Guest Post - I am a High-Functioning Depressed Person - Alex Davies

I am a High-Functioning Depressed Person

High-Functioning Depression

High-functioning depression is something that’s not talked about a lot.  Whenever I’m on social media, looking through some of the hashtags or talking to the different people on there, I find very few mentions of it.  It’s something I feel needs talking about.  So I’d like to tell you a bit about my depression and how I am a high-functioning depressed person.

When talking about depression, for those who haven’t experienced it personally, people often picture someone like Eeyore from Winnie-the-Pooh: someone who is gloomy, pessimistic and anhedonic.  If you think of the stereotype, it’s often someone who might look a bit like this:

Does that look familiar?  Your stereotypical, socially-perceived depressed person.  Well, what people don’t always realise is that there are two types of depression.

This one is known as low-functioning depression.  It’s what society commonly perceives to be “depression” and it’s where stigma creates one of the biggest problems for people who are depressed, because it’s “the way we should be”, even though that’s not the case.

The Reality of High-Functioning Depression

As you may have guessed, high-functioning depression is the complete opposite of low-functioning depression.  We don’t get stuck in the funk where we cannot do anything, we don’t spend hours upon hours trapped in our beds, we function more than that.  If anything, we appear to be normal members of society.  That does not, however, mean that we aren’t struggling.  Check out this article by amysboarderlineworld, which sums up what I’m trying to say quite nicely.

You see, we might appear to be normal, functioning members of society but that is an illusion, a myth we have created for others to see.  We struggle, perhaps just as much as someone with low-functioning depression.  We just continue along our lives as though nothing is wrong which, in turn, makes us seem like nothing is wrong.

That is the reality.  The struggle.  People see that we are “normal, functioning members of society” and assume that we are not depressed or anxious (as that’s the thing, it isn’t limited to depression).  Unfortunately, it’s the way it works, for people seem to think we are, for want of a better word, “normal”.

But we’re not.

I’m a High-Functioning Depressed Person

In reality, you won’t see me struggling.  I’m good at hiding it.  Very good at hiding it.  Look for it and you might miss it, because we get on with what we need to do.  I certainly do.  Even on the bad days, I’m frequently plodding along with whatever I need to do.  At work, back when I worked at the bank, I was often on a bad day yet no one knew.  Out of 100 employees who worked in the same office as me, only one person ever frequently picked up on my bad days.  In some cases, I’ve been on self-destructive bad days with blood leaking from self-harm wounds.  It’s not been pretty.

So high-functioning depression and anxiety is something we need more awareness of.  We need to get those discussions going! 

New Blog Post! Sharing a Chapter of my Memoir! - It's Not Your Journey

As long as I can remember, I’ve been dealing with social anxiety.  When it first started, I didn’t realize that what I was feeling fell into any particular category.  I’m glad to know now, but I’m wondering if it’s somehow made me even more susceptible.

I’ve always had poor self-esteem.  It comes from being overweight as a child.  It’s even worse now as I’ve gotten older and added more weight.  There’s a constant running dialogue in my head when I’m in public.  If someone looks at me, my brain automatically says, that’s right, stare at the fat girl.  I’m perpetually consumed by what people think, and what they might say when I’m not looking.

Ironically, it’s even harder when I’m with people that I know.  I’m always wondering if they noticed that I gained weight, can they see that pimple on my face, are my clothes OK?  Then I will start comparing myself to them.  Look at how good she looks in those jeans; I wish I could look like that.  I know it sounds absurd, but it’s extremely hard to overcome.

The Social Anxiety Institute characterizes social anxiety by this definition:

Social anxiety is the fear of interaction with other people that brings on self-consciousness, feelings of being negatively judged and evaluated, and, as a result, leads to avoidance. It is the fear of being judged and evaluated negatively by other people, leading to feelings of inadequacy, inferiority, embarrassment, humiliation, and depression.

If a person usually becomes (irrationally) anxious in social situations but seems better when they are alone, then "social anxiety" may be the problem.

