Depressive disorder

Everyday associations

August 31, 2019. This is the last clear photograph we ever took of him.

This article is related to the tragic and unexpected death of my son, Michael.

The days immediately after Michael’s death were very difficult. I had been warned that certain objects, sights, sounds, and even scents could trigger any number of strong emotional responses. I certainly experienced those.  Some were centered on physical objects, like the jar of peanut butter on the kitchen counter, the boxes of apple juice in the refrigerator, and the articles of clothing I pulled from the dryer. Others were connected to specific words that came up in conversation. Words like pillow, tent, phone, and blanket were among his most frequently used.

I was especially aware of sounds, or rather the lack of them. Michael would frequently take a smart phone or other handheld device and use it to play some of the worst “music” I have ever heard. A lot of the stuff he liked on YouTube, for example, sounded more like white noise than music. (For someone with his sensory issues it may have sounded just fine, but I hated it.) Whatever the case, for months there had been a constant, muffled stream of sound leaking from Michael’s bedroom. In the evenings following his death, I was very aware of its absence.

I also found some associations that I didn’t expect. Lisa and I like to watch Animal Planet together. Some of the shows we watch involve the operation of zoos and wildlife sanctuaries, where all kinds of animals are featured and discussed. Some of the other shows we watch involve game wardens and other types of law enforcement officers dealing with animal control issues. Sometimes these officers deal with the search, rescue, and recovery of missing people. On the night of Michael’s accident, I saw the real thing. A group of policeman and other first respondents were combing a wooded area looking for my missing child.  When I looked at the TV screen and saw those game wardens searching a wooded area, it was like a sledgehammer to the head. Knowing that those wardens were looking for evidence of illegal hunting, and not a lost child, didn’t matter. It was the visual image that set me off. In my contorted mind, all I could see was a man in a police uniform running out of the forest carrying the wet, lifeless form of my son. The images on the television were too similar, so I reluctantly told Lisa that I couldn’t watch any more. The TV was turned off, and the disturbing silence returned to our home.

It has been four months since that horrible day. The emotional associations with everyday objects and events are starting to fade, but they still occur. I suspect some will continue for some time to come. Perhaps for the rest of my life.

Crashing in slow-motion

For me, 2016 will be remembered as a “bad year.” When it started, I was making plans for a year of accomplishment and success. Instead, it was the year where I watched my career decline, falter, and collapse.

I was diagnosed with ADHD in early March. When I first talked about this last June, I believed that I had survived the worst of it, and that things would start calming down. I was about as far from the mark as a person could be. Things were only in a lull when I wrote that article. They soon got uglier with each passing week.

I may as well set the stage and state that this doesn’t end well. Today, March 6, 2017, is my final day as an employee of the Library of Congress. After more than fourteen years with the agency, the complications brought on by ADHD have forced me to leave.

Now I’ll tell you how and why this happened.

First off, understand that removal from federal service – that’s really what they call it – is not a simple process. It takes a long time, requires meticulous planning, and a lot of documentation. That’s one of the reasons it doesn’t happen very often, and when it is done it isn’t done lightly.

In all likelihood, the Library made this decision as much as two years ago. Given how long this process can take, they would have had to start that far back for this to end here and today. The worst part is that for much of that time I wasn’t aware of what was going on.

And yet, the clues were there. In hindsight, I think the Library had been trying to compel me to leave on my own for quite a while. My job became increasingly intolerable, in one way or another. No matter what I did to change things, or to improve my work situation, nothing seemed to work. I was never good enough, I was never efficient enough, I was never thorough enough, or something. I was always falling short in some way. Improvement in one area never mattered as much as deficiencies in another.

You may be asking why I put up with such a toxic situation if it was so bad. That’s easy: my fear of the unknown, namely being without a job and of being unable to provide for my family, was greater than whatever fear I had of the administration at the Library.

I should have been more observant, and definitely more shrewd.

The process really got moving in the summer of 2015. By then, the Library most likely concluded that I was not going to leave unless I was forced to (and that is actually true). It was then that the performance related disciplinary process began, though at first I didn’t recognize it as such. It wasn’t until February of 2016, when I was given a written warning that I was in danger of receiving an unsatisfactory performance rating, that the true nature of my situation started to become clear.

