Back in 1995, I had just graduated from college but was still living on campus, auditing a classical Greek course and trying to save money for seminary. I didn’t end up saving a whole lot of money, but I did learn how to read classical Greek pretty well.
I also had a lot more free time than I was used to, despite working a full-time job and having the Greek course to study for. College life had been all-consuming for me, and now most of my friends were gone. And my full-time job was at a Walmart distribution center, where my job consisted of taking merchandise-filled cardboard boxes from pallets, sticking UPC labels on them, and putting them on a conveyor belt.
It wasn’t what you would call a mentally challenging job. I had a lot of time to myself. I had always viewed solitude as a blessing, but things had happened recently which made the prospect of being alone with my thoughts less enjoyable.
Before the distribution center, I had had a part-time job at our college’s campus bookstore. That job had also given me a lot of time to myself—I worked back in the stockroom, which was a one-person job given the size of our college. I must have unpacked and stocked a lot of books, but mostly I remember using a lot of Goo Gone to remove price stickers from books to be returned. It was in the stockroom of that campus bookstore that I first experienced a panic attack.
Prior to that point, I didn’t know what a panic attack really was. I imagined it to be something that would manifest itself externally, like flailing your arms around and generally acting as though you were in a panic. But it wasn’t like that for me.
What I remember is an intense sensation that I could not do whatever it was that I was doing anymore. I had to get away immediately. I was shaking, I was unable to concentrate, and honestly I kind of felt like I was going crazy. After a while, I asked the manager if I could go home, because “I wasn’t feeling well.”
(At around that time, in what I had believed to be an unrelated incident, I had woken up in the middle of the night unable to breathe, and had to be taken to the hospital. I was given a breathing treatment and an albuterol inhaler, and thereafter believed that I had asthma.)
Now I don’t remember the exact sequence of events, but I do know that by the time I was working at the distribution center, I had decided to seek counseling. Because I knew that something was up. (Back then, the words “panic attack” hadn’t yet formed in my brain to describe what had happened. I Just knew that I wasn’t supposed to experience things like that.)
This was the first time that I had ever seen a psychologist, or a psychiatrist. I quickly learned the salient difference between a psychologist and a psychiatrist, however: psychiatrists can write prescriptions. So I got one, for Paxil. I was determined to be suffering from depression, and the medication was meant to help alleviate symptoms. I only took it for a short time, however, because the side effects (common to anyone familiar with SSRIs) were startling and seemed counter-productive.
What I know now is that the side effects of antidepressants typically kick in immediately, whereas the therapeutic benefits usually don’t appear for a few weeks. But at the time, I was only feeling nervous and jittery, which was the opposite of what I wanted. I discontinued the medication shortly thereafter, and didn’t ask for another one. I also decided that I didn’t much like my counselor anymore, because I was looking for explicitly Christian answers to my problems, which he was not able to offer me.
That was the beginning of my experience with the world of mood disorders and their treatment. For about the next five years, I didn’t seek out any counseling (or medication), believing that God was going to heal me of my depression. (I had even told my pastor and his wife that I had been healed of it, in the midst of a discussion about a relative of theirs who was struggling with depression. I had wanted that to be true, and I felt that I could will it to be true by proclaiming it to be so.)
Eventually, however, I went back to a doctor (not a psychiatrist) for a prescription for Zoloft, because I had been feeling the depression come back again. Zoloft was similar to Paxil, but this time I decided to stick with it. I skipped the counseling part of the equation because my time in the evangelical Christian subculture (as well as my previous experience) had fostered in me a suspicion of psychologists. Nevertheless, I still ended up discontinuing the medication because I didn’t like the way it flat-lined me emotionally.
This cycle continued for some time: going to a doctor for a new antidepressant, trying it for a while, then discontinuing it. I went through Wellbutrin and Celexa and others that I don’t remember anymore. Finally, last year I got a prescription for Remeron from a bona fide psychiatrist—because I had been admitted to a partial hospitalization program for depression.
One of the most valuable things I learned there was to pay attention to myself. To identify my in-the-moment thoughts, feelings and behaviors, and to trace them back to their possible causes. It’s been a learned skill which I still have to practice, but it led to an epiphany which you can guess yourself, as you read this. My problem wasn’t depression; it was anxiety.
Now, I do need to clarify that all mood disorders generally exist in the same space, and it’s often difficult to tease them out in that sort of concrete, categorical way. “I have depression.” “I have anxiety.” It’s usually a little of both. But what I realized was that for me, anxiety was the antecedent. It was the root cause.
What triggered this realization was a recent visit to my doctor. I came in complaining of possible allergies, and to get a refill on my albuterol inhaler, because I was feeling short of breath all the time. (I had been, on and off, ever since that night I was taken to the hospital 20 years ago.) When examined, the doctor could find nothing physically wrong with me, but gave me the names of a couple of specialists anyway.
Reflecting upon this later, it suddenly dawned on me that I didn’t have asthma (or allergies) at all. The chronic shortness of breath that I had had for decades? That sounded familiar. It was, in fact, symptomatic of anxiety, which I had learned at my treatment center. I also started to notice that whenever I would feel short of breath, I would also feel like my pulse was racing, and that there was an undefined something that I had to do.
I started to think back through my past depressive episodes, and was startled to realize that in many cases, what had preceded the depression was a defensive anger, which was a sort of shield against the vulnerability I felt when I would become anxious about something. Eventually the shield would become too heavy, and I would collapse into depression.
But what lay behind the anxiety? This was the tough one. Not tough to figure out, but tough to admit and confront. What lay behind the anxiety was shame. I felt ashamed of myself, and wanted to get away from everyone, myself included. Oftentimes I couldn’t retreat, so up would go the shield. Then I would tire of that, and the depression would take over.
I’ve also learned that these cycles are learned behaviors. Eventually they can become templates that we use to deal with emotional situations. And that’s the work that lies ahead for me. Dismantling all of this stuff, and learning new ways to handle things.
To that end, I’ve decided to start seeing a counselor again—with a new sense of clarity about exactly what the hell is going on with me. Which may not sound like much fun, but I’m actually looking forward to it. It’s a lot better than the alternative.