Wednesday, April 27, 2016

it's not you; it's me

I met with my doctor again yesterday. We meet every four weeks to see if our current approach is making a difference with my major depressive disorder (MDD). Yes, that's the official diagnosis; that's why I've been on medical leave for months. Yesterday's tests showed that no, we're not getting anywhere yet. 

If I had some other illness, I probably wouldn't have to tell you that. If I had some other illness, maybe you'd see my gaunt face, or you'd hear from someone how I haven't been able to leave the house so they're organizing meals. Or maybe you'd see me in a wheelchair or on crutches or dragging an oxygen tank. 

I told my doctor how frustrating it is to have an invisible disease. I reported some of the thoughtless things people have said. And some of the thoughts those have lead to in me. Thoughts like "Maybe I should go back to work even though I can't concentrate on anything, would be doing terrible work, and would end up shaking/crying again by the end of the first week." But mostly thoughts like "People think I'm shirking, that I'm not really sick, that I'm abusing the system; it matters to me what people think. If I went back they'd respect me again." 

My doctor was sympathetic. To the people in my life who've said those things, as well as to me. He pointed out that there's no way for people to know what it's like to have MDD if they haven't experienced it. They don't know the bone deep fatigue. The scrambled thoughts. The jangling nerves. The inexplicable head and body aches.

My doctor also said that I am not helping anything by masking my symptoms - that maybe if I walked around and showed people my test results they'd see something that doesn't show on my face or in my behaviour. Maybe if I fulfilled people's ideas of a mentally ill person they'd believe me (it reminded me of rape victims who aren't believed because they don't follow some expected response, but I digress). 

It made me laugh a little bit, sardonically. People often say that I'm an open book, and that my face betrays me - that's true. But a lifetime of pushing through has given me skills at showing the surface so I can hide what's behind it. I'm the Emperor of Oz, and like Dorothy my world is charcoal grey and the Technicolor is the illusion. The yellow brick road has fractured. I've hit some wall. I can't seem to keep pushing through. 

I could ask for help if I had any idea what to ask for. I could stop only seeing people when I'm on top and disappearing when I'm depleted. How could you know how bad the bad days are if you never see them? We all know that Facebook is a carefully edited highlight reel; it now occurs to me that my entire outward persona is a carefully edited highlight reel. I cycle between mysterious recluse and charming social convener - between Greta Garbo and Debbie Reynolds. The latter is the identity I prefer. I'm invested in you seeing me that way. I've been taught it's the identity most likely to be accepted. 
Really, which one would you rather hang out with?
I'm not on an extended holiday - I'm doing hard work trying to get better. Besides my doctor I currently have a team of 5 people supporting my overall health. My health trainers, a massage therapist, a counsellor, a digestive wellness coach (90% of serotonin is created in our guts, yet few depression therapies address gut health ...). I'm taking meds, but I'm also eating better, exercising, sleeping more. Pretty soon I start an 8 week cognitive training program - I'm excited about that. 

I shouldn't be writing this. I definitely shouldn't click publish. I want a better job, and in the meantime I want more responsibility at my current job when I return. I want to work. I want the routine and the social interaction and the income. Eventually I want clients who trust me to perform in my own business and help me create a life that's location independent. How is any of that going to happen when people know that I have unresponsive MDD that we (my team and I) haven't found an effective treatment for yet? How can they trust it won't recur when we do find the right treatment? 

But right now, today, I want you to know. I get that I'm responsible for not letting you know before. I get that you can't get it, and I'm sorry for judging you for that. Most importantly, I'm saying all this with the hope that maybe next time someone you know is on medical leave for a mental illness, you'll believe them. Maybe you'll take them seriously. And maybe, if you can't manage that, you'll at least keep it to yourself. 
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