Cola Addiction Revisited

Long-time readers of this blog may remember the post about Cola-addiction I wrote over three years ago. Even though I was fully aware of how unhealthy it is, I couldn’t go a day without it. When I noticed recently that my cola consumption had been comparatively low for several days in a row, I decided to attempt kicking the habit. It’s been over 48 hours since my last glass now and, to my surprise, easier than expected. The cravings are manageable, and the headaches I’ve had over the past two days may or may not be related to withdrawals. They are nuisance rather than a huge problem anyway.

Why now? The biggest factor in this is the valdoxan: since I’m sleeping better, I don’t feel as groggy anymore and thus don’t need the coke to “wake up” my brain. Plus I was ready for it – right now, I feel like I can handle making lifestyle changes and sticking with them. I am motivated by my weight loss; my depression index and anxiety are low, and I have a moderate amount of energy. Why not seize the chance?

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To Hell And Back Again

After the last post, I fell into a really dark hole. For every problem solved there appeared to arise two new ones, and between a lack of energy (which was bordering on apathy) and near-despair, I had some really horrible weeks. None of the bills due June had yet been paid, and I’d really had more than enough of those troubles over the last months: we got threatened with having the gas / electricity switched off twice and had to borrow money from a friend to pay those bills. I had my bank account terminated because I accidentally went over the credit limit and (thanks to being preoccupied with the side-effects of venlafaxine) didn’t notice immediately, so I ended up being blacklisted as a “financial offender” for the next three years – it will be as good as impossible to get any kind of loan, and I had to go begging at the bank to be granted another bank account, and on top of everything else I will have to pay off almost 1250.- Euros for the old account and in penalty fees. I tried explaining my situation on the phone, but first I had to wait three weeks for a call-back since the people holding the decision power were always busy, and when they finally did get back at me, the lady berated me for it “being all my fault”.
We just about managed to pay for my husband’s German classes and get some food on the table, even though the latter was perilously close to uncertainty at two times at least. There was one day when we had all but € 9.- between the two of us, and all that was left to eat was a bit of frozen vegetables, half a jar of jam, pasta and potatoes. No bread, fruit, rice, cheese, meat, fish, butter, milk or soy drink or whatever we usually eat. Our options were plain potatoes or plain pasta, with a bit of spinach or peas. Nothing you’d traditionally serve for breakfast – and having just asked a friend to help us out with money so we wouldn’t have the gas / electricity cut off, I didn’t want to go begging again. My mother-in-law unwittingly saved us from this by sending some money, and my friend scolded me for not telling her earlier when I related the story to her… All I can say is that there’s a difference between having to ask for help once, because you got into a tight spot, and having to do it again and again, week after week or month after month. It wears you out mentally.
I believe my husband became more worried about me and my state of mind than about the money, because even though I was not entertaining thoughts of suicide, he made me promise I wouldn’t do anything to myself. Nevertheless, even getting dressed became an almost insurmountable obstacle, and I oscillated between apathy and fits of crying. I felt like I had nothing left in me: no energy, no fight, no will. And even though I had successfully fought off the denial of the application in April, nothing appeared to move forward in that regard ever since – until the beginning of June.

