Hello Darkness, My Old Friend

It feels oddly comforting to be back to my old medium, my passion project, my baby from 2013 when I was for diagnosed with depression. We’ve had an on/off again relationship since then. Life has been busy lately, even more so I haven’t had the energy or motivation to update my blog with personal musings since October (red flag #1).

For me, this relapse was a long-time coming. I had begun to notice symptoms cycling since last August with experiencing periods of hyper anxiety and then crushing blows of depression, but I always came out of it on my own and plays it off to “it’s just my hormones around my cycle”. Even starting cognitive behavioural therapy to talk through my experiences in the PICU and navigate issues pertinent to my life. I told myself “things were okay”. Medication wasn’t even in the picture. The sun was shining, I fell in love with bike riding and running. Life was on the surface “good”

However as time passed, I felt the symptoms begin to creep in. December saw me struggling, moreso with anxiety, lack of concentration, and brain fog, I started a new course of medication with the help of my psychiatrist I could still feel myself spiralling as we welcomed the new year. I could sense a shift to mild depression in late January. Even on my medication I began to notice I was more hypersensitive to issues, low to no libido, and the day time fatigue started to set in despite 8 to 9 hours of sleep (red flag #2). However, all things considered I felt stable at this time, my anxiety was under control and my psychiatrist and I were preparing for my care to be transitioned back to my normal general practitioner (GP). Depression seemed like a distant past, that would rear it’s ugly head somewhat occasionally throughout February.

Until March hit.

By March I was hanging my a thread. So mentally and physically exhausted. I would have to spend 1-2 hours trying to motivate myself to workout (something I love doing) and often required a nap. My thought patterns were changing. My ability to focus was nil. My normal coping mechanisms and resources were failing me. I was overeating, particularly unhealthy foods, avoiding scheduling too many hangouts, I had little to no motivation to talk/open up to people I cared about, I was sleeping up to 14-15 hours a day and still being tired, and the smallest things would send me into emotional meltdowns (red flag(s) #3). As funny side note, I began talking about wanting to do puzzles this month (red flag #4), an activity I loved when I was first diagnosed with depression. What kind of rational person wants to sit on the floor for days on end mashing 1000 pieces together and losing sensation in their arms and legs?!

To be honest, i’m not sure what my triggers were as I can’t pinpoint a single incident per se. Because of my history of becoming resistant to anti-depressants around the 4 month park my psychiatrist believes I have a higher amount of inflammation in certain regions of the brain. We already knew I had elevated MAO-B from previous imaging which is often elevated in individuals with depression. This was likely exacerbated after getting COVID-19 in late September 2022. Research has noted a correlation between inflammation and depression.

Through this, guilt and shame have been words that pop into my mind. Aside from a handlful of people who I brought my thoughts up throughout the months (moreso disguised as dark humour) not many of those closest to me knew about my struggles. I felt apathetic to share my thoughts partially out of fear of rejection or the typical “aw I hope you feel better” talks that normally come from people who have never experienced the void depression throws you into. I felt shame with thoughts of “my life is good, why should I be feeling this way?.” I have a great job that pays well and is low stress, supportive and caring friends/family, ability to travel freely, dating someone amazing, and financially stable/housed. I should be beaming with rays of sunshine and exuding endless amounts of energy leaving shift work. So I continued to ride the waves of life and anytime I was asked how things were, the mental thought process was similar to these memes:

But the universe popped by and gave that idea a big, solid NOPE. I was thrust back in to the pits of darkness. A familiar territory for me. The creeping apathy of not being able to experience meaningful joy. Being sucked into a blackhole of endless sadness despite not having anything necessarily to be be sad about. The hemorrhaging of happiness and my motivation leaving my body. Did I miss this feeling? Absolutely not. It reminds me of the episode of Arrested Development in which Gob is sitting on the bench with the camera zooming in on him as he thinks introspectively about his life choices.

Initially my psychiatrist, psychologist, and I hoped to avoid any additional medications and decided to wait an extra week to see how my symptoms fared with time despite having now creeped into the moderate territory. However, there was no improvement in symptoms and if anything I began to creep into a deep pit I knew I wasn’t going to be able to claw my way out of without something changing. With the help of my psychiatrist I was able to start a new adjunct medication. So far things have been improving. I have been able to resume relatively normal sleep patterns this week, I have some motivation (enough to write this blog!), a return of a libido, and my mood feels slightly more balanced. On some level I feel optimistic for the future and am starting to see the world in colour again. That things will be okay. Hurray! But like all medications, time is of essence and I now experience low appetite, being overstimulated if theres too much going on around me, can be quite sensitive or the opposite completely apathetic to situations, and I still tired easily. Therefore, it’s been a slow process to acquaint myself with setting boundaries, cutting off most social media, and performing self-care despite not having the best week.

Relapse has been a tough pill to swallow though. I am used to being highly functional, motivated, and relatively energized. The thought exhausts me to think that it’s almost as if starting at square one and having to build back up. Part of me just wanted to keep it hidden under the rug and not feel embarrassed about how I was feeling or avoid feeling like a failure for not being able to push through this and having a huge set back. That eventually it would clear up on its own and no one would ever know except for my healthcare team and it was something I would just have to live with. I share my experience in hopes it can help others. In truth, we shouldn’t be ashamed of how we feel and we shouldn’t be afraid to lean on those who support us on the daily.

Honestly, I know I am one of the lucky ones. I know how to advocate for myself as a healthcare professional, be able to afford therapy, and know where to look for supports when needed. It’s unsettling to know that the only reason why I gained access to a psychiatrist was through the research study I participated in being completed and them agreeing to transition me to a new medication and monitor me to ensure I was stable before referring me back to my GP. I simply would not be able to afford the months to years long wait that most Ontarian’s face when waiting for even an initial psychiatric consultation. Let along having to wait additional time to receive further treatment.

The unfortunate reality is since I began this blog in 2013, things haven’t changed much. Mental health is still stigmatized, particularly amongst marginalized and vulnerable populations. Mental health services continue to be unaffordable and inaccessible to most average people. The concept of mental health continues to be exploited by corporations such as Bell Media.

I guess part of me has always kept this passion project open because I do genuinely hope that in time things will changed. That things will get better for people. I have to hold onto hope that there are gleams of sunshine that will poke though and eventually the clouds will dissipate and sunshine will outshine the rainy days.