Tuesday, August 27, 2013

"High Functioning"

One of the reasons my recent bout of depression went unrecognized, despite having managed through several other depressions in my life, is that I was "high functioning."  The term "high functioning" is usually used when speaking about someone with a disability, condition disease, such as autism or alcoholism, who can do many of the things that most people with the same condition cannot.

We're probably all familiar with the stereotypical signs of depression:  feelings of sadness or unhappiness, irritability, loss of interest in normal activities, insomnia or excessive sleeping, change in appetite, fatigue, feelings of worthlessness or guilt, trouble concentrating, and bouts of crying with no apparent cause, according to the Mayo Clinic.

I spent so much time being so busy with my family and my work that I noticed nothing.  Frankly, the difficulty of managing a three and four-year old and a solo legal practice could have easily caused the symptoms that I only noticed once I came apart and landed in the hospital.  Fortunately or unfortunately, they simply weren't the cause.

I didn't recognize the sadness or unhappiness, rather I would have described myself as "stressed," which I attributed to having a job where clients alternated from incessantly calling, to sobbing to threatening, and a workload that had me sometimes waking up from 1:00 a.m. - 4:00 a.m., just so I could work with no distractions and still get some sleep.  I also attributed some of the misery to navigating the terrible twos (My youngest didn't turn three until May and certainly didn't get any easier) and, as one wise friend called them, the "throat-slitting threes."  I also likely figured I was driven to "unhappiness" by managing the schedules and need of not only my two smallest, but also a teenager, who isn't mine and therefore deserved special effort so she knew how important she is.  For what it's worth, I never recognized "unhappiness or sadness."  It wasn't until the week before I entered the hospital that I noticed the recurring tears for no apparent reason.  

As for irritability, again, I'd call it stress.  Was I irritated with my difficult client(s), my full schedule and the demands of several trials in a few short months?  Of course.  Was I irritated with two small children who like to torture each other as much as I like to snuggle them?  I was, and understandably so. But I was irritated with everything then.  I believed I simply had grown to be an intolerant and irritable person.  I was devastated by that conclusion, but it was the one I came to nonetheless.

Having had two children in fourteen months, while trying to manage and build a successful law practice (in the trying area of "family law" no less), it had been a very long time since I had undertaken any activities to actually lose interest in.  My life was dictated by the schedules of my children, the courts, and the clients.  I hadn't taken any time for myself and by having failed to do so for so long, I didn't notice having lost interest in anything.

The sleep and appetite issues went hand-in-hand with everything else.  When you're busy and you have two kids that wake up before 6:00 a.m., there is no routine.  It's chaos and with chaos comes a lack of awareness of any changes.  There was no normal to have changed.

I was thoroughly tricked by my feelings of worthlessness and guilt.  The problem with depression is that it drives you to forget everything you've ever done that was good and to fixate on everything you've ever done, said, or thought as negative.  I downright loathed (loathe?) myself.  I described it as wanting to claw off my own skin.  It's perhaps the symptom I still struggle with most.  It's as if my own brain is fighting any recovery I could have and I can't even see it because I think I'm as terrible as I feel.

I didn't realize that I was struggling to concentrate.  When you have twenty clients, fifteen deadlines, three hundred emails to read and reply to, and the phone doesn't stop ringing, it doesn't seem as though there is any time to concentrate anyway.  Again, I labeled a reduction in my productivity, that was quite possibly as a result of lack of concentration, as "stress."

Last and perhaps most obvious are the bouts of crying.  I simply did not take note.  I knew, toward the end and before I entered treatment, that I was crashing hard and that's when I started noticing the crying, and somehow, I just wasn't alarmed by it.  I know my family saw it, but even for them I wore a carefully crafted facade. I can't honestly say how long it had been going on. If it was more than just at the end, it didn't register.

For me, it was when my therapist stopped gently suggesting and began urging me to consider taking psychotropic medication because I was getting no better, and perhaps getting much worse.  That night, I came home and talked to my stepdaughter, who is wise beyond her years and a rock I lean too frequently on.  Before I shared the therapist's opinion with her that night, I believe she'd seen my cry in pain or sadness one time, when I had a crutch dropped on my two-day old broken, set and pinned foot, post-surgery.  That night, I cried and she hugged me and it was comforting, but to hear how sad she was for me when I apologized for my behavior knocked something wide open in me.  And I went down hard.

There were other signs, probably dozens of them.  My anxiety was out of control and, while I recognized that I was stressed, it was the paranoia that really alerted me that it was something more than "stress.". I truly believe that the depression brought on the conditions for the anxiety, and while my depression is sort of under control and I have fewer and fewer days that I want to claw off my own skin, the anxiety lingers something fierce.  

I still struggle knowing that I woke up with my kids every day, I made them meals, I bathed them, I went to work, I appeared in court, I met deadlines, I laughed at parties, I read books, I shopped for groceries.  I did so many things beyond what "normal" depressed people could do that I just didn't see it...and what a shame for all the time I've lost.  

I am frustrated by my own lack of awareness, as I have always considered myself introspective and quite in tune with myself.  I don't know where along this path I left that behind, but I am working to regain the insight.  Perhaps most frustrating is that where I was once highly functioning in a depressive state, I'm getting help and support and now I feel as though I can barely move.  Recovery, fighting, and relearning how to function and feel is not an easy road.

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