I Have Capital-D Depression

Warning:  This post will contain candid and anecdotal commentary on my own experiences with Depression, Anxiety, Imposter Syndrome, and ADD, which some may find upsetting or traumatizing. If you are experiencing Depression or thoughts of hurting yourself, I implore you to reach out to someone you love and/or trust, or to the National Suicide Lifeline:  1-800-273-8255. They are available 24/7, and even have an online chat if you’re not ready to make the phone call. Know this:  You matter. You belong on this planet. I want you to live. Reaching out is the hardest part, but I know you are strong enough to do so. You are enough.

I was diagnosed with subclinical capital “D” Depression when I was 22 years-old, at the exact same time I was diagnosed with Attention Deficit Disorder. Neither diagnoses came as a surprise. By 22 years-old, I was well aware that something about the way my brain worked didn’t fit most definitions of right. During my teenage years, I thought that everyone was going through what I was. I was just an “angsty teen”, a portrayal I could find in any book, television show, or movie. To my knowledge, I wasn’t a suspected candidate for ADD because of the missing “H” (I wasn’t characteristically “Hyperactive”). It wasn’t a mental issue, it was a moral (/morale) issue. I was labeled a combination of:   Lazy, a procrastinator, a day-dreamer (once, a high school teacher used all of those descriptors in one breath!). My grades were okay-to-excellent, though. I needed a math tutor, but otherwise I could get by with cram-studying the night before an exam and writing 12+ page research papers the night before they were due and getting high marks. I accepted my labels because, as a teenager, I didn’t want to be different. Mental health had such a negative stigma back then (it’s gotten better, but we have so far to go). I just wanted to be normal. I just wanted to feel normal.

By the time I actually went in for testing, I wasn’t feeling much of anything. Or, I was feeling everything, and all at once. My grades throughout college were sub-par, except in the classes like Neuroscience of Animal Behavior and Comparative Vertebrate Morphogenesis (subjects that captivated me and and held my attention), or Spanish and Literature (subjects that came “easily” to me). My ADD was getting worse. I couldn’t focus, I couldn’t hold onto thoughts. I had to read sentences over and over again before finally comprehending them, because I was simultaneously thinking about my other classes, something a friend said, or my grocery list (or all three at the same time–sometimes more than just 3). As someone who was always told they were “intelligent, but could work harder” or “…but you procrastinate too much” or “…but you’re lazy” when they were younger, I found myself doubting that ascribed “intelligence”. How had I managed to make it to where I was? How had I manage to bamboozle high school teachers and college admissions? Did I just get lucky on those exams and papers where I did “well”? I felt like fraud, or on the bad days, like a waste of whatever intelligence people claimed to see in me (“Or were they all just lying?” I found myself thinking on more than one occasion).

It all came to a head one night, sat at the end of my bed in my apartment, sobbing into my hands. The inscription in my diary from that night (it is burned like a scar into my memory) reads:  “I don’t see a future for myself. I don’t see myself in the future.” I felt like a financial and emotional burden to my family. I felt like a failure. I felt like an imposter. I felt like the world would be a much better place without me in it.

I lost my friend Tye to suicide when I was 18 years-old. That night, while I sat contemplating my purpose, I remembered the pain his death inflicted on so many people. I remembered his funeral. I remembered that his suicide caused more pain than it alleviated. So I made my appointment for ADD testing at the University of Miami within the next couple of days. The process of just getting in for testing took a few months, but after that and a full day of testing, I had my diagnoses.

“What does that mean, subclinical Depression?” I asked the doctor.

“It means that, while you’re not big-D depressed all the time, it means that you are more prone to the chemical imbalances that lead to big-D Depression,” is how he explained it to me. “You may be more vulnerable to triggering or traumatizing events. Having ADD may exacerbate this.” He went onto explain that addressing my ADD would likely help to control my Depression as well.

I remember the breath I took after he told me this, because air has never tasted so sweet. It felt like I had been struggling out in the middle of the ocean, nose barely above the water in rough seas. Exhausted, sinking. Only able to lift my head every so often, only able to take in air in unfulfilling gasps. Having ADD and Depression explained to me felt like someone had reached down, grabbed me by the arm, and pulled me up onto the deck of boat. Granted, that boat was still in the middle of the ocean, in rough waters. But I wasn’t alone. I could breathe. I could get home.

I knew what I was getting into when I formally entered the veterinary profession upon my admission to RUSVM. Having worked in the field for 8 years at the time, I had already lost two friends (a vet tech and a zookeeper) to suicide, and one of my coworkers lost the veterinarian at the other practice they worked at to suicide. I had been exposed to the emotional trauma, abuse, and the death of patients faced on a daily basis by veterinary staff (veterinarians, techs, assistants, and receptionists alike). I had watched friends and coworkers and bosses cry in the hallways after losing a patient, and pouring over files far past closing time to find an answer they may have missed. I’d been the coworker crying in the hallway, or on the car ride home. I’d watched and experienced first-hand the verbal abuse inflicted on staff by clients. I’d been accused of not caring about animals. Demeaned and lashed out at because I didn’t have all the answers in that moment, or because the client didn’t want to believe results, or couldn’t understand protocol. Despite all of this, I know in my bones that there is no other path for me. I know I belong in this field. But this post is not about that.