It was also shortly after this that I was diagnosed with ADHD. That changed the whole situation, and put many things in a different light. Prior to that, I had been asking myself why I was having so much trouble, and why I always felt frantic and rushed. Now I had an answer, and with the root problem identified and addressed, I was confident that I could overcome it.

I was in constant contact with my professional guild (AFSCME 2910) about possible accommodations and help with legal issues. I changed my methods of therapy, and was put on a new set of medications. I implemented some workplace accommodations to help deal with the physical issues of ADHD. I frequently put in extra hours at work, in the hope of finding a pattern than would work for me. I was determined to sufficiently improve my work performance. By the summer things had quieted down. I thought I had found the right working pattern, and that things would start to improve.

The summer lull had given me in a false sense of security. In August I was given an assignment that proved to be exceedingly difficult, and I was given a very short time in which to prove myself. The task was indeed very complex, and had several facets to it. But it was not beyond the requirements of someone with my job title. Sadly, I was unable to adequately do the assignment. I thought I had, but I did not. Knowing what I do now, I don’t think there was any way I could have succeeded with that assignment, and the Library never seriously expected me to. The only possible outcomes were varying levels of failure.

I didn’t think my situation could get worse than this, because now I was quite sure that I would be receiving an unsatisfactory performance rating. But, in mid-September I was informed that I was not performing my job at the level expected of me, and that further disciplinary action would soon follow in addition to a likely unsatisfactory performance rating. I kept trying to improve, and working with my guild to find options

Nothing worked. In October I was informed that an adverse action was going to be filed against me, and that it would probably call for my removal. Even so, I kept trying to save the situation, if only because I had nothing left to lose. In November I received my long-overdue evaluation, which rated my job performance as unsatisfactory. I still kept trying. At this point I was hoping for a re-assignment or demotion, because I knew my current position was lost.

Finally, in early December, I was informed that I was going to be removed from my current position. Also, in the opinion of my superiors, given the severity of my unsatisfactory work, I was not being considered for re-assignment or demotion. I called on my guild one last time. I spent an entire day speaking with my representative, explaining everything I could in as much detail as I could manage. I also described, at length, exactly how my work is done, and how ADHD has created so many problems for me. My representative became crestfallen.

There is a fine line between being a quitter, and realizing that it is time to quit. On that day, I crossed that line.

I never allowed myself to seriously consider leaving the Library, because when I looked at the various issues in life that I need to juggle every day, the prospect of being without my federal job – or more accurately, the salary and benefits it provided – was too horrible to contemplate. But the facts were clear. The Library had exhaustive paperwork showing how that for the past three years my work performance had been steadily deteriorating. And for every argument my guild had for keeping me on board, my superiors were able to produce at least two additional arguments for why they shouldn’t. They didn’t know there was a medical condition involved until late in the game, but it wouldn’t have mattered if they had. Poor work, no matter what causes it, is still poor work.

A few nights later, in a fit of crushing despair, I finally accepted what ADHD had done to my mind: I was no longer capable of doing my job.

I considered ending my life. I’ve suffered from depression for most of my adult life, but I hadn’t been in a place that dark in over twenty years. But here I was, thinking about clocking out. I didn’t, obviously, but I still felt lost. The only career I have ever seriously pursued, or have any solid experience in, could now be closed off. I was faced with the very real possibility that I no longer had a career. I may have to go back to entry level work, or do wage based labor, to survive. For a man who is approaching fifty, has a medical rap sheet, a stay-at-home wife, and two young children to care for, this is a terrifying position to be in!

I still had one option. My guild recommended that I take involuntary retirement, based on a medical disability. It took some negotiating, but eventually a settlement was reached where I would be allowed to retire from the Library of Congress under those guidelines.

I was six weeks shy of my fiftieth birthday, so this was a very surreal experience. Most men my age are in the coasting phase of their career, and are getting ready to gather resources for retirement. Very few are actually entering it. Fewer still are entering it unprepared and against choice. But here I was, preparing to retire almost fifteen years earlier than I had ever expected.

