Tuesday, September 2, 2014

Recovering from chronic depression


I am acutely aware of survivorship bias and that I have had several lucky breaks in my life that empowered me to begin my own healing process. I still wish to write this in hope that some part may be helpful to somebody out there, or at the very least, demonstrate a sense of solidarity with the ones who are still struggling.
Some people move on by pretending their old self never existed, I insist on honoring mine. There are little simple joys that occurs daily that most people take for granted but still feel like miracles to me:
  • Waking up with no migraine and falling asleep within 15m
  • Jumping out of bed vs wishing not ever having to get out of it
  • Stopped feeling like I’m about to burst into tears at any moment
  • Stopped having fantasies about 10,000 ways “accidents” can happen so I can leave this world without any sense of guilt (alright, I still do this, but not as much)
  • No longer have unpredictable outbursts of temper or mood swings
  • Adequate, stable levels of energy as opposed to walking around like a zombie
  • Some semblance of mental clarity
Recovery was a long process that took years, in some ways it is still on-going and requires rigorous maintenance.

The healing process
Depression is caused by a complex myriad of factors and I cannot speak for everybody except for myself. The first step to recovery is to understand why:

Genetic

Research has shown that 50% of the cause is genetic. Family evidence has shown that I am most likely predisposed to misfiring neurotransmitters, which means that my neurological resilience to stressors is lower compared to the average.
What helped
Nothing much I could do about this one, but it made me feel a lot better because it is not “all in my mind”.

Overexposed to stimuli

The idea that I am exceptionally sensitive to external stimuli was only obvious to me much later on when I started researching the hell out of my condition:
“Such an inability to suppress seemingly unnecessary cognitive activity may actually help creative subjects in associating two ideas represented in different networks.” – source
TLDR: Imagination and creativity comes at a cost. Introversion play as part too:
Research has also shown that introverts have more neuronal activity than extroverts in brain regions associated with learning, motor control and vigilance control, and that their premotor cortexes process external stimuli more quickly.source
What it all means – I am uncontrollably reacting to everything every fucking second.
What helpedI now live by myself and spend copious time alone to reduce the amount of possible stressors that may trigger my adrenals. I no longer feel pressured to to attend social engagements, because I prioritize my mental health above everything else.

Sleep

I couldn’t sleep, because my nervous system was so stimulated all the time, that I was unable to wind down my brain. Sleep deprivation causes a whole lot of physical health symptoms. Without the healing process that comes from sleep, it is not surprising that my brain was dysfunctional. Imagine never shutting down your car engine. It will eventually give way.
What helpedI have a strict sleep pattern I adhere to, sleeping before 11pm and waking up without an alarm around 6–7 every morning. It is almost non-negotiable, but I have made really rare exceptions for those one-off amazing nights. It is difficult to be disciplined with sleep because I love staying up late, but again – tradeoffs.
Disclaimer: I was able to start sleeping again because I had the privilege of moving out of my very over-populated birth country and into San Francisco, hence allowing me to reduce the anxiety of my nervous system.

Diet

One word. Sugar. There’s a ton of research out there about how sugar is really stressful not only for our brain, but for our entire body. And then there’s processed food…
What helpedI still eat desserts and junk food like Hello Panda once in a while, but considering that I used to drink Coke and extra-vanilla-syrup-lattes like 3 times a day, my diet is healthier than ever before. I thought it would be difficult when I transitioned to unsweetened drinks, but I realize I can adapt as long as I want to. Carbohydrates are avoided as much as possible because it causes extreme energy and mood fluctuations for me.

Stress

This includes stress induced by other people’s expectations, or my own. I was also really stressed out in Singapore, where rent is more expensive than San Francisco (surprise!) and yet the average income is much less.
What helped
I learned to not give a shit about what other people think of me. Then, I learned to understand myself better, and that helped removing the stress I tend to give myself. Again, moving helped a lot, both mentally and financially.

We are who we surround ourselves with

It is hard to maintain any positivity in our lives when we are surrounded by perpetual negativity and wet blankets. Living in a society where anything except conformity and materialism is discouraged is depressing, even just to think about it. Human beings are social creatures, and I mean it even as an introvert. We feed on each other’s energy.
What helpedI only spend time with people whose values I align with. Otherwise, I am happy to spend time with myself. More importantly, I became someone I am happy to spend time with, so I no longer depress myself so much that I couldn’t bear to be alone. Living in San Francisco helped tremendously, it remains one of my greatest discoveries when I first experienced what it feels like to have strangers smiling at you for no apparent reason.

Stigma of sadness

It is a self-perpetuating cycle if we believe sadness is bad. I felt bad for feeling bad, and it never ends.
What helpedI no longer feel bad about my perpetual sadness. I thrive on my sadness, and accept it as another spectrum of emotion I am capable of having. Why is happiness better than sadness? Why must everybody be happy?

Trauma

I can’t go into details because of the people involved. Nothing acutely tragic happened, but it was chronically emotionally traumatizing for me while growing up. Here’s what I would say. To be told consistently and continuously that I was inept in everything I did, to be measured only by the virtue of my academic and career progress, to be denied unconditional love or support as a child — all the other things I can actionably fix, this is the one thing that I am still trying to recover from.
What helpedReading a lot. Developing empathy not only for myself, but for the situations and the people involved. Mediation. Understanding the true source of unconditional love has to come from within. Reclaiming ownership and power for my own life. Seeing the inter-connectedness of everything. Life, is a butterfly effect.

Meaning and purpose

It all ties in together, it is difficult to convince myself why I should even bother to sleep and eat better when I don’t even know why I should want to live.
What helpedI cannot adequately write this in words. I have found my meaning once I was able to give myself the space to think and love. This is where the Maslow’s hierarchy of needs come in – it is impossible to expect our fellow human beings to be capable of self-actualization, to be empowered to move us forward, when we are starving and disempowering each other all the time.

Closing thoughts
I had hesitated writing this, because it is the best and worst thing to have another chronically depressed person tell another that it is possible to get better. I sought tons of solace in depression memoirs, and one that particularly struck me chronicled Lincoln’s melancholy. It didn’t speak of any recovery. Instead, it focused on how Lincoln accepted his perpetual melancholy and channeled it positively for his life’s work.
It can be depressing to read survivor memoirs, because if someone can get better, why couldn’t I? Yet it was ironically inspiring at the same time. Maybe I could get better if other people did get better.
I did get better. A whole ton better. But I recognize that I had a lucky break in my life where I was in a privileged situation to move.
But in my opinion, privilege is not something to be wasted. If you’re given a silver spoon, you can reject that spoon and go live a life of remote simplicity, disowning all materialism in the world. Or, you can take that spoon and think of how to use it effectively to make this world better.
My recovery didn’t occur overnight but rather it took over the course of the past three years. I still have to be extremely careful with myself. There have been times when I let it slip, and the signs appeared again — trouble falling asleep, general apathy, the inability to observe beauty, exhaustion, irritability — the trick is to recognize these signs and kickstart the healing process again. Sometimes it takes making major decisions. Sometimes all it takes is a ton of time alone, away from the world.
But the biggest discovery for me throughout the entire process is — the discovery of who I really am and aspire to become, once I started functioning coherently.
That makes me keep thinking about the complex role society and environment plays in our mental health. How much of it is actually actionable and removable with long-term sustainable solutions. I think of the person I used to be, with impaired cognitive ability and poor decision making. I think of people out there who are still suffering, and I see my old self staring back at me.
I think of all the work I’ve accomplished for the past three years, and all the potential we’re missing out from the world, because we have not succeeded in making this world empowering and livable for all of our own species.

No comments: