Tuesday, April 28, 2009

I stood up for myself today

And I feel great!

Whenever somebody criticizes me in any way, I take it to heart. I see criticism everywhere; any hint from anyone that they think I've acted other than perfectly is perceived by my brain as "You're a bad person, Kate." I'm so ready to see my fault, and in my fault see my essential inadequacy, that I automatically assume that the other person is right. And by "right", I mean that they are right to have realized the deep, dark truth that I am a failure.

Now, over the last several years, I've begun to learn to produce a counter-narrative in my brain that takes apart my reaction of self-criticism. For example, my former boss sometimes yelled at me for how I completed a task, and I would feel really bad and inadequate. But I would also remind myself that I actually did the task the way he told me to, and that I wasn't responsible for him changing the procedure without telling me. This type of counter-narrative, this self-defense, has helped me weather criticism more than I used to be able to, but it has not erased the fact that my gut still wants to say, "you're guilty Kate." After all, I am so ready to believe that I'm a failure that I internally agreed with my boss every time he yelled at me despite the fact that I fully understood that he was fickle and abusive.

So if being criticized by a person who I know is wrong still has that much power over me, you can maybe imagine how I feel when I'm criticized by someone who I'm close to and who I trust.

Last Thursday, my therapist criticized a decision I made. This was very unusual behavior for her, and I took what she said very much to heart, assuming that she was right to criticize. I spent much of the time between then and today (Tuesday) agonizing over what she said. I felt guilty--if my decision was wrong, my emotions reasoned, that had to be a sign of how bad of a person I am. I felt sad--my trust with my therapist had been violated in a way. And, dare I say it, I even felt a little angry. But I also talked with some friends about what had happened, and they helped me regain some confidence in my original decision. The more I discussed, and the more I thought, the more I was able to realize that I disagreed with my therapist's analysis. As my confidence grew, my guilt and sadness and anger subsided.

And when I went to therapy today, I told all of this to my therapist. I told her how what she had said made me feel, how bad it hurt. I told her specifically why I disagreed with her criticism and where I thought her analysis was flawed.

And god bless her, she truly listened. She acknowledged that what she said last week was out of character and outside of her role as therapist. (As both she and I see it, it is not a therapist's place to tell you how to live your life; that in fact would be very counterproductive.) She acknowledged how much it hurt me, and she respected the reasons I gave in defense of the decision in question.

And that felt amazing. It felt amazing to actually stand up for myself, to tell someone I care about that they hurt me. It felt amazing to have my concerns acknowledged and addressed. I've never before been able to so fully work through a criticism someone gave me, to so fully triumph over it. I actually, truly don't feel remnants of guilt about the decision I made. I feel confident in it. I've quieted my doubts and self-criticisms surrounding it. I'm proud of myself for how I handled the criticism. I'm proud of myself for my courage. I feel strong and alive.

It's okay to be sad. Really?!

I met with my psychiatrist (different person than my therapist) today to check in on how welbutrin is going for me. I told him that I've had a very good experience with welbutrin generally, but that I felt really knocked down by some of the things that happened last week (close friend's five-year partnership ending, painful moment in therapy, and more recently, sort of getting stood up on a date). I was assuming that my sadness was disproportionate to the events that caused it; I was assuming that how sad I felt meant that I hadn't made that much progress on my depression. The psychiatrist said something really unexpected and helpful about this: given those events, he thought my emotional reaction was pretty normal, and not necessarily overblown by depression (or at least not too much). He said if I was still feeling bad in another week or so, then it might be worth looking into to increase my dosage; but since these things happened so recently, and since the sadness wasn't interfering with my ability to get out and do things, my emotional reaction was really pretty reasonable.

