The Jubilee Post

Today, I celebrate the 100th blog post. If the counter didn’t keep track of the statistics, I most certainly would have missed the milestone, but I’m glad I didn’t. When getting started, I had no real direction to follow and was more concerned with not running out of steam early on than with developing a writer’s voice or any long-term goals for “Lugubrious Layara”: I simply talked about what was happening in my life, in therapy and in my head.
There also was (and still is) an educational facet to the blog, even though from a strictly personal, non-professional angle. I get a fairly consistent number of hits through people googling CBASP, and I’m really happy that I can provide links, information and my own opinion – when I was about to start the therapy programme, there was very little to be found online, and nothing in regards to other blogs. Even now, the situation changed only marginally. And despite knowing that there are other people being treated with CBASP all over the world, and even at the same hospital, I have never encountered any other CBASP patient, neither online nor in the real world. If I have accomplished nothing else with this blog, at the very least it added a new voice to the plethora of mental health blogs out there.

Blogging means walkig a tight rope. How much of yourself do you put out there? And how much of the people you write about? I try protecting the privacy of everyone I mention as much as possible, even if it means that my writing sometimes suffers from the vagueness. Occasionally, I don’t post because it would mean discussing the personal history of another person more than I’m comfortable with – I can decide to put my own history out there, but not my husband’s, for example.

Sometimes, I want to post, but don’t have the energy for writing. There’s a good deal of regurgitating going on when developing a new blog post – I type, erase, type again, erase again, scratch certain formulations, phrases or entire paragraphs. And there were a few incidents where I had an entire post ready for publication but never chose to put it out there – because the situation described didn’t exist anymore, or because it had taken so long to jot the story down that I had already moved on from it by the time I was done.
And then, there are the blog posts I would like to write, but that are too emotionally exhausting to go there: for example, my sister’s “borderline meltdown” the day before my wedding. Or the post about my husband’s immigration process I started writing back in September, but the 800 words on that which I got so far only covered everything prior to our marriage day and revisiting the events make me feel depressed, so the progress on that is very slow…

Despite and because of all of that, blogging is very beneficial for me. My therapist always urges me to become “more visible”, to put more of myself out there, and the blog is one way of doing so. My friends and my husband not only know of its existence, but some of them even are somewhat regular readers. This allows me to talk about my feelings and problems at length without pushing them on anybody – they can decide when to visit, and how often.
There is a similar effect to writing about depression as visiting the student classes had; it gives me a sense of not only dealing with it, but of making it a little less like I wasted all those years with the illness. At the age of 32 years, I have spent a minimum of 20 years with the condition, about ten of them severely depressed. By sharing, it does not feel like I wasted those.

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Decluttering: Part I

Even though there are symptoms which the vast majority of people with chronic depression share, everybody’s got their own personal “bouquet”. In mine, lack of energy features very prominently. To the non-depressed reader, it might sound either very lazy, or pleasant even if I write that I don’t have the energy for anything but sitting on the sofa and watching TV, or browsing the internet, or playing computer games. The truth, however, is that these occupations are not thoroughly enjoyable, but merely a way to pass time. Plans one might have harboured when going to bed suddenly appear impossible to fulfil, turning into insurmountable obstacles when waking up.
There’s hardly a person who does not feel tired and worn out once in a while, consequently putting off all chores. But, for the non-depressed person, these feelings usually vanish quickly, and they go back to vacuuming, cleaning, grocery shopping, mowing the lawn or doing the dishes. For me (and many others out there), nothing changes after a day or two of rest… In fact, it can be like that for weeks or months even.

