In an Eeyore State of Mind

June 19th, 2018 at 3:12 pm (life in general)

(After the recent suicides of Anthony Bourdain and Kate Spade, I rewrote this blog post that I’d been working on, basically an update from my earlier post about depression back in 2016. It’s a heavy subject but I try to end on a hopeful note. It won’t interest everyone so I won’t be offended if you decide to skip this one. I’ll be back to writing about bondage again soon.)

Earlier this year I had to change my health insurance and, to my pleasant surprise, the new plan covers some visits to see a therapist. I’ve been in therapy many times over the years but it had been a while, so it’s really nice to be seeing someone again and to be able to talk freely about things.

After going through a very thorough intake interview in March, I was finally diagnosed with dysthymia – a low-level persistent depression that hangs on for at least two years, with at least some depression symptoms occurring more days than not. It used to be classified as a “personality disorder,” which sounds so stigmatizing, as if you’re just a permanently fucked-up person. Later changed to a mood disorder, it was most recently renamed in the Diagnostic and Statistical Manual, the bible of mental health professionals, as “persistent depressive disorder.”

One blog I saw recently refers to it as “the depression that stays hidden,” or simply as high-functioning depression. It’s basically like having the personality of Eeyore. I have good days and bad, and I hide it well, although on bad days I may seem overly quiet and inward. I am still able to feel joy and have a good time – things aren’t always bleak – but as I’ve written in this blog before I’ve probably been dealing with this since I was a child.

There is something strange about seeing a mental health diagnosis written down, as if to say, “Well, you always knew there was something wrong with you. Here it is.” Something else that I’ve struggled with for years, social anxiety disorder, was also listed on that sheet of paper. Neither diagnosis surprised me in the least.

I’ve never been actively suicidal but, as I’ve touched on before, I have had suicidal ideation for decades, starting back when I was about nine years old. I remember getting out of bed one morning to get ready for school, and as I walked into the bathroom to pee this wave of sadness and futility came over me and I wished I were dead. Since then over the decades I’ve had similar “death thoughts” probably thousands of times. When things are stressful my mind can easily go to those dark places, sometimes very dark.

Like many people, I was shocked and saddened by the news of Anthony Bourdain’s death by suicide, and Kate Spade’s just a few days earlier. Suicide has always been one of my biggest fears, so whenever I hear about someone actually going through with it, it hits close to home. Of course, with someone like Anthony Bourdain, who just seemed so cool and put together, it’s especially troubling.

Another suicide last year that really shook me up was that of pro-domme and fetish model January Seraph. I had never met her but again, from the outside, she seemed to have such a successful life and career, although she was open about the dark side and her ongoing struggles with depression. Her Twitter feed ominously ended with, “This is the last thing I was working on before The Nothing took hold.” Since last summer there have also been several other suicides and drug overdoses by models in the fetish and porn scenes, with several articles talking about the disturbing trend.

Obviously talk about mental health issues makes many people uncomfortable. There’s a huge stigma around mental disorders and especially suicide. I get it. It touches on our own darkness, and our potential for self-annihilation, which is frightening to consider. We all know that life could take a turn and beat us up so badly that we give in to despair. Suicide has always seemed to me like a temporary madness that takes over, and I have great respect for just how dangerous that impulse can be. One way I try to resist the stigma is to be open here about my own experiences with depression. Keeping the dark things hidden feeds the shame and self-loathing that so easily grow when deep down inside you feel like a damaged person.

Let me be clear again that I have no plans to kill myself. In my own case I’m talking about suicidal ideation versus actually offing myself, though I know my risk is higher than the average person, which is why I plan to never own a firearm and to do everything I can to minimize that risk. When I was going through a tough spell earlier this year, I even vowed to myself never to take my own life regardless of future circumstances. I hope that makes a difference in the end. Life is tragic enough without ending it like that, and I’d hate to have people on Twitter and Facebook writing, “Hey, did you hear about Sandra?”

So I cope, and I do pretty well though I can’t say I’ve ever felt cured of depression. I’ll have times – a few weeks when things are going well – and I’ll think, “Hey, maybe I’m getting this thing under control.” But the low moods, anxiety, and that empty feeling in my chest always seem to return. At this point I suspect it’ll be a life-long thing that I deal with, with ups and downs, although thankfully I’ve never been manic or bipolar, just a gloomy Gus.

