Diary: My journey to cure my depression

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Status: In Progress  |  Genre: Non-Fiction  |  House: Booksie Classic

Early this year I got diagnosed with depression (mild/moderate), social phobia and GAD (Generalized Anxiety Disorder). As a man I understand that this topic is still a taboo. Most of those I meet in this for me new world of mental difficulties are women. Is it really so that women struggles more than men? Probably not. I am writing this to hopefully shine a light on how it is to be a man with this type of problems, and to use it as a tool to document my progress.

My life living with depression - A life in progress

Mentall illness affects millions of people worldwide. At any moment, there are someone out there struggling. This has most likely always been the case, all the way since the dawn of mankind. In a way, it can be said that it is the cost of having the most advanced brain of all species. There is simply put more that can go wrong. Wether others struggle more or less than yourself is, of course, largely irrelevant. Egocentrism is greatly enhanced when something as fundamental as our thoughts comes to a standstill. 

The starting point for writing this is my own experiences with mental illness and what consequences it has for my life, hopes for the future, limitations and not at least opportunities. This means that this is my subjective perception of the specific dianoses I have, and not in any way a conclusion for others. Regardless, we can learn from knowing how others experiences and survival challenges most of us to a greater or lesser degree will experience. 

For those who are new to mental disorders, either because it has arisen recently or has recently been recognized, I believe that so-called psychoeducation is an important part of both the habilitation and possibly the rehabilitation. Psychoeducation is a cross between psychology and learning. The goal is for use to recognize symptoms, make the same symptoms harmless and thus reducing the level of stress by improving our understanding of what is going on in our mind. Psychoeducation is therefor best suited for anxiety disorders, and other diagnoses where the disorders do not affect our thoughts to much.

Knowledge and understanding must always be bult layer by layer. Specialized knowledge should therefor only be saught when we have acquired sufficient general knowledge. Of course, how interesting my experiences are for to others can also be questioned. Two people with the exact same diagnosis are likely to have different experiences of it. 

Searching for the correct perspective helps us to explore the real scope of a problem, and not least to understand that our problems are not unique. I myself resort to thinking in macro- and micro levels. How it behaves at the societal level and down to the individual level. For the individual, mental illness will be experienced as undeniably unique. We are trapped in our minds and will naturally have difficulty looking beyond that. But since mental illness is a common concept for a wide range of diagnoses, it will be necessarily also mean that it is not so unique anyway. 

Life is full if contradictions. In many ways, it provides life with the necessary spices. At the same time it leads both compclications and confusion. Women and men are separated by only one sex chromosome, nevertheless we are sometimes amazed of the small diffeneces that exist. Our brains are the same, most alike, but with amazing differences. Happiness and sorrow are something we all experience during a lived life, without it making it easier to deal with sensibly. Most of us understand that grief and grief processes are demanding and lead to reduced quality of life. It is probably a little known fact that happiness can also be to much. To much of something good is too much anyway. So too much air, hyperventilation, and too much food, overweight and obesity, is too much.

As many already knows, we are the result of herritage and environment. Without it being possible to know how important one is over the other. My thoughts is that at birth we are the result of 90 % genes and about 10 % environment. After that the environmental factor is strengthened until we reach middle age, before the genes again get the upper hand. These are, of course, my own unscientific reflections, and in any case it is not so important by and large. What we choose to believe in is largely the correct for ourselves and our lifes.

Maslows pyramid of needs is the one modell I lean most towards. Naturally understanding that models and forms are too static in an eternally changing life. In short, this particular model is a pyramid with the most basic needs at the bottom, and self-realization at the top. That is, the fact that we must first survive before we can live. 

The basis for creating both objective and subjective qualitity of life measures increases with the fulfillment of each step. Layer by layer our quality of life increases. The first three steps in this five-step pyramid are where the needs arises. If we lack something in thes steps, further self-development is prevented. We are not in balance and will thus always be reduced to organisms that struggle to survive, never live. We have not acquried the resources to achieve what Maslow described as growth needs. We are at a stage where we are no longer satisfied with survival, we also want to live life to the full potential.