For about 90% of my adult life, I have lived with the dishes piling up in the kitchen, my entire desk hidden under stacks of paper from the previous year(s), and the bookshelves covered with thick layers of dust. Both my flat and my behaviour lived up to the stereotype of the messy, absentminded professor.
I don’t really like living like this, but whatever little energy I had usually went into whatever was the most necessary at that moment. The last time my entire flat was neat and tidy lies a good ten years back in the past. After my husband moved in and there was someone to share the chores with, things improved visibly, but there still are piles which I have not touched in years.
About two months ago and after a particularly lethargic summer (completely drained from the exam), I found Cynthia Ewer’s “Cut The Clutter” at my local library (the book appears to a more fleshed-out, printed version of the author’s website, organizedhome.com). It did provide the inspiration and motivation so bitterly needed, and a few eye-openers. For example, it never occurred to me that chaos can be described as resulting from put-off decisions – definitely one of my weak points.
Of all the personality types Cynthia Ewers mentions in her book, I have elements of every single one in me: because I’m sentimentally attached to many of my possessions, I have a hard time throwing them away, even long after they’ve stopped being useful or important. Because I tend to think that I might need something later, I’m afraid of getting rid of it. Perfectionism gets in the way of organizing, because I am under the impression that I need a faultless system before I can get started. I feel bad about throwing out items which once were expensive. And a tiny part of me still is in rebellion against my mum telling me to pick up my room, even though I moved out of there a long time ago.
Four out of those five reasons I can overcome with rational thinking: even if an item used to be expensive, its worth usually decreases over the course of time. It’s more important to get chores done than to slavishly follow a predetermined plan. Most of what I was saving for later use could easily be obtained at the time I actually would need it, so holding on to it is just a waste of space. I am a grown-up now and do not need to rebel against my mother – having a nice place should be more important.
That leaves sentimental attachment as the only reason where pure logic alone does not help me changing my behaviour.

The decluttering process began as a rather assessable project, with re-organising my pantry. Certainly not the most pressing matter, but it promised quick results and little risk of running out of steam before completion and thus adding to the long list of problems. I finished within two days and due to instant improvements when cooking (ingredients were so much easier to find), it gave me the motivation to tackle a bigger challenge the following week: sorting out my wardrobe / closet, which I hadn’t done since the day I moved out of my parents’ flat (throwing away individual pieces does not count). By the time this was done, there were two big and four small bags of clothes as well as a bag of shoes waiting for the trip to the donation containers. For the first time in years I was able to move the hangers on the rack – another instant improvement.
Over the following weeks, I would finally put an old glass-showcase outside that had been sitting empty in my flat for at least three years, because I never got around to taking it apart, and then I’d move on to weeding out all the books I’d never read again, with the intention of selling them online. To this date, I have made just over 90 euros out of 87 books sold, with about 100 more titles I hope to sell eventually too. There were about 30 shelfmetres worth of books in my flat, and while I kept the majority, now there is actually enough space to put every single volume on a shelf.
The last week was dedicated to decluttering my desk, because I intended to put both the desk and my swivel chair out for the bulky waste collection. While the collection is free here in Germany, you have to call in and register in advance if you want it picked up, because in the past scavengers used to tear the piles apart, making a lot of noise and strewing the discarded items all over the neighbourhood. In my community, there is a collection every other month and you can order the service twice a year , meaning that you’d better have the bulky trash ready once the date rolls around.
The swivel chair posed no problem, because both armrests had been broken and resisted any attempts at repairing them in the past. It was utterly unusable and actually a minor threat of injury. The desk had two drawers, one of them unfixably broken, but otherwise it still was in a good condition. Had it been smaller, I’d have kept it – however, with dimensions almost as large as a single bed, it was too big for our bedroom and we could not keep it. Decluttering the desk was not as difficult as I thought since it was mostly paper, and after about two hours I was done.

This is the status quo; since I want to move some furniture in the bedroom and change a couple of things, I reckon that I am about half done now. I will keep reporting on the progress.

Just A Quick Update

I’m still alive, but very busy. Lectures at university started again – not that I had a lot of free time during the “break”. I attended an extracurricular class in zoology and passed the exam for that, and I didn’t pass the second attempt of physics because I was just too burned out and my brain didn’t cooperate at all. As a result, I opted out of taking maths again.
Currently, I’m writing a report on the field trip I took in February; the text is as good as done, but I still have to put in pictures and so on.

Then, of course, I got married and had a lot of family drama going down the day before the wedding, all of which deserves a dedicated post.

Finally, my therapist invited me to join a class for psychology students next week – as a “living exhibit”. They’ll present my data, including the clinical tests I took (the results of which I’ve never been told), and I’ll be there to answer questions. Bring the person to life, I guess, because according to my therapist, most of these students have no real idea of what it is like to be depressed and what it is like to undergo CBASP therapy. Besides the scientific data, I can provide insight into all of that. Strangely enough, I’m looking forward to this.

