A Woman on the Other Side of a Nervous Breakdown
Medication helped ease the immediate symptoms of the anxiety and depression that made me want to die, but I wanted a more sustainable solution
The summer in which I was 34, I came to believe I would be better off dead than to feel the constant and excruciating emotional pain that had become my daily existence.
That pain was due to a nervous breakdown that had been building up after years of struggling with anxiety and its frequent partner depression, a psychological event triggered first by the death of my mother and then the biggest heartbreak of my life about a year and a half later.
My mother died in October 2004, around the same time I was extricating myself from a co-dependent, abusive relationship. 11 months and one day later, I met a man I thought was “the one” but who himself was manic depressive and who would take me on a toxic roller coaster ride of emotions for the better part of two years.
Somewhere in the middle of that relationship, during which I was still grieving the loss of my mother, I hit a very solid and unrelenting wall in my capacity to sustain my mental health.
The ensuing emotional breakdown and its suicidal ideation inspired me to consider checking myself into a mental-health facility before sending me down the path of pharmaceutical intervention for my condition. For a time, I used prescribed medications to help ease my symptoms and help me find my way back to some semblance of sanity.
However, I found that though they helped for a time, medications weren’t a long-term cure for my underlying condition, and they didn’t help me create a lifestyle focused on consistent mental health. So eventually, I sought out and found a more sustainable solution that serves me even now, living a life full of joy and gratitude nearly 16 years after I felt so desperate that I wanted to die.
Summer of My Malcontent
It was mid-July 2005, and I had just returned to my then-home city of San Francisco from a trip to England, having chased the object of my desire to Shropshire, where he had a summer stint as an sculptor in residence. During my visit, he completely obliterated any hope I clung to that we could reconcile by admitting that he was already in love with someone else.
I tried to get back into the flow of my work and my life, but I was emotionally devastated. I was on my way to dropping 20 pounds before the end of the summer — a result of the crippling anxiety that, first experienced at age 21 in the form of recurrent panic attacks, had spiraled out of control. I could barely find the strength or will to feed myself and when I did, I would take two bites and feel sick to my stomach.
Somehow, I managed to sleepwalk through my full-time job as a technology journalist. What happened after work was a different story, however.
As soon as I would walk through the doorway to my one-bedroom apartment in Lower Pacific Heights, I would burst into tears and cry well into the evening. Dinner was anything I could scrounge from the refrigerator — one night it was the last sad bit of a rind of Parmesan cheese and a hard-boiled egg.
I would decline most invitations from friends to go out, even though I typically led quite an active social life. By 8:30 or 9pm, I would sink into an exhausted sleep that would only last a few hours before anxiety and dread set in once more. I would spend most of the darkest hours of the morning awake as I ruminated and lamented obsessively over the details of my failed relationship.
Something Had to Give
This was every day of my life for about a month before I knew I had to change something. One thing that kept my head above water (barely) was that I had quite a good therapist. She suggested I see a psychiatrist and get myself a prescription for some medication to help me navigate a situation that was clearly becoming untenable.
After one appointment with a psychiatrist, I had prescriptions for anti-anxiety, anti-depression and sleeping pills. (Yes, it was that easy.) Before filling those prescriptions, however, I took the psychiatrist’s advice that perhaps a brief stint at an in-patient facility for people who were mentally unwell would do me some good.
The day I had an appointment to visit the mental-health treatment center, I managed to drag myself out of bed, put on a summer dress and even some lipstick, and drive myself to facility south of the city.
I was invited to join the center’s current residents as they were shuffling in for a morning group therapy session. They looked largely unwashed, many still in pajamas, with most seeming a fair bit less alert than me. They looked at me curiously and warily, as if I was a rare species of animal that they couldn’t quite identify.
No offense to any of those poor souls — as my heart went out to whatever illness or experience had led them to that room — but the whole scene left me feeling even more depressed than ever.
So meds it was. It would take a few months to get the dose right, but the initial “placebo effect” of just taking action meant that I did start to feel better almost immediately.