Whoa! So I can have a bad week and feel sad, and all that means is I had a bad week? My depression hasn't returned with a vengeance? So awesome. Just hearing him say that, and realizing that I can have bad days or even weeks, and that's just part of life, made me feel a lot better. I think I'd been thinking, on some level, that my feeling bad meant that I was failing at fighting depression. It's a good and very helpful lesson to learn that I can feel bad sometimes and that doesn't mean I'm regressing or failing. I can handle the fact that life has downs if I also believe that life is capable of offering me some real happiness. :)

Saturday, April 25, 2009

Grey today

I have so many ideas for great posts, but I just don't have it in me this week to write them. I had been feeling like I'd been making a lot of progress, measured by increased energy, happiness, and enjoyment. But with just one not-great week those feelings have gone into deep hiding; I guess they're still pretty fragile.

So much in my life right now is good: I have a great apartment with great roommates, I met several cool people this week, I've been social, I've been attending tutoring training for a volunteer program I'm excited to be joining....

But with just a few daily-life challenges (a friend in a tough spot, a painful moment in therapy, and rapidly mounting feelings of guilt), I feel like the wind has gone completely out of my sails, or even that the sails have been torn. I am now unable to catch the wind; good things cannot penetrate my mood. For example, for a few minutes today I felt excited about meeting my student in the tutoring program. But quickly the feeling faded; it was not strong enough to withstand the unhappiness flooding my system.

I am taking a minute to sit with my sadness. I feel it pull on my body like gravity, beckoning me toward the earth, toward slumber. I can feel my heart beat, its pulse slow and steady. I don't know why I'm so tired; is it just the sadness manifesting itself physically?

I am choosing to give myself over to rest. Perhaps if I lie here and let myself feel the sadness pulse through me, it will then move on. I am trying to practice letting myself feel pain, because that is part of getting back in touch with my emotions. It's a fine line to walk though, because you want to feel the pain but not get mired in it. Maybe I am feeling so down now because I was not letting myself feel the smaller bits of pain day-to-day; maybe I was trying to force myself to be happy; maybe it's something you cannot force.

So I will lie here and rest, feel. I will say to myself, "I feel so bad, so guilty, so sad." And then maybe that will allow me to move on; maybe after that there will be space again in my body for good feelings. I'll let you know how it goes.


Letting you know how it goes: I think I do have to feel the pain, but then I also have to actively work through some of the scenarios I'm feeling bad about and try to gain some perspective on them. Otherwise I become mired. So, on to that now. Hmm, even just saying that gives me a bit of a smile, a bit of lightness to my mood.


Hahahah, or maybe it just takes is a couple of cute songs and videos, such as http://www.collegehumor.com/video:1908741 and http://www.youtube.com/watch?v=1tjC0mYfcrg . Maybe I really did just need to feel sad and (in my personal journal) articulate some of my sadness, because I'm actually feeling better, at least for the moment.

Monday, April 20, 2009

Person of size

"Person of size" is a tough phrase for me. Sometimes I like it; I hear in it echoes of the phrase "person of color," which to me conveys self-respect in the face of rampant prejudice. Sometimes I do not like it; this is when it feels euphemistic. Let's stop dancing around the issue and call fat fat.

I am fat. I'm a person of size. Perhaps the reason I feel ambivalent about calling myself a "person of size" is because I feel like a fraud in claiming a title of self-respect.

I'm fat. I'm learning to believe that I'm also attractive. Fat doesn't have to mean ugly; it's just villainized in our culture. We are surrounded by the message that fat is the most singly repulsive characteristic a person can have, and sometimes I like calling myself fat because I want to challenge that incredibly damaging belief. Fat and attractive: they can coexist in the same phrase, the same person.

Some days I believe I'm attractive, more days than I used to. Hey, I'm hella soft, that's pleasant to touch isn't it?

I met this amazing person the other weekend. She was so brilliant, so perceptive, so sharp; she was gorgeous; she had true depth of soul. I was blown away.

