Mass Shootings, The Media, And Mental Health

Dear media,

Like so many others, I have been following the events of Munich’s mass shooting on Friday night. Like others, I want answers. The answer cannot be, however, to publish psychiatric diagnoses without further comment or explanation by professionals.

You see, I happen to suffer from the same mental health problems which are now being shoved into the limelight as the Munich shooter’s conditions, depression and social phobia, so I might be more sensitive in that regard than your average person. But it is extremely unlikely for depression or social phobia to result in the desire to go on mass killing sprees – harming other people doesn’t even feature in the diagnostic criteria.

What you are doing is publicising facts which may have contributed very little to nothing to the crime at the cost of increasing the stigma for millions of people suffering from depression and / or social phobia in Germany alone. You are making life harder for all of us who are already receiving psychiatric or psychological help, and you are potentially discouraging others from seeking treatment because they don’t want to be regarded as a “loose cannon” or threat to society.

Next time, please consult professionals and add their opinion before releasing your findings. Instead of trying to be the fastest to get information out, how about striving to be the one who gets the best information out?

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Social Media & Social Anxiety

Where is this blog going? What does it say about me? Since blogs also are representations of their authors (or at least embody certain aspects of their personalities), it is important to me that it looks like something I can identify with, that I want to be connected to. After checking out other blog designs over the last couple of weeks, I finally decided to make the transition to a new look. I really liked the compact layout of the old blog theme, but had grown tired of the colour scheme and tiny font. The new one has a more elegant typography and no visual clutter, and the so-called responsive design ensures that it can be comfortably read from a variety of devices, from desktops to smartphones.
Lugubrious Layara also got an organisational makeover during the holidays: I streamlined the “About Me” section a bit, and reorganized the side-column. After almost two years, the scope of topics written about here became too broad to be faithfully represented by the tag cloud any longer, so I took it out. The “Social Anxiety” tag got turned into a full category, as it is too important a topic about which I write. I added share buttons to the posts and a contact info with an email address to the side-column. Finally, I designed my own header.
And then, I also joined Twitter in an effort to promote my blog a bit. This step I was not sure about, as tweeting does not come naturally to me. I will give it a try and see how I like it in a month’s time, and whether it actually is worth the effort.

I am old enough to still remember the way the internet was when it first became widely available for private homes – back when you could not receive phone calls while being online and loading graphic-heavy websites was a real test of patience. The era of dial-up, when surfing was so expensive that I was limited to two hours per month (sic), and when I could not even have imagined some of the programmes and games I use routinely now. Before web 2.0 became a reality, the internet was a much easier place for people with social anxiety, like me. One felt much more anonymous back then, and conversations took place on message boards or forums. If you wanted to lurk from the shadows, you did just that, and if you wanted to join in, you had plenty of time to formulate a response.
Nowadays, very many places on the internet feel like the virtual equivalent of a party in full swing. Social media live off rapid-fire smalltalk, and like with a real-life party, those who are best at this kind of conversation shine, whereas the rest awkwardly stare at their feet. On a message board, you could drag posts from the archives and revive threads which had been dead for years, and the discussion would simply continue if some other forum members had sufficient interest. On Facebook, a status update becomes obsolete after a few days at the latest (depending on the size of your friends list), and on Twitter the half-life of a tweet is a few hours only.
I am terrible at smalltalking, both in real life and online. I never know what to say, or how to phrase it, and I am also very shy about approaching another person. Fear of rejection, fear of humiliation, fear of boring the other person… the whole palette of social anxiety at work. And social media have a much lower threshold in that regard than old-fashioned forums. Facebook is ok for me in so far as I know all the people there, and the update tempo on my timeline is not quite that high. But Twitter is difficult, because I do not know what to say: for the mindless quips and joking, I’m not nearly funny enough, and generally too long-winded for anything of substance. Some people have the gift to be profound and deep in 140 characters – but I don’t.
However, it’s not only Twitter which freaks me out. I can’t play any kind of online game where I would have to interact with other players; it is especially stressful because I am supposed to be leisurely around them, but can’t relax in such a setting and tense up. I am also very shy on other people’s blogs, more often than not leaving without commenting because a wave of social anxiety washes over me: “What if they don’t like what you are going to say? I’m sure they’ll find it boring as hell! Oh, look, there already are three comments, and they’re all so much wittier than what you were going to write. Just leave before anyone notices you have been here…” Even on my own blog, I sometimes worry about my own replies to visitor comments.