What I didn’t realize was that Depression and suicide run rampant in the veterinary field, at epidemic proportions. According to the CDC, women veterinarians are four times as likely to commit suicide than the average American citizen, and male veterinarians are three times as likely (to my understanding this doesn’t include statistics on other factors such as race, sexuality, religion, or geographic region). Between 1979 and 2015, 11,620 veterinarians died by suicide. This year alone has seen the suicides of 6 veterinary professionals–including two Rossies.

This field has a mental health problem. This goes without saying. It needs to be said, though. It needs to be shouted.

I don’t claim to know how to fix it. I don’t know how to make it better. But I do know that something has to change.

Mental health is a sensitive issue. It’s uncomfortable. Addressing it requires change, and human beings as a whole don’t like change very much. Because change in itself is uncomfortable. Because our society as a whole doesn’t accept mental ailments in the way it accepts physical ailments. Because mental illness is still stigmatized and belittled. Because it is so much easier to send thoughts and prayers and talk about work-life balance, suggest trying yoga, and then turn around and continue on “as normal”, without taking action that might result in real, lasting change.

So I’m starting with me, by sharing my story. I hope that by sharing it, by talking about my struggles and my success, more people will feel comfortable sharing theirs. Every time I talk about my mental health, I get a little less uncomfortable doing so. I hope to give whoever I’m talking to a reference point if/when they want to further the conversation. Something like:  “Well when Brooke and I talked about it…” or “Brooke told me _____ about her Depression.” Anything to start or continue a conversation.

The more we talk about it, the better chance of someone (or a group of someones) coming up with a solution. So I’m going to keep sharing, I’m going to keep having these uncomfortable conversations until we figure out how to turn words into actions. 

I know this post is already quite long, but I would be remiss if I didn’t elaborate on what Depression can look like. For me, and for friends who have shared their experiences with me (with their permission and anonymity preserved).

Depression isn’t just laying in bed for hours upon hours in a dark room. It doesn’t have to have anything to do with happiness. Depression can be:

• Engaging in irregular eating or drinking habits. Eating more junk food than usual, consuming caffeine/energy drinks to excess. Not having the motivation to cook (if you usually do). Dramatically changing your diet.
• Drinking alcohol more than usual in a day or on a weekday, or feeling like you need alcohol to relax at the end of a long day.
• Going from 100mph to 0mph in your work and/or personal life (i.e., working really hard for several days straight and then being laid out for day(s) following)
• Losing interest in your interests. For example, this semester, Depression suggested that I didn’t want to run anymore. Or do yoga. Or go on morning walks with my dogs. These things, by the way, are activities that staved off Depression. Depression is very self-preserving in that way.
  (Note:  I went for a run today and yesterday and cried on the way home both times because I was so overcome with everything that I had been holding in. Because running felt so good and I was reminded of how and why I love it so much.)
• Absence of emotions, extreme apathy. There are days when I don’t feel much of anything at all. For me, those are the worst. It’s like I’m watching my life from the perspective of an outsider, not actually living it.
• Excess of emotions. Then there are the days when I feel my heart pulsing in my throat. Everything makes me want to cry. Something upsets me? Cry. Something makes me angry? Cry. Something makes me happy or excited or scared? You guessed it, I cry.
• Becoming hyper-critical of your actions — both successes and failures. Saying/thinking “If only I could have done–” or “I should have done–” even when nothing has gone wrong, when everything has gone right, or despite assurances that whatever happened wasn’t bad or wrong. Or, if it was a mistake or a failure, despite reassurances that it will be okay.
• Imposter syndrome. Going days feeling like you are a fraud. Feeling like at any moment, someone is going to pull the rug out from under you because it deserves to be pulled out. Because you didn’t actually earn anything. Someone, somewhere along the way took pity on you. Or just straight-up made a mistake. They’ve been found out, and now you have been too. There are still days when I am sure that I will be called into the Dean’s office and told to pack up and leave. Days when I can’t seem to remember a fact, or tie a proper suture on my practice board. Days when my mind blanks out when a professor poses a question, or days when I sit for an exam and it feels like, despite hours in lectures and pouring over notes and study guides, I hadn’t studied a minute.
•  Withdrawing from friends and family. Not going out to social events, not calling your parents, not responding to text messages. Not because you’re busy, but because you just can’t. I wish I could describe this feeling with more than those two words.
• Changes in hygiene. E.g., not showering as per your usual schedule, not brushing your teeth or hair, or wearing the same clothes over and over again.
• Inappropriate/excessive/out-of-character comedy. Deflection is a real (unhealthy) coping mechanism. I can be my funniest/wittiest self when I am Depressed. For me personally, it’s not so much that I don’t want to deal with my own emotions, but that I don’t want anyone else to feel the way I do. I don’t want to let other people in because I don’t want to bring them down. If I can make other people happy, I can be happy, if only for a few minutes. Making people smile is the best feeling in the world, even my Depression knows that.
• Insomnia/altered sleep schedule.
• Exhaustion. You’re not just tired. It’s different. It’s like you just finished a marathon, but without the endorphin rush at the end. It can include physical pain, too (achy limbs, nausea, and headaches).

