Dear Chiara Natasha

Update: Chiara has gotten in touch with me, thank you for your help in spreading the word!

Dear Chiara,

My name is Karen, and I’m a 23-year-old Indonesian girl. I read about you in stories covering the recent AirAsia tragedy. My heart grew heavy as I learned that you have so suddenly lost the people I imagine had been closest to you. I was filled with an overwhelming urge to get in touch with you, but I didn’t know how, so I started emailing the editors of Singaporean newspapers. But I realized I didn’t want to waste any time. To people who aren’t in deep pain, another day is just another few hours that invariably tick by. But for those in agony, time stalls and you find yourself in an abyss where past, present, and future meld together. And so I’m writing to you here, and I hope you see this. I don’t have magic words or any big promises. To be honest, I don’t know how I can help you, except to tell you that you are not alone. Maybe you have many strangers trying to reach you with a word of comfort right now, or maybe they, like me, don’t know how. Maybe you will read this and you wouldn’t be able to take me too seriously because I don’t know your pain, but I just need to do something and I pray I can help in some way.

Before I say anything else, I want you to know that I am and will continue to pray for your father, your mother, as well as your brothers, Nico and Justin. I believe in a God whose love and mercy is unparalleled, and I pray that He, with the intercessions of the saints and angels, will lead your family members’ souls to heaven. And I know I’m not the only one praying for them.

I don’t know much about you other than the few details I could find in those articles. If I gather correctly, you are an Indonesian studying in Singapore. If so, we have at least one thing in common. I was also born and raised in Indonesia. In 1998, my parents sent me and my older sister to Singapore to get a better education. We lived apart from the rest of our family for quite a while, before they were able to join us more regularly when our youngest sister got older. Between then and now, we’ve relied on airplanes to take either our parents to Singapore, or us to Indonesia. Once or twice I’ve imagined the possibility of a disaster, but never too seriously. Words cannot express how sorry I am that this has happened to you. As I thought about you, I couldn’t imagine anyone feeling more alone than you must have felt when you received the news. But at the same time, I also thought, wow, that this girl is somewhere out there right now, wow, she is strong.

Dear Chiara, I don’t know your pain, and I don’t know your fears. All I can offer is any empathy or insight that could come from having been clinically depressed a few times in my life. Each time, reality and facts would become so distorted in my mind that I believed with every fiber of my being that I was alone, and that I had nothing left. I pulled through with the unsolicited help of some very unexpected people in my life. For example, a friend of my ex-boyfriend’s parents reached out to me and became a listening ear and a constant source of support. Who would have thought? Well, God intervenes in our lives in very unexpected ways. Dear Chiara, I hope during this time you will be open to even the most unexpected sources of support. Dear Chiara, this must sound most contrived, but how I wish I could give you a hug.

I am and will continue to pray for you, my sister. Many things may not make sense right now, but have hope in a God who knows and sees more than we do. Where we see no open doors, He sees one that we don’t even know exists. You are very strong, and you are very loved.

Chiara, please feel free to contact me anytime at all. You can email me at: karen.zainal@gmail.com. If you’re not Chiara, feel free to share this with her, or anyone who might potentially know her.

With love,

Karen

holdinghands

Learning to love my name again

Since day 1 I’ve observed how students love doodling their own names. That’s the first thing many of them do given any downtime, boys and girls alike. Along the margins of their notebooks you’ll find their names in cursive, block letters, graffiti-style…

More recently, my colleague had the brilliant idea of creating an “Honor Roll” board to put up the names of students who are getting the target minimum B in their regular Math class. Everyone got busy writing their names on individual notecards. Boy did that activity take much longer than expected. For the first time, some were meticulously using their best penmanship, even decorating the borders and background, and asking to start over on a fresh card when they messed up. A far cry from the pages of their Math notebooks (you’d think they’re deliberately trying to veer as far from the margins as possible…).

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I mentioned this “phenomenon” to my RCIA instructor, who pointed out that name-writing is a powerful form of self-identity and self-expression . It makes sense that this impetus would be particularly strong during formative and experimental teenage years.

Your name represents you. It’s how you represent yourself to others, as well as to yourself, and is something people associate with you. While deep in depression, I developed a profound shame of my own name.

I wasn’t too surprised by how I hated seeing myself in the mirror — that happened the previous two time I was depressed and was a natural consequence of an unhealthy self-esteem. What was new this time round was how I hated seeing my name, hearing my name, and worst of all having to say my name.

While deep in depression, I had neither the mental energy nor agility to understand why this was happening. It’s clear to me now. I had come to attach my name to everything I have done, but most of all my failures and mistakes.