The money came in about three weeks ago, and despite the fact that we didn’t get approved for March (when I was still officially a university student and not available for welfare), we got monthly allowances retroactively from April 1st on. We could pay our bills, and get rid of the debts with the health insurance and the energy provider. I made a payment plan with the collection agency to pay off my old bank account in rates, paid off my sister since she had covered the contents insurance of our worldly possessions earlier this year, and gave two months’ worth of rent to my mother, as a thank you for supporting us when my parents were on a budget themselves.
Having this existential problem lifted off our shoulders has done more for my mental health than any other measure taken during the last months. For the first time in years, I go to bed without being afraid of what the next day is going to bring: even though I still get a fright when one of those “official-looking” letters comes in, I can immediately remind myself that we have the money to take care of whatever is heading our way.
The German welfare system is far from perfect and much criticized, but compared to our situation during the last year – and especially the last couple of months – we are doing peachy right now. Of course, we are not eating steak and lobster, but I can buy everything we need and some more, whereas before I would have to prioritize and calculate whether I had enough money to buy some yoghurt, for example, or whether it had to wait until the next time since it was not strictly necessary.
There was one day when I went to the neighbouring town for shopping, since the local supermarket had some offers which justified spending money on a tram ticket as we would still save compared to buying the same products in our hometown – and I made a mistake when calculating the expense. It was just a minor figure I was off, about 50 cents, but I ended up those 50 cents short for buying the tram ticket back home. I did not dare taking the tram without a valid ticket because of the € 60.- fine if I got caught, so I had no choice but walking home. It was a relatively warm day and I was dragging / carrying about 30 kg (roughly 65 pounds) of bottles and groceries in my shopping trolley and two bags. I had called my husband to meet me halfway, but by the time we got home, I was completely exhausted.
That is only one story out of many about how destitute we were. I walked around in jeans ripped from wear and tear for over a month, because I could not find a pair cheap enough in my size. When I finally found one, it had a bad, unflattering cut and I didn’t like the colour, but at least the prize was very low and the fabric not torn, so I bought it anyway. After just a few short weeks, the pull tab of the zipper broke – cheap material, I guess – so I had to put a safety-pin through the eye of the slider for using the zipper: the result was that every time I went to the toilet or got (un-)dressed, the safety-pin popped open and stung me in the finger. At that point, I made such a pitiful figure that my mother and sister gave me a part of my birthday present, two pairs of jeans, about ten days early.

Maybe that gives a little insight into why I have not been blogging. At some point, I just got too exhausted – all my mental energy went into making sure we would get on state support. And I wanted to escape from the daily struggles, not reflect on them.

Getting Ready For The Psychiatrist

Tomorrow is my appointment with the psychiatrist. I have a vague idea of what to expect, based on the psychological examinations at the hospital and internet research, and I’m quite used to recounting my history with depression. Hopefully, he will accept that physical reasons behind the depression have been excluded two years ago; I have documentation on the lab tests of my blood, but not on the ECG, for example – that’s still in my file at the hospital. I just don’t want to go through all of this again only to come to the same conclusion… Other than that, I’m open for any kind of neurological or psychiatric test he might want to perform.

I’ve been thinking about what I’m going to tell him. My top priorities are the lack of energy and the cognitive deficits; if we manage to do something about those two “symptom clusters” with tolerable side effects, I’ll call it a success. It might sound odd to some readers, but medicating the sadness away is not very important to me, because I feel that there is a reason when I am sad – even if I am not immediately aware of it. I just want to reach a state where I am able to deal with those reasons sufficiently.
I also hope I can skip the citalopram this time around. Here in Germany, it’s the most widely prescribed antidepressant, and usually the first antidepressant you will get prescribed. While it helped me in some regards, I feel that in my current state the side effects would outweigh the use I got out of it. Not to mention that it made me extremely sleepy in the beginning, which is certainly not what I am looking for currently.

Well, tomorrow I will know more.

Conquering The Valley Of The Dustbunnies

From September to November, I spent a lot of time decluttering my flat, especially the bedroom. But once I made the deadline for the bulky trash collection, my enthusiasm and energy dwindled, and I did not get back at the task for the entire month of December. And now it was another deadline of sorts which got me moving again: my sister bought a new bed and I “inherited” the old one.
I had never before owned a bed big enough for two people to sleep in, and so my husband and I had no other choice but putting our mattresses on the floor – buying one of our own simply exceeded our budget. In the beginning, we joked about camping on the floor, but after a while it got really old, especially since our mattresses are of different heights. A friend offered us her bed when she gave up a rented studio, and at first I accepted – but the problem with the mismatching mattresses, the difficulty transporting it home (my car’s boot / trunk was already permanently locked then), lack of time due to uni projects, and rising depression spoilt the plan.
We spent two days emptying all bookshelves in the bedroom and dissembling the ones which were mounted on the wall above where my desk used to stand. We moved the freestanding shelves to that wall, cleaned them and put the books I want to keep back. Since there will be no replacement for the wall-mounted units, the archaeology, geosciences and geography books  will have their place in the living room from now on.