But I consciously do a lot of positive things to manage it, some of which – keeping a gratitude journal – are easy to roll one’s eyes at. Corny as it sounds, though, that journal really does help. I also exercise regularly, meditate daily, try to eat my vegetables and drink more water, get a good night’s sleep (not easy since I often get insomnia), and try to watch my rumination and negative self-talk (again, not easy at all). I always look forward to the holidays too, with October through December usually being my best time of the year. I just really like Christmas!

Although dysthymia is a mental disorder, I’m a little skeptical to think of it as a disease in the same way that diabetes is a disease – for example, there is no blood test for dysthymia. And after all these years psychiatrists still don’t really know the underlying causes of mental illness. I’m no expert but it seems to me that this uncertainty just points to the complexity of causes – physical, social and psychological – behind mood disorders.

In my own case, there’s also the whole question of gender. I’ve never been particularly happy with being a man, but I also don’t really feel like I’m a woman. And while I don’t think about gender all the time it does often feel like a weird limbo state. I’ve thought it over many times but going back and starting over again with two X chromosomes somehow doesn’t seem like a particularly viable option.

A few people have asked me, why aren’t you taking medication? It’s a valid question. I actually did take Prozac for many years, and later Wellbutrin too, but after the first year I didn’t get much response from the drugs, which is an all-too-common outcome especially with milder forms of depression. Martin Seligman, the father of the field of positive psychology, points out that one of the dirty little secrets of psychiatry is just how often the drugs don’t work, with only a third of people taking them getting full remission of symptoms. For those lucky souls who get a good response the drugs do make a huge difference. But that leaves two thirds who get no relief from medication or only partial relief.

Although the verdict is still out, there’s even some evidence that long-term use of antidepressants where only partial remission occurs (which is what I experienced) can actually lead in some cases to a permanent depressive syndrome. There’s no way to know if anything like that happened to my brain chemistry but I do regret taking Prozac for so many years when it really wasn’t doing all that much. Having said that, I still follow the research on some of the newer drugs in development, such as Ketamine. It’s bizarre to think that a form of the club drug Special K would ever be used to treat depression, but if it gets good results in the drug trials I wouldn’t completely rule out trying something new.

In his book “Lost Connections,” Johann Hari argues that our modern world with its isolation and lack of social support is making so many of us miserable. Here in the United States, deaths from suicide now outpace deaths from traffic fatalities – close to 45,000 per year according to the Centers for Disease Control – with an increase of 25 percent in suicide rates since 1999 and thousands more failed attempts. The World Health Organization (WHO) now lists depression as the leading cause of disability worldwide, with a global increase of 20 percent in just the last ten years. CNN reported after Anthony Bourdain’s death that the WHO “estimates a global suicide rate of one death every 40 seconds, which by 2020 they predict will increase to one every 20 seconds.” As many have pointed out, something is deeply wrong.

But I don’t want to end on a completely bleak note. Collectively the world may be fucked but individually there’s still connection and beauty and meaning. Simple moments connecting with friends and family, or having one of those rare perfect days when the sun sets and all feels right with the world – I find those times do make it worthwhile. My fears of the future and of eventual decrepitude may tell me otherwise, but in the end I believe the struggle is worth it and that there’s a dignity in continuing on.

I may be a little nuts, but I’m still here and I hope to stick around. Keep the faith…Sandra

13 Comments

  1. spandexman said,

    June 19, 2018 at 4:03 pm

    Good luck Sandra.

    Back when I was slightly married we went to counseling. Dr. Johnson asked me what would I like to do to spice up our love life.

    I told him I wanted to tie my wife to a bed and make love to her. My ex was outraged and not happy.

    Dr. Johnson suggested that I put the clothesline in the washing machine first so there would be no rope marks.

    To say the least my ex never saw Dr. Johnson again.

    The good doctor was on wife #3 at the time and tied up #2.

  2. Victoria said,

    June 19, 2018 at 10:27 pm

    Very powerful, thanks for sharing.

  3. Lidia Erden said,

    June 20, 2018 at 8:26 am

    Again Sandra, thanks for being so open with us about you and your inner demons. I think talking about them is always good for helping understand each other and some self relief.
    You inspire me and many others, not only for being who you are and living your life according you, being able to be Sandra, creating this site and a great community (I really hope someday I could do a set for you), but you also have overcome this situation, and your are not afraid to be honest about you. In a world full of hypocrisy, being yourself and not scare to tell the world is a strong quality.
    Wish you with all my heart you continue being this great person and keep fighting all the situations with courage.
    There is always help to move forward in many ways (medication, alcohol, friends), but it’s up to us to overcome the challenges.
    Keep being so great Sandra! XOXO

  4. Joanne said,

    June 20, 2018 at 8:37 am

    Sandra,

    Very interested to read this. I had never heard of the concept of “suicidal ideation” before, but it perfectly fits what occasionally happens with my wife after being stricken with a disabling illness. Would it be fair to describe it as a feeling of “better off dead” with no intent of doing any self-harm?