I have applied to retire through the Federal Employee Retirement System (known as FERS). I have to be approved before I can start receiving annuity, and even if I quality, not all of my problems will be solved. More needs to be done.

So what am I doing?

Lisa and I are restructuring our family’s finances into something that can last long term. I’m trying to help Lisa find a job so that get her re-established in the work force. She is helping me look for a new career, or at least find a job that will help keep us afloat. We’ve both been looking over our various skill sets to see what, if anything, we can refresh or update by taking a class or online tutorial. We’re setting ourselves up with temporary employment agencies that may help get us through the upcoming drought. I’ve been contacting old colleagues from earlier chapters of my life to see what the professional landscape has become and where it might be going. I’m exploring some work paths that I had never seriously considered before, like home-based computer work, and freelance writing.

I’m trying to determine what I can or should do with the rest of my life.

I’m doing what anyone else in my position would do.

I’m doing what I have to do.

Winter of my discontent

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icydogwood

I can safely say this this calendar year started out well. I began to feel ambitious again. I wanted to do new things. I wanted to achieve things. I even made a list of resolutions for the year, and I was seriously going to try and meet them. In all, things were looking up.

But at the end of February, everything fell apart. That is the primary reason this blog has been quiet for several months. I’ve been a bit… preoccupied.

It began with a warning of unsatisfactory job performance at work. I don’t think I need to explain what that can result in. It wasn’t long before the cause was identified. I apparently have Attention Defect and Hyperactivity Disorder, commonly known as ADHD. The signs have been present for quite some time, but for whatever reason I never made the connection. Nor did anyone else in my life, apparently. My wife knew something was wrong, but like me and everyone else, she though it was that damn clinical depression I’ve been struggling with since who knows when.

I’ve been having trouble at my job for quite a while. There are a lot of things to remember and keep track of, and quite often I was overwhelmed. I also have never felt confident in my job, nor do I feel accepted by my colleagues. I’m not afraid to say that I have some colleagues who have openly questioned my competence and why I am even there. What’s worse, for a long time I genuinely believed that they were right, that I was not cut out to do my job, that no matter how hard I tried that wasn’t going to change, and it was only a matter of time before I was shown the door. It wasn’t until January, ironically, that I began to feel differently on this matter. I’m not sure why, but I started taking a different stance of a lot of things. By that point it was too late to prevent the performance warning.

At my agency, an unsatisfactory performance rating often results in a demotion or dismissal, which they euphemistically call “separation.” I had 90 days to improve. I did take steps to change my life and improve my job performance. But at the end of the 90 days I needed more time. Fortunately, thanks to the help of my doctors and my professional guild, I was able to get an additional 60 days. At this writing, my extended re-evaluation period will end in late July.

But that’s only part of the story. I wasn’t only having problems at work. I’ve been having problems at home as well. I’m almost always tired and short tempered. When I get home in the evening all I ever want to do is sleep. My brain simply doesn’t want any more stimulation, nor does it want anything asked of it. When all of this came to a head I asked my wife to make a list of personality changes she has noticed in me in the last few months. I won’t list them here, but some of them really hit hard.

I later shared this with one of my doctors, and his immediate response was advanced depression. That was no surprise, but it acquired a new wrinkle. One fear we had was that I had suffered a micro-stroke, but some blood tests pretty much ruled that out. (I don’t know how blood samples can determine something like that, but I’ll assume my doctor knows what he is talking about.) Another possible culprit was my hyperactive blood sugar, but he thinks that is a result and not the cause. He thinks the root problem is that I have been under so much stress for so long that my metabolism became unbalanced.

(There is a correlation between excessive stress and haywire blood sugar, actually.)

Over the last few years, I have been under constant, relentless stress from multiple angles. I’ve been dealing with the clinical depression, problems at work, problems at home, Michael’s medical history, some of Caitlin’s problems, diabetes, my mother’s death, Lisa’s car accident last August, and my weight problem. I’m sure there are other things as well.

Some of these issues have resolved themselves and faded. But the problem is the “damage” they did while they were happening. I was overloaded with stress and worry, and apparently it was more than my mind could handle. This caused the ADD to manifest itself. So even though some of the issues are no longer a concern, the residual effect of the stress has remained.