There is a sense of accomplishment which comes with having your books sitting neatly in clean shelves; especially if it has taken you years to get that far. My husband is a much faster worker, which is rather frustrating because it makes me feel so inferior, but I insist on handling certain things alone, even if that means it will take significantly longer to get everything done. I still have to sort through every single item and arrive at a decision whether to keep it or not, and where to store the pieces which do not end up in trash. Making that decision itself has become easier, though – it is not nearly as agonising anymore as it used to be just a few months ago. Partly that might be simply due to there being fewer and fewer possessions left which are still “unexamined” at this point, partly because I have experienced that discarding them only hurts temporarily.
My method may not be the most effective or stringent, but it is the only one that works for me, and I am almost done with the bedroom. I think from next weekend on, we can sleep in our new bed; my husband is really eager for this to happen and I certainly feel the same way. However, I want to make sure that I have gone through every last item before we move on, because I know from experience that stuff left for “later” will still be around after years. Then, I want to give the room a thorough cleaning, because once all the heavy furniture are up, certain areas will become as good as inaccessible. And, final reason, I have a therapy session on Thursday, which means that a) I am going to be out most of that day thanks to much longer commuting times without a car, and b) I will most likely want some time for reflection afterwards. But the weekend should be a realistic goal.

Fun Facts:
The most common finds in my bedroom were bobby pins (just how many can a single person lose over the years?), literally thousands of paper pieces – notes from class, drafts for letters or uni papers, transcribed poems, cash receipts etc. – and a wild assortment of pens and pencils.
The most unusual find so far was a kitchen knife in one of my handbags, the blade carefully wrapped in paper towel fixated with sticky tape – must be a leftover of some brunch we had at work, or a long-ago Christmas party or something in that direction.

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.

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.

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.”

First Day Back At Uni

The first day at university is over and I have rather mixed feelings about it.

On the positive side there’s the age gap between the other students and me. I’m 31, the vast majority of them is fresh out of school and thus around 18 or 19 years old. I spotted two people who were visibly older than me and maybe four or five who might be in their late 20s or early 30s, but about them I’m not entirely sure – maybe they just lacked sleep and looked older than they really are. But the rest out of around 150 GeoSciences freshmen are definitely more than a decade younger than me, and it’s obvious when observing the topics they talk about: their conversations revolve around how they got their driving licence or school-related matters, all of which is so far in the past for me… They are just discovering an adult lifestyle and most actually don’t have much of a clue yet who they really are, and I’m in a completely different phase of my social life. It suddenly made me feel very experienced.
The reason why I think that this difference is a good thing is that I won’t be expected to socialize with them. It will be perfectly ok if I attend classes and curricular excursions, but otherwise keep to myself. I don’t have to make friends with them, which keeps the social anxiety at bay.

Another positive aspect is that we’re all starting from scratch again in the mathematics, physics or chemistry classes. I don’t have to warm up long-forgotten knowledge.

Now on to the negative aspects: I am very much aware that I’m lacking the enthusiasm of back when I first entered university. Before the first problems with my Hashimoto’s struck and as a direct result of the hypothyroidism my depression got worse, this enthusiasm was so great that studying felt like fun. Now, I will have to substitute the enthusiasm with an iron will to not abandon the second attempt at higher education, which means that everything feels a lot more like hard work.

The most difficult today was the fact that during the entire time I was attending classes, I felt like a complete failure for messing up my first degree. The thought never left me, no matter how hard I tried forgetting it, and a good 30 minutes after I was home again, I suddenly broke into tears and cried heavily at the prospect of going through this for another three years. Doesn’t matter that my friends and my therapist tell me that it wasn’t my fault – I thought repeatedly that if I’d managed to finish, I wouldn’t have to go through this now. (And yes, I am aware that if I didn’t endure this in the present, there would be an even worse future.)
The entire day was very stressful for me and I feel physically exhausted. And it was only the beginning.

