Country of Origin: United States of America
Who are you?
What do you do?
Those are the questions I am asked whenever I meet a new person. For decades, the answer was my name and “I’m a Counselor.” Then I waited for them to get uncomfortable, as people sometimes do around the topic of mental health. I’m also a writer who focuses on horror topics. These days I mostly try to figure out who I am and what I need to do so I can keep my depression at bay. I debate whether I should call it “My” depression because I really don’t want it, but “The” depression sounds odd because there isn’t only one depression.
My experience of depression may feel different to me than how you may experience your depression, with different presenting symptoms. At work, I had to use DSM-5 codes to label depression. The DSM (Diagnostic and Statistical Manual, Edition 5) is used to clarify diagnoses so doctors and therapists and insurance companies can speak a common language about a set of symptoms. In another essay, I compared depression to a monster that I fight daily, and that characterization seems to make the most sense to me. So what do I do? I fight a monster daily.
I have been dealing with this beast since childhood. I don’t remember the exact age, but I was very young.
I can recall crying for no discernable reason as a young child and a teenager, confused as to why I felt this way. I remember blowing out my birthday candles and wishing for happiness. Most kids probably wish for a new bike or a puppy. I remember saying my prayers at bedtime and praying to be happy the next day. I could have been asking for world peace, but I just wanted to be happy. When I saw a redbird, I made a wish, as my local folklore suggests one do. Would you venture a guess on what I wished for? To be happy, of course.
I’m also an Appalachian. I am not speaking for everyone in the entire Appalachian region but just from my experiences. Mental health issues run in my paternal family just like eye color, height, and recipes. I knew from a young age that I could be next. It was almost expected, yet dreaded. There is still a stigma here. My sturdy German ancestors arrived in the US in the 1700s. They didn’t have time for such frivolous silliness as being depressed.
In the mountains where generations of proud people were self-sufficient and pulled themselves up by their bootstraps, we just didn’t talk about mental health. If we did, it was in hushed whispers, suggesting a person was weak or defective. Bless their hearts.
As a student of Psychology, a person coping with depression, and a rural Appalachian, I was at odds with myself and my culture. I was struggling with depression but I was disappointed with myself for being depressed. I was always told that I was easy to talk to…that I was a good listener. So, I charted a course to be a mental health helper. We didn’t have truly accessible educational opportunities until my generation, Generation X. I saddled myself with a mountain of debt and stepped into a different world. In the world of mental health counseling, people with mental health issues are people first. They are not “mental” or “crazy” or “weak.” They have real medical concerns that aren’t just “in their heads,” but being experienced on a microscopic neurochemical level that I still struggle to fully understand.
I eventually secured certifications and licenses and began to help others. I worked as a therapist for 16 years. I understood that feeling better was more complicated than “just stop it,” or “decide to be happy.” I knew it would take more than just yoga or coloring books to overcome. During that time, I had tides of depression that washed over me and then went back to sea. I began medication. One of the issues I am painfully aware of is how finding the correct medication or combination of medications can be like a blindfolded skeet shoot. I also learned about the patience needed to ride out side effects and see if a regimen is going to work. I didn’t want to wait 4 weeks….I wanted to feel better yesterday.
My most recent downturn during Winter 2022 was my worst episode yet. After years of referring folks for hospitalization for psychiatric issues and suicidal ideation, I was certain I needed to be hospitalized. I’ll spare you the details but I am a fan of horror movies and an author of dark fiction and I scared myself. I was imagining ways to end my life and was feeling at peace with those thoughts. I confided how I was feeling to a coworker, who urged me to see a crisis counselor immediately. In my rural area, if a person needs inpatient psychiatric care, it’s possible that the only bed available could be 7 hours away in another part of the state. I remember being so afraid that others would look down on me and that my former coworkers at the community mental health agency would be disappointed in me.
Of course, they weren’t. I called my former supervisor at the agency and she made arrangements for me to be seen at the local crisis clinic. We are fortunate to have one near my home. I was able to meet with staff who had not been coworkers and who didn’t already know me socially, and they helped me immediately. Before I called my supervisor, I had been trying to make appointments with private psychiatrists and trying to get an emergency appointment with my therapist. They were booked solid. For weeks. I don’t begrudge them for not “working me in,” because they have to have boundaries. Without boundaries, they will burn out and end up feeling how I felt that day.
The crisis clinic saw me that very afternoon. I talked with a nurse, a crisis counselor, and a nurse practitioner. I left a few hours later with an appointment for therapy, a plan for medication adjustment with prescriptions, and 24-7 support. A helping hand or voice was just a phone call away. I ended up not being hospitalized and could recover at home with my existing support system. I checked in with those crisis folks daily for several weeks. I ended up resigning from my job to work on myself. That was scary but I needed to do it. I was scared to tell my friends what was happening. After much hesitation, I wrote them letters to explain what happened and how I was feeling. They loved me anyway and were supportive. They knew something was wrong, but as teachers, artists, and attorneys, they didn’t know how to ask.
Now, I am working as a freelance writer. I may eventually return to mental health work, but probably not. I am enjoying writing. I write scary stories to keep folks up at night as I understand the importance of rest myself. I am feeling so much better.
I am having the happy days that I wished and prayed for as a child. I continue to try to be gentle with myself. If I don’t get my to-do list done on a given day, that’s ok. I had to be patient to allow the medications to work their magic.
I also had to be patient with myself. I struggled with feeling internalized stigma and judgment for allowing myself to fall in this hole. I felt that I should have recognized the signs of decline and I should have known better. I’ve come to recognize that what’s important is that I did recognize how I was feeling and sought interventions before it was too late. I will continue to use my support to fight this monster every day. Most days are good, but I have to stay in the right mind space to understand the temporary nature of the bad days.
So who am I?
What do I do?
I’m Senah. I’m a writer with a background in mental health and I’m working on myself daily. Today is a good day.
Thank you to Christina Lee for their inspired edit on this piece and everyone else on the Mental Health team.
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