I was on the phone with my mentor, telling him how great I was feeling — that I had made it to the “other side” of a depressive episode that had lasted years and cost me a six-week stay in a psychiatric hospital.
When I stopped chattering, my mentor said, “Be careful. Your depression could always come back.”
He wasn’t being mean or trying to rain on my parade — he said it because it’s true, and he wants me to be wary.
I have major depressive disorder, along with generalized anxiety disorder, persistent depressive disorder, avoidant personality disorder and binge eating disorder. None of these are easy to treat, especially my depression.
Understanding Major Depressive Disorder
I often find myself worrying about the likelihood of relapse. With major depressive disorder, I experience episodes, meaning I’m not depressed all the time. An episode is defined as a period of two weeks or more where you experience at least five symptoms most of the day, nearly every day, including a depressed mood, loss of interest in activities, sleep disturbance, fatigue, feelings of worthlessness and suicidal ideation. (However, this is not a comprehensive list).
According to the American Psychiatric Association, major depressive disorder is highly recurrent; symptoms return for at least 50% of those who recover from a first episode of depression. Approximately 80% of those with a history of two episodes will have another recurrence. One study found that, on average, individuals with a history of depression will have five to nine separate episodes in their lifetimes.
Addressing My Symptoms and My Fears
I’ve already had at least two depressive episodes since I was formally diagnosed at 19 years old. I’d like to think I’ll be “ready” should an episode come my way, but I panic now even if I have a bad day.
“Do I need to call my psychiatrist?”
“Maybe I should change my medications.”
“I’m going to go on low battery mode.”
And so on.
I’m always walking a tight rope. Even though I feel great now — and have for months — I still have to be extremely careful. I need to get enough sleep — not too much or too little. I must take my pills at the same time, twice a day, every day, and keep up with the refills. I have to follow a healthy diet, drink tons of water and avoid any triggers, like violent or sad TV shows and books. I avoid napping during the day. I remain active. I don’t drink alcohol and try to steer clear of stressful situations. I stick to a daily routine and structure as much as I can. While these measures might seem like “normal,” responsible behavior, they are more than that — they are lifesaving. If I “break the rules,” I become emotional, impatient and irritable. I lose control of myself, and my thoughts go to a dark and negative place.
Embracing the Journey
This is the major challenge of having several mental health conditions; sometimes, it can feel like negative thoughts are always waiting to slip through a crack and infiltrate your mind. At first, the thoughts and symptoms can be more subtle — I stop showering as much, then I take long naps during the day. I skip a day of brushing my teeth. But once my illness has me in its grip, it can be relentless and painful. I lose hope. I isolate. I give in to the darkness, losing my grip on the tight rope.
Another challenge is battling shame and self-blame. Often, I wonder, “Shouldn’t I be stronger now? Didn’t I already crawl back from the pits of hell? I have grit. I have coping skills and an amazing support system.” But I have learned to ignore that little voice in my head telling me I “should be” better or that I’m unworthy.
It has been a long journey. I’ve spent the past four years working on myself, and it’s been challenging. I’ve had bad days, even horrible ones, but I’ve kept going, and now I’m living my best life. I made that happen, with the help of my support group, therapist and medication.
And here I am now — voluntarily getting up at 5:00 am every morning. I take my kids to school and pick them up. I shower and brush my teeth daily. I have a column on mental health in the local newspaper, and I’m the communications manager for NAMI Greater Corpus Christi. I have found the right support, treatment and purpose.
I want to help others because I felt so alone in my journey, and it literally could’ve killed me. I want to lend my voice to those who can’t use theirs.
I understand that I have a mental illness, and that it’s never going away. That’s hard to accept, but even though the odds are stacked against me, I’m still betting on myself.
Heather Loeb is the creator of “Unruly Neurons,” a blog dedicated to eradicating the stigma of mental illness. Heather has lived with major depressive disorder, generalized anxiety disorder, avoidant personality disorder and binge eating disorder for the past 20 years. She also writes a mental health column in the Corpus Christi Caller-Times.