That we need food, water and shelter to survive is hopefully selv-evident. This step is usually fulfilled by most people, though with far too many sad exceptions. I think the problems in our climb towards self-realization start at stage two. This is where things are chopped less concretely than in the first fundamental step. Security and predictabilty. Often in the form of a job that provides us steady income. A support system that is willing to help us and to live in a stable society. What this step entails will of course be able to vary greatly from person to person. The important thing is that we feel safe and that the future can to some extent be controlled by ourselves, not constantly throw insurmountable challenges at us. 

Since I have managed to grow up, it is quite obvious that I got past step one. Other steps, on the other hand, have not been as linear. With a main breadwinner who was a young single mother, the very earliest socialization became somewhat deficient. It is easy to think that socializing is about getting to know people we do not already know. But the primary socialization starts with our parents. And yes, it does not matter if the parents are male and female, female and female, or male and male. Orientation has nothing to do with how developed our caring abilities are. As an example, my parents are traditional in that they were a heterosexual couple who were married when I was born. Nevertheless, they proved incompetent to take care of themselves, and not least a child. So already at the second stage my problems gradually start to appear. The root of all pain for those who want to be a little dramatic.

The third step is where survival begins to slip into quality of life. The most important challenge here lies in the abstract, and not least the game of chance. Belonging, love and family. I think of these factors as small microcosms that in total create a universe. Who we feel belonging to and love for will naturally change with age, although hopefully there are also constants. The decisive factor in most cases will be our and the others' willingness to meet us halfway. Life consists of an infinite number of compromises. We can not be everything we want to be, at the same time as our abilities and possibilities are often greater than we think.

A family can satisfy our need for belonging and love. For most children, this is also the case. Our perception of reality is still undifferentiated, and our surroundings are more forgiving of our child version than later versions of us. However, the uncompromising love we attach to our immediate family is of a mythical nature. Of course, parents can love their children, but it is not completely unconditional. It is their own flesh and blood, and they have expectations of what they will get back for their efforts. What they do is therefore neither uncompromising nor altruistic.

No one takes it for granted that being a parent is easy. As life is not a dance on roses, a responsibility for both one's own life and someone else's will be at least twice as demanding. Now it can probably be argued that the vast majority of newborns have two parents who can share the responsibilities and tasks. But it also means that there are 3 lives with unique and different needs. The biggest risk I see there is lack of experience. No matter how much you like children, having your own will be life-changing. There is no final or recipe for what it takes to be a good parent. At least not one that is generalized enough to function as a kind of universal tool. Many give advice and recommendations, be it individuals or organizations, but much is still up to those who know the child best.

Based on models like this and often Bronfenbrenner's developmental ecological model, where the mutual interaction and influence between us and our proximal and distal surroundings shapes us, we can try to understand why many people have mental disorders. Nevertheless, it is important to point out that psychology and mental processes are so complex that one should have an eclectic approach to it. Which means using different models and explanatory models, and not least individual adaptations. One size does not fit all.

First and foremost, it is important to keep in mind that mental illness is by no means a homogeneous collective term for transient difficulties that everyone experiences from time to time. There are a myriad of diagnoses to choose from, with a wide range in prevalence. Anxiety, social phobia and depression are probably the ones that are most familiar, and at the same time and most misunderstood. That a person says that he has depression does not mean that it is correct. Of course, that does not mean it is wrong either. Personally, to the annoyance of someone, I have become better at asking where that diagnosis comes from. Is this about your own diagnosis, or has a psychologist arrived at it?

To the great frustration of health professionals and others who still believe in scientific research and good source criticism, many are looking forward to the diagnosis on social media. Preferably by asking others who have already self-diagnosed themselves. This is a bit like the pygmalion effect of Rosenthal and Leonore Jacobsen. Their findings at the school are transferable to many other areas. We have preconceived notions and expectations that we actively seek, and filter out anything that does not confirm it. A phenomenon we have seen quite a lot of during today's ongoing pandemic; I do my own research…

Who has credibility when they speak out about mental illness is another important contentious issue. The sensible one chooses to listen to the advice of psychologists and psychiatrists, rather than friends' subjective experiences or social media. The problem is that on social media we will find solid answers, while those who actually have knowledge and experience with mental health are far less solid. The reason is probably the responsibility that lies with the messenger. Healthcare professionals have laws and regulations they are required to follow, while for example a YouTube channel can be created by anyone. The emergence of alternative truths is also an ever-increasing problem in our globalized society. We forget to be critical, at the same time as we think we are critical by looking for answers on our own.