So, it seems to me I have a textbook case.  What the definition doesn’t mention is the physical response.  The knots in your stomach, sweating, breathing heavy, crying and shaking, all of which occur for virtually every outbreak of anxiety.  I’ve never sought out any specific treatment to help me control these symptoms.  Maybe it’s time that I do.  I often miss out on important events because the anxiety is so overwhelming.  Without a medication like Xanax, I’m totally lost.  Just getting in the car sometimes terrifies me, and all of this ties nicely into my Agoraphobia.

Medicinenet.com describes Agoraphobia with the following definition:

An abnormal and persistent fear of public places or open areas, especially those from which escape could be difficult or in which help might not be immediately accessible. Persons with agoraphobia frequently also have panic disorder. People with mild agoraphobia often live normal lives by avoiding anxiety-provoking situations. In the most severe agoraphobia, the victims may be incapacitated and homebound. Agoraphobia tends to start in the mid to late 20s, and the onset may appear to be triggered by a traumatic event.

These conditions are very similar to one another, but even so, having both of them is a nightmare.  I’m making a confession; I haven’t driven anywhere in over a year. Joe does currently have to take my car to work, but even if he was home, I wouldn’t just hop in the car and go somewhere.  Between the Agoraphobia and just general anxiety, I’m afraid to drive.  There have been times when I’m driving down the road, or making a turn, and I can’t get the image of another car hitting me out of my head.  It’s scary stuff.  So, like a lot of people, I turn to avoidance, which is the wrong response.

So, now what?  Being aware of my issues hasn’t ever been my problem; it’s following up on treatment that’s the real puzzle.  I do have good news in that area, however.  I finally went to see a new psychiatrist.

If you’re unaware, for roughly three years (since my suicide attempt), I have only been seeing my primary care doctor for medication management.  However, he has run into some roadblocks with the insurance, so we started looking.  I found someone, and I really like her.  She’s the first mental health care provider that I have been to in about ten years that genuinely seems like she’s listening, and she actually cares.  I’m grateful for that.

I started two new medications; one for depression and one for restless leg syndrome. She also increased my anti-anxiety medication, which is a huge blessing. So far so good, except for being drowsy during the day.  It’s a side effect that I assume will gradually wear off.  If that’s all I have to worry about, I would say I’m ahead of the game.  Once again, it was suggested that I try therapy.  Perhaps I will.  If nothing else, I will meet the therapist that she works with and see if I’m comfortable.  If not, I won’t continue.  So, I feel like I’m off to a good start.  What about you?  Do these definitions seem familiar to you?  Were you even aware that there was a name for what you were feeling?

I’m working on it, and I think I will get there.  I’ve said it so many times before, but I’m so grateful to have the support of my husband.  Without him, there would be no me.

For now, I’m going to keep moving ahead and being grateful for the good days. I will focus on my healthy eating and healthy lifestyle.  We bought a heavy (punching) bag that we put up in the basement so I can let out some anger and frustration while hopefully helping me get in shape.  I’m very excited, and I know it will help with my anxiety level.

So, for now, hang on tight! It’s going to be a bumpy ride!

Guest Post - The Workplace Incident That Changed My Life - Davina Lytle

I remember August 9, 2005 like it was yesterday. That’s the day the person I used to be died in a workplace accident. The day a disgruntled client walked into the company I worked for and threatened my life. 

The event left me unable to work at that job and as it turns out, any job, due to post-traumatic stress disorder (PTSD) that took over my life from that day on.  

Sadly, this all could have been different had my employer understood the importance of responding more effectively to a workplace trauma to help prevent or at least reduce the risk of psychological injury.  

On that fated day, it was especially busy because the receptionist had called in sick and I was covering her job as well as my own. Around 2 p.m. a dishevelled looking man came into the office. I can still clearly remember that he was wearing khaki pants and a red golf shirt. He approached the desk and angrily asked to see the manager. I asked him for his name and with a serious face, he told me to tell the manager, “It is Dracula and you don’t want to see any blood.” I was shocked at this and asked again and received the same response. I felt a shiver up my spine and my stomach clenched. As I picked up the phone to call Mike*, who was the manager, the man leaned over the desk threateningly and said, “Tell him I have a gun.” Mike overheard this comment and asked me if I saw a gun. I repeated what the man had said. 

