My therapist informed me this week that lately I have been presenting as having my anxiety under control, but now am showing signs and symptoms of “mild depression.”
I have mixed emotions about that diagnostic statement. Firstly, yay! A thing that I have battled for my entire adult life is well managed and all my interventions, lifestyle changes, medication, and hard, hard work of wrestling with the trauma dragons of my past is working. Am I cured? No, unfortunately. I have what they call “generalized anxiety disorder” which means, according to a psychiatrist I used to see way back when, that on a scale of 0-10 of anxiety where 0 is blissfully unaware and 10 is fingernail-picking, pacing, heart rate slamming, and crawling out of your skin….I’m at about a 2 when “I’m doing well” and a 0 may not ever be feasible for me.
I liked that diagnosis. It gave me a reason, an etiological path, a clue to my sometimes bizarre behavior and paralyzing fear. Anxiety can be easy to treat. There’s pills. There’s meditation. There’s mantras to repeat in an attempt to self-soothe. There’s camaraderie. And it’s easier to talk about, even with virtual strangers.
Depression is, well, depressing. Sure, there are pills. And lifestyle changes. And the “easy” ones — diet, exercise, sleep, and stress management. But there’s also fatigue. And discouragement. And shaming. And questioning. And the self-doubt and the lie that I like to believe, which is there’s something to blame it on.
The reality is, there isn’t just one thing. Or at least that’s how my brain and body handle depression. There’s lots of things to think about and ascribe symptoms to. It’s January. It’s post-holiday blues. It’s grief. It’s fatigue. It’s healthcare worker burnout. It’s life. It’s the reminder that sometimes when you make plans and go to put them in motion, by the time you’ve done all the things to get yourself out the door, both physically and metaphorically speaking, the plans are gone. The opportunity disappeared. The intention disintegrated.
They say that anxiety and depression are related. No one has ever been able to tell me how. Is it a complicated and branch-filled family tree where anxiety’s aunt is depression’s cousin? Were they identical twins separated at birth, raised in different environments, each becoming a monstrous black hole? Can you have one without the other? Do you treat them separately or throw them both together in a cage and let them fight it out? And cross your fingers that the “right” one will win?
And if one wins, what about the other one? Do you mourn the loss of them? Recognize that they weren’t all bad and that you were able to use your greatest weakness into your greatest strength? That people likely connect with you on a level different than most because of these diagnoses? Because of how your brain is wired. Because chemicals are trapped in one area and not getting to some parts of the brain in a timely manner. Do you continue being kind and gentle with yourself and acknowledge them and how they might be helping? Do you keep them locked up and hidden and only bring them out when it feels safe? Do you go on with the lie you tell yourself that no one knows your secret, when in reality, the things you hide are behind a glass door and visible to all?
And if you have learned to accept these diagnoses and understand how they operate and why they make you feel the way you do, then what? And when you own them and make friends with them and treat them with respect and listen to them with love and grace and offer them what they need only to find them disappearing…who are you then? Who am I without my anxiety? Who am I with effective treatment and managing the symptoms and understanding the mental illness and with acceptance and limiting and controlling the amount of disorder it has on my life? Who am I without my anxiety to lean on as a crutch, or as an easy explanation. Who am I without my anxiety in the driver’s seat and instead it’s in the backseat, along for the ride, munching on snacks from the gas station a few miles back, and asking when the next bathroom break will be? Who am I as now my depression gets a turn and it’s her time in the spotlight? And where do I sit in the car? Am I a carefree backseat passenger with anxiety as we goof off and play “I spy” as we gaze out the window? Or am I in the front passenger seat acting as a co-pilot?
Or, and this is the most terrifying truth of them all, am I in the driver’s seat finally having found the power to tell them where to sit and informing both of them that from here on out, I’m in charge and I call the shots? And if I do that, how can I keep hiding from my trauma demons if I’m the one driving the car?
Who am I and how, indeed.