So how do you cope? How do you get better? How do you keep your head above water? Everyone’s experience is different, but on the off-chance something that helps me could help someone else, I’ll share some of the ways I keep moving forward. Note:  I am not a doctor. I am not a psychologist or therapist. What works for me may not work for you. These were mechanisms developed with my medical professionals, and they may not apply to everyone. Talk to your medical/psychological professional before making any changes to your routine. 

• Ground yourself in something, anything, that keeps you moving forward. For me, it’s my dogs. If I don’t get up, Lilo and Star Lord don’t get fed. They can’t relieve themselves. While experiencing Depression, I focus on my dogs. If I get up and take care of them, the day is a success. I move forward from there.
  • It also really helps me personally to ground myself by thinking about my Depression and ADD in the most scientific way possible. Breaking it down on the level of neurons and neurotransmitters and hormones, talking myself through why it’s happening. It brings me back to reality, takes away shame, and provides objective perspective. I sometimes joke and say that I have a “robot brain”, or that I “channel my inner Spock”, but it’s not really a joke. Sometimes, the best thing I can do for myself is look in the mirror and, in a Leonard Nemoy-esque tone, calmly explain to myself:  “While what you are feeling is valid and there is no doubt you are feeling it, it is not rational. It is being caused by a chemical imbalance in your brain. You must stay on schedule. You must take your ADD medication. You must call your mother/schedule an appointment with counseling center/etc…The chemicals will rebalance. It will pass. If it doesn’t, it is something that can be alleviated by seeking professional help from a Doctor.” Do I feel absolutely ridiculous when I do this? Yeah, usually, but sometimes that’s the only feeling I have, and it helps.
• Schedule calls with family and friends, and have them call you.
• Make a plan on the good days to prepare you for the bad days. Make a schedule and try to stick to it. Pick at least a few things that you do every single day, and make doing them a habit. Having those habits makes it much easier for me to maintain that schedule when I’m experiencing Depression.
• Speaking of good days. Set up a support system on the good days. Set up an appointment with a psychologist, a psychiatrist, at your counseling center, a trusted religious leader, family member(s), friend(s). You may not feel like you need to in those moments, but in my own personal experience, it’s a hell of a lot easier to reach out when you’re feeling good. It also makes it easier to reach out to someone you’ve already introduced yourself to and “briefed”, when you’re going through the bad days.
• Find a movie, a song, a TV episode that makes you feel — happy, sad, mad, everything, and make sure you have access to it on iTunes or whatever Samsung users use, Amazon, or your preferred streaming service. My movie for when I feel emotionally congested, like I need to cry but can’t, is Coco, because it makes me feel connected to the loved ones I have lost. My movie for when I feel completely apathetic is Anna and the King, because it makes me feel ALL the things, every time. They also have NOTHING to do with school or veterinary medicine, which are generally the sources of my triggers. Which, on that subject, brings me to my next point:
• Learn to recognize your triggers. What makes you feel bad? What causes your thoughts to spiral, your heart to race, or completely and totally drains you? Recognizing these things can help you avoid them, or help you prepare for them. I think of it like this:  Most people aren’t afraid of the dark, they’re afraid of what could be hiding in its shadows. Recognizing your triggers is like holding out a flashlight, or having a nightlight in your bedroom.
• Have a list of numbers you know you can call or text. Keep them in a place that is easily accessible. Do not move them from this place. This can include the National Suicide Lifeline, friends, family, a counseling center, a psychiatrist.
• Reach out. It’s so hard to take that first step, but you can do it. Ask a friend or family member to walk you into the doctor’s office, if that’s what it takes. Getting in the door is the hardest part, but it only gets better from there.

I didn’t write this post for attention or sympathy. I don’t need it. I wrote this post because I’m still here, even though there was a time in my life when I didn’t want to be, when I didn’t think I deserved to be. I’m living the future that 22 year-old Brooke couldn’t even imagine for herself. I’m still in my little boat, and sometimes the seas are rough. There are days when my mind feels like a jail cell. There are days when my biggest accomplishment is taking a shower, or not crying during class, or walking myself to the Counseling Center.

I’m writing this post because it needs to be written. I’m sending up a flair from my little boat, and hoping to see others go up in kind. Maybe, just maybe, we can light up the night.

I’m writing this post because I am proof that it is possible to push through. That no matter how long the night, the dawn is sure to follow. That the pain of reaching out, admitting you need help, can only change your life for the better. That your story is not over yet. There is a future, and you are there. 

Be kind. Be compassionate. Be gentle. To yourself and to others. I will leave you with the message I started with:

If you are experiencing Depression or thoughts of hurting yourself, I implore you to reach out to someone you love and/or trust, or to the National Suicide Lifeline:  1-800-273-8255. They are available 24/7, and even have an online chat if you’re not ready to make the phone call. You matter. You belong on this planet. I want you to live. Reaching out is the hardest part, but I know you are strong enough to do so.

You are enough.