[2022 Update]
May is Mental Health Month so I wanted to provide an update on my original post in October 2021.
It has been about a year since I started on psychiatric medications for depression after receiving several diagnosis in April 2021:
OCD, Anxiety, and Bipolar Type II
I would be lying to insinuate that life has been perfect since starting medications. To do this, let me will talk through each element of my diagnosis and where things stand today.
Depression
- At a high level I have only had 2-3 days that I was unable to get out of bed due to my mental health. This is a drastic improvement over 2020-2021.
- I wouldn’t describe my mood as “happy” however, generally I am able to avoid those very dark moments.
While this improvement is welcomed – depression is still a big part of my life and the general battle continues. Depression feels like you are in a dark pit with a rope that is just too short to reach.
The improvements that I’ve had are two fold, I have been consistent about taking the medications and have tried to employ a positive psychology framework called PERMA.
PERMA was developed by a Dr. Seligman from Penn State and is essentially “removing the disabling conditions is not the same as building the enabling conditions that make life most worth living.”
It stands for: Positive Emotion, Engagement, Relationships, Meaning, and Accomplishment (hence PERMA™). Within this framework you try to identify and amplify your strengths and choose actions that will enhance those.
I utilized this framework to create my resolutions for the New Year and then used a goal tracking app to keep track of my progress.
OCD/Anxiety
I put these two together because I have realized how entangled they are.
- Generally, intense feelings of anxiety have subsided.
- I still have moments – especially at night – when anxiety starts to build and I begin to focus on my anxious thoughts.
As far as medications go, Gabapentine is the main agent on board for anxiety. When I was feeling most anxious, I would take it in the mornings and evenings. When I start to feel anxious, it feels like someone is squeezing my chest – with it continually and progressively getting tighter and tighter.
For me, Gabapentine seemed to mostly help with symptom management. After about an hour or so the tightness in my chest would begin to subside.
Most of my anxiety tends to be work focused so outside of medications, I have tried to disconnect myself a bit from work. Specifically, I stopped checking emails and messages at nights and on weekends so that my mind can rest a bit and focus on my family and home.
Bipolar Type II
To be honest . . . I personally haven’t done much to address the Bipolar outside of taking the medications. I’ve noticed a considerable difference in mood variability and so has my family.
Personally, I’ve missed the “highs” that come along with Bipolar . . . but I am happy to see the lows gone.
[2021 Orignal Post]
In this post, I’m going to open up with you about my mental health journey – including some of my darkest moments – and where I am today.
October 10th is World Mental Health Day:
A day for global mental health education, awareness and advocacy against social stigma. source
So in light of that . . . I believe strongly that the stigma around mental health needs to vanish. It is so often the stigma that keeps many of us silent. As nurses we KNOW and we are taught to put aside the stigma, but when the mental health demons invade our lives, we to become silent and often avoid seeking the help we need.
My Darkest Moments
For a good part of my adult life I’ve suffered with depression (spoiler alert – there’s more to it) but for many of those years I was one who kept telling myself I could muscle through it or that I was smart enough to overcome it alone. I was wrong.
I want to share with you two of my darkest moments as well as where I am now – hopefully helping those who need help and/or are afraid to seek the help they need.
2017 – 2018
In 2017 I began taking Lexapro for what I thought at the time was just anxiety. Things rolled along ok for a few months and then in 2018, an enormous cloud of depression hit me. I was missing work 2-3 times per week. When I did go to work I would come home after and go straight to bed. Finding the energy to even get out of bed was near impossible.
Things began to spiral from there and I very vividly remember “rock bottom”. One night I went into my closet and suicidal thoughts crept in – I reached for a belt and even put it around my neck for a moment. At that point, I broke down. The thought of my children saved my life.
It is so hard to share this – and I’m not sure how it will be taken – but my mental health was so broken at that point that I saw no way out. That was one of the scariest moments of my life and I’ve never forgotten that moment. Even to this day it still terrifies me.
It was then I realized that Lexapro can intensify suicidal thoughts so I came off of it but failed to get further help – these dark ideas left and although depression. continued off and on – I continued on. Still keeping so much inside.
2020 – 2021
Toward the end of 2020 I new, more intensified cloud of depression began to roll over me. Around the end of October I began to feel as though my muscles were replaced with sand bags. My mind became foggy to the point of having no mental clarity. All enjoyment had been sucked out of life.
Then, the anxiety began to come back as well.
I remember nights laying on the floor in front of the fireplace just trying to get my heart to calm down – trying to focus my mind on anything positive – to no avail. I was engulfed in a constant feeling of impending doom while at the same time depressed to a state of being incapacitated.