I had come to despise my own existence. And your name, after all, is like footprints of your existence — it’s attached to virtually everything you’ve done: essays, standardized tests, consent forms, report cards, college applications, job applications, diplomas, awards, text correspondences, email correspondences, credit card purchases…

Since I was so plagued by overwhelming shame for everything I have ever said and done, I naturally began to be ashamed of my name. It is nothing less than soul-crushing to come face-to-face with your own name, one with which you’ve lived for more than two decades, and find that you’ve done nothing but sabotage and tarnish your own legacy.

Meeting new people was torture because it meant having to introduce myself. I’d reached a point where I’d begun to feel alienated from my own name. Saying my name had become like saying the name of an enemy! I hated having to wear my name tag at work. I squirmed in the inside whenever I had to introduce myself to colleagues and students. It made it hard to be fully present in any situation when you’re subconsciously trying to dissociate yourself from your name, your identity.

But as I make my journey toward full recovery, I am learning to be kind to myself. I am learning that there’s a depressed Karen, a non-depressed Karen. A proud Karen, a humble Karen. An insecure Karen, a confident Karen. A selfish Karen, a selfless Karen. A Karen who makes mistakes, a Karen who does things right. A hypocritical Karen, a genuine Karen. A Karen who wasted many opportunities, and a Karen who is learning from her mistakes. A Karen crippled by doubt, a Karen who walks by faith.

I am not perfect. I don’t mean to say that to suggest that I’ll just have to live with that. Instead, I am saying this: every up and down, every failure and success, is an important part of my journey toward becoming the Karen that God created and ultimately desires me to be.

Hear me, coastlands, listen, distant peoples. Before birth the LORD called me, from my mother’s womb he gave me my name.” (Isaiah 49:1)

I will end with this beautiful passage taken from The Inner Voice of Love, the “secret journal” of Henri Nouwen, a Catholic priest who went through a debilitating cycle of depression:

There are two ways of telling your story. One is to tell it compulsively and urgent, to keep returning to it because you see your present suffering as the result of your past experiences. But there is another way. You can tell your story from the place where it no longer dominates you. You can speak about it with a certain distance and see it as the way to your present freedom. The compulsion to tell your story is gone. From the perspective of the life you now live and the distance you now have, your past does not loom over you. It has lost its weight and can be remembered as God’s way of making you more compassionate and understanding toward others.

Can you identify with any of this? Have you ever attached shame to your own name? What’s the story?

Related post: Being depressed did not make me “an innocent in hell”

My students knew I was depressed before my colleagues did

During our training, we were told that students are far more perceptive than we’d expect. Students can tell if you don’t care, students can tell if you’re fake, students can tell if you’re pretending to be someone you’re not. These are all true, but who knew they’d also sniff out my depression?

They didn’t exactly read it from my face, but there are plenty of other signs they could pick up.

I was in the hospital visiting a student who’s recovering from a traumatic injury (and overall near-death experience), when I decided to tell him about my history with depression. It thought it would be a good way to start a conversation about how we can commit to learn and grow from life’s tragedies.

But before I could elaborate, he cut me off: “Oh, I knew that. I saw that book you were reading.” He’s referring to The Catholic Guide to Depression (How many times have I referred to this book on my blog? You’d think I was getting paid to plug it…). I have a rather messy workspace in the classroom, and would leave my non-class-related things at random corners. Now I wonder how many students saw my little orange bottle of antidepressants.

On a separate occasion, I was letting my students know ahead of time that I wouldn’t be in school the following day. I didn’t expect anyone to bat an eyelid, but one of them began “badgering” me.

“Why?”
“I need to see my doctor tomorrow.”
“Oh, during the day? What’s wrong with you?”
“We can talk about this after class.”
“No, just whisper it to me.”

While his desk mate was paying no attention, I casually explained, “I will be seeing a therapist tomorrow. The first appointment has to be during the daytime. Don’t worry, I won’t have to miss school for this in the future.”

Of course, he wanted to know more, this time with a hushed voice and a look of concern in his eyes.

“Wait, so what’s wrong with you?”
“Just finish your work, and we can talk more after class, okay?”

The sweet boy just wouldn’t have it, so finally I whispered, probably against protocols of appropriacy, “I was diagnosed with depression. But don’t worry, it’s under control.” I did not expect him to whisper back, “Oh, I think I have that too.” But I’m thankful he did — otherwise, I wouldn’t be able to support him as comprehensively as I now can.

Sensing that there is much potential for this “secret” to be “used” for good in the classroom, I told another student. This particular student wasn’t struggling with anything particularly atypical of a high-schooler, but he struggled a lot with motivation. He found it hard to want to do anything that was difficult or unfamiliar, which you unfortunately encounter a lot in Math. I was getting a lot of “I don’t want to do this anymore” and “I’m calling my mom” from this boy.

