Depression is a tricky and stealthy bastard. Depression is like a professional burglar who had been casing out my brain for quite some time. To this day, I still don’t know if this thief snuck in one night and cleaned house or pulled a trick out of Andy Dufresne’s book in Shawshank Redemption by slowly and steadily removing valuable pieces of my identity. I just woke up one day and noticed my drive, energy, self-esteem, motivation, happiness, joy & laughter had vanished.
The Fog Rolls In
In June & July when the rest of the US is enjoying summer sun, San Francisco is blanketed in fog. Having lived in San Francisco Living for a few years, I’d become accustomed to waking up to seeing fog outside my windows & hearing the strangely soothing sound of the fog horn off in the distance. Oddly, the fog did not bother me given I’d grown up getting slowly baked in Florida’s unrelenting sun. I welcomed the relief of the cool weather accompanying the fog. Some mornings, I would take my perch on the ledge of the front bay window and watch it retreat as I sipped my coffee.
One Saturday morning in June, I woke up to the usual fog outside my bedroom window and an unusual fog inside my head. This morning, I’d planned to head out for a long run run to train for an upcoming marathon. Instead of lacing up my running shoes and heading outdoors, I laid in bed for the entire morning staring at them. I wanted and needed to go for a run but felt pinned underneath the weight of my sheets unable to move or get out of bed. Unlike the summer fog in San Francisco, the fog inside my brain did not retreat mid-morning. Via text, I cancelled plans with friends. I withdrew from the outside world for the entire weekend like a hermit heading in to a deep dark recesses of a cave. By Monday, I emerged from my cave to go to work feeling a bit hazy. I thought to myself “I’m fine. I just needed the weekend to recover from a hectic schedule and enjoy some time to myself.”
The Blame Game
For the remainder of the summer, my internal fog returned and retreated intermittently clouding my view of myself and the world around me. I blamed these more frequent funks on the weather. Eventually, there were more mornings in which I lacked the motivation to go for a run. I blamed the lack of desire on training for too many back-back long-distance races. Instead of kicking ass at my highly-paid intellectually stimulating job, it was starting to kick mine. I felt less satisfaction in any achievements blaming possible burn-out. Invitations from friends to go out to events, dinner & drinks, I started to decline rather than accept. I blamed my lack of interest in socialization on getting older and growing tired of the party-scene. One of the biggest signs of depression I could not ignore, assign blame or make sense of was the rouge waves of sadness that kept crashing upon me unexpectedly.
Snap out of it!
Sadness turned into confusion which turned into guilt then sadness. I felt like shit for feeling like shit since there was no tangible reason. A few years earlier, I returned from an epic 8 month trip through Southeast Asia & India. My interactions, observations & experiences traveling through poor developing countries opened my eyes to true gratitude for everything, everyone and every experience in my life I had once taken for granted. I realized how lucky I was to be born a female to 2 loving parents in the USA with all the trappings of being US citizen. Growing up, I never lacked food, clothing or shelter. I could play with my brother and friends in the woods surrounding our house without fear of stepping on a land-mine. As an American woman, I had the right to education, a career & an option to get married with kids or not. With all this privilege, I did not feel I had a right to be sad and boo-hoo about nothing. I chastised myself. “Keren suck it up. Snap out of it. There is no reason for you to be sad!”
The Queen of Denial
My guilt about my fluctuating moods turned into denial about being depressed.
- I denied depression was real. Depression was just something drama queens/kings did to get attention by throwing pity-parties. Depression was just an excuse people used to not do something, which I always considered a sign of laziness.
- I denied it was possible for me to be depressed given my life was awesome. I lived in an amazing city, had a smoking hot boyfriend, a rewarding career, a great apartment sans roommates and friends and family that were always by my side.
- I denied I could be depressed living a lifestyle which included the textbook antidotes to depression:
- Get more exercise: I was training for a marathon. I practiced yoga. On the weekends I would hike, bike, dance salsa & walk all over the city. How can I possibly get more exercise?
- Eat a healthier diet: I ate a mostly vegetarian diet with fish added few times a month to get a dose of Omega 3’s. I did not eat processed foods or drink sugary sodas. How else could I improve my diet?
- Get more sleep: Dammit! I was getting plenty of sleep. In fact, I feel like I was sleeping way too much!
- Be more social: I had a large circle of friends, a hot young boyfriend & a caring family. I actively volunteered for the CCFA (The Crohn’s & Colitis Foundation of America)
- Reduce stress: I’m not one to stress about shit. Yoga & running are supposed to get rid of stress, right?
