So I've been Struggling Lately

Y'all.  I've mentioned in previous posts (Exhibit A) that I have depression, anxiety, and PTSD.  I wear it well, or in more technical terms, I'm very high functioning.  However, I got to a point the last few months where I knew I needed some additional help, some chemical assistance to pair with my other coping strategies.  ...And it was such an important conclusion that I let it set for another couple months before I did something about it.  There are a lot of complex pieces into this, but the current step I'm taking is starting Zoloft to see if that can help take the edge off in a few places.  

I find that the more women I integrate into my care team, the less I feel like I have to prove myself to my care team.  Even though I trust my doctor, I still found myself rehearsing how I wanted to have this discussion with her.  I journal through this blog; I take my dog on walks outside; I swim, Zumba, and have started rock climbing for exercise/endorphins; I have a good support network; I talk to my therapist every other week.  I am aware of many of my different trigger points and can recognize when I'm too activated, sometimes then employing smaller ameliorations (brief grounding/breathing exercise, fidgeting, finding a smaller task that I can complete for a shot of dopamine, venting briefly to a trusted source, etc.) if I cannot completely disengage for optimal recovery.  

All things considered, I felt that I managed both the stressors of nursing school, all of the insurance changes of new jobs, and onboarding of my new job itself fairly well.  I daresay that I manage the stressors of my rather stressful job decently, that there are times that are heightened and times where there is space to breathe and be a person with my patients and my peers.  Some days I leave bone-weary; other days I leave ready to punch a wall to discharge the last of the frustration and then cheerfully meet the rest of my evening; other days I leave tired but spiritually full, feeling a sense of purpose once again.  

And yet.  I was experiencing some low lows, found that I was paralyzed facing some decisions, and felt overwhelmed far more frequently than before or what seemed safe.  When my doctor agreed that it sounded like, yes, a medication might help with the degree of overwhelm and executive dysfunction I was describing, I was relieved, but also then able to acknowledge the low-burning rage that had been sitting quietly on the other side of the latest distraction.  

I'm not embarrassed to be taking an anti-depressant.  I'm not ashamed of my mental health needs.  I am, however, indignant and furious that the current state of our country is so detrimental to my own success in coping.  

• Medical costs in the US are patently absurd.
• There are thousands upon thousands of people in this country that have proved that they will not do the bare minimum to keep me safe, made bald and bold by the COVID pandemic.
• The continued gun worship within our culture routinely sacrifices children and other innocents on its altar, as if it's a normal Tuesday, and otherwise points fingers in any direction instead of addressing the problem.
• Roe v Wade.  The continual erosion of autonomy under the paper mask of one very specific perspective of religious self-righteousness, now forced upon everyone else while insisting consequences could be anything but holy rather than horrific.  
• Roe v Wade, part 2:  Anyone in support of a complete abortion ban may as well tell me that they would gladly condemn me to death, regrettable as it might be.  And then maybe ask themselves why they're okay with that.
• Hand-wringing from people in power who think that maybe extremists will play by the rules again one day and so they should be "the bigger person" using the old channels to half-heartedly attempt change as though tradition might somehow save them.  
• Police violence still disproportionately affecting specific demographics and letting white domestic terrorists walk freely.  Black lives still matter.
• Five people on the Supreme Court continuing to pursue a despicable agenda, with more and more damage amassing while somehow expecting to be free of the consequences.  
• A profound sense of injustice following the growing clarity of events leading up to January 6th, as well as despair that somehow key players have yet to be brought to any kind of meaningful censure.  
• The looming rise of fascism, already mid-stride, and the emboldened bigots who deny the humanity to anyone of different religion, sexuality, gender, or other twisted reasons as reason enough to threaten, physically harm, or torture in some fashion.

There are many, many good reasons to be angry right now.  To be able to be "apolitical" or to turn off attention to the problems for a period of time, that is a profound place of privilege.  And we all need to find spaces to take a breath of clear air from time to time, where we can.  In some ways, my job allows me a bit of escape, because I do not carry my phone with me on the floor and cannot doomscroll during the workday.  

I won't say that the current state of our country is the only reason for my depression; the material point is it certainly isn't helping, and I've long-since depleted a fair bit of reserve.  On the surface, many of my coping tactics seem positive, but my intentions were originating from darker places.  For example, I was exercising as a specific punishment to myself rather than to enjoy the movement or show compassion to my body.  Food was either seen as an annoyance (in which case I did not want to interrupt an activity to go eat something) or an emotional necessity (which was a degree of binging, specifically, with an attempt to punish well-disguised again).  I have denied myself the right to go to the bathroom until I have completed X paragraph or Y task.  I have denied my body rest in the "need" to be busy, which looks like harmless distraction.  So on the outside, I looked productive and that I was working out regularly and such, but with an underlying malicious and unsettling resentment.  

And just to add one more layer on top, starting ANY new medication hits my PTSD like a ton of bricks.  It was a large factor in why I was dragging my feet for so long in asking for one.  Not quite a week in, I am still hypervigilant with my body, dedicating a significant allotment of my daily spoons to running constant systems checks.  Was that twinge a side effect I need to worry about?  Is it working now?  How about now?  Where am I compared to when I started?  Is this my normal degree of low mood to use as a baseline or something with my cycle?  Is this nausea my normal degree of nausea or higher?  The doctor said we could increase the dose if I "felt" I need more, but what are the EXACT PARAMETERS for that?  In short, it's very hard to tell if I feel less anxious and depressed when I'm very anxious and depressed about starting a new medication.  

I also want to add that I am not specifically upset at anyone for not reading my mind to know I have been struggling for a while now--I know I wear it well.  I haven't been ready to talk about it in as blunt terms as these yet, aside from a couple pockets of honesty in trusted spaces that usually end up being a one-off sentence before moving swiftly forward in conversation.  It does mean that I have felt paralyzed in reaching out in some places or responding to invitations, and then the compounding guilt of temporal distance between people I care about.  Shame spirals suck, yo.  

So, actionable pieces:  I will always treasure people who earnestly ask how I'm feeling, what's real to me, etc., whether or not I'm fully ready to delve into those important topics.  It's the demonstration of care that helps, the offer, even if I cannot take it.  It's going to take me a while to sort out whether the medication is working, so I think my general bandwidth is going to be comparatively limited in some places as I recalibrate--thank you in advance for your patience.  And for the larger problems in our world, the least we can all do is vote.