Both in real life and on the internet, I prefer moving in social circles I am familiar with – among friends, I can become surprisingly chatty. Among strangers, no matter how amiable they may be, it takes quite a while until I will start opening up, and one of the advantages of the internet is that through blogs or forum posts, you can get to know another person a little before you even exchange the first greeting. Social media which put more emphasis on exchange than on content (I am somewhat simplifying here, for the sake of the argument’s clarity), like Twitter or Facebook, are not any different from real life conversations to me, in terms of difficulty. Virtual worlds or MMORPGs are even more stressful than attending a party.
The truism that increased internet usage equals increased loneliness is too simplistic in my opinion, because its default assumption is that online interaction is less meaningful than offline interaction. When you suffer from social anxiety, however, chances are that – given a conducive internet usage – you actually are going to have more meaningful contacts with strangers than in the real world, while experiencing less stress at the same time.
Do not misunderstand me, I am not arguing for the superiority of internet contacts. If given a choice, I will always take a face-to-face meeting with my friends over emailing or messaging them. However, the media tend to paint a picture missing crucial details, both when praising the new interconnectedness and when condemning the arbitrariness of the new online platforms. For many people out there, the reality is much more complicated.
Despite occasional bouts of anxiety, I value the contacts I have through my blog, because they make me feel less isolated regarding my mental health problems, because I can learn from other people’s experiences, and because they allow me dealing with my social anxiety on a smaller, controllable scale.

… And Little Strokes Fell Big Oaks

(Not that I’m a big oak. More like a weeping willow. Or one of those windswept, crippled conifers.)

On my old computer, I used to have a .pdf-file of a text-book on personality disorders. Unfortunately, I do not remember the title anymore, and so this source of information remains lost until I gain access to my old hard drive again. Said text-book not only gave me plenty of insight into the mechanisms of my own mind – many of the characteristics of avoidant personality disorder can also be found in my own avoidant behaviour – but also educated me about my mother’s obsessive-compulsive tendencies (my family displays an abundance mental health problems, namely depression, social anxiety, OCD, and borderline streaks – we’d make for some fantastic study material).
From this book I know that my mum’s rules are just a way of coping with what she perceives as threatening. Her constant criticism is born out of an urge to make a chaotic world appear controllable: for example, by blaming the gastritis on something I did wrong – “you are eating the wrong stuff / cooking unhealthily” – she reduces the emotional helplessness for herself, because in a world where I get gastritis just out of the blue and nothing can be done about it, she is helpless and at the whim of fate.
The problem is, I already am “out of control”: I am depressed and have a plethora of symptoms which come and go seemingly randomly, leaving me unable to function at times. Of course, my mother worries, and tries to bully me onto a path which she believes will keep me safe – oblivious to the fact that her criticism drives me even deeper into depression.
This phenomenon is not so rare, actually: whenever some outrageous crime happens, like a child being abducted and getting killed, you will hear comments from other people afterwards, blaming the child’s parents for something they did wrong or neglected to do – because if they admitted that we are living in a world where such cruelty can happen at random, without anyone who could have prevented it, they would have to face the fact that the same could happen to their own children. This, however, is too painful; it would destroy the illusion of absolute safety – it is so much more comforting and easier to believe the other parents failed and that they are doing a better job.
So, whenever something happens to me, my mother blames it on some shortcoming on my side, because that means she did not do anything wrong and that she is still in control.

From an unemotional point of view, I completely understand her behaviour, and it is obvious that my mum is not aware of the patterns herself. But that does not excuse the fact that my emotional well-being gets thrown under the bus time and again: it’s hard enough to live with what I’ve become, without having to deal with all those other flaws and failings I supposedly am responsible for.
There are a few things I will have to do to ensure my own well-being: short-term, I’ll have to talk to my mum about all of this. The problem is that either I’m in a state of anger about what’s happened, which makes me snappy and defensive – not a good basis for a discussion. Or I am not angry, which by default makes me lack the guts to breach such a difficult topic with her.
Long-term, I need to gain some more distance from my parents, emotionally as well as geographically. And financially. I just want to get to the point where I can have my own life at my own terms, without feeling guilty or pressured all the time.

