Depression Was a Living Hell
Since I was an eighteen-year-old college student, I have lived with mental illness. My 18th year was a living hell. That’s how I’d describe the severe suicidal depression that overwhelmed me.
What I Learned at 18
1) I want to live, even when the pain of depression is so severe that I think that the only way to end it is to die.
2) I can and will ask for help when I need it.
3) I’m not alone. My friends, my dorm resident assistant, and a cognitive psychologist at UCLA all supported me when I sought help.
4) Therapy works. The cognitive therapy I received helped me to rewrite negative depressive thoughts. I believed my parents, my sister, the whole world would be better off without me alive. That thought was irrational. I learned the skill of stopping negative thoughts, questioning if they were rational, and replacing them with more rational positive thoughts. The world would NOT have been a better place without me. My family and friends would have been devastated by my loss.
Mismanaged Medications Can Trigger Episodes
At thirty, I experienced a deep depression. I turned to medication for the first time. The psychiatrist I saw at the time told me that I was in the adolescent stage of development — an insult. I was a thirty-year-old psychotherapist who worked in nonprofits for low pay, yet I managed to put myself through graduate school and years of internship while supporting myself in the San Francisco Bay Area, an expensive place to live. The psychiatrist mismanaged my medication, so that over the course of a few months I went from depression to a week of full-blown psychotic mania. At that point, I had been unable to sleep for a week due to three simultaneous racing streams of thought about mystic saints, chaos theory, and binary code (ones and zeroes).
What I learned at 30
1) Again, I’m not alone. A dear friend of mine called my father and my priest, telling them that I needed help. My father immediately flew up from Los Angeles. My priest rushed over with a seminarian (someone studying to become a priest) who lived with bipolar disorder. They asked me if I had told my psychiatrist about my symptoms. I called my psychiatrist and described my psychotic thought process. Over the phone, the psychiatrist prescribed three antipsychotic medications, which stopped my thoughts in their tracks, allowing me to sleep.
2) Doctors make mistakes. That psychiatrist warned me to never disclose that I had ever been prescribed those antipsychotics. Whether his warning was to prevent a malpractice suit or due to stigma, as I was a licensed psychotherapist, I don’t know. Clearly, I needed a new psychiatrist. My second lesson learned: doctors are not always right. The psychiatrist I later saw helped me to find a medication that kept me stable for years.
3) Family support is important. My parents went out of their way to help me through this mental health crisis. I learned the importance of family support. I had been taught in my psychodynamic graduate program and in psychodynamic therapy that my depression was the result of abuse. Clearly, my parents loved me. Yes, my parents were not perfect. But, as a psychotherapist of severely emotionally disturbed children, I had worked with families who clearly loved their children. Many of those parents struggled with mental illness, substance abuse, physical and emotional abuse, even incest, but I could see that they still loved their kids. The dysfunctional family dynamics were learned. They came to therapy to unlearn those dysfunctional dynamics. If I could feel compassion for my clients’ parents, I could feel compassion and have forgiveness for my own parents. I ended up moving back in with my parents until I was stable enough to move back out on my own.
4) If at first you don’t succeed, try, try again. Just because I had a horrible reaction to the first trial of antidepressants, didn’t mean that antidepressants wouldn’t help me. The second psychiatrist I saw listened carefully to my story. Rather than tell me that I was an adolescent developmentally, he assessed if I had bipolar disorder or a severe reaction to an antidepressant. Back then bipolar disorder type II was not in the Diagnostic and Statistical Manual of Mental Disorders. He carefully titrated my dose of an antidepressant. When my thoughts raced, I’d call him and he’d lessen the dose, increasing it more slowly.
Diagnosing Bipolar Can Take Time
At thirty-nine, I was diagnosed bipolar type II. Since receiving that diagnosis, I’ve been hospitalized and participated in months of partial hospitalization. After trial and error, I’m “stable” on medication.
Living Purposefully with Bipolar
Twice I attended seminary where I wrote a mental health ministry workbook. I have found purpose as a mental health advocate. I volunteer for the National Alliance on Mental Health as a Provider Educator. I am active online promoting mental health. I write about living with bipolar disorder both on my website kittomalley.com and in my upcoming memoir, Balancing Act: Writing Through a Bipolar Life, to be published September 19th.