The Storm Intensifies
At the end of August when the weather cleared in San Francisco, not only did the fog linger inside my head but the dark storm clouds of the depression started to roll in from offshore. Larger & stronger waves of sadness crashed upon me pummeling me so hard I could barely keep my head above water. To escape the intensifyng storm, I retreated into my dark cave for safety. My apartment morphed from a sanctuary to a prison providing fuel for loneliness & emptiness. The gravitational pull of my bed became so strong it took hours to escape each morning. Simple activities that once required little to no thought in the past like eating, showering and getting dressed became monumental tasks. By the time I was ready to leave my cave each day, I was running on only a 1/4 tank with barely enough fuel to sustain whatever work or social activity awaiting me in the outside world. Everything I had to do felt impossible. Every aspect of my life was affected:
- Work as pharmaceutical sales representative had once given me great pleasure and satisfaction given the drugs I promoted saved lives. My role was to meet with doctors & other healthcare providers in Hospitals for tots, trauma & transplant to ensure my drug was prescribed appropriately, prevent overuse & promote patient assistance programs. Although satisfying, my job was extremely challenging on a good day given public perception of the pharma industry. MDs were not eager to meet with reps to avoid being seen as “sleeping with the enemy”. Given my appearance fit the stereotype: young, fit, attractive, I had my work cut out to convince doctors I was not a blonde bimbo but an intelligent female who knew her shit & gave a shit about their patients. Doctors & staff would sometimes treat me as though I was a punching bag rather than a person advocating for their patients making it more and more difficult for me to not take things personally. My productivity plummeted because I was spending significant chunks of time mustering courage as I stared at my phone before making a call to set an appointment or as I sat in the car before walking into the hospital for a meeting.
- Social functions involving more than 1 or 2 friends took substantial mental preparation. I’d prepare for the performance as though I were the understudy for the role of Keren by running through “lines” of my script to have topics of conversation with accompanying jokes ready. As I put on my make-up, I practiced smiling so no one would notice the real Keren was missing. The Keren I identified with was cheerful and so energetic people could plug themselves into her to recharge when they felt down & she could keep on going like the Energizer Bunny. After an outing with friends I found myself needing to hide in my cave for several days to recharge my batteries after nailing an academy award winning performance. Not only did I feel completely drained but I hated myself for acting so fake.
- Romantic life. If I wasn’t hiding in my cave, I was hiding out at my pseudo-boyfriend’s place. He was more of a boy toy than boyfriend given our relationship was more of a friends with benefits situation. He was a sweetheart but I was not ready to open my heart again after ending a turbulent 11 year relationship. Boy toy provided an escape from reality or as Marvin Gaye would say Sexual healing. Our sexual chemistry was mind-blowing but the other aspects of our relationship lacked substance. Despite having someone to snuggle with at night, I still felt completely alone and sad. My independent side would get angry for being sad because I didn’t need anyone, I can manage on my own.
Mid-September as the Atlantic was experiencing the 3rd most active hurricane season, the unrelenting storm inside my head had been upgraded to a Category 5 and had made landfall causing a large path of destruction. My head was swirling with negative thoughts and I couldn’t think straight or concentrate. I called in sick to work to avoid riding with my boss. My tank was depleted. I was exhausted despite the increased time spent in my bed. I was tired of trying to be so damn independent. I was tired of lying to myself. I finally admitted to myself everything was not fine. I needed help! Desperately! The problem was I did not how to ask for help. I was scared of looking weak in front of any of my friends or family because I believed they would think less of me or judge me. Who did I trust enough to share this horrible deep dark secret to call? I found myself just lying on my couch staring at my phone.
Thankfully, a former colleague and good friend of mine from the East Coast called. Since she had sold the anti-depressant ZOLOFT. She was someone I felt safe enough to trust with tales of my secret struggle. Once I came clean with my friend, I immediately felt lighter. Relieved. She encouraged me to call my doctor as soon as I got off the phone with her to make an appointment to get help. Before hanging up she said, “I am sorry you are going through this. I am here for you. Please call me anytime you need to talk. I will check on you tomorrow.” As soon as I got off the phone, I felt empowered and immediately called my doctor’s office. To my surprise, they scheduled me for the following day.
The feeling of relief was quickly replaced by feeling like a complete failure. Depression won. It beat me. Despite having a job as a “Pill-pusher”, I avoided taking medications unless it was absolutely necessary. Rather than immediately popping a pill for a headache, I always tried to figure out the source: Was I hungry? Dehydrated? Sleepy? and fix the problem at the source. I felt like a loser for not being able to fix myself. I did not want to have to “ask my doctor if ZOLOFT is right for me”.
To admit defeat isn’t failure, it is courage ~Mickaveli
I did not want to take an antidepressant. I did not want to see a doctor. I did, however, want to reunite with the Keren I knew and reconnect with the world around me. My desire to come out of the cave and emerge from the fog overrode my desire to avoid a medical intervention. I was no longer in denial. Something was wrong and I needed help.
My appointment was quick and painless. The doctor ran down a list of symptoms and asked if I had been experiencing any:
- Deep feelings of sadness, emptiness, hopelessness (Check, Check, Check)
- Depressed or irritable mood (Yes & Yes)
- Decreased interest or pleasure in activities (Check)
- Change in appetite &/or significant weight change (Not really)
- Change in sleep: (Yes, sleeping too much)
- Change in activity: (Ugh, yes)
- Concentration: (Check)
- Fatigue, lethargy, loss of energy: (Check)
- Feeling of guilt or worthlessness: (Yes to both)
- Physical symptoms: (Yes)
- Suicidal: (No thoughts of harming myself but I didn’t give a shit about living)
Generally, 3-5 of the above symptoms indicate depression and I had said yes to 9 of them. The American Psychiatric Association (APA) criteria for for major depression is 2+ weeks feeling depressed most of the time and an abnormal loss of interest or pleasure most the time. I had been experiencing symptoms for 2+ months! Without blinking, the doctor wrote me a script for ZOLOFT and set a follow-up appointment in 2 weeks…..to be continued