I friended her on facebook and was looking at some of her pictures. I was like, cool, that's the super-amazing person I just met; I feel so inspired! And then I saw some older pictures of her when she used to be bigger. I knew it was the same person; I could see that it was the same person; but my orientation toward the woman in the photos changed. Suddenly, I couldn't believe that this bigger person could also be brilliant, perceptive, refreshing. I tried to convince myself that she was--"remember that fascinating thing she said," "of course she was just as smart a couple of years ago"--but to no avail. My brain could not truly believe that someone who looked like that could be as amazing as the person I'd just met.

Is that how I see myself? Can I only recognize myself as a brilliant, capable person if I'm far from a mirror? I think I really struggle with that. Sometimes I see myself, I catch my reflection, the light hits just right, my cheeks are rosy, and I think, you're really pretty Kate. But I can't look at the reflection too long, otherwise I'll start to notice the double chin, the enormous stomach, the pudgy arms. How could someone who looks like that be smart?

I am trying to improve my body-image. I say to myself, Kate, you are pretty, many people find you attractive, your curves are sexy, look at those shapely lips, those high cheekbones, that light in your eyes. I'm trying really hard, and it helps, as does being around people who are not size-phobic and who offer compliments freely. More and more, I believe that a fat girl like me can be attractive.

Not beautiful though, not yet. Too often I catch my reflection at a "bad" angle and am met with that feeling of dull disgust. Even a good angle contains the threat of the slightest shift of position or light; while that threat remains, it is hard for me to accept myself as a beautiful person.

I want to work on this. I'm going to start saying, Kate, you're beautiful. Maybe when I learn to see myself as beautiful I'll feel more at ease claiming myself as a "person of size."

In fact, I am beautiful. I have beauty in my soul. I like saying, Kate, you're beautiful. It feels like I'm acknowledging that my outside is a reflection of the beauty that lives within me, that I'm acknowledging the deep and complex nature of my beauty. Kate, you are beautiful.

For a moment those words are real, and I feel good about myself. Then the doubts set in--how could someone so imperfect be beautiful? The meaning seeps out of the words; I am back to my drab, grey self-perception. But I'm going to practice recognizing and naming my beauty. Perhaps, just as I've started learning how to feel that I'm attractive, I'll start to grow a more confident sense of my beauty.

I believe I will.

Wednesday, April 15, 2009

How I got help with depression

This post is written for anyone who may be having some feelings of depression and is wondering what to do about it. This post is long because I want to share enough details that you can maybe find some commonalities and learn from my experiences. I want to tell you what I wish I had been told back when I started feeling depressed in college: Your feelings are real. Your pain is not your fault. You deserve help; you deserve better than this from life. Not only is it okay to get help but it is actually a good, smart, productive thing to do. Please go for it!

I first experienced depression in the wake of my parents' divorce when I was in 1st and 2nd grade. I remember very little of the pain I felt (this, I imagine, is when I first became adept at blocking my emotions), but I do remember that at that young age I considered myself depressed. I didn't receive any treatment at that time, but upon moving to a new town in 3rd grade my circumstances improved and I became much happier. I still tended toward loneliness, self-criticism, and intense feelings of guilt. Nonetheless, I had enough going for me that these tendencies were not debilitating, and I had increasing hope for the future.

My depression came back during my first year of college, and since then it has been seeping in and out of my life with increasing frequency and duration. In other words, I've had depression for the large majority of the last six years. Yet I've only sought serious, sustained treatment for my depression during the past two years.

I waited so long because I didn't believe that I deserved treatment. I believed that I was at fault for not overcoming my problems--if I just tried harder, worked harder, exercised more, studied more, had more self discipline, was more likeable, did more extracurriculars, applied to more internships, was thinner (read: prettier), was more cultured, was wittier, had better social skills--then my problems would be fixed. Sometimes I managed to voice a counternarrative in my head that would say "Kate, you're not actually a bad person," but I rarely actually believed those words. Attempts at compassion toward myself were always overwhelmed by guilt--"Kate, you're just being too easy on yourself; you should work harder; you should be able to fix these problems." Going to therapy seemed like giving myself undeserved, wasteful attention; antidepressants were nowhere on my radar.

