This post has been a long time coming, as it has been dwelling and languishing in my house of avoidance. Typically, I composed blog posts, edited and posted them. This one was minimally edited, against my better judgment as a wordsmith. It needed to remain in its raw, almost draft state, in order to convey the events accurately.
I am Clinically Depressed.
No, I am not “sad” or “melancholy,” as those terms lack the depth to describe what I have felt. Or in my case, haven’t felt.
According to Web, MD., “clinical depression is marked by a depressed mood most of the day, particularly in the morning, and a loss of interest in normal activities and relationships — symptoms that are present every day for at least 2 weeks.” Signs and symptoms include, but are not limited to:
Significant weight loss or gain (a change of more than 5% of body weight in a month) [Yes, there should be a proper citation here, but I need to exorcise this post from my psyche before I chicken out and retreat into my fortress of solitude. So, fellow wordsmiths and scribes, bear with me.]
I started this blog when I returned to undergraduate studies to complete prerequisites to apply for nursing school. After attaining a 3.8 GPA, being wait-listed, then accepted, I began the RN Level I course in the Fall of 2011. The material was challenging, in ways I never expected. To say that I was ill-prepared would be a gross understatement of epic proportions.
I graduated with my BA in Criminology in 1991, so my expectations were completely inconsistent to the new way of work of higher education. For example, I went to class with a course syllabus, notebook and pen, took notes, read my textbooks and supplementary materials, studied both and took written exams. In 2011, there were syllabi, textbooks, e-textbooks, videos from the textbook manufacturer, YouTube videos, Power Point slides, sample tests from an outside company used as predictors for the NCLEX Board Examinations, digital records of lectures and my own personal notes. This was for the lecture portion of the course, only. The practical/hands-on Clinical portion had it’s own syllabus, notes, “check-off” preliminary skills practice and finally, the formal hospital rotations working directing with RNs and their patients. I received a “B” in this class. I was 43 years old.
Spring of 2012 brought Level II (Medical Surgical Nursing and Labor and Delivery) and Pharmacology. I received a “B” in Pharmacology and a “D” in Level II. My instructors revisited and regraded each of my tests and quizzes because they could not understand the disconnect between the student they saw explaining concepts to classmates and practicing safely on the hospital floor, with the final grade of 79% (D in my RN school). My Clinical Instructor, who has sense become a good and trusted friend, asked me if I had ever been tested for Learning Disabilities. Having gone to a major university in the 1980s/1990s, before Learning Specialists were on staff, and performing well in my classes, I never considered it. I visited our college’s Learning Specialist who referred me to a Licensed Mental Health Therapist, specializing in Adults with Learning Disabilities.
At my first visit with the LMHT, he tested me for Learning Disabilities and determined that I had Adult Deficit Hyperactivity Disorder (ADHD), with an emphasis on Distractions. He described my brain as being a shelf with cubbieholes. Each cubbiehole was a part of my brain and as long as each cubbie was filled, I was able to function well. My challenges were when I had to concentrate on only one item and leave all the rest of the cubbies “empty.” My brain would naturally want to fill them up. In layman’s terms, I was/am fantastic at multitasking, but terrible at concentrating on one project alone. This served me well when I was working professionally, but was my kiss of death in Nursing school, where any tiny distractions would pull my attention away from the material I was supposed to be learning.
The college allowed me to re-slot back into a Level II course in Fall 2012, while my classmates moved on to Level III. Along with swallowing my pride, ignoring the growing guilt about “wasting” money again, trying to ignore my feelings of inadequacy and embarrassment at having to repeat a course for the first time in my life, I retook Level II, this time with appropriate accommodations for tests, which included a quiet, private room and extra time to take the test to allow for mental “refocusing” breaks. I don’t think I ever fully processed my personal biases against needing ADA accommodations, because I expected I would “snap out of it,” as my father suggested. Of all the courses to repeat, the irony and agony of retaking Level II, with its emphasis on Labor and Delivery, was not lost on me – a childless middle-aged woman. I made it through with a “C.”
Spring of 2013, brought with it Level III (Medical Surgical Nursing, Pediatrics and Hospice Care) and Psychosocial Nursing. I received a “B” in Psychosocial Nursing was the only person in my class of 30 students who actually looked forward to our clinical rotation with Mental Health patients, or “my people, as I began to think of them, almost immediately. I passed Level III with a “C” and thought it was the most rewarding Medical Surgical Nursing rotation, because I had so many hands-on experiences, it re-energized me for the final semester and was working with a population very precious to me – Veterans.
