The black dog, the blue period (Part II): Coping with Anxiety

In the first part of this series, I detailed my experiences with clinical depression in high school and early university. I had the second post completed and ready to go but the response I got from the first post was nothing short of overwhelming. I received messages from approximately 40 different people over text, e-mail, and in-person expressing their own or their loved one’s struggle, asking questions, and/or thanking me for the post. I am so grateful for all of these messages. They confirm what I have always known about the prevalence of mental health concerns, and they also remind me of how much stigma still exists. Having worked in mental health for so long and now conducting research on the same, I tend to forget that it is still a sensitive subject for most. A lot of the messages remarked on my “bravery” or “courage” in being open and writing about my personal struggles. Initially, I felt very uncomfortable with that sentiment because I was just doing what came naturally to me. I am very open about my history with depression in my personal life with my friends and family. It is not a topic I hesitate to talk about. But, I realized that there used to be a time when I was terrified of hearing or talking about the subject or anyone “finding out” about me.  It took a very, very long time and lot of work to get to a point where I could speak about it with others, let alone talk about it on such a public venue. This post continues where the last one left off, and details my journey until now, and my hopes for the future.


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This image is from the video “I had a black dog, his name was depression” by Mind, a UK mental health charity. It is an amusing and accurate look at the experience of depression

Things were starting to look good. I finally had a path I could follow. While pursuing medical school applications, following a successful MCAT, I decided to take a few GPA boosters in Summer 2011. I chose courses in the department of anthropology. I had never taken any anthropology courses before and, beyond the classic description of culture, evolution, monkeys, and bones, I had no idea what to expect. Somehow, in the course of learning about classical anthropology, I stumbled upon a world of anthropological theory and research that exhilarated me more than any other discipline.   In my restless pursuit of knowledge, I had finally found the place where I felt I belonged. I learned about the sub-field of medical anthropology and it was truly my “eureka” moment. Finally, FINALLY, there was a place for me. Medical anthropologists and associated researchers were asking the same questions I had pondered and answering them using a methodology I loved. It was so very “me”.

The rest, as they say, is history. I flew through a second degree, a BA in Anthropology and English. There was no doubt in my mind that I was in the right place because it didn’t feel like “school”. I quickly abandoned my dreams of medical school (or should I say others’ dreams for me) and it felt like a huge weight was lifted. I wasn’t living according to society’s expectations anymore. Of course, I decided to pursue a different, albeit equally difficult, route of graduate school. And my family was happy too, because I would eventually have those two little letters, the bane of every Asian student’s existence, in front of my name!

I still occasionally suffered from low periods. The fall months, especially October and November, were the hardest, because the optimism and enthusiasm of the start of a new school year had faded and the relief and cheer of the holidays were still far away. Because my depression was cyclical, I became extra vigilant during these times. I was keenly aware of my specific signs of depression and kept them at bay for the most part by listening to myself. If I began thinking negatively, I knew it was time to disrupt the pattern, or engage in self-care activities, or talk to someone. These all usually worked quite well.

Then things got weird. I can remember it vividly.


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In the early Fall 2013 term, I was walking down the hallway of the arts building on campus. I was running slightly late. The hallway was completely empty and the click-clack of my boots echoed off the cement walls. As I came closer to my classroom, something happened. My heart began to race and beat against my chest. The room began to spin and I felt as if I couldn’t breathe. I stood frozen in place against a wall for what felt like hours, though only a couple of minutes had passed. Then, as if nothing had happened at all, the feelings faded as quickly as they had begun. Because I was already running late for class, I shrugged it off as an anomalous, isolated event. But this wasn’t true and I knew it.  From all my new knowledge of depression and mental health, I knew that I had just had a panic attack.

I had had those feelings before, years earlier, when I was at the peak of my depression, though they had never been quite so intense. You see, the other side of my depression coin was crippling social anxiety. Social anxiety is often seen as extreme shyness. Perhaps they are related in some ways but social anxiety is a different beast altogether.