One day, I sat him down and told him about how hard it was for me to go through college while depressed. I shared this not to guilt-trip or shame him, but to explain how things would have turned out much different had I lived according to the mantra of doing only things that are easy or comfortable. I also shared how my deepest regrets from my younger days are exactly that: forgoing many opportunities for growth simply because they weren’t within my comfort zone. “You know, that’s why I still can’t ride a bike today.” That drew a chuckle, but I knew I finally had him in a way that would last a longer than my previous ‘life lectures’. The message was clear: we won’t grow if we’re never uncomfortable.

I believe there is room for vulnerability (in appropriate doses and at appropriate times) in the classroom. It makes you more human, a concept many students find difficult to grasp.

And it helps establish genuine relationships. Some believe it’s better to keep things “professional”, but I doubt that’s universally applicable. These relationships, in turn, will help you teach. Not just classroom material, but lessons in life and virtue.

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A candid shot taken by my colleague

Related post: My students are helping me recover from depression, “It all started with tea.”

You don’t need empathy to support a depressed person

When a friend was hospitalized for appendicitis, people flocked to visit him at the hospital. When I was clinically depressed, some who knew it avoided me like the plague. But I completely understand — it’s natural for us to be afraid of the unfamiliar, including unfamiliar illnesses. And when it comes to depression, people are wary not because they are afraid it might be contagious (hey, many don’t even recognize it as an illness!), but because they are afraid of saying the “wrong” thing.

A friend once apologized to me, “I’m sorry I haven’t been reaching out to you or being there for you. I’m not like J — I wish I were, but I’m not. But know that I’ve been praying for you, okay?”

At the time, I smiled and told him not to worry about it. I read between the lines and I read his facial expressions — I knew what he was saying was that he wasn’t good at empathizing and didn’t want to do or say things that might end up aggravating matters. We exchanged hugs and parted ways for the remainder of the academic year. But that night I wept in my room. I wasn’t sure why at the time; I cried over the silliest things after all.

I know why now. I felt abandoned by a friend. Sure, he wasn’t my best friend, and I did have other close friends who were walking the journey with me, but when an individual walks out on your life, his/her absence can’t be compensated by quantity. The next time I saw him, it would be the beginning of a new academic year, and I’d have already recovered over the summer. We hung out again and were friends once more. This was no isolated case. It happened again, and again, with different people.

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But my friends are not bad people. They are wonderful people. They did not stop being my friend during depressive episodes because they were tired of me. In fact, I don’t think they even intended to stop being my friend. And I’m sure they believe they were doing what was best for me. From their point of view, they were temporarily stepping out of my life so someone more “qualified” could step in to take better care of me. Someone who would have the right things to say, someone who perhaps have gone through the same thing I was going through, someone who could give good advice. Basically, someone who could empathize.

And yes, I wished I had people in my life who fit the above descriptions, and I was indeed blessed with at least one such individual, but it didn’t erase the deep pain of being “left behind”. And one thing I’ve come to realize over a few cycles of depression is this: depressed people don’t need you to empathize; they just need you. A depressed person would rather have you say all the worst possible things, rather than not have you at all.

It is very difficult to understand what a depressed person is going through. That is an inescapable fact. But even a fellow depression fighter/survivor would not be able to understand completely, since disorders of the mind affect each individual as uniquely as his mind is unique.

But a general common theme is that the depressed individual experiences and perceives a reality different from that of the non-depressed individual. I remember despairing not because I didn’t know if I would ever recover, but because I came to believe there was nothing from which to recover. I didn’t believe I had a negative cognitive bias, but believed that it’s others who had a positive cognitive bias, while I saw my existence for what it truly was.

Loved ones of those who are depressed, you have a very tricky and very important task of holding their hand and walking together, even though you are walking in different realities, until you are once more reunited at the end of the tunnel. This is very important because they need to be walking with someone who can see the light at the end of that tunnel. If you choose to wait to greet them on the other side, what if they never make it there?

Someone very dear to me had no experience whatsoever with depression. He bought himself a book on the topic (The Catholic Guide to Depression, which I’ve recommended multiple times in previous posts) in an attempt to understand what I was going through. It’s safe to say that even after a year, he never came close to understanding, but what mattered was that he never stopped walking with me. He never got tired of me even when I got tired of myself. And he never stopped believing that God would deliver me even when I’d lost all hope. You have my eternal gratitude.

On “zentangling”, life, and God

I haven’t written anything new over the last few days (though there are many thoughts I’m itching to get on paper), because I’ve been…doodling. A lot.