Constant Dripping Wears The Stone

(Source: Dan Piraro)

I am not entirely serious about the comic strip; it’s more of a hyperbolic comment on my life, but I need some humour and the chance to vent in order to deal with today. My mum has been cavilling me since the morning, a constant trickle of criticism and petty jabs. And even though I am fully aware that I am not the reason for her jibes, but merely the most convenient target for her projections, it still hurts. Drip.
The individual remarks are trivial, not worth getting upset over, one should think: one was about my doormat having been dirty for “at least three months”, when the handymen who are currently renovating the flat next door had left the crumbs of mortar and concrete only 36 hours ago – which have been cleaned away since Friday night already. Drip. One was about me relating a news article of local interest I had read online which according to her was “old news” – despite the publishing date being yesterday. Drip. One was a degrading remark because I had to take a nap this afternoon, “just because you had to go shopping at 10 AM” – even though I’d had a really bad night with only 5 hours of fitful sleep (when I need 9 hours because of the depression) and still had gotten up without complaining. Drip.
What upsets me the most is that my mother makes these comments because she is upset with another person, and then takes it out on whoever crosses her path. I’ve been through this in therapy so many times and know exactly what I should do and say, but she triggers an automated behaviour in me which just makes me sound sulky and defensive instead. We are not really interacting with each other, but acting parts in a pre-determined script. There is so little self-reflection on her part…

My sister is between jobs right now, with another month to go before her new employment starts. Being divorced and unemployed, she and my mother spent a lot of time together: eight, ten, twelve hours a day, for the last three months. My sister also has started seeing a psychiatrist and taking antidepressants; generally speaking, a very good development. So I understood that my mother would be preoccupied with all of that, since it indirectly concerned a large part of her own day.
My mother has strong tendencies towards OCD-behaviour, with a myriad of unwritten rules one better not crosses. Doing something in a different fashion than the one she uses will give her a very hard time. She is also “orthorexic” in so far that she is obsessed with nutritional properties, minerals, vitamins, and whatever positive qualities an ingredient might have. So when my sister decided to try a vegan challenge, or go at least vegetarian for a while (she took a break for Christmas), my mother was all over that.
Now, I don’t have anything against vegans or vegetarians. I understand and even agree with a lot of the reasons why people would choose to eat this way. In fact, I try to have a vegetarian day or two every week, but I could not go without meat for a longer time, and my husband is quite the carnivore. I respect the choice others made, and want mine to be respected as well. But once my sister embarked on her vegan adventure, my mother’s occasional negative remarks on what I am buying / cooking turned into a steady stream. Drip, drip, drip.
Thanks to the antidepressants, my sister had the urge to walk a lot, and so they would go out together, walk two or three hours every day – and are now bragging about the weight they lost. Some days, they make me feel like a fat, blubbery pudding; the German word I have in mind is Trauerkloß, literally a “mourning dumpling”. The idiot who is too slow and pathetic to get on with her life, the fat fuck who always sleeps. Of course they do not use those words, but this is the effect their little verbal needle pricks have on me. Drip, drip, drip. And it took two years of psychotherapy just to come to the conviction that the problem is actually on her end, not mine.

Not only are they together 90 % of the time these days, but on the rare occasion I see my mother without my sister, she incessantly talks about her. And while I understand that this is on the forefront of her mind due to the many hours they spend in each other’s company, I would very much like to talk about something that is important to me once in a while. I feel like I am going to have a melt-down if the situation goes on for much longer.

Come A Little Bit Closer

The news about the TV appearance were not the only unusual part of the last session. Two years of therapy mean that eventually, the appointments start to resemble one another; the discussions are important, but you know the routine and after a couple of weeks you recall brief scenes rather than the whole meeting.
Over the course of spring and summer, the hospital wing where my therapist sits got renovated and he had to move out of his office temporarily. He’s been back in the old location since September, but had decided to furnish the room differently: the set-up of desk, armchairs, file cabinets and the exam table is mirrored now. All of this was reason enough to break the routine and to make me feel uncomfortable at first. I got so used to always having the same perspective in that room that the familiarity of sitting in that armchair gave me a sense of security. Before that background, the last session took place.