In my previous post, I mentioned that I missed classes a lot. While, yes, sometimes it was because it was too difficult to get out of bed, the main reason was my inability to confront what I perceived to be the judgement of a thousand strangers. While today I walk around without a care in the world (some would even say I strut), back then I could not walk through University Centre, the hub of the university’s social life, without feeling intense anxiety. As I would take each step, I would feel hundreds of eyes look at me and pierce me with their critical gaze. I projected my insecurities through them onto myself. Whenever a face turned to look toward me, I only saw a million different judgments of myself and my presentation: was it my clothes, body, face, hair, the way I walk, can they tell I didn’t go to class, do they know that I’m unintelligent, a failure? It sounds strange, even silly in retrospect, but to me that was reality. I felt like everywhere I went I was being looked at, judged, picked apart, ridiculed. I felt like I was a fraud and would be found out any second. I would hide in the library and, even then, I would just sit and ponder the fact that my life was controlled by thoughts I knew were irrational, and that I was powerless to stop them.

 

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Woman with Raised Arms, Pablo Picasso, 1936

Not only would I skip classes, I couldn’t or wouldn’t do simple things like talk to a cashier or a receptionist. If I absolutely had to speak to a stranger, I would rehearse what I wanted to say a hundred times before I would say it. Even then, I would judge myself as having “screwed up” the interaction in one way or another. Overtime, talking about these insecurities and reversing negative self-talk, allowed me to conquer social situations again. Today, people who know me consider me to be an extroverted, outgoing individual, which is true of my personality. However, if they had met me then…well, we would have never met.

After my first panic attack, I didn’t experience an event like the one in the hallway for a while. Until I did. This time it happened when I was going down the stairs of the same building. But, this time the intensity of the physical feelings was accompanied by vertigo. I still did nothing about it. However, three times the charm. Plus, as October drew close I became concerned about my depression recurring because I found myself feeling blue without reason more often than I would have liked. I spoke to my doctor, my family, my sister who is a pharmacist with an encyclopedic knowledge of all things pharmacy-related, and we finally agreed on a pharmaceutical course of action. I had always been terrified of “being on medication”. I grew up in the 90s in the era of Prozac and I didn’t want to be “artificially happy” or an emotionless zombie. But I decided to take a leap of faith anyway. And what a leap it was. I know antidepressants get a really bad rap and usually for a good reason but that’s because we don’t tend to hear the positive aspects of it. I think I know more people on anti-depressants than those who are not. And, just like people assume of me, you wouldn’t think they would need them either. But I did, and I didn’t realize it until I took them. When I followed up with my doctor a month afterwards, I could only explain my experience of medication through a description of a graph (insert grad student stats joke here). I have expertly doodled it to explain what I described to my doctor:


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Mood Vs. Time With and Without Medication

As you can see, before medication, I went through intense low periods which I thought were just normal. And my high periods weren’t really high at all, they were just periods where I was “not depressed”, thus I was never happy. I often wrote in my journals that “I don’t know what the word ‘happy’ means.” I wasn’t being dramatic either, I didn’t understand it because I hadn’t experienced genuine happiness in so long.

After medication though, my feelings evened out and I realized that this is how “normal” people function. I began to understand what other people meant when they were happy or having a good day. In the past, a good day was anything that wasn’t a bad day. Rather than being “artificially happy”, medicine allowed me to start at level 0, rather than -50.

Obviously, as is life, I still have ups and downs but the downs aren’t so extreme anymore that I am unable to function. Today, I can easily brush off bad days for what they are rather than letting them ruin my whole week or even month. In fact, the bad days remind me of the good days around the corner. Medication allowed me to finally work on myself and my mindset so that, rather than feeling like I was carrying a 1000-pound gorilla up a steep hill towards the end-goal of recovery and happiness, now it felt more like I was just hiking upwards with a large German shepherd by my side.

PictureIntihuatana Stone in Machu Picchu, Peru, from my trip in 2014. It is thought to be a relic of Incan spirituality and is said to consist of infinite positive energy, visitors place their hands over it to absorb the positive energy.