My heart sank and all I could think was that I shouldn’t even be here as my daughter was at home sick and I ought to have been looking after her. In that office however, calling in sick could get you fired.

I had no place to hide and truly believed he was going to kill me. There was no way I could get away. 

I looked up at him trying to see if he actually had a gun and he repeated the threat saying, “You don’t want to see any blood do you?” I backed away instinctively, thinking only of how to escape. I had never been so afraid. I didn’t believe I was going to get out of this alive. I’m not sure what I said to him other than offering him a glass of water. I know that sounds strange, but our boss, Susan*, was very strict about making our clients comfortable. This was another issue she brought up regularly to threaten us with dismissal. 

By the time Mike came into reception the man had calmed down and the police were on the way.

I grabbed my purse and ran out to my car. I was shaking uncontrollably and don’t remember picking up my daughter who I was taking to the doctor. On the way, my boss, Susan called. She asked me if I was okay and I told her I wasn’t sure. She said the police were coming first thing in the morning and that I needed to write down what had gone on with the man in the red shirt, word for word. She also said she wanted to see Mike and me in the morning before we talked to the police.

While I was at the doctor’s I went over and over what had been said. When I got home and started writing it out, the reality of the situation hit me. I broke down and sobbed. 

As I drove into work the next morning, I couldn’t stop shaking. I thought the man in the red shirt would be angry the police were called and he would be waiting to finish me off. I pulled into the parking lot, but froze, unable to get out of my car. I truly believed he was going to come back and show me “blood,” and I started to cry again. After about 10 minutes a co-worker pulled into the parking lot beside me and smiled. I felt relieved, wiped my tears, grabbed my purse and got out of the car.  

What happened next felt like further trauma. It started with my boss telling Mike and me to “suck it up.”  She said there was no need to be shaken up because they knew the assailant. He was a long-time client, who had recently lost his business and separated from his wife. Mike’s attempts to collect $3,000 the man owed to the company had been “the last straw.” She asked for our copies of the conversations we’d had with the man and then told me to wait for her and the police in one of the meeting rooms beside the reception area. I felt terrified and all I could think about was the need to get out of there and find somewhere safe, but I was afraid that I’d lose my job if I left. After a long wait, Susan and the police officers came into the room and started questioning me. It felt like I was being grilled as if I was the criminal. The sting of that exchange still haunts me.

I learned that the police had gone to the man’s house to question him after the incident. Their words to me were that he was “just having a bad day.” When I asked about the gun, they said he didn’t have a gun registered to his name so there “mustn’t have been a gun,” it was “something he made up.”  

I was also told that because he didn’t actually say he was going to kill me, I couldn’t press charges.  Only the firm could, but wouldn’t because they were up for a business award that year and didn’t want the publicity. My boss said that they felt that cutting ties with the client should be enough. 

It wasn’t. With no support either professionally or socially I wasn’t able to continue working at the firm. It was years before I could drive anywhere near that area of Burlington, because I was still afraid that the man with the red shirt would be looking for me. I had no control over these feelings. Despite my bosses and law enforcements perspectives that the threat wasn’t real and therefore didn’t require a response – it was very real to me.  

I was diagnosed with PTSD (post-traumatic stress disorder) and told by several specialists I would never be able to work again. I was and still am being alienated by some of my family and friends because they can’t, or don’t want to understand why I don’t “get over” it! Dr. Viacheslav Wlassoff (Brainblogger) says “There is no use telling PTSD victims to “get over” it because PTSD fundamentally changes the brain’s structure and alters its functionalities.” The shape of our brain; particularly the hippocampus, changes and PTSD victims are unable to discriminate between past and present experiences.  For instance, one of my biggest fears is going anywhere I could get held up and for me that means wherever there is money being transferred from hand to hand. Banks, grocery stores, gas stations, restaurants, special events, etc.  For most people these are safe places and the chance that something bad is going to happen is slim, but I have a psychological injury and my brain has trouble distinguishing between past and present. I am hyper-vigilante, and on guard all the time.