Apparently, this type of detail-oriented (or should I say “obsessed”?) and geometric doodling has a name — it’s called a “zentangle”. I would not have known this if my colleague hadn’t passed me a Zentangle workbook to pass to Omari, my student who’s currently in the hospital.

Annie the Antisocial Anteater
Annie the Antisocial Anteater
Camille the Capricious Camel
Camille the Capricious Camel
Malcolm the Maladjusted Meerkat
Malcolm the Maladjusted Meerkat

I am hooked, and think I may have figured out the appeal of zengtangling. It’s a lot like life — you can’t erase any of the strokes you’ve made, but you can adapt and build off from those accidents, misfortunes, and mistakes. In the moment, every detail seems random and incongruous with everything else, but at the end of the day you find yourself with a final tapestry much more complex and beautiful than what you could have dreamed up at the beginning.

And it reminds me very much of God’s continuing work in my life and yours. In the words of a very wise priest, God is a skillful impressionist painter — his work can make little to no sense up close, but when you step back you see a masterpiece.

This has been fun and therapeutic for me, but I also connect deeply to the idea of characters who are so fixated with a certain trait that they forget there’s so much more beauty and complexity to them. I’ve seen it in myself, in people struggling with mental illnesses, in my students, and in how people view those who have special needs.

I’m now thinking of putting them on sale as prints/T-shirts/tote bags/iPhone skins on Society6. What do you think?

How do you maintain your grip on reality?

About a year ago, I wrote a letter to my future self. It was barely three months after what had been my debilitating bout of depression to date, and I was a little nervous. To realize that for eight out of twelve months I could have been so wrong about so many things, so blind to so many truths, so caught up in the half-lies of my distorted reality — it was a world-shattering realization. (In my previous post, I write in greater detail about the distorted thought patterns of a depressed person.)

I say world-shattering because most of us grew up being told to believe in ourselves, that if we believed something about ourselves then that’s true. Or at least, that what we see in ourselves is supposed to be more valid than what others see in us. Never let anyone else have the final say. They are but naysayers. Trust your heart. 

I was finding that that wasn’t so great of a mantra to live by. In my depression, I believed that what I had was not a treatable illness, regardless of what anyone told me. I also believed God had either abandoned me, or He simply hated me, regardless of what anyone told me. Because it sure seemed that way to me.

I remember being 15 or 16 and watching supermodel-turned-talk-show-host Tyra Banks instruct the teenage girl on her show to “go home, take a post-it, write I am beautiful, stick it on your mirror and recite it to yourself every day until you believe it.” The live audience promptly rose to their feet for a watery-eyed standing ovation. I remember grimacing at my laptop screen, not because I disagreed that this girl looked perfectly pleasant, but because all these women were essentially telling her to completely disregard her own conviction. And they expected it to work? I won’t pretend to know how one overcomes Body Dysmorphia Disorder, but I doubt that was it. I don’t think they let the poor girl say anything, but I knew that if I were her, I would have thought supermodel Tyra Banks was just patronizing me by telling me I was beautiful when I really wasn’t. It’s not going to work. Not unless our culture stopped worshipping self-belief and self-determination above all else. Because sometimes, many times and for many reasons, we are going to be misguided and we are going to be wrong.

Who, then, can we trust to tell us truths that can be so counter-intuitive?

Back to the letter I wrote to myself. I hoped for this letter to protect me against depression’s most powerful trick: the distortion of perceived reality. This is part of what I wrote to a future self who might be caught in another raging mental storm: If that’s what’s happening now, hold on to this golden nugget of truth: Many things in life have failed you, but God will not fail you. If you’re going to succumb to the lies of depression, fine, but this is one thing you can vouch with all your mind, heart and soul is true. Otherwise, strive to know more of Him and His plan for your life, his role for you in His kingdom. Go into storms confident that you are standing on solid rock. . . . You are a daughter of God and He loves you more than You could ever know.

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This was written solely to myself, and no one else has seen it till this moment. I thought this would be foolproof. It’s in my handwriting, and it’s sincere — how could future me distrust it?

But I did. About six months later, I opened this letter again and I wanted so badly to rip it to shreds. I read my own words and chastised myself for being so delusional at the time of writing. For the second time, I became obsessed with the theory of depressive realism: depressed individuals make more realistic inferences than non-depressed individuals. While everyone around me insisted that my depression gave me a negative cognitive bias, I believed in myself so much that I thought it was them who had a cognitive bias — a positive cognitive bias. And I, being supposedly depressed, had the more accurate appraisal of myself and the world.

What arrogance, Karen.

I remember my then-boyfriend trying to tell me I was being arrogant. It made no sense to me at the time. How could I possibly be arrogant when my self-esteem is at rock bottom?