Practicing alternative behaviours is a huge part of our routine: my problem is that I tend to do nothing at all and just remain silent when I should speak up instead, and so my therapist lets me reenact scenes we discussed, but where I behave the way I should have for getting a more desirable outcome. He lets me repeat phrases until I get the words and intonation just right, and then some more to “hammer” them in.
This is by far my least favourite part of therapy as it goes completely against my instincts of hiding myself away. When the acting was still new to me, I would occasionally break out in giggle fits due to the embarrassment, but that wouldn’t let me off the hook. My therapist would just sit there with a smile on his face, wait until I calmed down, and ask me to try again. Of course, I could just refuse and sit in my chair for the rest of the appointment, but that’s not what I go to therapy for… So, the best way to handle this for me is to get it over with as quickly as possible – the more I concentrate and the sooner I get it right, the fewer repeats we’ll go through.
Last time, however, my therapist decided to take it a step further: he had me stand up from the chair. I repeated my little speech two or three times, then he said:
“Come a little closer, please.”
I made a small step towards him.
“And even closer, please.”
Eventually, the distance had shrunk so much that I could have reached out and put my hand on his shoulder; since my therapist was still sitting in his chair, I had to look down on him – a position which makes me feel extremely uncomfortable, and he knows it. I had to repeat my sentences again, then he asked:
“What did you just think?”
“I was thinking about my arms, about how I have been clasping my hands at this really weird, crampy angle.”
“Your arms looked just fine. Why don’t you try a different position?”
I tried to relax my limbs and folded my fingers in front of me, but since I had also inched back a little in the process, I had to step closer again.
“How does that feel?”
“Ok. Better than the crampy clasp.”
“Try something else – why don’t you just leave your arms hanging?”
I did, but immediately felt like they ceased being a part of my body and turned into two dead appendices rather. I stretched and flexed my fingers nervously, hid my hands behind my back and then let them hang down again immediately.
“How does that make you feel?”
“Nervous. Extremely uncomfortable.”
“But you look more relaxed and more approachable. If you fold your arms, you are creating a barrier. And to me, these positions are comfortable. I don’t feel threatened by you at all.”
In the past, we had talked about how this particular constellation – he sitting, me standing up – made me feel like I was being this huge mass ready to bulldoze him. Like a gross, obese entity crushing him under my excessively large body. I am (by now) completely aware that a lot of the negative self-image and negative thoughts exist in my mind only, and that they are very much over the top, but that does not make them go away.
“How do you feel now?”
“Still nervous.”
“Look at my face. What do I look like?”
“Neutral. Relaxed.”
“How can you tell?”
“There are no signs of stress in your face. No creased forehead, relaxed eyes and mouth.”
“It’s good that you can see this!”
We talked a few moments about how I hardly ever relaxed when sleeping either, that I often woke up with my hands clenched into fists, and the muscle pain I had from that.
“How do you feel now?”
“A little better. Still uncomfortable, but not as much anymore.”
“Good! It’s very important that you experience this!”

When I was finally allowed to sit back into the armchair again, I felt fairly exhausted. We have done similar exercises before, but never that long and intense. Rationally, I know what this is all about: by exposing me to an uncomfortable situation and having me observe that the effect on my therapist is not a negative one, my self-image gets altered. Physical proximity is not a bad thing, and I am not causing negative emotions in another person by standing close to them. At the same time, I am forced to endure a situation I’d usually avoid, so that I can experience how the discomfort starts decreasing after a while.
Strangely enough, despite experiencing mostly negative emotions, thoughts, and despite how stressful this was, I felt really good after the session. In my family, nobody would ask how I felt, and if i talked about it, the standard response would be to pull myself together. In fact, that is what I used to do – so much so that I always downplayed all of that or ignored it even, and it felt good to acknowledge the existence of those emotions and having them taken seriously.

Going Public With Depression – On TV

In the first session after my recent participation in the student class, my therapist paid me a compliment on that. He said he could see a huge difference between the way I carried myself in April and November respectively. And then:
“I think it would look pretty good when filmed, too.”
I didn’t know what to make of this comment, assuming he was talking about having a camera roll in another, upcoming student class:
“You think? I don’t know – and can’t really tell; it’s not like I’d ever watch that anyway.” (We’ve had discussions in the past about whether I wanted to see footage from the early sessions, which were all filmed. I always refused.)
“We are planning a featurette for [news show on TV] next spring and I could imagine you making an appearance as a patient.”
I was rather dumbstruck after that and don’t quite remember what my response was, something very non-committal in any case. We dropped the topic afterwards and it was only after a night’s sleep and some serious thinking that I sent my therapist the following reply via email:

“After giving the TV featurette you mentioned yesterday a lot of thought, I came to the following conclusion: should you really do this and by that time still be interested in having me in it, I would participate.
My biggest question was whether I’d be willing to have relatives (likely), neighbours (possible) and fellow uni students (unlikely) recognize me in the feature and asking questions about it. The result is that I am willing to accept that.”