Mathematics For The Clueless

Part of my university schedule for the next semester has been published. It’s going to boil down to about 25 hours per week – not yet sure how many exactly since it can still change. The whole structure of it is a lot more like school than my old degree was. I’ll start at 9 AM every day and have lectures until the early afternoon, afterwards there will be more practical classes on most days. Friday afternoon appears to be off, however, which is nice. If nothing else, it offers me a comfortable time window for therapy sessions.

Apart from geosciences – geology, palaeontology, micropalaeontology, crystallography – I’m going to have classes in mathematics, physics, chemistry and biology. Crystallography is the only subject I haven’t had anything to do with at all so far; mathematics the only subject I am afraid of. I’ve always struggled with maths in school, so that makes me a bit nervous, but I checked a book on the basics out of the library and will start repeating them so they are already fresh in my head when I get confronted with it in class. It’s aptly named Mathematics For The Clueless. I also checked out books on physics and chemistry, but since I never had any problems with either, this is intended as a little warm-up rather than serious repetition.

Right now, excitement clearly outweighs the anxiety and I hope it stays that way. Unlike a couple of weeks ago, when going back to university still appeared the lesser of two evils, I am actually looking forward to it now and am very motivated. I only hope it stays that way; intellectual challenges I can tackle, but it’s going to be difficult if I start feeling like me being there doesn’t make sense anymore.
As long as I am undergoing psychotherapy, there still is the option of my therapist giving me a sick note if things go wrong really badly. Of course, I do not want that to happen either. I want my degree, want to prove that I can do this. I’ve spent so many years with a sense of failure lingering in the background…

A “Security Blanket” Letter

Tomorrow I’m going to the university administration for starting the transfer to the other degree programme – today I overslept, and their opening hours are restricted to a 90 minute window in the morning during summer break. I want to minimize the risk of running out of time, and waiting too long only makes me lose courage or the anxiety creep back in…
When I contacted the hospital concerning therapy last November, they wanted to know how I would like to handle this, and I asked them to proceed as quickly as possible, thus preventing second thoughts. And after all the examinations were done, they presented me with the choice between starting therapy immediately and waiting for the new year, and again I picked the quick start and had my first session a week before Christmas.
The bigger part of that motivation came from actual suffering – I just wanted to get better as quickly as possible – but there was a very real chance of me getting so scared or self-conscious that I’d convince myself they did not really want me and cancel the whole enterprise.
Besides, I told my therapist I could do it before our next session and intend to keep my word.

Back in February, my therapist wrote me a letter to show the university administration, so that I could be granted a sabbatical. I’m going to take this letter with me tomorrow again, as my “secret weapon”; if anyone’s going to give me a hard time, I’ll just show it to them:

Ms Layara is receiving our specific ambulatory psychotherapeutic treatment for chronic depression since 11/2010.

With chronic depression, there is no homogeneous field of symptoms. This term subsumes a group of affective disorders which are indicated in Ms L. by fear of punishment coupled with high demands on herself as well as depressive symptoms. The disorder begins – as with Ms L. – very often in adolescence (75% of all cases). Frequently the disorder influences the lives of those concerned significantly (reduced life expectancy, loss of a normal healthy life and occupational as well as social activity). Because of the documented course of Ms L.’s illness, her ability to study has been severely reduced in 2010 and it is not possible for Ms L. to attend classes or exams in spring 2011. From an iatric-medical point of view, the resumption of her university education is of outstanding importance for long-term stabilization – that is for maintenance of a meaningful perspective and for participation in society – from autumn 2011 on, when a stable partial remission has been achieved. From a physician-directed perspective, the treatment concept intends for a continual ambulatory psychotherapeutic care with the same practitioners at the [insert name] hospital throughout the studies.

Should you require further details, we are happy to be at your disposal at [insert phone number].

Back then, there was no talk of me going back to university – I only needed the sabbatical to save money (because I did not have to pay the full fee, but could keep my student-ID) and to buy me some time for attempting recovery. But several months later, it almost appears as if my therapist foresaw a scenario where I would actually do that.
In any case, this letter makes me feel a lot better. It invalidates a lot of criticism – criticism I might never face in reality and that only exists in my head, but it gives me the courage to actually show up in the office and ask for a new start…