It turned out that while depressed, I lost many things — self-esteem, self-love, empathy, love for others — all but my idolatry of my own intellect. I suppose it didn’t help that I’d been immersed in an academic environment that worshipped the intellect as the harbinger of Truth.

Recently, I talked to my RCIA instructor about my struggle to retain my faith during depressive episodes. He said that we consider the human person, we often don’t look beyond the intellect, the emotions, and the body. Our free will, he says, is a very sacred gift God has given us. It operates outside of intellect, emotions, and body. He has given us our will so we can know Him, and choose whether or not to love and follow Him.

I see now that as a Christian, I must, using my free will, submit my intellect to God. While this must sound like blasphemy to any post-Enlightenment atheist, I declare this unashamed because there is no better option.

To people for whom religion is but a tool of rationalization, I say the same of secularism. It comes down to the question of which is the more reliable tool. Well, my religion is not quite a tool, but a relationship with the true and living God. He gave me my capacity to think and capacity to rationalize. When my brain is “broken” and doesn’t perceive things quite accurately, I can turn to its manufacturer to tell me what I ought to be perceiving. Thank God for the Church that has been entrusted to guard and dispense God’s truths, so we will never be left as orphans (John 14:18) flailing around trying to make sense of everything given our limitations.

I repent of my life-long arrogance and self-idolatry. I will end this post with one of the most-cited verse of the Bible: Trust in the Lord with all your heart, and lean not on your own understanding. (Proverbs 3:5). I used to think this applied mostly to those who “aren’t smart enough to come to their own understanding of things”. I take that back, and I would even add that this is particularly relevant to those we consider to be highly intelligent.

What I needed was not a letter from me. What I needed was God’s Word and the teachings of His Church, and the humility to trust Him over myself.

I know not all my readers share my convictions, so I’ll open this up to you: how do you maintain your grip on reality? Or more broadly speaking, how do you know what’s true?

Related post: Being depressed did not make me an “innocent in hell”

Recommended reading: In Miracles, C.S. Lewis demonstrates how the fact that we can even reason and rationalize is a great argument for the existence of a transcendent Creator. Or go to Wikipedia for a summary of the argument from reason.

Being depressed did not make me “an innocent in hell”

People suffering from clinical depression are often likened to an innocent in hell by medical professionals and their loved ones. It always stems from a well-meaning attempt to lift the depressed individual from the quicksand of self-loathing and self-beratement. You are not any of those things you say you are. You are not evil, you are not selfish. I know you. You are an amazing person and you are suffering due to no fault of your own. Basically, an innocent in hell.

I disagree. Yes, it was never my fault that I was depressed, but I am in many ways flawed, just as you are. I am not innocent, just as you’re not.

The only difference is that those who are depressed feel the weight of their flaws, and the flaws of others (though mostly their own), far more intensely than those who are not depressed.

While deep in depression, I mulled and mulled over how I hadn’t fulfilled my duties as a daughter, how I’d been too absent as an older sister, how I was too uncaring as a friend, how I was a terrible girlfriend, how I’d been irresponsible with the resources entrusted to me, how I’d wasted so many opportunities in my life, how I was terribly hypocritical as a Christian. All those things are true to a certain extent. It’s just that while depressed, I was so crushed under guilt and regret and I wasn’t able to be realistic or to move forward.

And as we all know, depression distorts our perception. The key word here is distort. Depression doesn’t just make stuff up out of thin air to torment you. Depression reaches into the recesses of your memories, pulling up real memories of real thoughts you’ve had, real things you’ve said, and real things you’ve done (or have not done, as the case may be). You become hyperaware of these things — your flaws, deficiencies, failures — and that’s all you can think of. You’re so aware, too aware, that these images eclipse any positives you might still remember. And yes, it later magnifies them, such that you come to think that the damage is so big that you can’t ever do anything to rectify things.

And then the self-fulfilling prophecy is set in motion. Believing I was an irrevocably depraved person, I started thinking and behaving like an irreparably depraved person. I would sometimes try to drag my then-boyfriend down into “hell” with me so I wouldn’t be so alone in my inescapable misery. I shudder at this confession, thinking about how I acted like the thief who “comes only to steal, kill, and destroy” (John 10:10).

Too often, though, we are told that “depression lies to you”. I cannot count the number of times I heard this while deep in the throes of depression. I have a big problem with this phrase. It creates in the mind of the depressed person an impossible dichotomy: either I am the horrible person I make myself out to be in my head, or I am completely innocent of all the things I am accusing myself of. It seemed like wishful thinking to believe the latter, and so I’d stubbornly cling to my own (distorted) assessment of myself. The fact of the matter is that I am neither of those things, and there exists that middle ground we are so afraid to tread: I may not be a good person, but I can change that. And I have to start somewhere. Will you help me?

