Lately it feels like every day comes with a new insight into just how broken I am. I’ve known since I was fifteen that I have clinical depression. For more than twenty years I have cycled between dysthemia (low level but constant depression that dulls your senses and affects every part of your life) and major depressive episodes. There have been periods where I was depression free – most of university for example and most of the time since I’ve been on my meds – but most of my life has been lived in varying degrees of depression. The first time I spoke to someone about it I was fifteen, ever since then every conversation I’ve had with anyone about my mental health has been about depression.
No one has ever asked me about anxiety, no one has asked me about flashbacks, no one has asked me about anything that would have helped them to see what I believe is the bigger picture.
The first time it occurred to me that I might have PTSD was over ten years ago. But the images we are given of PTSD are of soldiers returned from war hitting the deck when a car backfires. We are led to believe that anyone with it can barely function and has vivid full-blown flashbacks where they lose touch with reality and relive their trauma. So I never spoke to anyone about it because I didn’t think anyone would take me seriously, I’d never been to war after all and I never hallucinated or lost touch with reality.
It’s the same with anxiety, I’ve only ever had two anxiety attacks in my life. When I was about ten I had an attack that left me rocking back and forth, crying, convinced that “they were coming to get me”, I’m still not sure who “they” were. Last year I had a mild anxiety attack with a racing heart and shaking hands. They were very different experiences but I call them both anxiety attacks, the first because of the intense fear and paranoia, the second because of the physiological symptoms. I had always thought that having an anxiety disorder meant having panic attacks all the time so I figured that while I had some anxiety it obviously wasn’t bad enough to talk to anyone about.
A lot of the time if someone had asked me about anxiety I would have said, “No, I don’t have a lot of anxiety” when what I really meant was that I don’t feel anxious all the time. What I failed to acknowledge was that the reason I didn’t feel anxious was because I had circumscribed my life to avoid those things that made me anxious. But living a life of avoidance is not the same as being anxiety free.
Part of the problem too is that I honestly don’t know what “normal” feels like. I don’t know how non-anxious people respond to things so I don’t know if my responses are anxious or normal. I find myself asking things like, “Is it normal to get shaky and feel butterflies in my chest when I mildly disagree with someone on Twitter?” I’m guessing no.
So maybe I could just say that I have the dual diagnosis of depression and anxiety but I still don’t think that’s the whole picture.
When I went in for my mood disorder assessment the psychiatrist told me that I needed to treat my trauma before I got any CBT or MBCT. Which got me thinking about PTSD again. So I Googled it, and there was one symptom that really jumped out at me: The sense of a limited future (you don’t expect to live a normal life span, get married, have a career). Did I ever tell you that I used to believe that I would never live past the age of twenty-five? True story.
Another significant symptom for me was “persistent feelings of helplessness, shame, guilt, or being completely different from others” (http://www.medicinenet.com/posttraumatic_stress_disorder/page4.htm#what_are_ptsd_symptoms_and_signs). Although, to be fair, I’ve felt completely different since I was a child, the feeling has only grown more intense as I’ve gotten older.
So, last night I started looking at online assessments. After three tests the consensus is that I do likely have PTSD.
So I guess that’s how broken I am.
This whole journey has consistently shown me how wholly inadequate the mental health care system is. Not once in the last twenty years has anyone given me a comprehensive mental health evaluation. I said I was depressed, they asked depression related questions and then they agreed with my assessment. This is not how diagnosis should work.
Depression is known to co-occur with, or be a symptom of, other mental illnesses but everyone I ever talked to took for granted that depression was the extent of my problem. A friend of mine recently had the same kind of experience. He’d spent most of his life trying to get treatment for depression only to find out upon proper assessment that he has BPD (you should check out his blog, he’s writing great stuff about his own process).
It’s hard enough to get any kind of treatment or assessment for mental health issues – especially when you have no money – but to have a diagnosis based on tunnel vision can severely prolong how long you go untreated or inadequately treated. How might things have been different for my and my friend had we been properly diagnosed ten or fifteen years ago? Nobody knows. All we really know is that our lives have been put on hold for way too long, and to think that we could have had treatment and perhaps moved forward with our lives decades earlier is saddening and infuriating.
And even now that I feel pretty sure of this diagnosis I have a sinking feeling that there will still be no treatment in sight. And of course that awareness that I may continue to be insufficiently treated only solidifies my fears that I have gotten as far as I can in my professional life, because without some kind of healing I can’t begin to imagine how to do what I need to do to move forward.
Cognitive Behavioural Therapy
Mindfulness Based Cognitive Therapy
Post Traumatic Stress Disorder
Borderline Personality Disorder