for the darkness to creep in. In that vulnerable place, I followed all my routines but I forgot one major component of good mental health: self care. I sat in front of my television and watched 24/7 coverage of the election and the beginning of the first 100 days. Feeling a need to stay informed, I filled my head with as many facts as it would hold. I submerged myself in politics. I did not, however, anticipate to what degree I would be affected by what I was watching. Politics aside, the world news is not a compassionate forum for the exchange of ideas. It is raw information, often subjective, coming at you hard and fast. I tried to find some encouragement and comfort in the voices I heard, speaking, singing, and shouting my truth but by then, it was too late. I was already falling and could not regain my footing.
Depression is a strange creature. For me, sadness doesn’t accurately describe my depression. Sadness implies that there is the presence of something. In my experience, depression feels like the absence of something. Depression doesn’t fill my chest, it empties it. The hollowness left behind can be soul crushing. Over the last several weeks, I have continued to see both my psychiatrist and my therapist but beyond that, I have fallen into many of my old patterns. I sleep away much of my day. Ordinary routines as simple as showering and brushing my teeth have sometimes been insurmountable tasks. Most days, I don’t get dressed. I sleep on top of my bedspread. I sit in silence for hours. My head hurts, skin hurts, my entire body feels the ache.
In this moment, I’m quite fragile. This bout of depression has reminded me just how unsafe the world can feel when my illness is out of balance. I also know exactly where all of this leads, if left unchecked. It leads deep inside the black hole of depression, and the deeper you go, the harder it is to climb out. Because I understand this, last Tuesday, I sat on my psychiatrist’s couch and explained everything. I told him all there is to tell and he said what he has said so many times before, “Begin again.” That’s the exciting, daunting, stupid, fantastic news. When this happens, no matter how you got here, the only thing to do is begin again. This treatment plan, Begin Again, can feel insultingly oversimplified, but it is the truest thing I’ve learned about my illness. Ask for help, keep your appointments, take your meds, avoid your triggers, but for heaven’s sake, don’t forget to practice self-care. Do the things you know with certainty to be healthy but be kind to yourself in the process, in whatever form that may take. You can go for a run or you can eat a piece of pie for breakfast. You can take a nap or you can call a friend. You can watch a rerun of Law & Order or you can embrace the silence. Your list may look quite different from mine but don’t forget that self care is an integral part of wellness. In a few days, I’ll see my psychiatrist again, to chart my progress. Until then, I think I’ll have a piece of pie and watch the sunrise.