A Reflective Guide to Harm and Healing 

You know that one scene of The Matrix, where Morpheus tells Neo to pick either the red or the blue pill, and the unknown is the only constant between the two choices? Well, going to see a psychiatrist for the first time is kinda like that. It had been about four months at this point that I felt two degrees removed from my life, like a shadow lurking in the dusty corner of my 10 x 12 bedroom watching the reflection of myself stumble through a so-called life.

 

If you too have ever felt yourself living as a dusty corner creature ready to re-enter the meat sack that envelops your essence, then boy do I have some tips for you.

 

1. Recognize the fact that you’re slowly losing your grip on reality

 

This is tricky I know, but I have found that there are some warning signs. If you stare at the mirror and have conversations with yourself for more than five minutes, maybe you should think about researching for a friendly local mental health provider. If you’re unable to do anything in your free time other than sleep, maybe enlist a friend to pick up the phone. If your entire family on one side has generational mental illness, really wouldn’t hurt to at least check in on the upstairs thought factory.

 

2. Try therapy first before turning to meds

 

Congratulations, you’ve come to the conclusion that you need help, and that’s totally okay! Before popping prescribed pills, try therapy. The pills may make you feel better, but they will never make you feel like you’re less alone in your mental health struggles. The way my lovely gorgeous wonderful therapist Jackie describes it is, “I will never be able to carry your load for you, but I will always be here to guide you on the path, and help you up when you stumble.” And let me tell you, I have done my fair share of stumbling.

 

3. You’ve tried therapy, now comes the psychiatrist

 

My recommendation here is twofold. First, if you’re one of the lucky ones (like myself) who inherited their major depressive disorder (50% of MDD is caused by heritability) ask your depression role model what medication have worked for them, or haven’t, if applicable in this situation. Secondly, if the option for a zoom consultation is provided, take it. Zoom is a convenient side effect of the pandemic, don’t you think? But more than convenient, after your appointment is over, you can immediately scream into a pillow to let out all the pent-up anxiety that talking about your innermost thoughts and feelings can bring up (so unexpected I know *rolls eyes*).

 

4. Brutal honesty: with your mental health providers, and with yourself

 

There’s a very real cognitive dissonance that comes with mental illness. At the point of this specific depressive episode that drove me to seek psychiatric pharmaceutical help, I had been in weekly therapy for about 3 years and was almost finished with obtaining the credits for my biology degree. I understood the science behind major depressive disorder and generalized anxiety disorder. I studied cell signaling and receptors, and the intricate cell machinery running 24/7 to keep a body in homeostasis. That perfect state of being. Having this background in biology made me feel both more and less competent to handle the situation at hand. With a medication like Venlafaxine (aka Effexor), a serotonin and norepinephrine reuptake inhibitor (SNRI) that targets the receptors that bind to serotonin so that your body has more natural “feel-good hormones” to work with, you gotta be on top of your shit. The med has a half-life of four hours, and only takes a day to be completely out of your system. Most other antidepressants take weeks. The positive side of this is the medication only takes a few days before it begins to take effect on the brain and body. On the other side of the coin, if you’re not taking it every morning at the same time it will be measurably less effective. When sitting with my psychiatrist for the first time in mid-august, this was all carefully explained to me. Now, I’ve never been one to do anything in the morning well, and certainly not one to do something every day at the same time for an extended period. If I have an 8 am class there is a 50% chance that I won’t even go, and if I do go, there’s a 95% chance that I will show up in the clothes I slept in with my unbrushed hair in a messy knot at the crown of my head. So, you may be thinking then why choose this specific medication? And that’s a great question, one I have returned to many times.

 

Effexor is one of the quickest antidepressants on the market to start working. It also had one of the lowest rates of causing weight gain as a side effect, and even showed weight loss in some patients during studies. When the psychiatrist mentioned that I internally perked up and made a mental note, careful not to make any expressions or comments to tip her off to my deep seeded compulsive ode to control. Something I was not ready to make known because it wasn’t something I was ready to give up. Admittedly I don’t think I ever would’ve if it weren’t for the snowball that came from this virtual consultation in my room filled with the warmth of the mid-August sun shining through open blinds. It was the type of warmth that either felt like the welcoming beginning of new life, or the fiery end to an old one. I know now that it was the latter, and I can recognize now that this end was brought about by my inability to face honest truths.