Fresh Start
I even felt well enough to make a planned move the next month to New York City, where my company asked me to fill a recently vacated position.
It had always been a dream of mine to live in New York, and it was about a 90-minute train ride from where I was born and where my father, sister and her family lived. I thought given the circumstances, it was a good decision to reconnect with them.
For awhile, it was, and things stabilized. Although I was terrified and cried often at the stress of starting over alone in such a big city, I took it day by day and tried to find a rhythm to my new life.
Luckily, I had a few acquaintances who became friends and warmly welcomed me to the city and helped me settle in, inviting me for dinner, events and all the other social opportunities that what I still consider the greatest city in the world has to offer.
I eventually moved to a shared apartment in Spanish Harlem, then to my own place in NoLIta, befriending a young woman from Dublin who managed a local restaurant and became my partner in crime for hitting the town on the daily for fun and frolic.
I continued on the medication — in San Francisco it had been Effexor, but in New York it was a combination of Wellbutrin for daily mood control and the occasional Xanax that I would take only when the anxiety became crippling — and for a time I managed.
Throughout it all, I continued to exercise regularly, jogging and even cycling through the city, walking or taking the subway nearly everywhere most of the rest of the time. I started playing tennis again, a sport I had loved as a child and played at the club level at university, joining a group that organized lessons and meet-up events throughout the city.
I kept myself as busy as possible to stave off the darkness, which only haunted me when I was sober and alone. Naturally, I tried to avoid either these scenarios as much as possible.
I knew drinking alcohol was a bad idea that would only compound my depression and anxiety, but I was young and single in New York City, and I was determined to take advantage of the opportunity to attend dinners and social events — most of which of course involved alcohol — to the fullest extent.
Unsurprisingly, I still wasn’t happy, and still experienced bouts of crippling anxiety and depression that resulted in taking most of my sick days at work as “mental-health” days. I ultimately knew this combination of pharmaceutical medication and self-medication was not the way forward if I wanted to reach full mental health and stability.
Eventually, I began to explore the possibility of a healthier lifestyle across the board, one that didn’t require me to be medicated in some form or another — whether it was by pharmaceuticals, alcohol or the company of other people — to feel calm, safe and content.
The Unmedicated Solution
The first variables that I considered eliminating from the equation were the pharmaceutical medications, which I had switched several times due to experiencing various side effects that were common with the versions of the drugs available then. They included drowsiness, a lack of interest in sex, weight gain and a bizarre phenomenon I can only describe as a “head zap,” in which occasionally I would feel like someone had suddenly given my brain a very brief electric shock.
One of the therapists I was seeing in New York (yes, there were a few) integrated traditional counseling and psychotherapy with something I had heard of but never understood before — mindfulness, also called Mindfulness-Based Stress Reduction (MBSR).
MBSR is an idea based on meditation and other Eastern philosophical ideas that medical doctor and meditation practitioner Jon Kabat Zinn first began using in 1979 as a solution for depression and anxiety in patients who did not respond to traditional treatments.
I told my therapist about the side effects that I was having with my medication as well as the fear I had that if I stopped taking them that I might spiral down the rabbit hole again and find life too difficult to continue.
She counseled me to be cautious and suggested that if I wanted to wean myself off of the meds, I should also consider enrolling in the eight-week MBSR course she and her colleague were about to begin. I took her advice, and it was one of the best decisions I ever made in my life.
I’m not going to write extensively about mindfulness here, as there are many resources online to learn about this practice. But suffice it to say, learning to slow down and focus only on the present moment rather than ruminate on past failings or create doomsday scenarios about what the future holds did wonders to ease my anxiety and depression.
I think the greatest lesson I learned from my experience of mindfulness was this: It’s OK to feel bad and even to fully embrace that feeling in the present while recognizing that all feelings, like everything else, eventually pass and aren’t going to last “forever.”
You see, one of the worst things about feeling constantly anxious and depressed for so many years was the feeling that there was something inherently wrong with me, and that I would never be “better.”
