Here’s the thing about having anxiety and depression.
Usually, you have one that’s more prevalent than the other. This might change throughout your life, the dominant trait. In high school, my depression was my main source of focus. I didn’t realize I had anxiety until after I graduated. Looking back now, I can see a lot of evidence: my need to constantly keep busy, my aversion to sleeping or any quiet time, the irritability. In my adult life, my anxiety has been the star of the show most of the time.
When they work together, that’s when things really start to suck.
Right now, I’m standing in the middle of an abandoned highway. The headlights on the horizon are unmistakable - my depression, barreling towards me at a blinding 100 mph. On the other side, a pair of tail lights are all that’s left of my anxiety, retreating into the darkness. I’m clutching a prescription for Ativan and discharge papers that say the same shit as every other time I’ve made my husband sit in a sterile room into the wee hours of the night with me - “ANXIETY DISORDER UNSPECIFIED”.
How many times do I have to stand in this exact spot, allowing myself to get bowled over before I learn my fucking lesson?
I’m so embarrassed and frustrated and… well, depressed. The voices that I had thought I’d done so well with muffling are currently so loud. It’s taking every ounce of energy left over after four hours of sleep to not react to them. Oh, how I want to react to them. I want to sleep until I transition seamlessly to a quiet death. I want to lay on the floor of the shower and drown myself by a thousand tiny droplets of water. I want to scream until I lose my voice, I want to call an ex, I want to open an old scar, figuratively and literally. The voices are shouting over each other now.
“You’re a fucking idiot.”
“Everyone would be so much better off without you.”
“This will never go away. This is the rest of your life.”
“Just go back on your medication. You obviously can’t function without it.”
“You should be ashamed of yourself.”
“You’re a fucking idiot.”
I’ve gone to the hospital for my anxiety... too many times. Last night, after a really vague and unsettling attack with record high blood pressure numbers, I called a 24-hour nurse hotline to ask if I could take another dose of my BP meds to bring it down. By the end of the call, she told me to lie down on my left side and call 9-1-1. I was so rattled - it can’t be that bad, could it? - that I sat on the bottom of a hot shower, shivering out of my skin. Nicholas sat on the toilet and talked to me (“about anything, please, I don’t care”), to try and get me to be calm. I should have meditated. I thought it a hundred times it feels like. But the noise inside of me was so loud and I hadn’t sat in days and I slept poorly the night before and I’ve learned nothing and I like to think I don’t overthink everything but I do and I suck I suck I suck I suck
Eventually, I called them. Nicholas refused to drive me to the hospital since the nurse had told me he shouldn’t. Or maybe he was trying to call my bluff. When four EMTs and a police officer arrived in my hotel room, I was already thinking I’d made a grave error. Dawn, the senior officer, said, “Better safe than sorry.” I’d hear the phrase several more times that night. Maybe they were right. But right now? I’m thinking I’d rather die of a heart attack paired with stubbornness than waste resources, money, time, and Nick’s precious sleep. (A side note to this: not once last night did Nick ever complain about me dragging his poor ass to the ER like I’ve done half a dozen times before. He was never anything but sweet and concerned for my health. He was one of my “better safe than sorry” people. I appreciate him beyond the capacity of words, even if he didn’t want to sit on my bed with me.)
The ride over to the hospital was maybe fifteen minutes. My BP dropped a little in that time. I was relieved, of course, but also starting to feel creeping dread settle in. Not again.
Somewhere between having my urine collected, blood drawn, an EKG machine hooked up to me, and the hours upon hours of just listening to people who have real fucking problems, my anxiety was leaving me in its dust to deal with the mess it’d made. I’m fortunate that this particular time, I have health insurance, but it’s not a great plan. My medical debt will probably quite literally follow me to the grave. I’m starting to think I should just accept that instead of entertaining this fantasy that someday I’ll pay it all off.
And so the symbiotic relationship between anxiety and depression is triggered. Now feeling immense shame about how I was duped by my body once again, the depression approached rapidly. Waking up at 5 am after crawling into bed a little past 1 am, hearing my poor fucking husband force himself to get dressed for a long day of working so I don’t have to is pretty much the nail on the coffin of any feelings of self-worth. As much as I want to sleep for days, I peel myself out of bed. I won’t allow myself to sleep while he suffers because of me. This means staring in the face of my feelings of worthlessness.
