As I was stumbling across a bustling Barcelona street, my body didn’t feel like my own and my mind was overcome with anxiety, confusion, and utter despair. I thought for more than a moment that I should just let the next flow of oncoming traffic lay into me. I didn’t want to die. I just thought the idea of being in an ambulance, heading to the hospital would bring some relief to the torment that had become every waking moment of my life.
“The opposite of depression is not happiness, but vitality.” –Andrew Solomon
As I was stumbling across a bustling Barcelona street, my body didn’t feel like my own and my mind was overcome with anxiety, confusion, and utter despair. I thought for more than a moment that I should just let the next flow of oncoming traffic lay into me. I didn’t want to die. I just thought the idea of being in an ambulance, heading to the hospital would bring some relief to the torment that had become every waking moment of my life.
Just two weeks prior, my brain seemed to be in its peak state. I was 22 years old and living in Barcelona; studying language, art, and culture. I had never felt more independent, clear minded, or in control of my life and its future. As was the case with most of my life up to this point, I woke up excited each day to nourish my relationships, learn something new, and just soak in the beauty that is existence.
Most of the dozen or so psychiatrists, therapists, naturopaths, and other health professionals tell me now that sometime in those two weeks the gene for depression that infests my family tree “got turned on.” Whatever that truly means, I don't think anyone really knows.
I first noticed a problem when I was sitting in my Catalonian Art History class, diving into why Picasso was really a major asshole, and literally thinking that I was having a heart attack and going to die. I stood up, walked straight out and just lumped over in the hallway. If I was home in the US, I would have called 911. Instead, I just wallowed in what felt like an eroding shell of my mind and body. This event seemed like an outlier until a few days after, when I stayed up all night; I was sure if I fell asleep that I would never wake up.
This was accompanied by other strange symptoms that I'd never experienced; the way I looked at the world, my body, and my mind was entirely different. All my perceptions and sensations changed. It was my new truth that nothing ever has or will actually matter. It really was as if my mind and body fell into a deep, dark, rotten, infinite hole in the ground.
When I moved through the world, it was as if I was one layer behind my own mind and eyes, both metaphorically and literally in my field of vision. Everything was blurry. My night vision was terrible. My entire field of vision seemed to be filled with static, like from a TV, and my brain felt extremely slow and foggy. Every signal from my brain took ten times as long to get to my senses. Many doctors like to label this simply as dissociative or depersonalization. At the very least, it seems like it's a newer rare visual phenomenon called ‘visual snow’. Whatever it actually was, it was frightening.
As if that wasn't enough for my senses, my ears were ringing constantly. I still have tinnitus to this day, but the severity seems to ebb and flow. Same goes for the strange visual sensations. The anxiety eventually calmed down somewhat, but led to a deep, intense depression that manifested itself mentally, emotionally, and physically. I would often stop in the middle of the busy streets to sob, unprompted by anything at all. Crying suddenly seemed to bring me the only shred of relief I could find in the world. I couldn’t find anything positive in the world anymore. Everything was pointless. Everything I loved about my life--hobbies, interests, even my friends and family--seemed meaningless. “Why do or care about anything at all when we would all be dead someday soon?” was the new mantra to my life.
I remember keeping a journal from my travels in Europe during that time. When I got depressed, most of the entries stopped. I didn't want to write these feelings down because I never wanted to be reminded of how dark and terrible those days were. But there was one entry that I’ll share with you, simply with “fall 2006” written at the top:
“as i stumble around
my new life is filled with holes in the ground
some are shallow
some are deep
one is infinite nothingness
not deep not shallow
not black nor white
only fear
there is nothing to stop your fall, to latch onto
all you have is time, only time”
In addition to the mental despair, there were extreme physical symptoms. Two weeks prior I was literally running all around the city. I would fly up the stairs at Parc Guell, run miles on streets filled with tapas bars and Gaudi Buildings. I would end at the bustling sunny beach and then do yoga and go for a swim. I was playing soccer and basketball a few times a week. I was a very healthy and active 22 year old.