I also doubted that my depression was real. Early on in my college years I did not know that my feelings of emptiness, guilt, and apathy were symptoms of depression. Thus, I only paid attention to my pain when it came in the form of sadness or hopelessness.

Twice, in the midst of episodes of deep sadness and hopelessness, I sought out therapy. Both times, I went to the free counseling services for people affiliated with the university. I saw my first therapist during the winter of my first year of college. The therapist was very kind and had a few helpful suggestions, but I left the sessions feeling somewhat unsatisfied. I knew we weren't getting at the heart of the matter, and I felt like she never quite understood what I was trying to express. After several weeks, as I started to feel better (thanks to my social science class and the onset of spring), I decided to stop going. I tried counseling again my second year, briefly meeting with an academic counselor to help me stop procrastinating and focus better. Again, I found the counseling to be mildly helpful, but because it was limited to the subject of academics, I didn't feel like I was getting to the root of my problems.

Both of my first attempts at therapy were relatively unsuccessful because I did not know that I was allowed to try different therapists until I found a good fit. Here's what I needed to know and want you to know so you can have a better experience than I did: when you're trying out a new therapist, after your first session, sit down with yourself and think: do I feel like they were able to challenge me in a helpful way? Did I get something out of that? Do I think I could develop a connection with them/feel safe with them? If the answer is primarily "no", then politely call and cancel the next appointment/ask to see a different therapist at that facility/try a therapist at a different facility. If the answer is "I'm not sure" or "yes", then try another session with them and see how you feel at that point. If at any point you become uncomfortable with your therapist, it is okay to switch and try someone new. Therapy is for you. It is not your responsibility to try to avoid conflict or protect the feelings of the therapist; any good therapist will be professional about the situation if you want to see someone else. Therapy works best if you feel a good fit with your therapist, so keep trying until you find someone who you think can truly help you.

I didn't seek therapy again until the end of my fourth year in college, even though I experienced a lot of depression in the intervening two years. During this time I was no longer having many episodes of deep sadness and hopelessness; thus, I doubted that my depression was real. Every time I had a good week, or even just a good day, or even just a good afternoon, I would convince myself that my earlier feelings of emptiness, guilt, sadness, and lack of motivation were just "all in my head." I took online tests for depression time and again and consistently was told that I had depression, anywhere from "mild" to "severe." But my fear of being too easy on myself and getting therapy that I didn't deserve was so great that I doubted my results; I wondered if I had rated my symptoms too severely in order to give myself an "excuse" to say I had depression and get treatment.

Finally, after dozens of tests, countless hours logged on wikipedia and psychology websites, and endless conversations with my supportive and patient best friend, I began to believe that my depression was real. With only a couple of months remaining in Chicago, I went back to the student counseling center and worked up the courage to ask to see a different therapist. My request was met with grace, and I began seeing a new therapist. This therapist provided what I'd been longing for--he was incredibly smart but also compassionate, and he quickly picked up on what I was saying and helped illuminate the relationships between my feelings and experiences.

Unfortunately, I had to leave Chicago very soon after I started therapy again. A small part of my brain was telling me that I needed more of this kind of therapy, that I wasn't emotionally equipped to jump into teaching in struggling schools. But I was in no way able to let that thought fully speak, and I moved to New Mexico and began my life as a teacher.

Once I began teaching, I experienced the worst depression of my life. I needed immediate relief, so I started trying to find a therapist. I asked some people I worked with if they knew of any good therapists, and I searched on the internet for therapists in a city a couple of hours away. Unfortunately, because I was living in an isolated rural area, I suspected it would take me a long time to find a therapist who was a good fit, and I couldn't stand to wait that long. My mom and best friend started suggesting that I try antidepressants.

I was resistant to the idea of antidepressants for a couple of reasons. For one, I was worried about how they would make me feel; maybe I'd feel like a "zombie" or have bad side effects. I was also worried that taking anti-depressants was taking the "easy" way out, that it was somehow cheating. Luckily (?!), my pain was so bad that my resistance quickly faded. I made an appointment with a primary care physician in town and she wrote me a prescription for Lexapro.