Thanks to medication, counseling, prayer, spiritual direction, and the support of those who love me, I am now a lot better. But I choose to remember the things that were brought to the surface while I was deeply depressed. They are real and I am making use of the energy and optimism I now have to seek healing. In myself, I am hoping, by the grace of God, to overcome my flaws. And in my relationships with other people, I am seeking to love and serve better, with Christ as my guide. He, after all, is the great physician.

There is great temptation for those coming out of depression to frolic in “the land of the living”, leaving all the pain behind. I fell into this temptation as I recovered from my previous cycle of depression. I was too eager to see myself as a good person, and I swept all my failings back under the rug, where they’d been for so many years of my life. But I now believe that God allows us to go through suffering not just so we can appreciate its absence. Suffering can grow, refine, and even heal us. We just need to sift through the rubble to find those hidden treasures. St Faustina wrote: Suffering is a great grace; through suffering the soul becomes like the Saviour; in suffering love becomes crystallised; the greater the suffering, the purer the love.

I would encourage anyone, clinically depressed or not, to occasionally sit amidst the rubble and ask God what you ought to do with the mess around you. Mend those broken relationships. Forgive those you haven’t forgiven (including yourself). Ask for forgiveness from those you have wronged (intentionally or unintentionally). Overcome those self-indulgent habits. Pursue a vocation that, rather than helping you not to run away from the messiness of the world, allows you play a role in healing it. And be there for those who were there for you, as well as those who weren’t, because you now understand the darkness of suffering alone, and you understand the power of solidarity and grace.

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With a little help from antidepressants

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This month, The American Recall Center is encouraging conversations online and offline about medication safety (check out their post on the newly-discovered side effects of Xarelto). Judy, their Outreach Coordinator, got in touch recently asking if I’d be willing to write about my own experience with medication. I realized I’ve hardly (publicly) talked about the role of antidepressants in my road to recovery, and so I thought this could be a good place to start.

For 3 months or so, I’ve been getting by with a little help from Lexapro (or escitalopram). Owing to my own stubbornness, compounded by my ignorance about the nature and effects of antidepressants, I waited almost 6 months into this current cycle of depression before agreeing to be medicated. There are a few things I wish I’d known earlier, which I hope could be helpful to you or someone you know:

Antidepressants are not magic pills that will “make us forget all our pains” a la Helen’s drug in The Odyssey, as many people might assume. People looking for a “quick fix” would be disappointed, and it is unfortunate and irresponsible that antidepressants are overprescribed to people who don’t necessarily need them. On the flip side, they are underprescribed to those who actually need them, but are wary and skeptical of antidepressants. I belonged to the second camp.

I was under the impression that antidepressants were mood-altering drugs that would do no more that make me numb to my problems. So to me, to take antidepressants would be to live in denial. And since living with integrity is of paramount importance, this was a huge no-no. For half a year I resisted my parents’ and then-boyfriend’s persistent efforts to get me to see a psychiatrist, until eventually caving in only because I felt guilty for making them so anxious. “Oh, you’re definitely depressed,” the doctor told me as I tried to argue incoherently that I was simply seeing the true terribleness of my existence. She prescribed Lexapro. I brazenly told her, “This is not what I need. What use would it be to feel better and still be this despicable person that I am?” She asked matter-of-factly if I had anything to lose. I guess I didn’t. Perhaps at the very least I would stop embarrassing myself by sitting on road curbs or hugging lamp posts while sobbing about being alive.

Most antidepressants take about 4-6 weeks before they start taking effect. (There’s also a very real possibility that a particular antidepressant may have no effect, or none that is substantial, even after that period. In that case, your doctor would put you on a different antidepressant.) I first noticed it when I began moving around a lot more than usual while in the shower. Considering that I’d recently found myself curled up in a fetal position under running water, that was a big deal. On the same day, I also found myself having enough energy and motivation to finally clean up my bedroom from corner to corner. Overall, I began feeling generally “lighter”, while remaining acutely aware that I was still struggling with negative thoughts and a low self-esteem.

That leads me to the next point: the first symptoms to improve will be energy level, concentration, and motivation. And the last to improve will be your low mood and feelings of hopelessness. I was experiencing improvements in my ability to think, read, articulate myself, and perform basic, everyday tasks. And yet I continued to hate myself and have a bleak outlook on life. I mistakenly thought this was a confirmation of my initial understanding of antidepressants.