And still . . . I was afraid to open up and get help.
On October 22, 2020, I sent an email out to the NURSING Family to share my current state as a beacon of hope for those who were also struggling. I was flooded with messages of support and many more messages from nurses and nursing students who were also struggling.
I would like to say that at this point I went and got help . . . I did not.
This state only began to intensify from October 2020 until about April 2021.
At that point, I was inches away from being broken.
I asked my wife to make me a mental health appointment at a nearby clinic (I was feeling too ashamed to admit my need) – luckily I was able to get in that day.
I remember parking at the clinic and walking in – feeling like a broken man. How was I able to let my mental health get away from me? I thought.
The Physician Assistant walked me into the exam room and asked: What’s going on?
At that moment, I broke down.
I told her that I couldn’t keep going on like this trying to overcome it all with brute force. I admitted that I needed help and I needed it bad.
Her response floored me: “Thank you for telling me that. That you would trust me enough to share that means a lot.”
A sense of relief hit me immediately as if I was confessing a crime and had been granted clemency.
That’s it I thought. This whole time I’d been bottling this up – here she was empathetic – not even judging me in the slightest. After making sure that I wasn’t thinking of harming myself or others. She let me know that she wanted to get me in the Mental Health NP – but that I wouldn’t be able to see her until the next day. The wait seemed endless.
The next day, I shared my whole story.
The NP listened with deep concern before telling me her diagnosis: OCD, Anxiety, and Bipolar Type II.
I wan’t entirely surprised by any of that and was able to identify moments in my life that would have pointed me toward that much sooner. She provided a ray of light and we began discussing treatment.
Treatment
What’s unique about mental health is that there is no lab value you can draw . . . it’s not like running an EKG and diagnosing a myocardial infarction on the spot. The fact that it can’t be seen and that no one talks about it also leads to much of the stigma that surrounds it, I believe.
I started on four different medications to help with anxiety and bipolar – as well as to aid with sleeping.
The medication I was prescribed for depression made an immediate impact – but it also led me to almost a permanent state of hypomania. My mind wouldn’t stop and I was unable to sleep. As someone who has experienced hypomania in waves – I really enjoy that state – but this was never ending.
We adjusted meds . . . and then . . .
Like so many, I thought I could taper down my doses and I didn’t want to continue getting help.
That was a bad idea (of course).
Within a few weeks of stopping meds – my mental health deteriorated. I remained suffering in that state for about a month before returning for help. Meds were adjusted and over the last 2 months or so I’ve been in a much better state.
What Helped Me
Meds weren’t the only thing that helped me of course. Over the past year I’ve been trying to add in many things. Here are a few things I’ve tried:
- Meditation: just a short 10 minute meditation in the morning
- Reading: I love reading and I mixed in a few books on mental health
- Exercise: trying to walk 10,000 steps a day really give me a daily goal to work toward
- Diet: through diet I was able to lose many of the pounds that crept on between 2017-2020
- Painting: watercoloring (I’m no good at it) helped my mind escape the anxiety for short periods
- Journal: writing three things I’m thankful for each night
- Talking: telling family and friends helps to get it out in the open and stop hiding
When all of those combined were not able to “kick the depression” I knew I needed more help. Medication has been a tremendous help for me and has given me the boost I need to continue healthy habits, get out of bed, and face the day.
There is so much more to my journey and I could talk about it forever. The darkest part of it lasted a few months – but it felt like several lifetimes. Time stood still and it felt like endless suffering that I was incapable of escaping.
You CAN Do This!
I know some of you reading this are suffering in silence. I know you might be scared to seek the help you need. I understand that fear – but you are not alone. There is compassionate help available for you.
The pain, the loneliness, the fear, the exhaustion, the self hate that comes along with mental health creates a personal hell and it can be very scary.
I once heard depression described as being stuck in a well with no way out. Even in your best moments, you are still just hanging on to the sides of the well knowing you will fall back down.
Please seek out help.
Your Journey
Your story and your journey will be very different from mine and what helps you will be different than what helped me . . . I know that.
But by sharing my story, I want to encourage you to seek help.
If you are in a dark moment right now it will feel like it will never end – it will.
Let me just leave you by saying there is light on the other side and you can get to that other side. Please don’t judge yourself or feel weak for this. As a nurse you would NEVER say to a patient “stop having a heart attack!” – be kind to yourself. It is okay to struggle with mental health – YOU ARE NOT ALONE.
We love you ❤️
-Jon Haws, RN, BSN, CCRN Alumnus
If you are thinking of hurting yourself please call the suicide hotline: 800-273-8255