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…

Change Of Plans

Due to health reasons, I had to cancel my mother’s attendance for the therapy session on Friday and it will just be a normal appointment for me. My mum had been sick last week already and even though she’s not bedridden anymore, she’s not 100% either. Nor am I, and if being honest, I’m secretly relieved about the turn of events: there are so many other things on my plate that I’d like to discuss with my therapist before my mother joins us – last Friday, for example. Also, I’m going to have a friend visiting all weekend long, and regardless of whether our joint session leads to a long amicable discussion or a long argument between my mother and me, I would need a lot of time for that…

I’ve been put on the sick list for the rest of the week because of a stomach bug myself. There are three general physicians who share the practice I go to; some of the patients only see one of them, others – like me – go to whoever has the first slot available that day. So I ended up with the same doctor as back when I fainted on my way to work and broke down crying in the practice (check the “Pre-Treatment Diary” for the entry of October 19, 2010). He’d urged me very much to find a therapist then, which was just the extra encouragement I needed to actually call the hospital three weeks later.
The memory of losing my composure last time, even though more than a year in the past, embarrassed me a little, but fortunately the doctor didn’t ask any questions about it. He had my file already open when I walked in and thus doubtlessly was reminded of the incident, as well as my stint with citalopram and the fact that I get a referral for psychotherapy from them every three months. He was especially nice, though – a kind of cordiality that goes beyond good manners and agreeable behaviour. It reminded me a little of my therapist. There was nothing he could do about the stomach bug (“That just takes a couple of days to get through.”), but he did inquire about university and I told him about changing to geosciences.

The doctor actually asked me how long I wanted to stay home and despite really being sick, I feel a little guilty for making it the whole week. Not that attending classes would do me any good, and thus (as my therapist would say) there’s no reason to even debate the matter.
It’s more than the stomach bug, though. I’m constantly tired – Christmas break didn’t do much to change that. In fact, only the last two nights I managed going to bed and falling asleep at a decent hour, following several weeks with insomnia.

Not to mention that I have been missing my boyfriend insanely. Now that we can actually count down to the day he’s arriving and almost reached a single digit number of days left until our reunion, it’s worse than all those last months. Like the last mile of a marathon: you know you are almost there, but because you’re so close to the finish line, you just want to be done with it and let go of all the self-discipline which got you so far. Every single step makes you ache more, every muscle is sore, every breath laboured. I just want to be at the airport gate and wrap my arms around him, and then the world may end.

Slaying A Dragon

Yesterday was a very significant day for me – one I had worked towards since April last year: I told my mother that my boyfriend and I wanted to get married. This was problematic in several respects, not only because of the generally difficult communicative patterns in my family, but also because my mother is decidedly against marriage (never mind the fact she’s been married to my father for over 30 years). At her most irrational, she claimed she’d “outlaw” it if she ruled the country. My sister’s failed marriage didn’t do much for swaying her in a more favourable direction either.
In most families, the news that their daughter wanted to get married would be regarded as happy news, but I wasn’t so sure about that and thus the topic had been fraught with a lot of anxiety. The range of possible reactions just was too broad to predict a likely outcome.

To make you understand the scope of this, I’ll have to go way back to spring 2011. My boyfriend and therapist actually met ever so briefly once – hardly more than a greeting and shaking hands – at the visitor lounge at the psychiatric hospital, so my therapist was able to put a face with the name. After my boyfriend had to leave Germany at the end of March because his tourist visa expired, my therapist had assumed a quasi-parental role and questioned me on our relationship in the first therapy session after the separation.
I summed it all up in an email to my boyfriend the next day:

Each of our sessions start with him asking me about my depression index – whether it went up or down, and what I did to get there. The philosophy in CBASP, my treatment programme, is that your mood always is a result of things you do or don’t do (when usually, one tends to assume it the other way around).

I told him that you had to leave again and that my points probably would be lower if not for that. And he said with a major change like this, we must have done a lot of things right or else I would probably have bounced back quite a bit, to 20 or possibly even higher.
So I related to him everything that went down since my last session – how we had looked into ways to get an extended or permanent visa, how we found out that you had to leave again and still tried to make the best out of the last week. I told him about the trips we made […] and he asked what the goodbye was like, whether we cried – whether we *could* cry, because the inability to cry signals deeper depression than bursting into tears. If you cannot cry even though you feel like it, it means your access to your emotions is disrupted: crying always is a good sign in their books.
He went off on a little tangent here, explaining the differences between “primary emotions” like happiness, sadness, fear, anger etc. and so-called “social emotions” to me: the former are understood by all humans in the world and elicit the same reaction, and they are also “contagious” to the people around us. Every time we display one of those, we radiate it off to other people, too. That is why being around happy people can make you feel happier and why sometimes one person can get a whole group down. “Social emotions” are defined by culture. He gave me an extreme example: a member of a cannibalistic tribe will have no problem eating human flesh, while we would have to torture ourselves into it and endure very strong feelings for doing so.

