depression, anxiety, and the changed self

Stay with me here.  This post’s intent is to share a bit about how a severe bout with anxiety and depression can change a person — like change their brain.  And in doing so, coming out / recovering on the other side, a person feels like a different “self.”

I’m going to use myself as an example, because I cam currently in the process of figuring out who the “new Michael” is after a serious and multi-month battle with these two disorders.

As I’ve noted in recent posts, I don’t currently like this “new Michael.”  I am actively trying to learn more about the new me, and how I can successfully navigate the world in the new self.  As my therapist says, if I can do that … if I can accept the loss of the past self and learn to enjoy the new one … I will be much better off.  It takes work (which I am very willing to do and actively doing).  But it’s a process, and sometimes a long one.

Fact is, I’ve done this several times before in the past dozen years.  I’ve had several major bouts with anxiety and depression.  It’s just that this past bout has been the scariest, the most debilitating, and I feel the most life-changing.

But I have to do some context-setting before I share more about the changed self.

As I noted in The days the music dies “The deck was stacked against me.  As a child I had several knocks to my noggin … a couple pretty severe.  I grew up poor with my brain seeped in the chemicals of toxic stress that often accompany poverty.  And (most-telling) my DNA included one (possibly two) family lines that gave me a predisposition for a potpourri of mental health difficulties.”  In other posts I’ve noted that beyond the poverty my family experienced, my childhood was not an easy one … many, many hardships that do not need to be rehashed.  Lastly, I was born prematurely … like very premature.

All of these things made a struggle with anxiety and depression a lot more likely for me than for someone who did not face these issues.

I note these things not for a pity party.  I just want to give an accounting of some of the things that can impact a brain and its development.

My brain is different than a healthy brain.

It’s quite likely my childhood brain was frequently seeped in the chemicals that for evolutionary purposes were supposed to be helpful in escaping predators.  Fight-or-flight.  These chemicals — again speaking from an evolutionary perspective — were to be unleashed upon the brain infrequently and were more useful to adults who could fight or flee the predators (e.g. like lions, tigers, and bears … or a woolly mammoth) coming after them.   But when a child’s brain is seeped in these chemicals, it is more likely to become an adult brain that releases the same chemicals way out of proportion than when and what’s necessary.  It’s high anxiety in situations that should not require it.

Also, depression and anxiety — as a child or adult — can cause severe damage to the architecture of a brain.  Specifically, parts of the central nervous system can atrophy.  For example, the brain’s hippocampus — the center for learning and memory — can actually shrink and become less capable.

Next, I’ve been told by both my prior and current psychiatrists that impeded brain development as well as bouts with anxiety and depression can fray and / or kill neurons and deepen the synapses between neurons, making it harder for them to “fire” or “communicate.”

(Two side notes.  First, thankfully, there is some hope and evidence that treatment can reverse some — I don’t know about all — of these effects on the brain.  And second, I ask my psychiatrists and therapists lots of biological “why?” questions, because I really want to understand these disorders and do what I can to change future conditions.)

Lastly, treatment (often medication) can cure or put depression in remission.  But the more recent research says that anxiety is more difficult to completely erase.  My current doctor and therapist have both told me “some people are just anxious,” (i.e. (paraphrase) “Michael, this is something you’re going to have to manage; it’s a chronic and ever-present condition.)

The statement “some people are just anxious,” being said to me — attached to me — really impacted me.  Deep sorrow followed.  I’ll share more why later.

Now, let’s get into the versions of Michael.

Self (pre 2003):  

I can’t remember exactly what made me seek treatment for the second time in my life.

I tried getting help once before while I was in college for Seasonal Affective Disorder (SAD).  I knew I got the winter blues, and some reports on SAD started to make their way into mainstream media.  But what I now know was complete unprofessionalism, the therapist  I was assigned actually laughed at me — uneducated jerk!  I left receiving no professional help.  I bought what I lovingly called a “happy light,” and saw dramatic — although by no means complete — improvement in my moods.