Lexapro was a godsend. Within two weeks of starting Lexapro (it always takes a little time for antidepressants to build up in your system) I felt lightness of spirit again. Teaching was still incredibly difficult, but I did not dread every second of every day; the world was no longer entirely dark; I was able to see positives and look forward to things. I didn't feel falsely cheery or zombie-like; I just felt okay enough that I could live again, could have more good days than bad. The main side effect that I noticed was increased sleepiness. This was kind of helpful though, since I'd been having trouble sleeping and now was able to go to sleep instead of lying awake and worrying.

Lexapro made it possible for me to survive the schoolyear, but I was not able to do anything more than survive. Despite trying several therapists I was not able to find a good fit; the options were just too limited in such a rural area. I finally decided to focus fully on treating my depression, so at the end of the year I moved to Oakland, CA.

I want to suggest a couple of methods for how to find a good therapist. If you are lucky enough to know someone who has a good therapist, ask them to get recommendations from their therapist. My friend in Oakland had a therapist he was very happy with, and she offered to call me to discuss my options. She looked at therapists on my current insurance plan to see if she could recommend any of them, and she also recommended a sliding-scale clinic in Berkeley. I chose to try the sliding scale clinic because I did not want my ability to see my therapist to be dependent on my insurance (and thus my current job.) I ended up getting matched up with a fantastic therapist who I have been with since. (Based on the wage I was making as a legal assistant, 17.50 an hour, my sliding-scale price per session is $65.)

If you do not know anyone to ask for recommendations, call the local university's counseling department. Explain that you are new in town and are looking for recommendations for a therapist. I've done this a couple of times to help friends find a therapist or a sliding-scale clinic, and the people I've talked to have always been very willing to help.

I've been seeing my current therapist for over six months now, and I feel like I am finally making true headway on recovering from depression. I have also more recently made a change to my antidepressants. My therapist began to wonder if my antidepressants were doing all they could for me because I had some persistent systems, most importantly a tiredness that would not go away even when I was taking good care of myself. I thus saw a psychiatrist and was prescribed Welbutrin in addition to Lexapro. Since I've started Welbutrin my energy levels are much higher, and I have seen a large increase in my ability to motivate myself to do things and engage with the world around me.

I now recognize that the depression I have experienced for the past six years is, in fact, real, and that nothing in my life is more important than recovering from it. I see depression almost as a physical presence in my life. This visualization helps me to recognize how serious the thing I'm up against is, which in turn gives me more power and determination in fighting it. I know from hard experience that if I deprioritize my mental health before I am healed I will end up right back where I started. The depression is there and it HAS to be dealt with.

Saying those words gives me a great deal of satisfaction and peace, because they mean that I have finally accepted the importance of loving and caring for myself.


If you're having any of the thoughts or feelings I described here, I deeply encourage you to reach out. Reaching out might mean starting by telling someone in your life what you're going through; it might mean visiting a doctor and telling them about your symptoms to see if antidepressants could help; it might mean calling your local university to start searching for a good therapist. If you can take any lesson from my experience, I hope that it is this: blaming yourself for your problems will only paralyze your attempts to move forward. True, it is your responsibility to do what you can to help yourself get better, but you did not choose to have these problems in the first place. Depression is an illness, and like any person facing a major illness, you deserve to get treatment. Not only is it okay to get help but it is actually a good, smart, productive thing to do. Please go for it!

Sunday, April 12, 2009

Coming into focus

The original name for this blog was Eye of the Brainstorm. This name appealed to me because I liked the idea of the calm within the storm, the idea of finding peace despite the persistent unease of my mind. But calm is not what I need. My existence, over most of its 24 years, has tended toward an increasing calm at the cost of life, a numbness called upon in emergencies to cover wounds too deep and shocking to bear. This numbness grew into a lens through which I viewed all of life; I constantly searched for and guarded against the threatened pain beyond the horizon. To protect against old and new pain, to hold together a spirit never allowed to heal, I was forced to maintain an increasing emotional rigidity, to never reach so far out in pursuit of a hope that an old wound could be reopened. Calm is what I have, but it is not what I need.