The fourth step in Maslow's pyramid, which not everyone reaches, is about self-esteem and ability to succeed. What we do with life, what lifestyles life takes us, will promote and inhibit aspects of our self-esteem. A popular misconception is that self-esteem is most often a general self-perception. That we as human beings are worth much or little. For most people, self-esteem is probably more specific. Everyone has areas in which they find their strength or weakness. But of course, good or bad self-esteem will create a domino effect. If we feel failure in one area, it will from time to time metastasize to other areas, as malignant cancer is basically harmless until it spreads.

The fifth and final is the nirvana of life. A feeling of mastery, self-realization and personal growth that fills our lives with meaning. This step is also the most demanding to reach, at least in western countries where most other needs are adequately covered by society at large. Those who are unable or unable to climb up to this step will feel the gnawing feeling of lack. That life should have contained more. What it should be will, like everything else, be individual. Money, own family, education, job, love. No matter which of our needs is never met, it is just as tragic. A wasted life. A life where everything has been about surviving, not living.

The fact that heredity and environment, ie genes and surroundings, turn out to be far from optimal does not mean that fate is fixed. As we have seen among, for example, people who have experienced concentration camps during World War II, children in orphanages in Romania and refugees, some are apparently blessed with resilience, that is, the ability to cope with conditions others would have struggled significantly more with. Somehow the negative is not internalized. Something that for many under similar conditions could develop into post traumatic stress syndrome (PTSD) or generalized anxiety disorder (GAD).

Our genes affect our lives, just as the environment does. What can be confusing is how and in what ways. Simply explained, one can think that genes are about physical health, and the limitations and opportunities it entails, and the environment is more aimed at what can inhibit or promote quality of life. What complicates it all are individual differences. As a wise person once said; it does not depend on how you feel, but how you take it. We have mapped genes and parts of genes that we know, or make probable, that heredity is an important factor in many diagnoses. But it's getting too deep and nerdy even for me.

Ok, so to the egocentric. How mental health has affected me and my life. To start anti chronologically, I am currently on leave from my studies. Since the beginning of February 2020, I have visited a psychologist weekly. The road to diagnosis has been somewhat tortuous and, strictly speaking, not very useful. But now it is the case that further treatment requires a diagnosis. After exploring possibilities such as bipolar disorder, schizophrenia, personality disorder etc. it ended up with dysthymia. It easily corresponds to a moderate degree of depression that has lasted for 2 years or longer.

Timing mental illness is virtually impossible. How precise will of course depend on the diagnosis and how many factors come into play. Refugees who have felt fear for life due to acts of war will be able to develop PTSD. The chances that something other than the acts of war have led to the diagnoses are in most cases small. It is something completely different when it comes to mild to moderate degree of depression. As human beings, we have a strong need to understand. Find rational explanatory models, even when they are not necessarily present. Bullying, emotionally absent parents, unrealistically high inner performance demands and so on can lead to depression. But the chances are greater that the depression has its background in several factors. Such as that bullying does not occur in a vacuum. The bully's parents and the bully's parents have not been able to put a stop to it. School and surroundings have not done their part either. Which leads to a distrust of the environment, and their desire to help. Bullying leads to isolation, which in turn creates a socially skewed development, and we need someone to support us. As people are dependent on each other at both the micro and macro level, it goes without saying that deficient social skills will have far-reaching consequences for them.

Causes of origin and maintenance reasons for mental disorders are in my mind important pillars for our mental illness. The reasons are either simple or complex. Bullying, poor upbringing conditions and congenital cognitive and / or intellectual limitations are frequent sprouts for depression in particular, and not least trigger factors for other mental disorders that are initially latent in our genes. It must be pointed out that heredity is similar to genes, while having a specific gene variant does not mean that it comes to "live". Such a person who is hereditarily predisposed to lung cancer most likely will not get it if he never smokes and lives all his life out in the countryside.