Over the years, while my happy light helped, my overall condition worsened.  But I felt like I was just like a number of other people in my family.  I know a couple people in my family suffered from undiagnosed Obsessive Compulsive Disorder. (OCD).  I did too.  I just thought it was a family trait.  I didn’t connect it to anxiety or depression.  I didn’t know that OCD was an unhealthy expression of trying to control something in a world that felt like chaos.

If I had truly reflected on who I was and what I was going through, I would have known that I was anxious and depressed.  I probably started to accept this when I again — but hesitantly — sought help in late 2003.

Between 2003 and 2005 I was put on and taken off of several medications.  Most worked at erasing my depression — although it returned a few times.  Most also completely erased my OCD … oh what a relief!  But my anxiety levels were still pretty high when they hit me.  I probably thought, “OCD gone.  I’m cured,” not truly reflecting and realizing that the anxiety was just reduced, but I could be even better.

Self (early 2004)

Anyhow, a key thing to know about my changed self after (partially) successfully receiving treatment is that my motivations for doing many things changed completely.  Before seeking treatment, anger motivated a lot of my actions, especially in my job / vocation.  I sought economic justice, for example, because I was very angry at the systems that made people poor.  It was beyond any “righteous anger.”  I was burning-hot angry that America accepted poverty at the levels it / we did.

And I personalized that anger.

I’m pretty sure I became a social justice advocate because of the poverty I experienced as a child.  I remember a case worker telling my dad that the only way we would qualify for some sort of assistance is if he “got sick” and couldn’t work for a couple weeks.  The case worker wasn’t trying to humiliate us.  She was just trying to help in what she saw as a desperate situation.  But we left without help because my family was “too proud” to do that.  The only forms of assistance our family would accept were the free- and reduce-priced school lunches and fuel assistance — my childhood home was always cold in the winter … the walls and floors were often covered by frost during the coldest winter spells.  We never sought food stamps — although I’m certain we would have qualified; and to my knowledge never tried to get other forms of assistance other than some low-interest VA loans.

After I got help for my anxiety and depression and once I got on medications, I changed dramatically and in an awesome way.  Nearly all of my anger-motivations turn into hopeful-motivations.  I believed in change rather than raged against the system.

However, I remember as my mind and motivations were changing, I actually got scared.  Would my hopeful self no longer want to work for justice?  The community fighting for justice was where nearly all my friends and community were.  But I was so hopeful; internally, I just felt out of place.

I had to spend quite some time figuring out how to do my advocacy differently.  Thankfully, it did not take too long to make the adjustment.  (I now call it “expanding the love camp for fighting poverty.”)  But, fundamentally, I was a different person … a different self.

Another huge change happened to my brain that I cannot explain at all … and no one has been able to help me figure out.  Back when I was OCD and getting no treatment for anxiety, details mattered a ton.  Things had to be just so.  I had to have my facts straight before taking any major action.  And I was sort of a “go-to-guy” on the facts and figures regarding homelessness.

Once I received treatment, I became much more of a big-picture thinker.  Over the period of a couple years I lost my detail-oriented self.  To this day, I often say “the facts don’t matter.”  (Of course, I know facts matter.)  But in my job, I thought “Geez, if the facts mattered then our response to homelessness would increase proportionally as things got worse.”  But the the response : the problem ratio were always way askew.  I realized that political will was so much more important than any data I could spout.  I then started focusing my advocacy through more of an organizer’s lens than fully embracing the lobbyist-advocacy approach.

Now, in my job and in every other part of my life “the big picture” and concepts are what drive me and are how I think.  (This matters a lot when I get to my current struggle.)

Self (late 2004):  

My psychiatrist and I were both unhappy with the levels of anxiety I was still experiencing.  I switched up all my medications and for a period of about six months I was “Super Michael!”  Every barrier, to me, became an opportunity to overcome something and succeed.  I actually think I became extroverted during this time period — in reality, I am a huge introvert.  For six months I made a huge impact on so many things in my life and in my vocation.  But “Super Michael!” was really an unsustainable situation.  Happy chemicals were probably flooding my brain even when those happy chemicals were uncalled for.

I don’t remember if it was in late 2004 or early 2005, I crashed and burned big time.  I seem to remember an emergency call to my psychiatrist to help me calm down before I could get in to see him.  I also know I remember a specific trip to the pharmacy.  I was shaking and shouting “Give me my drugs!”  (Of course, I am not proud of this moment.)