And he emailed back:

“Thank you. In such a featurette, the main focus is on the treatment method and on what you learned through it. It’s great that you are going to be a part of it!”

I know the news show he was talking about very well; it’s on every day except for Sundays, in the early evening. Each region within the federal state has their own version, where they focus on what is going on in that particular area. It’s certainly not nationwide. Once per week they have reserved broadcasting space where they highlight a medical topic. One week it may be the latest development in terms of laser surgery for cataracts, the next week the specific problems of teenagers with diabetes mellitus, and after that it might be migraines or heartburn or coronary heart disease or hearing aids or dentures etc. They tend to focus on health problems which are common among the general demographic here in Germany and on treatment methods available in the area, including mental health issues, and one of the episodes planned for next spring is going to be about chronic depression and CBASP.

Generally speaking, the filming process shouldn’t be much more difficult than talking in front of the student class. It’s going to be a little different, but it does not spark any more anxiety in me than being in a presentation in front of an audience I can actually see.
However, since the exchange of emails with my therapist, I had time for contemplation and realized that the underlying issue is not so much going public, but rather relinquishing control over who knows and who doesn’t. Right now, I recall exactly whom I told about the depression and psychotherapy, and I have a pretty good idea of who told somebody else. In total, it should be about 25 people who are in on it, give or take a few. Once I appear on TV – with my real name, my face clearly visible, my voice saying the words – it will be impossible to tell who has and who hasn’t seen the feature.
For people who suffer from anxiety, it is very important to be in control of problematic situations, because that is what keeps the anxiety at bay. If I decide who is being informed or not, I also control for whom I’ll be vulnerable and who is excluded from knowing that “secret”.
There has been a similar situation in my life before: when I was in my early twenties and had to decide whether I wanted to come out of the closet or not regarding my sexual orientation. Before I came out, if I got into an argument with someone or somebody hurt my feelings, it comforted me to have a secret. They did not really know me; there was a part of me hidden from them which they could not reach, which they could not hurt. With the depression, it is the same mechanism at work.
Coming to this conclusion doesn’t change my position. I said I’d do it, and I will, but it’s always better to be clear about what is happening emotionally and to adjust one’s behaviour accordingly. I do not want my mood to tank afterwards because suddenly I feel exposed and vulnerable. And everything else is a challenge, I guess.

Exhibit B: A (Not So) Hopeless Case

Exactly a week ago I appeared in front of a group of 19 psychology students as an example for chronic depression, but was (still am) so swamped with homework that I didn’t have the opportunity to write it down yet.

I went to the hospital straight from university, so I was a good half hour too early and had plenty of opportunity to get nervous. It was a part of the hospital building I did not know too well either, so I did not dare going to the restroom out of the irrational fear I would miss my therapist. Fortunately, we had about ten minutes to spare when he came to pick me up…
We spoke a few minutes outside – about how I was doing in general, and about being nervous and how curiosity got the better of me. We also discussed which personal information my therapist was allowed to disclose (he was very discreet, though, and spoke only of my “significant others” instead of naming a person, and he did not talk about anything personal). I gave him free range on whether he wanted to wear his white coat or not and on whether we’d sit at a table or not, so my therapist decided to recreate the therapy setting – no white coat and no table.