“Why do I feel this way?” “Why can’t I be ‘normal’?” “Everyone else seems to manage, why can’t I?” These are common thoughts that run through the mind of anyone who has every experienced any kind of depression, anxiety or other types of mental illness. Mindfulness helped me let go of all these thoughts and accept how I felt in the present moment without judgment.
And the thing is, life is fucking HARD. It is absolutely normal to feel sad, depressed and anxious — especially during such an incredibly confusing, tumultuous and divisive time on planet Earth.
It’s when that depression and anxiety becomes so all-consuming that it stops you from experiencing joy and embracing the people and things you love with gratitude and kindness — so much so that you may even want to end your own life — that you should consider getting some serious help for it.
A Sustainable, Supportive Lifestyle
After I took the mindfulness course, I was able to wean myself completely from pharmaceutical intervention. I have never taken anything prescribed by a doctor for my anxiety, depression or sleeplessness since.
And though of course I’m not always happy all of the time, I can now honestly say I experience at least several if not many moments of joy and gratitude for my life daily, and authentically look forward to living every day with hope.
Though mindfulness is what set me on the path to mental health, it certainly wasn’t the only tool I used to help me coexist peacefully and sustainably with anxiety and depression since that dramatic episode in my life.
Indeed, that’s what it’s about for me — coexistence, not complete elimination. It’s not like my mental-health problems have disappeared completely; it is the day-to-day management of my life that affords me the happiness and emotional balance I have today.
Soon after I went off meds, I moved from New York to Portugal to live in a quieter and more slow-paced community close to the ocean and nature. The move allowed me to reduce a significant amount of environmental stress from my life as well as become a freelancer and have a more flexible work schedule. This also gave me more free time to pursue other interests.
I also adopted a more healthy diet, a commitment to regular exercise — including surfing, a sport I discovered in Portugal that still brings me much joy today, and yoga— and a predictable sleep schedule.
I learned to recognize toxic situations and people and avoid them as much as possible, as well as take as much time as I need to be by myself to recharge my energy when I feel drained from interacting with other people.
I also use various forms of writing as a tool to express myself and my feelings when things become overwhelming. If I find myself particularly anxious about a situation in my life — so much so that I wake up immediately upset and stressed out — the first thing I do before rising in the morning is write out my feelings in a journal. This helps me leave some of those emotions behind immediately so they don’t stay with me throughout the day.
What all this amounts to is this: I am careful with how I live my life now and have adopted a set of tools that I can use if things start to get out of control. I get regular exercise and regular sleep. I retreat to spend time alone if I feel my energy draining. I drink alcohol only in small doses and never to excess.
And after years of being a co-dependent love addict, I am finally partnered with a man who is as emotionally stable as I can be erratic. He is patient and kind whenever my stress levels elevate, which helps to diffuse any potential extreme reaction I might have before it even starts.
Don’t get me wrong — I’m not saying every mental illness can be managed without medication just by making lifestyle changes. For some people, pharmaceutical intervention is an absolutely necessary aspect of a holistic approach for maintaining mental fitness and stability. And some people just don’t have the freedom and flexibility that I did to change my life to reduce external stressers.
But in my experience, people seem to turn to pharmaceutical solutions all too quickly as a quick fix to a persistent mental-health condition by attacking the symptoms rather than the cause of those symptoms. (Don’t take my word for it — this is something Dr. Josh Axe writes about in the medical context in his new book, “Ancient Remedies.”)
In fact, I believe long-term use of medication to treat anxiety and depression, even when accompanied by therapy, may preclude people from ever making appropriate and helpful lifestyle changes that can allow them to live a happy and fulfilling lives even without prescription drugs.
Indeed, while medication can be a solution for the chronic or clinical anxiety and depression that many people experience, I believe it should be used as merely one tool in a set of mindful life practices, not a cure-all or something on which one’s mental health becomes dependent.
In my humble opinion, it’s been far more beneficial to go deeper than simply treating the symptoms of my anxiety and depression to understanding the scenarios in my life that have perpetuated them, and from there create a self-care program and overall holistic lifestyle for long-term, sustainable mental fitness.