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That period before your mood begins to improve can be dangerous. While my suicidal thoughts used to be purely fantastical, during this period, I began to think they were actually quite reasonable and doable (it scares me to admit this now). This is a very real danger for anyone starting out on antidepressants: you might begin to have energy and cognitive ability to actually execute suicide plans. If a loved one is relatively new on antidepressants, please be more attentive and vigilant than usual. It is also important that they are taking these antidepressants under regular consultation with their doctor. He/she will be able to assess how well the patient is reacting to it, if there’s a need to adjust the dosage or switch to a different kind, etc.

I have come to a point where my mood has improved remarkably, and where I’m starting to have much healthier and more realistic thoughts. There is still one more thing I or anyone in my position should remember: do not stop taking your antidepressants at this point. During this cycle of depression, I was informed by my doctor that at whichever point I start feeling “fine”, I will actually need to stay on my medication, and at that optimal dosage, for an additional 9 months to maintain the balance within my body.

I’m also seeing a counselor regularly, even though I didn’t think I needed it anymore. When I found out what a long wait list there was, I told her, “You know, you should just give my slot to someone who needs it more than I do. I’m honestly quite okay nowadays.” However, she told me that given my history of recurrent major depression, it’s important that I continued to see someone to process what’s happened, and also so that the symptoms can be caught much earlier when depression returns. Experience with previous episodes confirm this: inadequate treatment can lead to relapse and recurrence. We should also note that it’s been well documented that the risk of recurrence increases with each subsequent episode. It’s not something we want to gamble with.

Lexapro is an SSRI, or selective serotonin reuptake inhibitor, one of the main classes of newer antidepressants. SSRIs act on a chemical in the brain called serotonin (a neurotransmitter), which helps relay signals from one area of the brain to another. Its many functions in the brain include the regulation of our moods, and many researchers believe that a serotonin deficit leads to depression. SSRIs elevate the level of serotonin in the brain by inhibiting its reuptake. They do not alter our personalities. I also strongly recommend talking to a counselor to complement the medication, and your doctor will most likely say the same. The medication will help us be better receptive to adjustments to our thought processes achieved through counseling, so these go hand in hand!

While depression distorts our perceptions, there are very real hurts in our lives that need to be healed, and real problems to be solved. We need to be in the right frame of mind and have adequate energy to be able to deal with them, and that’s where antidepressants come in. We are “dependent” on them only in the sense that someone with a broken foot has to depend on crutches until he recovers.

My final concern, and this will be pertinent to fellow Christians, is where psychiatric medication falls in our theological framework. We recognize the limitations (and dangers) of psychiatry when taken to reductionist, materialistic directions. It is preposterous to oversimplify mental illness as “chemical imbalance in the brain”, though I have definitely been guilty of that. The Church teaches that the human being is a union of body and soul — what affects physically will also affect us spiritually. We need a physician for our body, and we most certainly and desperately need a physician for our soul, and that is Christ. Seeking medical treatment is not to turn our backs on God — all truth is one; the wisdom amassed in the field of psychiatry, when rightly applied, is part of God’s gift to us. (Highly recommended reading: The Catholic Guide to Depression by Aaron Kheriaty, MD with Fr. John Cihak.) At the same time, we also don’t want to come to view antidepressants as a guarantor against suffering, for we know that in this lifetime there will always be suffering. But we take comfort in that with God we can offer our suffering for something greater than ourselves (I will save this another time — I know it’s not an easy thought to swallow — I will admit it is also rather difficult for me at this moment and I have much to learn from the saints who so lovingly carried their crosses).

I’ll end here for now. Unsure about anything? Talk to a medical professional. All I can share is based on my own experiences, plus some information from trusted sources — I am in no way qualified to dole out expert advice!

Depression taught me to love the developmentally disabled

The title of this post was originally going to be “How I came to empathize with the developmentally disabled”. Then I realized I had no right to use the word “empathize”, because I have never walked a day in their shoes, and will never fully empathize. But I’m writing this because I believe my depression offered me a small window into the world of those who know they are different from the majority, those who feel incapable of fully participating in society. My last two cycles of clinical depression taught me to have compassion for those for whom such struggles are part of an inescapable reality.

Depression affects everyone differently. A recurring theme for me is being robbed of many cognitive, social, and emotional abilities. While I haven’t figured out how much of it is real, and how much simply a matter of distorted perception, it all seemed to me like an objective, permanent reality (and there was no talking me out of it — just ask my therapist, my family, my then-boyfriend, and my close friends).

I distinctly remember what it was like being at a friend’s 21st birthday party. I excused myself to go to the bathroom many more times than necessary, all to avoid having to converse with another person. I don’t know how to hold a conversation. I wouldn’t know how to respond and react appropriately. All it would take is one sentence or one stammer and I’d be exposed. They would know I’m a freak. And then they would either walk away, or at best they might stay out of pity.