What is most interesting for all of us who have some diagnosis of varying degrees are the reasons for its maintenance. Here, too, I will focus on the most common diagnoses, and not entirely random ones that I myself have received, such as depression, anxiety and social phobia. The reasons for maintenance are what cause a certain behavior to repeat itself. Here it is implied that the behavior is of a negative nature and involuntary.

After I met my breaking point, I was almost forced to grab things. Which of course is very demanding when you are at your weakest. Fortunately for me, the school was understanding and has always been willing to make things easier for me. I first contacted my GP to be able to document the need for leave from the studies. In the midst of a pandemic, a phone call was the most appropriate. But it soon became clear that the focus of the GP was the immediate danger, ie the risk of suicide. To my great frustration, a further reference to the report on DPS was rejected. Suddenly I had no basis for leave, and was already so absent that the academic year would not have been approved.

With what little I had left of inner strength, I contacted the school again and was recommended the school's psychosocial health service. It worked better. Another phone call, but this time longer and with a psychologist. Who sent a referral to DPS who after a short time approved it. In short, everything worked out in the end, the GP understood the seriousness, probably after a conversation with the school and my psychologist.

According to the lead was the principle I had to undergo physical tests to exclude that there was something wrong with the heart or brain. I probably understood already in advance that it was something mental, but I also knew that there could have been something physically wrong with me. Neither ECG, spirometry nor blood tests showed anything wrong. The information from the health worker was not universal, as it is the doctor's responsibility to interpret the test results. Fortunately, I had sufficient knowledge to know that my blood pressure was within normal, my lungs were ok and that I had no known symptoms of the virus. I must admit that even before I got this far, I had been equipped with a 24-hour blood pressure monitor at another doctor's office.

My expectations for the assessment and the later treatment I think were both high, low and pragmatic. All gathered in one wonderfully confused package. Still in shock at having lost virtually any control over my thoughts. A kind of tornado in my head that was getting harder and harder to stop. At worst, it felt like I was about to vomit, my chest was painful, tingling in my fingers, and oddly enough my lower lip. Feelings that until now had been unknown to me, and thus also all the more frightening.

Although I have had difficulties with my thoughts for many years, known others with similar challenges some of which chose to end my life, my knowledge of the psychiatric health service was sparse. What a DPS was had avoided me completely. My knowledge of what a psychologist does was taken from movies. So the starting point for prejudice was so absolutely present.

The first hour was thankfully early Monday morning. We probably have different preferences when it comes to time for important meetings, but early in the week and early in the day fit well for my stress management. Maybe the end of the day on Friday would have been the same day, made the weekend relax. In any case, the first impression, which I actively choose not to trust, was quite ambivalent. DPS is a bit to the side for an area I am quite familiar with. A little secluded, without being too secluded.

My first meeting at the front door was a guard asking if I had any symptoms of the ongoing pandemic. Something that seemed a little scary there and then, but has gradually become a routine on my gradually regular visits there. As I had received confirmation on time both by letter and by SMS, I just sat down in the waiting room and waited. It was my very first surprise in my first encounter with psychiatry. They had gone for an open solution, where everyone sees each other. It undeniably felt a little uncomfortable now that I was at my weakest. As a student in a field with a strong focus on normalization, I see the point in bringing things to light, instead of letting stigma and prejudice live freely. But at the same time, it can probably have unfortunate consequences for those who now need treatment. Those who only see you and do not ask why you are there will draw conclusions on a particularly failing basis.

What I thought sitting there in the waiting room is hard to remember now in retrospect. Tension in the body and thoughts flying around. Note, however, that the others who were waiting were quite young, in the early to mid-twenties. Of course, it could be a pure coincidence that this day at this moment were the other young people. But after sitting in the waiting room x number of times after this first visit, this is a trend that has repeated itself. The majority are young people and women. Guess it's because those with more complex challenges or problems who have "sat down" more go to more suitable places or departments. Have not thought too much about this, and also feel a more or less justified worry about rethinking things. Here and now I owe it to myself to focus on myself and mine. Selfishness is a negatively charged word that is not necessarily negative.