Summer passed quickly and I looked forward to completing Level IV, Role Transition in Nursing and the Nursing Care Management Practicum (aka. Management rotation). I received an “A” in Role Transition in Nursing, because it was not academically challenging, but took precious time away from my Level IV study time. Level IV and Management ran consecutively, and in order to qualify to take Management you had to successfully complete Level IV with a “C” or better. Adding to the pressure was the knowledge that at the end of Level IV were two exams, the Level (or class final) exam and the ATI comprehensive test. Students who did not pass the ATI test – a predictor for success on the NCLEX – were ineligible to proceed to the Management rotation. Consequently, the amount of stress we were under was tripled. Needless to say, I cracked under the pressure and finished Level IV with a 78%, another “D.” Ironically, once my grade was posted I felt an immediate sense of relief. Unfortunately, I had to share the news with everyone I knew, including my parents who had changed their travel plans to ensure they could attend my RN Pinning Ceremony and Graduation. That was probably one of the hardest phone calls I’ve ever had to make.
Additionally, at a time they should have been celebrating, my classmates were stunned, sad, and angry….very, very angry. Out of 112 students in our Level, 27 of us failed to make the Management rotation. As competitive as we were with each other, the nature of Nursing school (and the Nursing profession) was infinitely more congenial, team-oriented and we became a “family.” They wanted to know why their teammates would not finish the program with them. And they vocalized this, loudly. It was just before Thanksgiving 2013 and I was 44 years old.
As this was occurring, I took to my bed.
For the next two and a half months.
I dragged myself out of bed, showered and participated in holiday activities, or what I labeled, resentfully as “mandatory family fun.” When December ended and January began, my husband, who had been my rock during this entire episode, suggested I speak to my Primary Care Physician about my “lack of moods and tired feelings” at my annual physical. I will forever be grateful to him for this, but at the time, I simply wanted to be left alone to be in my room, pretending to read, sleep or watch funny animal videos online.
My Primary Care Physician was a Puerto Rican woman, whom I adored, admired and respected. She was the right person to discuss my condition with me. All of it. The comforting numbness, the security blanket of obesity that I had started weaving around myself, the lack of interest in anything and the heart-stopping pain of knowing I had disappointed everyone…including myself. In our typical Spanglish, we went through issues I had never discussed with a doctor. Ironically, Nursing school deserved a great deal of the credit. One of the skills we practiced from our first day on the floor with patients, was teaching. I was a natural teacher and I enjoyed it. So, if I was able to ask men in their 60s, 70s and 80s about their current sex lives, and ensure they were using condoms correctly, answering similar questions about myself should not have been a barrier. It wasn’t. In fact, it was the first time in my life that I had been asked many of the questions.
My doctor became concerned when we discussed my mental health. and she asked me to describe how I felt.
I never felt sad.
I never felt happy.
I felt mildly to severely inconvenienced and numb.
Devoid of all emotions, feelings and sensations, as if I moved into
a fluffy, shock-absorbing, grey Cloud where all lights and sounds were muffled.
Waking up and engaging the world required more energy than I could, or cared to, muster. Showering, washing clothes and spending time with people entailed bracing myself for questions I had no answers to, conversations I had no desire to participate in, and were physically and mentally draining.
I had become comfortably numb, just as described by Pink Floyd.
The truth was…I liked it. It worked for me. On every level.
Numbness required little or no time away from wallowing in my own self-pitying disappointment. Unfortunately, as a “responsible adult,” numbness is frowned upon as a way of life. It prevented me from engaging in life. I was a failure in school, unemployed and rudderless. My security blanket of obesity had taken me past the point of being an unattractive “fat person,” and into the realm of “the invisible people” quite effectively.
To my doctor’s credit she listened. Carefully. She referred me to a therapist and prescribed an SSRI (Selective Serotonin Reutake Inhibitor), that I immediately researched in my Nursing Drug Guide. Simply explained, serotonin, a neurotransmitter, is responsible for sparking the body’s natural chemicals that control feelings of happiness and well-being. The body distributes it when needed, and then collects it, when not. People with depression, tend to lack enough naturally-occurring serotonin, or too much is recollected at the end of emotionally difficult or sad moments – resulting in the “numbness.” Additionally, the SSRI prescribed me would help my lack of focus, related to my ADHD.