My therapist proceeded to ask about our contact and very much approved of daily Skype sessions, then went on another tangent by telling me that he had a short relationship with an American girl from New York City when he was a student and that the costs for phone calls almost ruined him back then. He even did an internship in New York City and got an unlimited visa for the States then (that was during the early Clinton administration – wouldn’t happen anymore today, and his is not valid anymore because he left the States again). That’s also part of the CBASP programme, that you get to know your therapist on a personal level, because it helps you discriminate between different people’s reactions instead of just assuming that everyone will reject you.

Finally, he asked what we had planned for the future and I told him that you wanted to come back and that there were basically only two ways for you to stay here other than a tourist: either by job offer or by marrying me. He asked a lot of question about you to get a better picture, and I told him that you had worked as a historian and then, recently, for [international company]. He said you must have incredible skills to handle the [international company] job and was very impressed. He wanted to know what social climate prevailed in [my boyfriend’s current location] and when I said “Bible belt” and that originally you came from [city in New England], via [different state], he said he couldn’t blame you for having difficulties. He is very familiar with [city in New England] and called it “my city” – I think he has been there quite a few times on business trips and for workshops, and also said that it was rather European compared to other places in the States he has been to.

Eventually, my therapist came to the conclusion that I already communicated to you yesterday. He thinks that we have a very healthy relationship and that in his opinion, the key for lasting relationships lies in how well you get along in everyday life, and how well you support each other there. Everything else is secondary – no matter how good you are as a couple on holidays, for example, if everyday life together does not work, there’s nothing you can do.

That is only a rough overview; strewn in between were always small “lessons” for me. For example, when I said that our goodbye at the airport was very teary, he asked if I could have cried in front of my mother, too, and I said I wouldn’t. I’d try to hold it back there with all my might.
Or we compared and contrasted our situation with a hypothetical situation where we would not have sorted out all the legal stuff and lived in uncertainty.
In his opinion, we made the absolute best out of what we were dealt.

Anyway… just so you know what we were talking about yesterday. I personally feel very glad we spoke about all this in therapy, because it helps me process, and I am also glad that we had a whole session just for “understanding” what has happened here.

Unfortunately, I don’t have access to the first email I sent my boyfriend directly after the session, so I might have forgotten details. I do remember that we focused on behaviour a lot and also that my therapist asked about my boyfriend’s language skills, job perspectives, health management  etc. And I do remember that he advised me to not suppress or try to conquer emotions, and to cry when I feel like it, for example, because “trying to be strong” and suppressing costs too many resources and too much energy. In the end, he came to the conclusion that there were “no pathological structures” in our relationship, with an emphasis on the fact that he’d tell me if he detected anything like that.
Over the following weeks, we roleplayed me telling my parents about it, and he assigned me the task of making a list with reasons why I’d want to marry my boyfriend – because I’d been dumbstruck in the session when he’d ask me that question. “Because I love him” wasn’t enough of an answer, and so I started writing down arguments and categorized them into topics: “Because he respects me as a person: my sexual orientation; my feelings, opinions, ideas and wishes; my personal belongings; my privacy.” [On physical appearance:] “He likes me the way I am and doesn’t expect me to conform to some ideal standard.” [On depression:] “He can handle my depression and endure it, even if I’m feeling significantly better or worse than he does.” I had close to 50 reasons when I stopped.

Another email I sent my boyfriend, about two months after the one mentioned above. In the session, we’d talked about some unexpected news my boyfriend had received and how they’d influenced me:

We had some administrative stuff to sort out then, but at the very end – I was already half out of the door – he asked: “Can I say something about you and [your boyfriend]?” I stepped inside the office again, closing the door once more: “Of course you can!” Inside, I must confess, I got a little nervous at that moment, wondering what he possibly might want to say.
“I don’t know [your boyfriend] personally, even though he has been very ‘alive’ in our sessions through the way you spoke about him. I mean, I have seen him, but I don’t know him from personal contact. Still… I just wanted you to know how very deeply I am touched by the relationship between you and [boyfriend]. In my profession, I see so many relationships every day, but…” – he shook his head here – “…what you two have… this is what is important in life.” At this point I was just stammering ‘thank you’ and how much this meant to me, taken completely by surprise and once again speechless, so that I repeated the same two phrases at least three times. We said goodbye again, and just before I opened the door once more, “I believe [your boyfriend] is a really good person. I don’t know him personally, but I have a feeling that this is the right stuff.” And he smiled.