 

5. Remember, you are not your parents

 

Ah yes, nature vs nurture, the debate as old as time. I think we can recognize that both are important influences, but they are just that, influence. 20 years before my run in with the psychiatrist clacking away on keys that determined my fate, it was already decided. As you may have caught on, my depression apple fell from the tree of Mark, my father. He too has visited many psychiatrists, whom he lovingly refers to as “sham doctors who just want to take your money,” and from that you can probably guess that he never found a medication that worked for him. A quick fun fact, you can request your session notes from mental health providers, something my lovely but narcissistic, depression prone, anxiety ridden father has done. Apparently, his doctor had written, “Just plain crazy.” He does twist the truth though, so how much truth is in that we’ll never know.

 

Having what one could call a depression role model is both better and worse. Better in that I have proof that one can exist alongside the gnawing existential discomfort nestled deeply within the psyche, and someone who will always be able to understand, a least in a broad sense, how dark the days can become. Days where inward apathy is so strong that I could no longer process that I was a real person in the world who needs food, water, and a very much needed shower to unplaster the greasy hair from my sweat crusted neck. Worse in that because of the silent contract in which we are to a certain degree reflections of our parents, who are imperfect, we too can succumb to the same imperfections.

 

There are few creatures more observant than children. After years of observing easy to procure coping mechanisms, like the six pack of beer my dad drank every night followed by a few mixed drinks and topped off with thick clouds from the “secret” bong that lived in the attic, I too thought maybe these techniques would work for me. They never did for my dad; no amount of drinking, smoking, or sex could cure what is uncurable. All it ever did was drive a stake between who he is now and who my mother met in Germany 30 years ago when he was in the Army, and she was an au pair. And if you’re wondering, yes, they did get divorced, yes, he cheated on my mom before said divorce, and yes, it has scarred my concept of love and marriage. But the main thing I took away from this is the field guide for how to numb yourself out of miserable existence, for better or for worse.

 

But while that was my guide, at least for a little, it wasn’t the fate I was doomed to because we are not the same. Where he made the decisions to swirl within mental illness, I made decisions to swim to different waters. Not all these waters were clearer, or less turbulent, but at least somewhere within myself I tried to break free from the generational riptide.

 

6. Take stock in what coping mechanisms don’t work

 

So, at this point you probably already know where this one’s going (you clever chap you), but worth mentioning again nonetheless. I would be hard pressed to find anyone who can say that compulsive drinking, or nursing the bong, or casual hookups as a means to forget your intense loneliness has genuinely improved their mental health. They’re all just numbing agents. And that’s not to say that you should never do these things, because I think numbness has its value when the alternative is taking lighter fluid to yourself and your belongings and watching all the pain go up in flames. There is value in being numb, but there’s more danger in numbing yourself to the point where you forget you are a part of life: yours and others.

 

I spent months unable to cry, which may sound like a relief, but sometimes a girl just needs a good cry, and when you can’t, all that energy remains pent up in the body, ruminating until it all comes pouring out into one moment. That moment is dangerous, because it sends you spinning into a fit of emotional vertigo, and when you’re spinning around, you just reach out and grab whatever you think will make it stop, and I never had the wherewithal to consider the long-term physical deterioration my hand-me-down coping mechanisms would have on my health. But sometimes, the thing you reach out for can be permanent, and that’s the most dangerous of all. 

 

7. … and which ones do!

 

Battling clinical depression is not an easy fight by any means, but that doesn’t mean it has to be an endless loop of hitting your head against the wall. In case you haven’t heard, I’m in therapy, and I probably will be for the rest of my life because I know that it is an outlet I need to stay on top of my mental health. These hour-long sessions have granted me with skills and wisdom I use every day to survive. It would be a whole different essay to talk about all of them, but there are a few that I swear by to impart onto you (and maybe you already know these things, but it never hurts to hear).

 

First, and most importantly to my life, is leaning on your support system. Friends, family, emotional support animals (registered or not), all ease the burden of life, whether depression ridden or otherwise. All of my most life-affirming experiences have been by the side of loved ones, even if that’s just sharing a meal in the dingy basement apartment that wasn’t supposed to be where we lived almost all of college but has become more a home than anywhere I’ve ever known before. Second, getting out of the depression environment we can create for ourselves. If your room is a blaring reminder that you’re slipping through the cracks of your mind, it is crucial to step out of that reality, if only for an hour, to remind yourself that the world is so much bigger than this. Lastly, and while this does fall under the general criteria for staying alive, eating, specifically eating something of some substance (I’m not saying eat a salad here, but preferably not just hot Cheetos and tortillas) does wonders for your mental state. Bonus points if you leave your room AND eat some food with a friend. I mean at that point your practically cured. Practically.