In 2004 and 2005 I learned what panic attacks were.  (They eventually got treated away until the year leading up to and including my most recent bout.)

Self (2005 – approx 2009)  

A med change.  Some tinkering with those meds.  Nothing dramatic.  I just know that I realized that the detailed-Michael completely disappeared.  In fact, I forgot (and still forget) a lot of details.  Also, I felt / feel that I went from being an INTJ to and INFJ on the Myers-Briggs Indicator Assessment … although I’ve not retaken the test / tool and no one can tell me why or if it had anything to do with my mental health bouts.  They just feel connected to me.

I tell my wife that she does not know who I was before.  I feel like a completely different person than when we met.  (We met during that “Super Michael!” stage.  Luckily, she still loves the simply-Michael.)

Self (approx. 2009)

I went through another med change around 2009.  I wouldn’t say I experienced a dramatic self-change.  It was just that my old meds stopped working and new ones I was put one brought me back to a stable place:  no depression, still living with anxiety, but no OCD.

I was this way for about six years.  That’s a long time for one mental health medication to work.  I may have become complacent.  I may have ignored some signals beginning a year ago that the meds I was on slowly stopped working.

I feel I need to explain why I gave a background on brain development, the brain’s architecture, and fight-or-flight chemicals:

  1. It’s quite likely that long-term damage has been done to my brain because of living with anxiety and depression from at least my teen years through my mid-thirties.
  2. Different medications I have been on have worked on increasing or decreasing different chemicals in my brain.  That’s got to make a person feel different.  In some cases I would call it a changed self.
  3. The prolonged bouts with depression, but especially anxiety, even after seeking treatment have likely continued to have an impact on my brain.  And, I am learning now, an the life-long struggle has and likely will impact my body for the rest of my life.
  4. (And this deals with me now.)  The fact that “some people are just anxious” I equate to meaning not only is this a condition I have to manage rather than be cured of … it is a disorder that will continue to wreak havoc with my brain.  I can just do all within my power to minimize the impact.  Perhaps I am wrong about this.  Perhaps I can dramatically reduce its impact.  But that’s what I’m concluding now.

Self (2015)

My old meds likely slowly became less effect some time last year.  I remember living through a terrible August 2014.  I was depressed.  Just as I was about reach out for help, I snapped out of it.  So I did nothing.  Looking back, I wish I had done otherwise.

Then, on March 26, 2015, a panic attack unlike one I had ever experienced before hit me.  It wasn’t the first panic attack in years.  I had had many mini-eruptions going back several months.  But I tried to ignore them.  But I couldn’t ignore what happened that day.

Within a couple weeks I was full-blown depressed and experiencing panic attacks daily.

I found out my old psychiatrist had retired.  It took awhile to find a new team of professional help:  a Doctor of Nursing Practice and a therapist who both work out of the same office.

If you’ve followed this blog, you know that I had to transition off the old meds and onto new ones.  I spent a couple months bed-ridden (when I wasn’t at work).

Thankfully, I would say I am at least 2.5 months on the upswing.  But I am not all better.  As I noted in a recent post, my therapist informed me just a few days ago that I am still depressed.

She told me this after I informed her that I was feeling stronger, more capable in all parts of my life, and I was enjoying things a lot more.  There was just one catch:  I didn’t like myself.  As I noted in that post:  “I don’t like this new me I’ve become.  I don’t like hanging out with myself.  I feel like trash.  I feel ineffective, inefficient … I feel less able to make an impact on the many things I try to do and accomplish in my life.”

My therapist doesn’t think my continued depression is a “your meds aren’t working” depressed.  She thinks it’s a “you haven’t accepted the new you” depressed.  For me to make it to the other side completely, I need to accept that I’ve lost my prior self … there’s no going back.  Accept the new me.  And then I need to like this new self I’ve become.

I am going to try.  In fact, I’m pretty sure I can do it.  But here’s where I need to just state some hard things I need to grapple with.