Last night I read a tweet that claimed: “depression is a choice”. The phrase makes me nauseated and I could not disagree more. That’s like saying diabetes is a choice. Though I could see some validity in an accompanying tweet, that more or less could be summed up like:
You: *binge drinks, sleep deprived, smokes cigarettes, never exercises, poor diet*
Also You: I’m depressed
There are choices that you can make. The real issue that comes in is how much energy do you have to make these choices? In my deepest pits of depression, I can barely force myself to get out of bed. Crying is asking too much. In those moments, I force tiny, baby steps to feeling better. Watching videos of cute animals. Texting my friends. When I’m able to physically move, I get water. Eat a cheese. Once I can add more than just “go to the fridge, go back to bed” to my range of motion, I brush my teeth or take a shower. Incrementally, slowly, I get my shit back together. But just the energy to convince yourself it’s worth doing these things and maybe they’ll help is a whole exercise in and of themselves.
Like a diabetic, they can choose whether or not to take insulin. If they don’t, they’ll fucking die. Plus no one tries to shame them into just producing the insulin on their own. So it’s a pretty clear cut decision in their case.
For depression, you can choose whether or not to do things that support the production of dopamine and serotonin. If you don’t, you also could fucking die. People will shame you constantly, whether consciously or not, into thinking nonsense like “depression is a choice”. Your treatment options have varying effectiveness depending on your body’s chemistry, the therapist you end up with, and your life.
In relation to my own life, I have a serious question to ask myself. Do I need to go back on medication? To be quite frank, I really ! fucking ! don’t ! want ! to ! I spent months working through Serotonin Cessation Syndrome and the idea of ever dealing with that again brings me inexplicable fear. Even with the Lexapro, I was still an anxious, depressed mess. I hated the side effects. Wellbutrin made me feel awful. Xanax had begun to trigger panic attacks (fucking ironic, I know). As it is, I’m so apprehensive of the Ativan I was prescribed that I’m probably going to take literally one-quarter of a pill and see how it makes me feel. I’ve had it in ERs before but something about the way I am now makes me absolutely loathe the way barbituates and related medicine makes me feel. Like I’m detached from my body, unable to sense anything. Just drifting uncomfortably through space.
I’d already planned on looking up a therapist when I’m back in Michigan since we’ll be there for a few months. While I feel knowledgeable about the Cognitive Behavioral Therapy tools I have, my ability to utilize them well enough to not call 9-1-1 is obviously lacking. Maybe this is all I need. All I know is I can’t tolerate the idea of backsliding anymore.
That’s mental health, though. One step forward, two steps back. I keep reminding myself over and over that recovery is not a straight line and unfortunately, I probably will be dealing with this shit my entire life. It could be worse. It is what it is. All the phrases of acceptance in the world probably won’t ever make me stop thinking but wOW DOES IT FUCKING SUCK.
I can only hope that in being transparent with you guys, it can help you from feeling horrible if something like this happens to you. If you asked me literally twenty-four hours ago, I would say I have my anxiety/depression well under control. I was in a car, zipping towards the New York state line with excitement in my heart to see the city of my dreams. Generally, I put up a brave face and most people (erroneously) think that I have my shit together. Most of the time I’d probably agree with you. But if looking back on the last twelve hours has taught me anything, it’s that while you may try and keep your shit museum as tidy as you can, it’s still a shit museum.
And as always, writing all this out made me feel a little less hopeless. Like maybe it’s okay after all. At the very least, I realize that beating myself up about the whole thing is basically the least helpful thing that I can do for myself. There’s a part of me that wants to punish myself (ahh, old cutting tendencies never really go away, even when you put away the knife), but I know that’s also counterproductive. Instead, I’ll probably cuddle my poor cat a lot. First, the poor guy had a vet appointment the day before. Then after a long day of being alone in the room while I went from place to place, last night he was so scared when everyone came into the room that he had to be coaxed from under the bed by Nicholas after we left. I’ll try to nourish my body because when the sadness hits, I either binge eat trash or starve myself, with no in between. And as guilty as it might make me feel to enjoy myself while Nick is suffering at work, I know he wouldn’t want me to deprive or push myself. Right now my job is to feel better. And if he’s hard at work, I should be too.