As mentioned, the group was rather small, creating a somewhat intimate setting – as far as that is possible given the circumstances. My therapist acted as a moderator, introducing me and my diagnosis, and I smiled a hello into the round. They had already learned about the characteristics of depression before and seen an in-patient earlier that day, who had also volunteered to talk about her depression. The in-patient, however, had been an example for biological reasons behind depression: a disturbed transmitter chemistry and psychiatric treatment with cipralex. I had come in as a representation of environmental and character-related factors, with the biological components playing only minor roles.
I started off recounting how I got misdiagnosed by my former general physicians, how I suffered from panic attacks in summer 2010, got on citalopram but could not shake the depression, and finally got in contact with the hospital. My therapist elaborated on the importance of behaviour in medical caregivers – had my first contact not been such a positive one, I might never have followed through with everything that followed.
There was a sheet with the results of all the clinical tests I did during the first 48 weeks of therapy – BDI-II, IDS-SR, MADRS and possibly some more I forgot, plus the results of the “therapy cards”. My therapist was not supposed to know the results until recently, because they evaluated the level of trust between him and me, but from the beginning of their evaluation (from therapy week 4 on), they had shown I trusted him. All the other tests showed the same pattern: a very high score in the beginning, then a steep decline over the course of a few weeks only, and a long phase of slowly fading out. Towards the end, my scores went up a little again, when I decided to go back to university.
We spoke about how important it is to trust the therapist and I listed some of the irrational fears the therapy setting could have evoked – fear of being ridiculed, getting yelled at, not being taken seriously, or cancellation of therapy as a punishment for increasing depression symptoms, for example.

I did surprisingly well during the presentation. My biggest fear had been to just freeze or being unable to get proper words and sentences out of my mouth, but I spoke with a loud and clear voice, looking at all the faces around me and also taking in their reactions. Everyone looked friendly, some even smiled encouragingly, and I found it easier to open up than expected. Of course, we did not discuss anything private, but considering that in university I have not told anyone anything that is even remotely close to the truth, it was a pretty huge step for me. Part of what kept me calm was that I knew no matter the outcome, the people would learn something from my appearance. If I could talk about it all, they’d learn from my report, and if I froze up completely, they’d get a demonstration of what depression can cause.

Today, I had a regular therapy appointment, and my therapist said he could tell the very moment I relaxed during the presentation just from observing my body language. He gave me quite a lot of praise and also thanked me for doing this: “Half a year ago, I wouldn’t have asked you. Not that you couldn’t have done it back then, but the risk would have been too high.”
There are several reasons why he asked me: for one, I’ve been long enough in therapy to know the process very well, to have recovered enough for being able to reflect, and something he has been stressing a lot over the last weeks is the fact that I went back to university. Last month, he told me about a colleague’s patient who had a similar diagnosis as I do, and she actually quit her job – whereas I went back to a place that terrifies me quite often. On about four days per week, it gets so far that I think I can’t take it anymore. I fantasize about quitting. But, there’s no realistic alternative, and so I struggle from week to week. My therapist knows this – he gets to hear plenty about that, of course. University was one of the catalysts which propelled me further into depression, so he thinks that it is of utmost importance now that I confront those situations and master them. He never influenced my decision on whether I should go back or not, but clearly approved of it afterwards.

One reason why he asked me might have been that the outlook for me without CBASP would have been pretty bad: “Early-onset chronic depression with life-long co-morbidity of panic disorder.” He called it a “horrible, horrible diagnosis” which without this special therapy programme would be pretty much treatment-resistent. CBASP actually works on both a personal and an environmental level, whereas other schools of psychotherapy concentrate on one aspect onely: classic Freudian psychoanalysis operates on the personal level only, classic cognitive psychotherapy on the environmental level. Neither of them would have been sufficient for me.
They didn’t even put me through pre-treatment self-evaluation as they usually do, because they thought it would trigger my flight instinct and drive me away. Yet, despite the very bad odds, here I was – more or less functioning now, and definitely able to talk to a bunch of strangers without running away.

At the very end of the presentation, everyone clapped and I blushed and looked down to the floor, until my therapist told me: “Look up and take it in. This situation will be over soon, so this is your only chance at grasping of how well it went. You need to take this memory home with you.”

Finances, Fear, Family, Frustration

I’ve been in financial trouble lately, culminating in a letter threatening to turn off my gas and electricity if I didn’t pay within the next few days. It came as a really unpleasant surprise, because I was under the impression that I had already paid all I owed last month, but apparently had been mistaken. My boyfriend was able to cover for that and so we’ll continue having warm water and heating, but it still weighs down on me. My mother barks at me that I have to quit university and get a job, my therapist tells me it’s of utmost importance that I finish university, as does my boyfriend… I’m tired of being stuck in the hamster wheel, tired of the perpetual financial strains.