I came to see the danger of this lifeless calm by my last year of college. Over the four years I spent in college, my ability to motivate myself withered significantly. I always managed to hold it together well enough that one had to look closely to see my internal stagnation; I maintained good grades, wrote an honors-worthy thesis, kept up with friends. But I spent the better part of my days in a haze of emptiness, dull guilt, and the ever-available distractions of the internet and television. School was not hard enough to force me into real activity, and I felt hopeless at the prospect of ever motivating myself.

I thus sought a source of external motivation upon graduation, and I joined a program that put recent college graduates into struggling and under-resourced schools. I was placed in a rural region in New Mexico, living and soon teaching in a town of 20,000 that lies on the edge of the Navajo Nation. This is when things got really bad. While I was relieved to finally be doing something that mattered, and while I truly loved my students, every day was a living hell: not being able to meet the demands placed on me (internally and externally), dreading school from the moment my alarm went off, sitting exhausted and defeated and sobbing after I got home. Thankfully, my mother and best friend convinced me to go on antidepressants and my life became bearable again, but still very difficult. I never had enough to give my kids, and I never had anything left over to give anyone else in my life: my internal resources were completely dried up. I realized that no amount of approbation, of prestige, of doing what I thought I was "supposed" to do, was worth feeling this bad. It was finally okay for me to radically change my life because the path I'd always seen myself on--honors, brilliance, success--was not worth living if it felt like this.

I left New Mexico at the end of the school year, thus breaking my two-year commitment to the (prestigious) teaching program I had joined. I decided to move to an urban area so I could find a good therapist, and to my great fortune a friend from college convinced me to move out to green and sunny Oakland, CA. My decision to make this move grew from my burgeoning awareness that it is necessary (and thus okay, according to my poor twisted conscience) for me to seek happiness.

Immediately upon moving to Oakland I found a job working for a lawyer; within a couple of months I'd found a good therapist. I grew progressively unhappy in my job because my boss treated employees and customers extremely badly, and while my depression was not as bad as it had been in New Mexico, I was desperate to find a new job, a difficult task in this economy. This situation created the circumstances for my second, even more radical, departure from the status quo in pursuit of happiness.

A close friend, who saw how miserable I was in my job, offered to help support me financially until I was able to find a new job so that I could quit. Because my friend comes from a wealthy family, he has access to considerable resources and it was not a hardship for him to offer this support. But what a prospect! I was raised to believe that hard work and responsibility are the most fundamental qualities of a good person. I believed (and still have a hard time not believing) that my worth as a human being is directly correlated to the work I produce. I feared that I would feel guilty--nay, be guilty--for accepting such a generous gift and temporarily leaving the work force. But again, my misery outweighed my reservations, and I stepped out onto a completely unfamiliar path.

I am now three months into this path. For the first couple of months I took a much-needed rest from work and focused purely on therapy and putting the pieces of my new life together. More recently I have built up enough energy to start looking for work again. I am seeking a job that will place light enough demands on my time and energy that I can maintain focus on what I am now fully committed to as the main point of my life: finding my happiness.

My hiatus from the world of recognized "honors, brilliance, success" may seem like a retreat, an attempt to burrow into that suffocating calm, but nothing could be further from the truth. By questioning the standards of success that I absorbed from my society, by recognizing my own inner needs and risking judgment and disapproval (not only from others but also, most damagingly, from myself), I took steps that were possible only because I had courage. I am now learning how to grow this courage. I hope to use this blog to chronicle my thoughts and observations as I learn how to use courage in my everyday decisions, reach out further in pursuit of hopes, risk pain, and find life.