One thing I need to stress is that ADD and ADHD are not “acquired” conditions. They are genetically based (which also suggests they can be hereditary), and can manifest in different ways. My doctor figures that I simply hadn’t been diagnosed. A lot of people with ADD and ADHD are never diagnosed, because the condition is not problematic so long as the patient can compensate. And generally people compensate without actively thinking about it. Like anyone else, they find courses of action that work best for them, and proceed. They may not realize they have ADHD, and so long as they can continue to compensate, the condition will go unnoticed, and may never be a problem.

It’s when the patient loses the ability to compensate, and can no longer find effective courses of action, that the condition becomes apparent. My doctor suspects that up until 2-3 years ago, I was able to compensate, at least sufficiently, to keep ADHD at bay. But then I was hit with too many things in too short a time, and it became more than my depression and ADHD riddled mind could handle. Even so, I tried to compensate and roll as best I could. Along the way my brain chemistry was changing, as it tried to continue compensating. Sadly, the changes didn’t work. Unfortunately this how it often happens, my doctor said. Once the ability to compensate is lost or becomes insufficient, and ADD fully manifests itself, it’s as good as permanent.

I described my situation as “overclocking” my brain, like one can do with a computer. By means of overclocking, it is possible to make a computer go faster and therefore do more things. But the system board is operating at a hertz rate that exceeds design specifications, and it will eventually overheat. When that starts to happen, it’s not long before the chips are fried and the computer is as good as toast. The doctor liked that metaphor.

One he likes to use is to compare it to managing fires. There is a limit to how many “fires” one person can manage at a given time. For someone with ADHD, that number is lower than most. In my case, some of the fires went out of control, because I couldn’t divert the necessary attention to fight them. I simply had to let them burn.

There was an episode of the animated show Gravity Falls, called Dreamscapers, where one of the characters used virtual-reality technology to look into another character’s brain. The place looked like a very convoluted wooden house. If someone were to do that with me, parts of my brain would look like the aftermath of a forest fire.

After her car accident, Lisa was found to have a serious vision problem, which had not been apparent until that time. The eye doctor called it a “reveal,” where a condition the body had been compensating for, and hiding, suddenly becomes apparent and the body can no longer compensate. I had a reveal of my own. Near as I can tell, up until around 2013, I had been doing an elaborate balancing act to keep ADHD hidden. But once that balance was upset, the ADHD did a reveal.

This also reminded of my father’s condition. He died of an angina rupture, which is genetic in origin. There are symptoms, but it’s hard to make the connection unless you know exactly what to look for. My father was generally OK. He had blood pressure problems, and was badly overweight, but he managed to keep both of those conditions more or less under control. At the very least he was able to prevent them from getting worse. But in May of 1993, the right set of circumstances occurred, causing the genetic time bomb that had been with him since he was born to detonate, and his life ended.

Apparently I had a genetic time bomb of my own, and somewhere within the last three years it went off. But mine didn’t go off with a loud, catastrophic bang. It was a slow moving incendiary device, that gradually chipped away at my mind’s ability to work. I had been too long overclocked, and my circuit boards suffered heat damage. Too many fires had burned out of control.

And my life has changed forever.

Currently I am in the process of changing to a new medication plan. My brain stabilizer of choice is Adderall; so far I need a small but consistent dose. I will admit that I’m not comfortable taking an amphetamine, even one that is very mild and tightly regulated. I have heard horror stories about what those things can do under the wrong circumstances. But it was either that or watch everything that matters to me fall away. So, bottoms up!

I’m also looking for an additional counselor to help me with some specific issues. I’m also putting together a plan for controlling my weight. These are all part of a larger gestalt of treatment plans. How well it works remains to be seen.

My reactions to this whole affair have covered a huge range: anger, sadness, confusion, and even vindication. And this ride is still ongoing. In fact, this may only be the beginning. This isn’t something I can fight. I can only manage it.

Time to adjust course and move on.