I remember leaving the therapy session that day, feeling like I was walking on clouds. I was just utterly touched by what he’d said, and the fact he did say it at all. In CBASP, one of the therapist’s roles is to heal emotional-behavioural damage in the patient through making them experience healthy behaviour in sensitive situations, and that was one the most important moments I had together with him. I knew I could completely trust every word he’d uttered to be sincere, that he had no reasons for bullshitting me, and this kind of openness was one of the great “healing moments of my therapy.” There was a lot more going on at that moment than is visible on the surface – every person in love likes hearing nice things about their relationship and partner, but apart from the content of the sentence, I felt being taken seriously and listened to. I felt I and my future happiness were important enough to someone that he’d trouble himself with examining it closely.

With so much support in my back, it should have been easy to just tell my parents – after all, I was in the unique position of being able to cite a mental health professional’s opinion. Nobody could accuse me of being deluded by my own romantic feelings. However, it wasn’t easy for me at all. I made a couple of attempts, but at the last moment, the words just got stuck in my throat.
There was one notable Sunday which I’d looked out as the date when I’d tell them: I’d be alone with my parents in the afternoon, with plenty of time for talking. I bought a cake for us and wanted to create a pleasant atmosphere. Everyone was ready when I noticed I’d forgotten something and ran out of the room, returning literally a minute later, but those 60 seconds had been long enough for my parents to get into a petty argument over something really insignificant. Frustrated, I ate my slice of cake in silence and retreated without bringing up the subject.
Weeks went by, turning into months. Stuck with waiting for some important document on my boyfriend’s end, there was no imminent pressure to come out with the truth – it was something present in the background, but I didn’t feel any need to act immediately, and thus the anxiety prevented my saying anything at all. Only when said document was suddenly approved and I received an express-delivery of my boyfriend’s paperwork, I knew I had to get moving – yet it took almost another four weeks and the flight to Germany getting booked until I could finally realize it. Fortunately, my boyfriend was cognizant and understanding of my difficulties and didn’t push me; he appeared more confident than I ever felt that eventually, I’d manage.

It happened on the way home from a farm shop where we buy most of our vegetables. My mother doesn’t have a driving licence, so I chauffeur her there, and it looked like a good opportunity: we were not going to be disturbed in the car and, in order to ensure the security of all passengers, my mother couldn’t have a complete melt-down there. Still, my stomach slowly twisted into a tight knot and nausea started to rise up. I was only a heartbeat away from breaking into a cold sweat, and there was this imaginary voice screaming in my head: “Stop as long as you still have a chance to do so! Just don’t say anything! Abort mission!”
We were literally two minutes from home only when I swallowed all of the silent terror, took a deep breath and said: “Mum, I need to tell you something… [Boyfriend] and I want to get married.” The rest is only a haze and I do not remember it very well – as I wrote in previous posts, stress and anxiety tend to wipe the memory out. I do recall that my mother said something like, “I thought so, I was kinda expecting that.” And, “You two need to know what you want.” Which I answered with a simple but convinced, “We do.” She asked a few practical questions about finances, health insurance; she was rather anxious about us wanting a huge celebration (which, considering the facts that we’ll get married on short notice whenever the paperwork goes through and that our finances are limited, is not the case at all). What I remember very clearly is that I parked the car in front of our house and that the last thing she said before getting out of the car was: “After that I need a cup of coffee now.” And I replied, with full emphasis: “Me too!”

After I was back at my own place, I updated my boyfriend, therapist and some friends via email. I have to credit one of my friends especially: we had been emailing back and forth this past week and also that morning, talking about my problems opening up to my mother among other things, and she had reasoned with me that the situation couldn’t really get any worse than what I was already experiencing. And she was right.
The huge wave of relief one might expect did not come, at least not so far. Maybe it will take a little longer until I really feel it, maybe that’s not going to happen. That was a huge dragon to slay and a lot of personal angst I had to confront – really one of the most difficult things I did in my life. Intellectually, I’m just glad to be done with it finally, the emotional reaction might or might not come still. Right after talking to my mother, I was in some turmoil as a direct result of the stress: shaking knees, slightly trembling hands and a little agitation, but none of it too violent.