I knew my psychologist, or therapist as they prefer to call it, was a woman. I did not know anything more than that, and also considered it irrelevant. Could probably google the name and possibly find something, but doubt that it would have had anything to do with it. Sometimes, in fact, ignorance is bliss, an open mind is most teachable.

Was picked up by my therapist in her office. An ordinary office with a window, chairs, and otherwise nothing psychological. First I got an introduction to what kind of help they had to offer, and then I tried to the best of my ability to convey my expectations. During this period, I was so mentally run down that many of the details are forgotten. Anyway, the first impression was fine. Less scary than I thought. My therapist was young, but I had no reason to suspect that she was not good at her job.

The first treatment hours were about finding exclusion and inclusion criteria. What spoke against and for diagnoses, respectively. This was done by telling me about my physical symptoms, such as tingling in my body, confusion and despair, as well as a questionnaire. Mental disorders do not have a test that certainly finds the diagnosis. The conversation is just as important as a symptom outbreak is after all the tip of the iceberg. Something made the cup overflow, but the time before has filled the glass to a breaking point.

Various proposals were thrown out, some more credible than others. PTSD, schizophrenia and bipolar disorder were opportunities that were quickly rejected. In order to keep my place at DPS, and maintain my leave from my studies, I had to have a diagnosis. It fell on dysthymia. Which means mild to moderate degree of depression, which has lasted for 2 years or longer. In addition, it is assumed that I also have generalized anxiety disorder (GAD) and social phobia. Most recently, my treatment sent a referral for group therapy, probably psychodynamic group therapy, and an appointment for the first conversation has been set. I think it can help me, but I have very little to base it on.

How far I have come in the treatment I am unsure. Weekly one-on-one treatment hours are held every other week until the start of studies. The plan is then to resume weekly hours in case I get problems again. This is because I understand that my life is now a kind of artificial reality. Those I have contact with know that I have a diagnosis, and their task is to arrange for me to get well again. I am the focus of my life. This is not the real reality. It is not the case that everyone can or will pay attention to us when we feel tired or have otherwise reduced our ability to function.

One of the most important goals for me, and thus my therapists, is socialization. Get me out and meet people, build a network. It is, of course, easier said than done. As a child, it was very easy to make friends, but with age it gets harder and harder. This applies to both those with mental disorders and those who are mentally well-functioning. Why this is so is difficult to know for sure, for the simple reason that there is not only one reason for it. Little socialization at an early age intensifies with time. As our socialization becomes more complex and takes place in more arenas, the more obvious our lack of adaptability becomes. Other things are finances, such as the opportunity to participate in activities or buy status, and the end result is low self-esteem that unknowingly repels potential friends.

The next step in treatment, on the road to a better life, is group therapy. My individual therapist was the one who referred me to that ward. My main problem is even isolation, little social network and thus room for a lot of pondering. So meeting others in a similar life situation in a safe setting makes sense. For me and others who struggle with negative symptoms, this can seem both scary and too unpredictable. Negative symptoms can easily be explained as that we lack something we should have had more of, while positive symptoms are too much of a good thing. Although these terms are mostly used about people in a state of psychosis, they also apply to varying degrees to other diagnoses. My most prominent negative symptom is passive-apathetic withdrawal. I feel a need to be social, but in a social situation all desire to get involved disappears.

When it comes to mental illness, and strictly speaking life in general, quality of life is closely linked to the consequences of our actions. Having good parents and supporters growing up increases the chance that we make good choices, and thus experience good consequences. This means, however, that both coincidences and personal characteristics are fairly normal. For those of us who have mental challenges, it will naturally be difficult to function as expected in normal society, we fall out easily.

For my own part, I think it started with uninvolved parents. The type who does not bother to teach things, but rather takes it for granted that it is learned magically. The consequences for me were that there was no help to be had when I needed help with homework, or when teasing was about to be bullied. Over several years. With more committed parents, I would not have had any diagnoses today. But that's life. I would assume that many with anxiety and similar challenges have experienced the same thing as me. Lack of support from those we could expect to support us.

This was a bit about what has happened, and a bit about what awaits me. Over time, I will write more to give you an insight into my world and what it can be like to have a mental illness. If anyone cares about that then.









Submitted: November 23, 2021

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