Suddenly, every step I took seemed like I was walking through cement. Every muscle in my body was sore. At some point in Barcelona, probably shortly after a session of intense and unprompted crying in the street, I had this cheesy yet very hopeful moment. I thought that if I ever got to the other end of this dark tunnel in my mind (and I thought the odds were low, honestly), that I would have to help other people who have experienced this. There was surely nothing more worthy in the entire world. I slogged across that street that day almost hoping to get hit by oncoming traffic. When I decided to step up on the curb at the last moment to the sounds of car horns aimed at me, I also decided I would seek help. I went to my program director and laid out what I was experiencing and he facilitated an appointment with what seemed like the oldest doctor in Europe. He prescribed me a ‘mood stabilizer’ that I’m pretty sure was just a placebo. Two days later I crawled into his office even worse. I was convinced the world and my life had no meaning and that everything that has happened or will happen in this awkward time space continuum that I used to call “life” was completely meaningless. I barely had any desire to fix it. I was certain that this was the truth and this was my new forever. Couple that with the feeling that I was losing control of this thing I used to call my mind and my body, and I was basically a walking existential crisis who would break down in tears in the middle of the street for no reason. Still, I clinged to hope. I clinged to the idea that somewhere deep inside myself, I thought that maybe I was still ‘me,’ and that I had been a victim; overtaken by this strange, demonic presence. He gave me a card for Dr. Alberto Pertusa, Psiquiatria (Psychiatry).
My mother has struggled with depression her entire life. My brother Graham had as well, until depression essentially ended his life when he was 23. (thats a story for another post.) Growing up my own childhood was about as depression free as they came. I was happy and healthy since I was a baby. It was easy for me to make friends. I played sports and was good at (some of) them. I had very loving and supportive parents. The idea of ‘depression’ was probably one of the most powerful and yet confusing things in my life. It still is. Why would someone not love life?
And yet in Barcelona, when I compared my symptoms to online reports of what depression was, they matched almost exactly. Loss of interest, hopelessness, meaninglessness, change in sleep and eating patterns, lack of focus and concentration, physical pain and fatigue, suicidal thoughts. When you read those words on WebMD.com they don’t hit as hard as when your life becomes them.
My life had become stripped from everything it was in about seven days. My mind had me convinced that who I used to be and how I used to think of the world was 100% false. One of the most profound symptoms I experienced was confusion and overwhelm. It was a complete mind-fuck that turned my train of thought into a tragic upside down train-wreck.
The thing about depression is there is nowhere to hide; there is no just waiting it out. You can’t just chill on the couch until the storm passes over. Your brain is the storm. It follows you everywhere. “Just try to do something you enjoy,” they say. As if, like when you have cancer plopping down on the couch and watching your favorite movie gives your cells a break from attacking your body.
With depression, being reminded of doing things I enjoyed only made me yearn for the life I used to have, then feel worse that it was gone. I used to enjoy simple pleasures like food, conversation, reading about the news, or watching sports. Depression takes that away. You don't care about anything. There are no more simple pleasures. Only reminders that those simple pleasures were so trivial and meaningless anyway. What a fool I was for getting so excited about watching some dumb game or meeting up with friends who were all going to be dead eventually anyway.
What’s the point?!
That's another thing with depression – some of my thoughts were rational! My friends and family ARE all going to die. This entire planet means nothing in the grand realm of the cosmos and the universe. There is, in fact, no absolute “meaning” of life. But there was always that something deep inside me, no matter how small it became, that accepted those facts but also accepted the fact that life is full of profound beauty and amazing experiences. That every single being on this planet is unique, even if not by much.
Back in Barcelona at my first psychiatric appointment, I was sitting on this man's couch in his apartment in the bustling Sant Antoni neighborhood. It took me about 10 minutes to attempt to convey the mess of thoughts and feelings - “symptoms” - of what I’d experienced the last couple weeks. I chuckled at the fact that I was trying to describe this indescribable feeling to someone who spoke English as their third language. He looked at me as if I just told him I simply had a broken wrist. Here’s your diagnosis (Major Depressive Disorder) and here’s your medicine (Effexor 37.5mg). I thanked him and left, with a slight bounce of hope in my step. I remember staring at that little red pill in the palm of my hand. I was not only filled with despair, confusion, disappointment, but also hope. I was now a person who had a psychiatrist and was going to take an antidepressant medication. I didn’t have much shame in it, but it just hit me as a shocking shift in my life. There are still some days now I put that pill in my palm and just stare at it for a few moments.
I look at my life now in two parts – pre and post that Fall in Barcelona in 2006. I was on Effexor for 10 years. I weaned off and that coincided with a new intense episode of depression and anxiety. After that I got back on Cymbalta (very similar to Effexor) and am still taking it every day. It’s my belief that these medications have helped me immensely. They seem to put a floor on the bottomless pit of darkness. I still drop into it sometimes, but never as low as when I’m not on them.
Three days after taking the pill and still living in an upside down world of permanent blurry, confused darkness, I called Dr. Pertusa. “Imagine you're dying of thirst in the desert and someone gives you one drop of water. This dosage is one drop,” he said. Most people's dosage ranges from 75-150mg of Effexor. The official maximum recommended dosage is 225mg. Over about a month of seeing no real improvements to my life, I started taking 300mg/day. Dr Pertusa calmly assured me that what I was going through was as straightforward as something like a broken wrist. It was going to take time, but it would heal. About 3 months later, after returning back home to Colorado, I finally felt some relief. No longer was every day a historic battle to make it to bed, where I could fall asleep and hope the next day I would wake from this nightmare. Some moments I could breathe peacefully. Some moments I could feel the sun beaming my being with warmth, and some moments I felt like everything was OK. My recovery was typically nonlinear. Some days were triumphant. Some of the most satisfying, happiest days of my life. My core would radiate with the simple acknowledgement that I wasn't suffering in that very moment. Then, the next day, I would break down and sob in the bathroom stall in between my college classes for no real reason. Eventually, I came back to ‘baseline’. That's psychiatric speak for ‘normal’. But my new normal would never be like the old normal. I wish I could say that I fully recovered from that initial episode and I went on to live happily ever after. But my experience is like that of many others; I was struck by two more major episodes with the same general symptoms over the last fourteen years. Besides that, I seem to go in and out of moderate to mild episodes with varying symptoms and degrees throughout the year. Frustratingly, I (or countless medical professionals) haven't found any patterns, triggers, or real answers as to why I’m prone to these symptoms, other than my family history and an apparent genetic predisposition to chemical imbalances in my brain.
I’ve mostly come to terms that this is something I’m going to have to manage throughout my life, each and every day. But it does have some positive effects. It gives me perspective. It helps me prioritize my life. It gives me the ability to not give a shit about small, petty things that I often see ruin other people’s days. It has motivated me to adopt a healthier lifestyle. Exercising, eating healthy, sleeping, and maintaining positive relationships are things that we all strive for but not being depressed is a helluva motivator to keep those habits up.
When I’m symptom free, I have a bounce in my step, both physically and mentally. I describe it as a type of carefree buoyancy, whereas when I feel the opposite, it's like I’m being dragged down into the dark ocean during a storm, barely keeping my head above water. My brain is malfunctioning; my eyes get blurry, my brain foggy and my ears ring badly. Everything positive is subdued yet negative experiences are heightened. Small stressors seem insurmountable.
I have so many more thoughts on the complex and terrible world of depression and anxiety, but this short antidote is meant to give a glimpse into my life; my brain; my experience. So many of us have similar stories, none the same. I share this because sharing personal experiences is an effective way to reduce stigma, educate others, raise awareness, and give hope. If you are reading this and are suffering, you are not alone. There are so many treatment options that have worked for millions of people. Depression and anxiety are treatable, and there are millions of people who have been at absolute rock bottom only to ultimately endure to regain their vitality.