And I feel guilty because I do not have the stamina for handling both a job and uni. I can’t even hold up university alone…

Last week I saw my therapist for a few minutes because he had to give me a doctor’s note so I’d get out of the second attempt of the chemistry exam. He puts a lot of emphasis on the fact that I learn to put up boundaries towards other people and learn to defend myself so I can actually do what I need to make myself feel good. Which is a lot easier said than done, especially since my brain just “empties” under stress and I become completely speechless, in the very sense of the word. It is a reaction to the cortisol surge one experiences under stress: long-term exposure to this stress hormone damages the brain cells in the hippocampus, which results in memory problems, and it also impairs retrieval of already stored information.
This morning, I was crying after receiving the letter from the energy supplier, and despite my boyfriend asking me to talk to him and say something, I just was not able to. I could not form a coherent sentence, neither in English nor in German. Even now, it is difficult to describe what is going on in me in these situations – one should assume that once the problem is taken care of, everything is alright. And my boyfriend echoed what my therapist tells me as well, that I have to stay in the present and not make this about everything that went wrong in my life, but I am not always able to do that immediately. The fear and despair can be faster than any rational thought.

Money is not the only source of stress – there also are the uni exams, of course, family situations, and the fact that the bureaucratic process for our marriage is very frustrating. I had to hand in a statement from my parents that they supported me financially, which got “lost” – even though I handed it in, it never arrived at its destination. Then I brought a second copy of the statement, only to be told that I had to re-write it. It is almost ridiculous that my boyfriend’s American documents are all fine, but my German documents create all kinds of problems…

Semester Exams

The next two weeks are entirely dominated by exams, plus a palaeontology / micropalaeontology test which got announced on short notice, because too many people want to get into the zoology class. Tomorrow I’m taking the test, Tuesday the chemistry exam, Friday crystallography, the following week physics and mathematics.
Even though I’m rather good at palaeontology, I had to learn for this test because here the absolute grade isn’t as important as the relative placement – in other words, one wants to leave as many people behind as possible, to ensure getting into the class. However, studying for palaeontology is taking away time I meant to invest into chemistry, which is the exam I have the least chances for passing to begin with. At the beginning of the semester, I would have thought that role fell firmly to mathematics, but chemistry is twice the workload and just more than my brain appears capable of handling. I somewhat regret registering for the chemistry exam now as it will use up one of three attempts for taking I have – guess I will just give it a fool’s try on Tuesday and if I fail, I’ll spare the other two attempts for next year…

I’ve written before about the effects depression has on the brain: it alters and destroys synaptic connections in the brain which then have to get re-connected again (through therapy). I really feel the difference between now and ten years ago – I tire much more quickly of learning and have a harder time remembering facts. When working on long-term projects, like writing a paper, it doesn’t create too many problems because I can take breaks as I want and the result depends on continuous effort rather than a moment’s “genius”, but I struggle with preparing and sitting exams. After about 90 minutes, I need a break for several hours, and even though I still have two weeks to go, “learning fatigue” has already set in.
The sad part is knowing that ten years ago, I easily would have excelled in classes where now it takes an effort to be “merely” good. And I know that it could be worse, that after all I still manage to keep pace – but there is a lot of frustration still, and I am constantly afraid that from the outside it looks like I am procrastinating, and I am afraid that I will be judged by the professors and other students, because they are not aware of my background story.

You Better Watch Out, You Better Not Cry…

Christmas usually is an especially difficult time of the year when it comes to family relationships. The stress prior to the actual holidays brings out the extremes in our behaviour. My mother regularly explodes on December 23rd because she has problems delegating tasks, but gets overwhelmed by the load and vents her frustration and stress violently…

Thursday, December 22nd

Twelve minutes into Christmas break on the way home from university, I slipped on the escalator leading down to the tram station and twisted my right leg, while simultaneously tearing my left arm (which was still grasping the handrail). I could still walk, but only with a heavy limp, and had to have my sister pick me up from the tram station in my home town so she could carry my bag.
Over the course of the evening, I got rather upset because while my mother was rather worried, it was over the fact whether I would be able to drive her and my grandmother to the supermarket the next morning, and she didn’t express any concern regarding the pain I might feel. Functionality trumps pain – her problem with my depression was that I didn’t function anymore, too. Now that I appear functional again, my feelings become secondary once more.