When I turned 30, I looked at the decade behind me which supposedly defines what kind of person you are, and all I saw were missed opportunities, failures and loneliness. Years lost to depression. I don’t want to do the same when I turn 40, and so I try to push myself – no matter whether it takes 2, 20, or 200 attempts to realize my goal. The only way I can ensure a better future is to change something in the present…

Looking Back At 2011

The year is coming to an end and it’s time to take inventory. Over the last twelve months, I have time and again observed anniversaries and compared my life to what it used to be, but it’s because of New Year’s Eve that I feel like I’ve truly come full circle.
A year ago, I was just experiencing the very first days together with my boyfriend, I had just started therapy (but was still in the anamnesis phase, not yet learning coping / healing techniques), was still in the last throes of quitting citalopram. I had an incredibly bad year behind me, full of anxiety and panic attacks, physical and emotional pain, cognitive deficits and side-effects. 2010 was left behind tired and exhausted, but with a tiny spark of hope.

There’s so much I have to be grateful for in 2011:
– My boyfriend. We only lived together until the end of March and certainly didn’t think we’d still be on different continents on Christmas and New Year’s Eve, but even if most of the year was spent geographically apart, we’ve remained emotionally closer than ever. If anything, this forced separation has galvanized our desire for being together, and the bureaucratic process – which took far longer and was far more costly than anticipated – proved that we are serious about our commitment to each other.
He’s made me laugh (despite myself, sometimes), held me when I cried (both literally and figuratively), endured my endless therapy talk without complaining or becoming jealous of my therapist once, cared for me when I was bedridden with influenza for weeks on end. Through him, I learned to enjoy life again, learned to want something more out of life again than just the mere absence of pain. Through him, I lost the fear of giving myself to another person.
– My friends. All of them have been incredibly supportive, encouraging and generous with their feedback as well as very patient listeners. I owe lots of laughter to them and many a good idea. After having been largely unable to maintain social contacts, I am grateful that nobody held this against me and that I actually did have a social life again this year.
– My therapist and the team behind him. Everybody at the hospital I ever had contact to has been nothing but friendly and highly professional. A special mention must go to the psychologist who was my very first contact person ever there; who did the phone interviews and various formal clinical interviews with me as well as the two MRi scans, and who coordinated most of the appointments with other specialists for me. Her kindness ensured that I even made it past the initial phone interview stage without getting scared away.
Towards my therapist I have to be thankful not only because of his skilfulness and expertise, but also for his constant support beyond the requirements. In addition to the therapy sessions, we must have exchanged about a hundred emails over the course of the year. He’s helped me getting a sabbatical at uni and wrote to my health insurance. In crisis situations, his response was quick and most helpful. Most importantly, he treated me humanly when I felt most inhumanly.
– My family. That might come as a surprise, but despite all our problems and dysfunctional ways, I want to be grateful for the good times we shared.
– The progress I made. I learned to verbalize my problems, ask for help, selectively trust people, maintaining social contacts better, take care of my needs, find solutions for my problems. I can read books again and am attending university again. I found out what “normal” feels like and was euthymic for the first time since childhood. Over the course of the last year, I gave my life a completely new direction. I learned to have hope. Last but not least, I started a blog which I’ve managed to maintain for seven months already and which brought me much joy.

To my readers, all the best wishes for the new year – may it bring you much happiness and joy!

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”.

Last Session Of The Year

Last therapy session of the year; the next one is on Friday the 13th (January 2012), to which my mum will accompany me. Apparently, my regular therapy is also coming to a close – I’ve had 31 sessions so far and if I recall correctly, that means only 4 more in the normal rhythm before drawing them out. Not sure about the time periods between them, but I do know that session 40 is definitely my last one. I’ll part with a laughing and a crying eye: laughing because my life improved so vastly, crying because I will be sorry to say goodbye to my therapist for good. The whole purpose of our relationship was that it would end again eventually, but I’ve grown fond of him… but, I guess that’s a bridge I’ll cross when I get to it.