I have panic and anxiety attacks. I sweat so badly because of my fear I have to carry a change of clothes with me at all times.  Simple tasks like being a passenger in a car, are so stressful for me, I need to take meds to calm myself before I go out. I have nightmares so vivid that I’m literally afraid to go to sleep and the lack of sleep makes me so tired that I’m unable to concentrate.  I double book myself all the time, or forget things completely. There are many days I’m so afraid I won’t even open my curtains.

During the first five years of being diagnosed with PTSD, I went through four assessments with four different facilities. Each time I was put through an assessment, it triggered a difficult emotional response and I would become suicidal.  The rejection from some family members when I would talk about my diagnosis or what I was going through contributed to the desire to take my own life. Fortunately for me, my partner was, and still is, there to support me through it.

I tried cognitive behavioural therapy (CBT), which looking back, I believe was worse for me than the trauma itself because it just compounded how frightened I was of the outside world.  Part of the CBT I received was exposure therapy; going to sit in a bank, restaurant or anywhere else that caused my PTSD symptoms to go through the roof and stay there until I felt comfortable.  The extreme stress and mental anguish even thinking about this was horrible. I got my PTSD diagnosis ten years ago and I still can’t do those things without a panic attack.  I have also tried anti-depressants, and sleeping pills; amongst other things to help me get better, but so far nothing has worked.

As a result, I’m the one who has been sentenced to a life where I am unable to conduct normal everyday activities like going for a walk or picking up groceries. I was diagnosed with stress-induced diabetes and central serous retinopathy; which is a serious condition I was told could cause me to go blind if I didn’t get my stress level under control. For me this meant getting rid of the negative people in my life, including family members, because my relationships with them only increased my negative self-talk.  I’m a people pleaser and I always worry when a person doesn’t talk to me anymore, or treats me differently, so this was not an easy task.  I almost always think I’ve done or said something wrong instead of considering that maybe it was the other way around - I think some negative people thrive on that.

I have now started to surround myself with positive people, those who would never think of questioning why I wasn’t the same person I once was. People that embrace me as I am because they know that if I did have a choice about my injury, things would be so different. Surrounding myself with supportive people is not just comforting - there is evidence that it can help prevent and heal trauma.

I recently read that a research study in the U.K. showed that perceived social support reduced the severity of PTSD symptoms that could lead to suicide. Social support at work has been defined by Cobb (1976) as the belief that you are valued and that your well-being is cared for as part of a social network of mutual obligation. For those who perceived themselves as having high levels of social support, resilience was improved and the impact of PTSD symptoms were lessened.

I fully believe that a supportive response from my employer and recognition that I had experienced trauma would have encouraged me to reach out for the help I needed in time so that I could have continued working. Further, the workplace could have put processes in place so that I, along with my co-workers, felt safe and supported. This might have included:

• Making counselling support available through the company’s Employee Assistance Plan or a community resource. 
• Having a more supportive process for investigating, following up and recording the incident.
• Communicating how to prevent or respond to future incidents including conducting a risk assessment.
• Delivering an education program on prevention of workplace violence.
• Ensuring that the organization's direction for workplace safety was reflected and highlighted into corporate and service-specific goals.

My workplace’s response was ineffective and made my symptoms of PTSD even more severe. They didn’t and still don’t get it. 

They say I’m not the person I used to be and they’re right. That easy-going, active, friendly woman doesn’t exist anymore. She died in a workplace accident 10 years ago. The worst part? Her injuries could have been prevented.   

*Names have been changed

Published by Moods Winter 2016 - Workplace Mental Health http://www.moodsmag.com/moods/order_previous_issues.php