 

8. Find beauty in pain, but don’t fetishize your sadness

 

If you also grew up in the era of 2014 tumblr, this needs no further explanation. However, if that’s not you, allow me to continue. When I think about the journey of battling depression, especially during an episode, my mind always goes to the iconic robot living in a clear acrylic cage within the walls of the Guggenheim in New York City, a city I’ve always loved and has always felt at least a little bit like home for no reason other than the same one that eludes many of its 8.5 million residents. Can’t help myself, the work of Sun Yuan and Peng Yu, features an industrial robot programmed to contain this blood red liquid within a certain parameter. When first debuted, the mechanical arm swung around in a frenzy, frantically trying to capture the escaping liquid and pull it back towards itself. Years later, the robot remained within the same four acrylic walls, straining to complete the endless task at hand, but with noticeably less vigor. The arm moves with a tiredness, slowly pivoting around to pull in the liquid again and again, programmed to complete an impossible task for as long as the machinery will live. And there’s something so human about that.

 

There’s also something really fucked up about equating my depression to this robot because while I humanize this art piece, which there is nothing inherently wrong with, I am dehumanizing myself. I am placing my feelings onto something beautiful, channeling my pain into an expression that does nothing but perpetuate the notion that depression is the most interesting, unique, beautiful part of myself. During this depressive episode, I developed an eating disorder. And (trigger warning I suppose) I had never felt more beautiful. I channeled all of my pain and yearning for control over my life into my body. I had never felt more beautiful, and I have never, ever, felt more sick and more miserable in my life. That’s the thing I have to remind myself of everyday.

 

9. YOU ARE NOT YOUR THOUGHTS

 

Repeat after me: “I am not my thoughts.” Okay great, now say that 10 more times. And now remember that there will be times that you forget this truth, and remember to give yourself grace when that happens. During depression, there are times when I succumb to the historical forces at work in my body and brain, dragging me down to the lowest functioning version of myself. It’s important to remember, as therapist Jackie likes to remind me, it’s just a version of myself, and not what I am because it can very much feel that way in the moment.

 

Plagued with thoughts of I’m bad and I can’t do anything right and I’m stupid, worthless, irresponsible and any other negative descriptor known to man. But it’s hard to remember that’s not what you are, it’s how you feel. At the point of writing this essay, it’s been 9 months since my last major depressive episode, and now on the other side of the fence instead of wondering how I could ever feel happy, I wonder how I could’ve ever felt that bad, that inhuman. Our brain is amazing for what it can make us forget in the name of self-preservation. Not that I had the energy to keep a detailed journal, but as a writer there are always moments that demand to be captured on the page. While flipping through the notebook I kept at the time, a dusky blue cloth golden spiral notebook with “Notes, to-do lists, and secrets” written on the cover with silver sharpie, I came across four lines I wrote during those dark winter days that followed what was once August. It read:

 

“Can’t and won’t

are two very different things.

I could keep going,

but I won’t. There’s no will left in me.”

 

These words aren’t me, they aren’t my truth, they were just thoughts.

 

10. Don’t forget that you’re that bitch, no matter how long it’s been since your last shower

 

It takes a lot of will to do the things that you know are good for you when you barely have the energy to get out of bed to pee. So instead, you do the things that maybe aren’t good but at least they put another Band-Aid on the bullet hole so you can try again the next day to see if your will returns. And sometimes that takes a lot of days, but it always comes back, and the February cold turns into the April breeze blowing milky white flowers off the trees, and that eventually turns into long July days where hope gets a few more hours a day to grow.

 

Sometimes the diagnosis of depression, or any lifelong illness, can feel like a death sentence, a new reality that you suddenly find yourself trapped in. A life sentence would be more accurate, in the same way that being a parent or an artist is also a life sentence. There will be really bad days, and there will also be days that are so bright they make it all worth it. I’m sure I will face more episodes in the future, but each time I make it out, I become stronger, more resilient, and better equipped to find peace within this reality. This shit is hard, and I don’t think that saying it gets easier is accurate, but I’d say it’s true that it gets less scary.