At the dinner table, I freaked out when an academic asked me what I was majoring in in college. I knew that the moment I said Sociology, he would follow up with a question that would expose my ignorance and my failure to understand my own discipline. And I dreaded how everyone at the party would inevitably ask, “Where do you go to school?” Because I knew what they’d expect when I told them I went to the University of Chicago. They’d expect me to be intelligent and insightful, and I would hopelessly fall short. I didn’t even dare to talk to the little children at the party, believing that I would be looked down upon even by those a whole decade younger than me.

There was one partygoer different from everybody else, an elderly lady with Down Syndrome. I quietly watched how she stared into space most of the time, and how her relatives coaxed her into standing in the right place when the time came to take a group picture. I felt a profound sense of affinity with her. Though I wasn’t sure how aware she was of her own disability, I yearned to commiserate with her. It’s okay, I don’t belong here either. I don’t know what these people are talking about either. I don’t know why they’re enjoying themselves either. This world is a strange and scary place. 

It wasn’t just in public. I found this picture of me (in green) and my sisters watching Midnight In Paris at my apartment.

You can’t tell from looking at the picture, but while my sisters both loved the movie (as do most who’ve seen it), to me it was torture. I couldn’t really pay attention to the plot or dialogue — I was too busy feeling tortured about not being able to identify with the thoughts, motivations, and emotions of the characters in the film. The credits rolled and I had no idea what the movie was about.

And here’s a picture taken on graduation day.

graduationIt’s an iteration of classic goofy shot I often took with my friends. Except this time, it wasn’t funny to me because all I could think of was how I would ever justify being a UChicago graduate when I was so “dumb”, when I could function neither in the classroom nor in the real world, when I believed my life was “over” because I’d never be able to get/hold a job or start a family in the future. Not long after this picture was taken, I began going around saying my goodbyes as if I’d never see many of these people ever again, as I was planning to go into reclusion for good.

And as I come out of depression, as my mental agility, emotional energy, and ability to relate to other people are coming back, I haven’t been able to forget how lonely and out of place I felt all those months. Those feelings of not belonging in the world, of not being able to live up to the expectations of society, of being defective in every way, of being a mistake amidst all of God’s perfect creations, will always remain fresh in me.

And this is the story of how God humbled me, and instilled in me new and deep love and compassion for those labeled by society as “defective”, or “different” at best. I invite you to reflect on how you’ve perceived or treated our brothers and sisters who don’t meet the constructed, arbitrary standards of beauty, success, and normalcy.

If you personally know what it’s like to have a developmental disability of any kind, or if you know someone who does, I would be honored to hear about and learn from your experiences.

Related post: Those with “special needs” can teach us a thing or two about humanity

Who do you live for?

I share a particularly close relationship with one of my students. Today, I asked him: “Do you think your life is valuable?” He answered, “Sometimes.” I proceeded to steal 10 minutes from my Geometry lesson plan to discuss this further. We arrived at a common realization we’ve both experienced: you can’t always live for other people. It’s not sustainable.

We have both been at rock bottom for different reasons. In the deepest throes of clinical depression, I’d found myself absolutely abhorring myself, to the point of emotionally abusing myself as long as I’m awake, and being unable to look at myself in the mirror. I tried to keep myself going for the sake of the people who love me: my family, my then-boyfriend, and my close friends. But as my condition got worse, I would often think to myself: “Sure they’d be devastated if I were to take my own life. But realistically, they’d move on at some point. They’re not going to grieve forever.”

My doctor once told me, “You’re right, you can’t live for others. You have to find it within yourself.” But that, too, isn’t a foolproof mentality. Like I said earlier, it was it was impossible to live for myself while severely depressed. I simply wasn’t a fan of me. While I often tell this student about all the ways he is amazing, about the importance of loving himself and seeing his own potential, at the back of my mind I do know he needs more than that. And I hope he finds it someday.

So who am I living for?

Well, I live for my God. The God who breathes meaning and purpose into my existence, my relationships, my career, my joys, and even my suffering. In Christ the solid rock I stand, all other ground is sinking sand. I could crack or crumble, but the mighty hands that hold me never will. May I allow the recognition of His unfathomable love to fuel my every breath, thought, word, and deed. I pray the same for you, my brothers and sisters.

I know I have readers who don’t share my Christian convictions. Regardless, I would love to hear your answer to the same question I had to ask myself: “Who do you live for?”

(Addendum: I know I wrote about the importance of pouring ourselves out for others in my previous post. I am not negating any of it. But all the reasons I have any desire to serve others are rooted in God: He created us all and He created us all to love Him and love one another. Without God in the picture, living for others eventually became exhausting and “hollow”. But the moment God becomes the source, His goodness animates everything it touches.)

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Related post: My students are helping me recover from depressionHow do you find your “passion”?