Thoughts of Eeyore

eeyore

I’m sure some of you have seen this meme image. I first saw it on Facebook, via Inspirational Quotes. I like the message of the quote, but I’ll confess that my first reaction was “If only that’s how it was in reality.” Eeyore is an extremely lucky donkey, because his experience is probably the exception.

Usually, the kid with Clinical Depression is ostracized, even shunned, because no one wants to be around a such a gloomy person! Such a child is also a frequent victim of bullying and other forms of abuse. These children are rarely (if ever) invited to adventures or shenanigans. They are always expected to be happy, and are always being left behind! Granted, they are never asked to change. Instead, they are asked to simply stay out of sight. This may sound cruel, but that’s how it often is. The problem is, when you’re talking about tweens and teenagers, that attitude makes some sense. Seriously, who would want to be around the kid who is depressed and grumpy all of the time? How many self-help experts advise staying away from people who make you feel bad?

Believe me, this is something I know about. I’ve been in treatment for clinical depression since my mid-20s, and I suspect I will continue to receive some kind of treatment for the rest of my life.

When someone with clinical depression attempts to socially connect, it’s usually because they are trying to get out of the deep pit they are trapped in. They hope that by latching on to other people, they can be pulled out of their melancholy and enjoy life for a time. Unfortunately, such people are just as likely to drag other people into the darkness with them, rather than be lifted out. A lot of people are unwilling or unable to take that risk, and stay clear of the depressed person. The one type of person who doesn’t avoid the depressed person is another depressed person, which is one of the reasons they tend to pack together. It’s the old adage of “misery enjoys company.” Unfortunately, this doesn’t do any of them any good, because they feed each others depression, and collectively make things worse. I found that for myself, the best thing to do was to isolate myself until the mood passed. Or at least until I had the strength to venture out again.

People sometimes ask me why I abhorred high school so much. Well, see above. Granted, some (but not all) of that isolation was of my own design, so this is not a black and white issue. It’s also much easier to see the patterns, and understand what was going on, when viewed through 30 years of life experience. If you had spoken with me about this topic back in 1985, I would have given you a totally different account.

Clinical depression is a very nasty condition that can hit from a variety of angles, and in ways that are hard to anticipate and impossible to control. Sadly, the first steps to recovery must be done alone, because the recovery has to come from within.

The patient has to decide that first they no longer want to live this way, and second, they need to seek guidance on how to change. This first phase of recovery is very lonely, and very difficult, because no one else can make that first decision. Others may suggest or advise, but the real decision must be made alone, in that dark, cold, featureless room.

It may sound simple, but it isn’t. There is no help at this stage. Help won’t be available until the patient consciously decides to seek it. For some this first step can be easy, especially if they have a few close friends or family available to support them, and a therapist or other type of mentor to help them find a method of treatment what works best for them. For others the first step can be very difficult, because self-esteem is usually in short supply, and the will to continue frequently ebbs. Such people need a good support network to keep going, and without one, they have trouble. Tragically, for some, that first step can be almost impossible, because they can’t see a way out and there is no one who will listen. Such people tend to suffer in silence until a stroke of luck sends someone to ask “what’s wrong.” Or, even more tragically, they opt for the permanent solution of ending their own lives.

Perhaps the most frustrating aspect of clinical depression is that it can’t really be cured. It can only be treated and managed. The black cloud can be kept at bay, but for most it never completely goes away. It’s always there, always waiting for a chance to plunge the patient into darkness again. Like any chronic disease, clinical depression can make even the simplest of days difficult to face.

Don’t let people tell you this disease isn’t real, because it is. If someone tells you that it’s “all in your head,” well, remember this quote from a famous fantasy novel:

“Of course it is happening inside your head, but why on earth should that mean that it is not real?”
― J.K. Rowling, Harry Potter and the Deathly Hallows

And then tell them to do something anatomically impossible.

So Eeyore, you are very lucky, and you are awesome. You have a way to deal with your depression, and you’re using it. You have a group of friends and family to help and support you, even if all they do is keep the doors open, and the lights on. You’re working through it. There are a lot of us who are right there with you, slowly but surely moving forward, battling the monster that is clinical depression, one step at a time.

Keep it up, little guy. Your silent determination to steadily keep moving is an inspiration to many.