The old adage of the glass being half full is exactly how I would describe my worldview now. I can’t help but be optimistic even in difficult situations. Of course, it took years to get here and I still work towards building and maintaining this optimism everyday. And, I still have to catch myself if I start to go down the road of negative self-talk and remind myself to be kind to myself. If you are struggling and reading this, I would say the same to you: start with kindness towards yourself.

My original intention was just to write about the experience because I felt that it was time. As mentioned, I am very open about my experiences with friends, family and acquaintances, and I welcome questions. However, it took me a long time to get comfortable with that. I realized that if I was to truly be a mental health advocate then I had to practice what I preached. I first started doing this when I heard others being open about their own current or past struggles. I, too, thought they were brave and honest. I applauded them. But, I never wanted anyone to find out because I thought people would see me differently or judge me before they knew me. I thought that professors or other academics would think I’m unreliable, unpredictable, irresponsible, but the opposite was true. I was lucky and privileged to have never faced any discrimination, but others with more stigmatized illnesses tend to be discriminated against, especially those from specific backgrounds such as Indigenous people and marginalized minorities in North America and elsewhere.

They key to ending the stigma, for me, was talking about it as much as I can. And, unsurprisingly, about 75% of the people I talk to express having struggled with mental health issues at some point and almost all of them know someone who has. In many of the messages I received since, friends and family expressed the familiar notion that you just never know what someone may be going through. This is true.

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I received a lot of questions about what individuals and families can do to help their loved ones. In my opinion, my family’s support was incredibly helpful to me; I was so taken aback by their understanding and empathy. They gave me space when I needed it and let me have periods of quietude. Depressed people can also be irritable and they were so understanding about this. They listened to me without judgement. In my own experience in working with people suffering from depression/anxiety disorders, I avoid preaching or giving advice. People who are depressed usually have a thousand thoughts in their mind, and many of them induce feelings of guilt; making them feel more guilt is obviously ill-advised. I recommend trying to provide realistic messages of encouragement, hope, support and understanding; and validate their feelings. However, recognize that one cannot just “pick themselves up” out of depression. Understand that it is a slow, sometimes frustrating journey and it has to be taken day by day.

But, not only is recovery possible, with the right resources and support it can be an enormous source of growth. I know it was for me. When all is said and done, I am, believe it or not, grateful for everything I have been through. I feel that my experiences have been a blessing. They have helped me become more empathetic because they opened my eyes to a world beyond my own bubble.

If nothing else, I hope these posts have shown that mental disorders are not only a product of cognition and associated emotions but a biological phenomenon, as well. They are as real as any other illness. And as with any other illness, it is your choice to share your story with others, but like any other physical illness, it is never something you should be ashamed of.

Today, my academic work is motivated by a passion to help those who are struggling with similar issues. In fact, my current research focuses on university students with mental health concerns. In the future, I hope to branch out into other areas of medical anthropological research, but I know I will always be involved in mental health advocacy. I encourage you to get involved too, in whatever way you can. You don’t have to disclose anything about yourself or anyone else, but you can help support those who are struggling by sharing stories and images about mental health online that help to end the stigma. You can donate time or money to a mental health volunteer organization or event in your area. You can educate yourself on topics regarding mental health that you may have been curious about.

In your daily life, you can lend an ear to someone you know who may be having a rough day and just listen. And, if that person is you, listen to yourself. Close your eyes and listen to your thoughts, your feelings, think about your needs and your goals, the people in your life and how they make you feel, and ask yourself: am I truly happy? If the answer is anything other than a “yes”, I hope you will do whatever it takes to work towards the happiness you deserve. And, if you were able to relate to my experiences and are struggling right now, know that you are not alone and you can get better. Be your own advocate. To paraphrase J. K. Rowling: just because it is happening inside your head, doesn’t mean it’s not real, and don’t ever let anyone tell you otherwise.

Thank you for reading.


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2 thoughts on “The black dog, the blue period (Part II): Coping with Anxiety

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