a Scarlet D

At the end of May I had a physical. Since I’ve been on anti-depressants (2001+) every time I see the doc I get to fill out a PHQ-9, and usually get some discussion about the state of my mental health. As usual, we talked quick about it, and moved on. But I stopped the doc (who I love) and asked to back up a bit. I said that actually talking about it really moved me, and thought maybe I could talk to someone again in therapy. My doc said there was a perfect fit in the office, and gave me a referral.

I also went on a solo trip out of town for a nephew’s graduation. It was great to see family, and I got to stay with my sister at her house on a beautiful island. Just an amazing place to be. But I was feeling awkward and depressed and the anxiety was just really starting to creep in. The four day trip was supposed to be something of a “wind down” for me and it was nice to get away from work for a while, but it didn’t wind me down at all — if anything, maybe a bit up. Overall a happy trip, but I was starting to see there were some bigger issues at hand.

On the 2nd of June there was a neighborhood festival that I usually enjoy. My son and I will walk among the exhibits and booths and people watch and chat. He was back from college but busy that day, and the wife and daughter were off on their own as well. I went alone and all I could feel was being alone, and seeing all of these people being happy in the summer sun. I just wanted to slap them all and tell them it wasn’t okay and there wasn’t anything to be happy about.

By the 13th I was having trouble scheduling the Psychologist – a very popular one indeed. My wife knew if I called the scheduling line they could hook me up with a social worker who would assess and recommend someone else. Looking at this psychologists profile I really knew they would “get” me, so finding someone else was not helping my outlook.

And it was a bit of a kerfuffle. The first appointment I showed up only to find out they tried to call me and tell me the social worker was sick. Fine. The next day I show up and the social worker asks me the standard questions, and looks on the schedule and finds a doc in the next town over who specializes in Postpartum depression and domestic abuse. Neither of which apply to me, but I’m game so I take the appointment.

At the interview with the social worker I was asked about my support circle. I said my wife and children were my primary support. What about friends? I thought about it and realized I didn’t have any friends that I felt like people I could go to for support. That actually disturbed me more than anything, and it made me realize I’d fallen off the earth of my friend circles. (To anyone reading this who is a friend, I’ll throw in the caveat that my understanding of who and how I could go to for support is different now. Nobody need feel slighted!)

I was still having no luck getting The Good Psychologist, and the routine was to call the scheduling line and see if there were openings — but an intake is a special appointment, so it was harder to find. Luckily, my primary put in a good word and I got put on a waiting list, and eventually got to see my new Psychologist.

In June it began to manifest as more severe generalized anxiety and panic attacks.  My psychologist referred me to a psychiatrist.  I’ve had therapy in the past but not with doctors who “get me” so well and really understand and care.  They’re the best I could ask for.

I really liked the Psychiatrist, but as it happens it’s the same one as another family member, so she set up a transfer to a colleague who happened to work on the Partial Hospitalization Program, which was convenient.

By July/August I had entered a major depressive episode for the first time, which is a completely different beast.   The anxiety and depression increased and I had trouble making it to work on some days.  I was getting new meds that gave me some pretty wicked side effects and that didn’t help the hopelessness or anxiety.  That’s about the time my passive suicidal ideations evolved to more serious issues (planning, no intent) and at times I have concerns about my impulse control.  My company and boss and the founders all love me and value me, and had suggested I take some time off to get my meds sorted out, so I took a week off.  That week didn’t help, as I was without the daily structure and just inside my head the whole time.  

My care team and I talked about a day program three afternoons a week, but that didn’t seem like enough. Things had gotten bad enough that we were all talking about hospitalization, and my worry about being away from work was pretty much irrelevant. So I accepted my situation and decided to go with the Partial Hospitalization.

So we called my boss back and told him I’d be out for another few weeks. He was absolutely supportive and passed on that the CEO back in Scandinavia was “200% behind me.”

I had no idea what to expect, but as it turns out, that’s the right attitude.

In the fall of 2018 my son, our oldest child, went off to college. Many hour away. We’re so close I used to tell him that his leaving will be like losing a limb. When we did finally send him off it was really quite hard on me, but I moved on. I got to visit him and see that he was still my close son, and even saw evidence that he was homesick or missed the family. Hard as it was, it didn’t feel like a traumatizing event worthy of a depressive episode.

I do remember a month or so later when I was due to take a business trip to Scandinavia, I was worried about my depression when I was far away and alone. I had my anxiety (don’t like to talk to strangers, feel self conscious in public, etc.) but that was with me for decades and I knew how to deal with it. Or avoid strangers. But even then I had my depression, though I powered through it and had a great time and did some great work.

