Adventures in geekdom

25 Jul 2020

Yes, Let's Talk About Mental Health.

This entry was originally one I posted on my work blog in response to someone posting a blog post titled “Let’s Talk About Mental Health…” to their own work blog. It talked about their struggle with depression and I was really moved by seeing someone being open about their own mental health issues. I think it’s important to be open about the topic, so I started writing a comment on their post about my own experiences. As I was writing it, though, I realized it was getting long and I should just post it to my own blog because I didn’t want to distract from theirs.

Since I posted this my teammate has made their post available on their own blog! I’d recommend reading it as well as it’s important to read about other peoples’ experiences and also gives my post slightly more context: Let’s Talk About Mental Health

Mental health issues are not easy thing to be open about but, as I mentioned, it’s important to talk about them. Much of what my coworker said mirrored my own experiences, from spending entire days or weekends in bed to feeling like a failure for taking anti-depressants just to feel normal. We need to do what we can to remove the social stigma from having mental health issues and the best way to do that, I think, is to be open about it and help people realize they’re not alone and that there are other people who feel the same way they do and in some cases have the same experiences.

In case anyone reading this doesn’t want to read on due to the CW (totally understandable), just know that many people feel the same way you do and it’s not a failure to get help! Also, as people in the trans community say and applies here as well, you’re valid and your feelings are valid. If you need someone to talk to, whether it’s about depression, anxiety (I have big trouble with that too), LGBTQIA+ issues, or anything, I’m here and willing to help in any way I can. People being open and available were what helped me and I want to be available to be that person to someone else.

Below I’ve written about my own experiences in the hope that, like my coworker, talking about mine will help someone else with theirs.

CW: Depression, Suicide

Accepting I’m Depressed

I’ve known I was trans (though I didn’t know the term at the time) since I was very young. At the time, though, it wasn’t something you talked about in society and a secret I was determined to take to my grave. For brevity’s sake, though, I don’t want to get into much detail about that here (maybe another post sometime) but I think it’s needed for some context, especially since it’s such a large part of who I am.

For a long time, I just lived my life and didn’t care about myself, my body, or anything other than existing. I heard about people being depressed from time to time but decided it was something that affected other people and I couldn’t possibly be depressed because I had a good job, friends who cared about me, and a family who loved me. What could I possibly be depressed about?

Around 10 years ago I was in a bit more of a funk than usual and just didn’t feel like doing anything. I was taking guitar lessons and just couldn’t muster the enthusiasm to practice, among other things. One day during that time I was talking with my teacher (we’d become friends) about how I felt and how I just couldn’t get myself to practice. He asked, “Did you ever think that you might be depressed?” It was the first time anyone else had suggested that it’s possible that I could be and I still remember that question pretty vividly. It was not enough to get me to do anything about it but it was enough to plant the seed.

Also around that time, I was following Wil Wheaton on Twitter and he’d started talking about his own experiences and struggles with depression. It was the first time I’d seen someone famous, well-off, and well-liked being open about their own issues with depression. It made me reconsider whether I could be depressed as well but I still didn’t do anything about it. I saw going to my doctor for medication as a failure and thought that I just needed to try harder to be happy. It’s something people will say when they hear someone is depressed and it’s a very damaging thing to say. It can cause people to internalize the idea and, like me, avoid getting help.

There were two things that made me take action, though, and they both happened near the second half of 2014. The first, Robin Williams’ suicide, hit me pretty hard. He’d always made me laugh, seemed really likable, and seemed like a person who just loved life. I enjoyed watching his movies and he tended to play upbeat, happy characters so the fact he could take his own life came as a shock. A few months after that I got the news that one of my old friends and co-workers had committed suicide. That really scared me. In the span of a few months, two people I greatly admired had committed suicide and made me afraid of what I’d be capable of doing (wow, this is hard to write). I made an appointment with my doctor and talked with him about what I was feeling and he prescribed me an anti-depressant (Citalopram/Celexa, an SSRI). He told me some of the things to be aware of and I saw posts about people’s issues with/concerns over SSRIs but honestly, at that point, it didn’t matter.

Cycle of Anti-Depressants

I started feeling better and was able to cope with adversity in my life, so I thought all was well (or at least my “normal”) and for a few years it was. I started talking with other people about having depression or being on anti-depressants and I was surprised by how many people also had the same issue. I’d had no idea how common it really was because of the stigma surrounding being open about it.

Eventually, though, I started spending more time in bed and noticed it was easier to become irritated with myself. Even though I knew where it was coming from I still told myself I was just being lazy and I just needed more willpower to get things done because other people were able to get chores around the house done. Fear of suicide crept back into my mind and that scared me enough to talk with my doctor again. We ended up doubling my prescription by switching me to Escitalopram/Lexapro (he explained it as basically a twice as effective Citalopram) and that got me through some more time. Again, though, I eventually started spending a lot of time in bed and we added Buproprion/Wellbutrin. The cycle continued and we doubled that too.