First, my prior changed-selves were pretty awesome.  I mean, the first change was me loosing my anger-motivations and becoming a more hopeful guy.  That was pretty easy to get used to.  True, I needed to figure out how to move through the world differently than before, but for the most part that was fun figuring that out.

My next major changed-self involved me going from being a detailed-oriented person to gravitating more to “the big picture” and concepts.  While I love, love, love big-picture thinking, I can’t say I appreciate loosing some of the attention to details.  Details were once one of my strengths; I’ve lost that.  That’s a pretty big deal.  Thankfully, I am surrounded by many other people more than happy to be detail-oriented, and my big-picture thinking is usually helpful and inspiring rather than pie-in-the-sky, unrealistic dreaming.

And then there was the gravitation from being a thinker to a feeler on the Myers-Briggs way of thinking.  This is kind of attached to the loss of detail, but it’s much more.  Thankfully, I appreciate this not-so-new-anymore touchy-feely self.

So who am I now?  Truth is, I really don’t know.  And that scares the bejesus out of me.  It also means I haven’t identified that parts of myself that I will someday come to like.  What I do know is that I still enjoy doing a lot of the things that used to matter to me:  I love gardening and am passionate about food justice and food access.  I love yoga.  I love the simple act of learning new things.  And I really enjoy my ability to walk a line of being a social justice lobbyist who looks at things through an organizing lens … although I am not an organizer.

The problem, again, is that I feel detached.  I may enjoy doing the things list above.  But I rather dislike the person doing these things.

I’ve got a pretty good guess why:  my bully named Anxiety.

While I’ve always been anxious, my relationship to Anxiety has changed dramatically.  It used to be something that came and went … sometimes predictably, sometimes not.

Now, Anxiety is always there.  It doesn’t always consume me.  But it’s like it’s always beside me, ready to pounce.  And sometimes it does.

And managing Anxiety is terribly exhausting.

It means I’ve had to slow everything … and I mean everything … down.

Here’s why.  Imagine Anxiety is your bully.  And only by planning for ways to outwit It, or sometimes sit with It, (because you can’t fight Anxiety … in fighting It, It wins).  So if you don’t want to embarrass yourself in public, you really have to plan.  You have to be intentional.  You have to breathe when you feel Anxiety wants to pounce on and in you.  You have to stay silent when you recognize irrational words are about to come pouring out of your mouth.

Now, assume success.  You’ve outwitted Anxiety by planning and slowing down.  But then also put yourself in my place — I know it’s not a unique place, but it is my place.  I am an introvert.  Introverts are by nature slower.  Recall comes to us more slowly; we must think before we speak if we are to be comfortable and natural to our true selves.  And lastly, my place is one where the details either don’t matter or are hard to recall … and it goes beyond simple introversion.

So where does that leave me.  Since March 28, 2015, if I’ve done anything effectively, I’ve done it slowly, with tons of intention, and usually a lot of planning.

Can you understand why this may not always be enjoyable?

For a guy with a huge imagination and who loves big picture thinking, this need to always slow things down is often annoying and sometimes downright angering.

I hate how terrible my recall is.  And I hate how when I get excited about something, I can also feel Anxiety wanting to latch on to that positive energy and make it negative energy.

I am told by my therapist that over time, with practice, I will get better at navigating these situations, at navigating life.  But, she said, it won’t come naturally.  She likened it to a pro ice skater who learned earned early on in life how to skate versus me trying to learn to ice skate at 45 years old.  I may catch on somewhat.  I may become proficient.  But I’ll never be a natural.

So, this new me I am.  Because it’s a new me dealing with a chronic condition of Anxiety, well, something are just never going to come naturally.

Again, I’m not seeking a pity party.  I’m just trying to figure things out.  And sharing, because I know there are millions like me trying to figure them same things out as they live with these disorders.

We can’t just “snap out of It.”  Our Anxiety and Depression bullies take a lot of strength to live with.  And I think anyone being honest would say, we’d much rather put that strength to a different use.

But we can’t.  So we learn to navigate the world.  And then eventually like the person doing that navigation.

(This, I think, has been my saddest post on Depression and Anxiety.  I hope in writing and acknowledging this sadness and loss, I someday can move on.)