In december a peer quit our company. We were both a little overworked, but this meant I was going to be taking on more work than usual. Love the job, love the company, love the people I work with, so it’s no big deal working a bit harder or more. That and we had plenty of open positions, so help would soon be on the way.

Again, I still don’t track my major episode to that person leaving, or to the company or the work. I think in the end it’s more about a growing dysthymia and additive depressive episodes – or “mental flu” as I called it.

Regardless, December was the beginning. I stopped seeing friends, doing hobbies, going out, doing anything except work or escaping into video games. Sure, there were family functions, even vacations, but through it all I became more and more isolated. Still wearing my mask, so even my wife couldn’t see the growing horrible.

January, typically a quiet work month, was bonkers. We added a member to my team which helped immensely, but I was still juggling the workload as well as larger clients. And looking for more “me”s to add to the team. It’s hard to find more “me”s because of the experience we were looking for, and the type of job. Not impossible, but tricky.

By the end of May it was getting worse, but it still felt like the usual depression, though I hadn’t really thought about the fact that instead of a few days or a week, it had stretched out into months.

How long I’ve been dealing with depression and anxiety

I know that during middle school and high school I wrote moody poetry. I listened to “dark” music. And one day I was online talking to a friend and they misinterpreted something I said as a suicidal ideation. They went to their guidance counselor, who contacted my schools counselor, who had a “chat” with me. I clarified that it was a mistake, and that I was fine.

On the way home, Mom picked me up and the first thing she said was an angry “don’t you ever do anything like that again!” – we never spoke of it again. Once, much later, my dad alluded to the incident in discussing how we talk to people online, and how things can be interpreted. Those were the only two times the incident was brought up. It was the 80’s and our town wasn’t progressive enough that common kids would get therapy or meds.

The thing was, it really was a misunderstanding. What surprised me was that I wasn’t really feeling suicidal then. But that I did feel that was quite often. I know now that I was depressed and maybe even glanced off some severe episodes, but even personally wrote it off as young angst.

Later, in my 2o’s I distinctly remember sleeping through weekends. That’s called hypersomnia, and it’s sleeping too much. I was doing it to escape, and I did it as much as I could. Again, young angst.

By the time I was in my 30’s and having children of my own, I had settled into a routine. I would get what I thought of as the “mental flu” — you’d feel yourself coming down with something, then it would hit (hard) and you’d be in the midst of it, and eventually you would recover and soon enough be back to normal. This could be over the course of a few days or even a week or two.

Just after the turn of the century, the economy turned and I got laid off. Office closed and we all got our walking papers. I remember at one of the happy hours we had after the office had been shut down, I turned to a friend and asked her if she’d ever dealt with depression. I was in a rough spot. She turned me on to a walk-in counseling center in the area, and I stopped in.

Right away they pegged me as having clinical depression and anxiety, and in a fairly strong way. Since those days I’ve taken more than my share of PHQ-9 questionnaires about how you’re feeling. That wiki article includes a link to an online version. You should take it and see what it says for you.

I was hooked up with a Psychiatrist who gave me some meds. Now, you have to understand that someone with depression get good at wearing masks. Hiding depression is the best way to not have to deal with it. So I took the meds and convinced the psychiatrist that I was fine after a few weeks of meetings. Maybe he knew I wasn’t, maybe he didn’t. Maybe I was fine. Regardless, life carried on.

Another decade passes and the Wife is seeing a psychologist and suggests I do too. So we get matching his and hers Psychologist/Psychiatrists and do separate therapy. It was fun and all, and I got something out of it, as I remember scream-singing to Dresden Dolls a number of times after appointments. So the Psychologist was stirring the hornet’s nest nicely. But after a few months I was pronounced fine again and sent on my way.

Interesting note: In one of my first meetings with that psychologist, I was talking about how hard it was to have depression and anxiety, and how exhausting it was. And that I really wasn’t having it and didn’t want to have to put up with it for the rest of my life. We talked about my suicidality, and she essentially told me to go home and think about it. Almost daring me to do it. I called her our on it at our next session and she said some people just need to be given the freedom to kill themselves. That it would have been unfortunate, but that sometimes you have to let them go. It seemed ballsy, but I always wondered about the ethics of it. Obviously I’m still here, so I didn’t kill myself that week, but in some ways it felt like she was calling a bluff. I was truly suicidal – I had plans but no intent, but suicidal nonetheless. Overall I liked her, but she wasn’t that effective.

Skip forward another near-decade. and begin reading here.