Friday, December 23rd

At 9.30 in the morning, I found myself at an overcrowded supermarket. Finding empty space in the parking lot had already been a challenge, especially since my grandmother uses a rollator walking aid and wants to park as close to the entrance door as possible. The situation inside was worse rather than better.
With the need to pull myself together for uni temporarily suspended, my mood had started tumbling down quickly, and the longer we were inside the grocery store, the worse I felt. My swollen foot pulsated with pain and the constant bickering between my mother and grandmother – who were both affected by the general atmosphere as well – grated on my nerves.
After about half an hour, it took a really insignificant event only to push me over the edge: I was waiting for my grandmother to finish her business in the butcher’s section and just biding my time, when suddenly I felt the gaze of a middle-aged man on me. As he noticed that I caught him looking at me, he winked at me. No idea why it upset me, but it did. I wanted to yell at him to stop looking or winking at me.
I hid in the only empty aisle I could find and actually started crying. Because of the limping, I was always behind my mother and grandmother anyway, so nobody missed me, but in order to not rouse suspicion, I couldn’t stay there for long. Managing to pull myself together until it was time to queue at the check out, where people were standing in long lines already, I excused myself and went to wait in the car: officially to rest my foot, but really for calming down. I switched the radio on and concentrated on the music, so that by the time my mother and grandmother had finished their shopping, I had regained my composure.
In the late afternoon, I got once again into my mother’s crossfire when she repeated her threat that I had to move out if I didn’t get a student loan, which caused me lots of anxiety again.

Saturday, December 24th

Christmas Eve is the main event of the festivities in Germany, with big family dinners and the exchange of presents in the evening, and it started even worse than the previous day for me. I was already crying in the shower, with no clue how I was supposed to get through the day, and poured it all into an email to my boyfriend, which I felt guilty for later – waking up to your girlfriend’s hysterics doesn’t make for the most relaxed Christmas either. (He was utterly lovely about it, though.) Somehow I managed to dry my tears and leave, though, so I could help my mother with the preparations for dinner, but what happened then took me by surprise:
The conversation turned to my 10-years-old niece, who had exhibited rather ill-spirited moods that morning too. I remarked that I’d occasionally wondered if she didn’t suffer from the same condition as I do, but had never said anything because that was a hunch rather than something I could back up with solid facts. And that’s the truth – there are certain gazes or the way she holds her head or looks at people that feel utterly familiar to me, like the seed of all that avoidant behaviour, but I cannot present any evidence.
My mother nodded, then asked: “Where does this come from? Is it me?” (My mother looks after my niece when she isn’t in school.) I was completely flabbergasted and utterly at a loss. There are basically three reasons which cause chronic depression: 1.) genetic predisposition – which I certainly have from both sides of the family; 2.) neglect in infancy and childhood – which I can exclude for myself; 3.) repeated experiences of helplessness over long periods of time, concerning “significant others” like parents or other very close family members – which is very much the case with me. I had never told her what caused my chronic depression, because that’s simply too damn difficult a task – I don’t want to hurt my parents, because I know they had to endure a lot worse from their parents and never had a chance to not become slightly messed up either, but I could name dozens of situations that led to me becoming depressed and developing patterns of avoidance. My mother probably noticed that I was looking for the right words a little too long, and when I finally answered, it was just the three points mentioned above without connecting them to any personal experiences.
This was the worst time possible for this conversational topic to come up; on a different day, I might actually have welcomed the chance for broadening this point with her, but NOT ON CHRISTMAS EVE…
Myself, I started feeling better in the afternoon and got through the evening ok. We had all agreed to not buy any presents for each other because money is tight, so the big emotional climax was missing, but at least nobody fussed about it and I wasn’t reminded to get a job either…

Sunday, December 25th

I slept like a stone, until noon almost. The day was quiet, but pleasant. In the afternoon we went to see my grandmother and aunt, and in the evening I met one of my school friends who is home for Christmas. I didn’t feel like crying.

Monday, December 26th

Boxing Day is a national holiday too in Germany and at least in my family entirely dedicated to laziness. This year was in so far unusual as the family had a bowling tournament with Wii Sports – my mother isn’t much of a computer user and doesn’t even have an email address, while the rare behaviour for my father was to actually come out of his office for a family activity. So it was rather strange to see them playing a console game, but I really enjoyed the whole enterprise!

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So that was my Christmas, in a nutshell. In a little while I’m leaving for meeting another friend; I’m trying to fill the days with pleasant and diverse activities, so that my depression index goes down again and I will be fit for the last month of uni and exams once Christmas break is over, because if I learned one ting in therapy, it is that you must “fake it until you make it”.