We took a look at my uni schedule today, trying to find out what I can eliminate – all contact hours, homework and commuting time added up, I had a 50-hour-week and a BDI-II score of 20, with a tendency for the worse. Friday was crossed off the list completely and I’m supposed to figure out what I can do without until I reach a point where the work load does not push me into a depression anymore.
“We are pulling the emergency brake now,” my therapist said. “And if it gets too much,” he smiled, “just scratch another class off the list and go to the cinema instead.”
Eliminating classes wasn’t the problem, I didn’t need help for that. The huge difference is that if my therapist “allows” me to take it easier, I feel like I’m actually doing something pro-active and taking care of myself, whereas without discussing it in therapy, I’d have suffered from a bad conscience and felt like I was only procrastinating. That’s clearly something I still need to learn during our remaining time together: that I have a right to take care of myself and that I’m allowed to set limits.
A job is only possible in summer, because I’m going to have exams and an “en bloc” course and an excursion (probably followed by another protocol) during the upcoming semester break, and during the second semester my situation will hardly be any different…

Our roleplaying exercises were a little different today: not the usual dialogues acted out, but instead my therapist challenged me to defend my position. After I told him that I preferred learning at home over learning at the library, for example, he said: “Convince me! Why should I believe you are learning more effectively at home?” So I listed my reasons – that I felt more relaxed at home and could concentrate better because I wasn’t constantly aware of the people around me, that I didn’t have to watch my stuff if I walked out of sight of the desk, that I had more freedom on when I wanted to learn…
Later he made me stand up while he remained seated (a position I hate, because it causes me to feel vastly overweight – even though he doesn’t get that impression and it exists in my head only) and voice the effects the depression has on me as if talking to my mother: “I have troubles falling asleep and wake up in the night; the muscles in my arms and legs hurt, my joints too. I have headaches and backaches and stomachaches. My eyes are inflamed and hurt and I can’t always see properly because of that. I can’t concentrate very well either and doing my homework gets really difficult because of that. There are cognitive problems which make me forget words and sometimes I don’t even understand my homework anymore because of this.”
Only when looking back I realize I listed exclusively physical symptoms, but didn’t mention the sadness, crying and despair descending upon me. Had I spoken to my therapist directly instead of him acting as a proxy for my mother, I would probably have mentioned this, but since we hardly ever discuss intimate feelings in my family, I didn’t speak about this in therapy either.

One aspect I forgot about and which my therapist highlighted today was exercise. There is no room in my current schedule for any kind of physical activity. He described a scientific experiment to me, in which hamsters had been exposed to stress over a long time, leading to the hamsters becoming depressed. The source of stress was removed then and the hamsters got divided in three groups: group A had a nice cage, plenty of food and social contacts; group B a nice cage and plenty of food; group C a nice cage, plenty of food and an ergometer. Everyone suspected group A to show the fastest recovery rates, but in fact it was group C which was the most successful within the given time frame…
Exercise is supposed to be light and fun – no pressure to achieve any results, but regular periods of physical movement. I certainly remember how beneficial my Tae Bo classes were, even though I have nowhere near the energy for that now. But I’ll try to reserve a fixed time for swimming or cycling or something like that.

Depression Revisited

Those last few days my situation has been really bad; as mentioned before, I depend on financial support from my parents, and my mother has been urging me to get a job, even though I hardly have the time and capacities for taking a job on top of my studies. I tried handling the situation on my own, but when she threatened I had to move out of my flat (which would equal moving in with my parents again), I panicked and wrote to my therapist about the situation. He replied:
“My medical opinion is that a place of your own is very important. Moving out or getting a job at this time would put your health in extreme danger and further increase the risk of chronification. That’s a specialist’s opinion. Please stay calm and tell your mother that you are in close contact with me and asked for my medical opinion. I’d be happy explaining it to her personally in the new year.”
I am going to take him up on this, because I believe that he’ll be able to speak with much more authority to my mother than I could ever have. If I say anything, it might look like I’m unwilling to get a job, when in reality, that’s not the case at all. I wish I had the energy to handle both…

I don’t actually think my mother was going to kick me out – it’s more like a really inappropriate kind of hyperbole to steer me in the direction she wants me to take. But at that time, the idea really freaked me out: I do love my parents, but living with them permanently would drive me over the edge quickly.

I’ve had so much stress lately that the muscles in my limbs turned stiff and hurt so much that I can’t fall asleep until 4 in the morning. My eyes are inflamed again too. Those are symptoms I can handle, though. What unnerves me is how much my cognitive abilities are influenced by this: it’s harder to concentrate and doing my homework becomes more difficult. It started about two weeks ago already, but has increased since.