That brings us to early 2019. With the continued increases of my anti-depressant dosages over a relatively short amount of time, I began to be concerned that it would just be a cycle that continued ad-infinitum until there just weren’t any other options. I realized I needed to do something else because that just wouldn’t work.

Starting Therapy

I’m in a few Slack channels with a number of friends/old co-workers and we’ve become pretty open about mental health issues with each other. Some of them talked about how much seeing a therapist had helped them and I remember thinking that was probably the next step I had to take if I didn’t want to keep getting bigger and bigger pills. I was pretty reserved about it but mentioned it was probably something that would be good for me and they agreed. For months, though, I made excuses on why I couldn’t go see someone. I was worried about how much it would cost, I was worried about taking time off work to go meet them during office hours, I was worried about everything I could use as an excuse. Thankfully, though, a couple of them gently prodded me periodically to see if I’d had a chance to see someone yet. Eventually after using the “I can’t call them to set up an appointment during the day and they’re closed when I can” excuse one of them told me to just leave a voicemail. That sounded reasonable. Looking back on it, I wonder if that all was my anxiety coming into play?

That night or soon after I started looking up possible therapists. I’d struggled with being trans my whole life even though I tried to suppress my feelings and knew that was likely a large part of my depression, so I specifically researched therapists who worked with gender-related topics. I wasn’t planning on actually saying anything about it at the time but I think in the back of my mind I wanted someone to pull it out of me. I found a clinic near me that listed gender as one of the things they specialized in and left a voicemail. The next day they called me back and told me the person I wanted to see wasn’t taking any new patients but they had a psychiatrist who had joined the practice and had availability. I made an appointment to see him and my time of excuses was over!

Did you know there’s a difference between psychiatrists and psychologists? I didn’t… When I was talking with the psychiatrist I had mentioned wanting to see him every week or so because I felt like I needed that. He said insurance companies usually won’t cover seeing a psychiatrist very often but they will cover seeing a psychologist. Apparently, the difference is that psychiatrists can write prescriptions and focus on the physiological side while psychologists focus more on the emotional side. I asked if he could recommend any psychologists and he introduced me to one at their practice.

I went to our first session and wasn’t sure what to expect. My friends had told me to make sure I’m comfortable with my therapist and you don’t need to stick with the first one. That’s important to remember if there’s anyone reading this who’s considering finding a therapist. If you’re not comfortable with them it’s going to be hard to be honest and it can take a few sessions to find if you really click. I’m happy to say our first session went really well and I set up weekly appointments with her going forward.

Aaaaaand I’m Trans

I started seeing my therapist around September of 2019 and every week we covered various issues that came up in my life. I felt comfortable talking with her almost immediately and thought we were making good progress on the emotional side of my depression. It was really nice to have someone to talk with about my problems without feeling like I was burdening my friends or family with them, even though I was paying her for the privilege. 😛 Early on when we were going over my life I’d mentioned there was something I wasn’t comfortable talking about with her, so she knew there was something deeper even though she didn’t know what it was.

For a few months we talked and I was feeling better but at our session a few days before Christmas I kinda ran out of things to talk about. I wasn’t feeling good enough to consider dropping down to a session every two weeks or month but I also didn’t feel like I would have enough to say at a weekly appointment. I had some things to think about and during my yearly two-week sabbatical for the holidays I decided that the only way I could keep getting anything out of my therapy appointments was to be completely open with her. I resolved that I would tell her I’m trans at our first session of the year.

That session was the hardest thing I’ve ever had to say, let me tell you. Only one time in my life, on an anonymous forum, had I ever uttered the words “I think I’m transgender” before either vocally or virtually. It took a long time with a lot of pauses, “umm"s and “uhh"s but I also think it was the best thing I’ve ever said for myself. Eventually it got easier to say and we were able to talk more earnestly because I realized many of the causes of my issues and insecurities had also been suppressed as well. Since that day I’ve felt much happier overall and I hope it continues.

Take Care Of Yourself!

This was all, I guess, a long-winded way of trying to reinforce what I said in the beginning. People being open about their own struggle helped me realize that I could do something about my own. If you’d told me a year ago where I’m at right now, first I would be elated but also shocked (even ignoring the current state of the world). There’s no way I could have imagined that not only was I an Atlassian (a company I’ve admired since the early days of JIRA) but that I’d actually be transitioning. Since I joined Atlassian a little over a month ago I’ve been able to stop taking my Escitalopram and feel better for it. Maybe I can eventually stop Buproprion as well but one step at a time.

Things can change for the better and sometimes you just need a nudge to get there, whether it’s emotional, medicinal, both, or just a message from a friend. Our bodies are complex machines. As people who work for a software company, we should all know how hard maintaining complex machines can be. Imbalances can happen and we should do what we can to correct that. My imbalance just seems to be Estrogen-based…