Depression and CBT

I’m good under pressure. My fight or flight adrenaline response tends to result in me being calm, clear minded, and focussed. I can be a bit of a twitchy weirdo about things that don’t matter – I’ve been known to feel paralyzed with anxiety about posting a comment in an academic forum for my peers to see, or making a decision about purchasing a new couch. But when the shit actually hits the fan, I’m centred. When I got T-boned by an elderly woman running a red light on Christmas Eve 2015, I was the one who called 911 and made sure that the appropriate help got there quickly – and calmed my sister down when she came to pick me and my dog up because unfortunately my car was totalled and I wasn’t able to drive it away from the scene.

So with everything that has happened ¬†in the last year or so, I’ve simply handled it, and remained calm, at least on the outside. When we finally settled into our new home, and all the loose ends had been tied up, all the stress came home to roost. Like a stress hangover, almost. Basically my brain, without something to latch onto and focus, decided to see it it could destroy itself.

The thought that I didn’t want to be here anymore scared the ever living bugeezuz out of me. My psychologist termed it “passive suicidal thinking”, which makes sense. It was that thought that made me go back and see him again, because I realized that my mental state was spiralling beyond my control. This wasn’t the first time I’ve experienced depression, but it was by far the worst. I finally had to admit that although I would love to blame my infertility for this, I had symptoms and depressive episodes before we ever started to try to get pregnant, which suggests that this is more about my brain chemistry and way of thinking, and that the infertility is just a trigger. There were a few weeks where I was barely able to keep myself together at work, and was crying at the drop of a hat. I was able to turn it on for my patients, but wasn’t able to talk to my coworkers, maintain social interactions, and had no interest in food or sex. I also ¬†started sleeping 10-12 hours a day, and have trouble getting myself out of bed. For me that is very out of character, most of the time I sleep 5-7 hours max and get up at 4:30 to go rowing.

I went to see my Psychologist and admitted how bad things were inside of my head, something I had only told my Husband, and I had limited how much I told him, I didn’t want him to worry – and there was reason to be worried. I don’t seek help lightly, I hate to admit that I need it, and being vulnerable scares me.

We started working on some cognitive behavioural therapy (CBT) – something I was peripherally aware of, and had been using some of the techniques without realizing what they were. It was valuable, although more because it finally highlighted the central thought around which I base the worst of my negative self talk: I’m unloveable. Because I’m unlovable, I’m not worthy of affection, help, praise, support, etc. The CBT helped me to see how to set those thoughts against the empirical evidence in my life that contradicts them. For example the thought that I’m worthless is contradicted by my patients who tell me that I’ve helped them to regain their physical function and supported them in returning to their lives. The thought that I am unlovable is counteracted by the evidence that my husband is openly affectionate and has loved me for almost 15 years. The thought that if someone really knew me they wouldn’t like me is remanded by reconnecting with friends who have been in my life for anywhere from 5-25 years, and who have seen the good, the bad, and the messy, and still want to be part of my life. There are blips on the landscape I can’t ignore – my “bestie’s” rejection last summer still bothers me a bit, although I remain somewhat inclined to think that he’s just a self centred ass hole. There have been people who have dropped out of my life and probably won’t be back, but by and large those events have happened because of circumstances beyond either of our controls – moving away, etc., and there is no malice or negativity left in the void.

I am learning to seek out the circumstances that give me clear indication that my negative thought cycles are based on flawed logic. Mental health care is hard – the physical stuff I understand intimately, the mental rules I have trouble figuring out how to apply to myself.

I know that this needs to be an ongoing process. I know that I will have to keep working on this, because ignoring it doesn’t make it go away. But I am happy that I am back to singing to myself in my car, and my doodles are not depressing monsters anymore.