  5. Stephi Mayfield said,

    June 21, 2018 at 3:05 am

    Hello Sandra,

    I felt as if you were describing me as I read through your blog. I have taken Lexapro, Zoloft and Wellbutrin for depression/anxiety going back for many years and I cannot say they were very effective but therapy definitely helped. For me, learning more about how we are taught to think in a negative manner and how that impacts are body has been more helpful than the meds. I used to think that the solution to this “low-grade depression” as it was once put to me, was through my ability to reason why I shouldn’t be depressed. However, the mind is part of the problem and is a good indicator that you are feeling depressed and need to move, exercise, meditate, or be active. The key seemed to be through the body, not the mind as it is part of the problem.

    I know it has become “cliche” these days but being mindful of your thoughts, living in the moment is so helpful and so important to helping reduce depression for me. The mind wants to fix things, even if they happened 20 years ago. Then the body reacts and its as if I am re-living it 20 years later.

    Anyway, thank you for sharing, I can relate to nearly every word you wrote.

    Sincerely,
    Stephi.

  6. Mike said,

    June 21, 2018 at 4:45 am

    I completely agree that psychiatrists and therapists don’t know about what causes mental illness and drugs are a complete crap shoot. The side effects can be a nightmare and getting off them is a bitch.

    I’ve had severe anxiety and depression since I was a teenager and they’re still with me at 59. In my neurotic opinion, not only do we know exactly what our problem is that causes the distress but we’re the only one that can fix it.

    As Charlotte Joko Beck said: “We have to face the pain we have been running from. In fact, we need to learn to rest in it and let its searing power transform us.”

    Take good care.

  7. Louis A Dilonardo said,

    June 21, 2018 at 11:00 am

    wow…..keep fighting the good fight…so remarkable a perspn!

    and Still..the best legs on the net!

    Lou

  8. Miki said,

    June 21, 2018 at 4:47 pm

    It is interesting how many of “us” have similar feelings and experiences. Thank you for sharing. It made me feel less alone. ;)

    Miki

  9. Sandra said,

    June 22, 2018 at 7:49 pm

    Thanks so much, everyone, for all the nice comments. I also posted this over on Facebook and there were so many comments over there that I got sidetracked trying to respond to them all! I appreciate everyone who wrote and left their thoughts here (thanks, Lou, I owe my supple legs to the gym! ;-) Let me add just a few individual comments below…

  10. Sandra said,

    June 22, 2018 at 7:52 pm

    Thanks, too, @Lidia, for your nice comments. I agree about trying to be honest about things. From the things I’ve shared since 2016 I find that the more open I am about this stuff the more I find that lots of other people are dealing with their own challenges, which are often kept hidden.

  11. Sandra said,

    June 22, 2018 at 7:54 pm

    Hi @Joanne. Thanks for posting. I hope you’re wife is doing okay. I think suicidal ideation is pretty common. The danger of course is if it becomes more than just dark thoughts about death and giving up. My father also had it and I have another close family member who deals with it, so it’s possible that there’s even a genetic element to those dark thoughts.

  12. Sandra said,

    June 22, 2018 at 8:03 pm

    Also, thanks, @Stephi, for posting! That’s very interesting what you say about the body versus the mind. I totally agree about trying to stay in the body more than in one’s thoughts. My own “inner voice” is kind of a bastard and can really bring me down. I had attempted meditation off and on for about ten years, with most of the time being “off.” I kept quitting and then trying again a few months or a year later because I felt that there had to be something to it but I found it so damn hard and frustrating. It really wasn’t till this year that I started to get some traction with it. I’ve been using the Insight Timer app on my iPod, which is helping enormously, and I just read Dan Harris’s “Ten Percent Happier,” which I really enjoyed and got inspired to double my efforts, which seem to be paying off. But yes, the whole “mindfulness” thing seems like such a cliché and a fad, but there seems to be something to it, certainly the science backs it up. Anyway, I hope you’re in a pretty good place now. Thanks again for posting.

  13. Sandra said,

    June 22, 2018 at 8:09 pm

    And thanks for posting, Mike. I’m sorry to hear you’ve been dealing with this stuff for so long. I hope you’re hanging in there. That’s very interesting about Charlotte Joko Beck. I had never heard of her before but just looked her up on Wikipedia and read some interesting quotes. Thanks for sharing.

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