I resentfully, took the loading dose (30-90 days), and noticed a gradual change in my moods and energy levels. Not a “magic pill,” by any means, as all it did for me was begin to dissipate my Cloud. But, I resisted. Dissipating the Cloud would allow the sunlight of self-exploration to take place. It would require me to notice and acknowledge my obesity blanket and begin to reconnect with others. I wasn’t sure I wanted to do any of that.
I really loved my Cloud, dammit. Cloud understood me without judgment. She was my mistress and best friend. She was also my greatest enemy, and a jealous one at that. That was February 2014 and I was 46.
For the next few months, I struggled to find myself. Every day Cloud waited patiently for my return, letting me I know she loved me more than anyone, just as I was. I am disgusted to admit that more often than not, I would let myself float into her beautiful numbness, as my medication would begin the arduous process of pulling me back out. As I was experiencing the allure of numbness and the frightening thought of leaving Cloud behind, I stopped being a wife. I simply was not interested in any of it. For months, my husband would come home from work, only to find me lying in the same position I had been in when he left for work at 5:30 every morning. Dishes went unwashed, dogs were not walked, dinner was not cooked. His patience, already worn thin from dealing with my stress during Nursing school, disappeared. For weeks, then months, we lived an existence of cohabiting strangers.
In October 2014, a dear friend whom I met working on political campaigns sent me a Facebook message. He recommended me for a job as a Regional Field Canvass Director for a political action committee. After all, I had done community organizing work for years and had the necessary networking and human resources experience to successfully do the work. Thinking this would be a great transition, from unemployed to temporary employment, I accepted the position. Then lasted two days. My husband saw me for my dinner “break” on the first day and grew concerned, as he said I was simply staring into space and speaking in tongues. On the second day, he visited my office, helped me out of my chair, waited until I had sent my resignation email, and escorted me home. The only word out of his mouth when he saw my work environment, was, “no.” In fact, he called my parents and in-laws to give them his impressions of the “cold, ugly, white box” I would have to work in. He told them, “I just got glimpses of my wife back. I am not willing to knowingly send her into an environment that will only make her worse.” Like I said, this man was my rock. He knew and supported me like no other.
But, Cloud was already there. Soothing me, reminding me how much better I was wrapped up in my blankets at home. She was right.
This proved to be but a minor setback and the climb out of Cloud was easier.
In December, my Father arrived for a Christmas visit, and repeated his “my daughter was confident and fearless, this is only a phase, just snap out of it,” mantra. I heard similar versions, in various levels of resentment from my mother, mother-in-law, and several friends – dissonance. I have always been able to tune people out so well and quickly, that it makes my own head spin, sometimes. Frankly, I have never cared if they knew it.
2015 arrived with a renewed, albeit cautious, sense of purpose. And Cloud. Always waiting patiently to embrace me in her soothing emotionless depths and play my new theme song, Bad Day by Fuel.
Before I flunked out of Nursing school a dear friend I met in Level I and I found very inexpensive tickets to New York City and planned a girls’ weekend to celebrate my graduation and Pinning. Needless to say, I neither graduated nor received my RN pin, and now had nonrefundable tickets to New York for the four days before St. Patrick’s Day. I asked my family to help me take the trip, and they agreed. By now, my parents were fully paying my mortgage, so I was asking two retirees for money to take a leisure trip. The ugliness and lack of fairness was not lost on me, but I was learning my new normal. I had a wonderful time in New York and was reminded of when I would travel there for business, years ago. Suddenly, I began to see, and miss, the old me. And Cloud knew. She always knew.
Cloud reminded me that my “new” life was online – a mixture of reality and fantasy. Interactions with strangers who now knew more about me than my own family. Sharing myself in depression-themed and other chat rooms, finding kindred spirits who never asked me to change or leave the house. Cloud approved of my new friends and generously created more space for me to experience these relationships within her numbing comfort.
Which brings me to the present, and the impetus for finally writing this post: a new friend. A new friend who sees more of me than I am comfortable showing, and yet, accepts me as a I am. A friend who asked me, rather audaciously, to share how I got here. The boldness of this request both surprised and frightened me, as it would require tracing my steps back to my bottom: the end of Nursing school. It would mean taking responsibility for my own selfish behavior, regardless of whether or not, it was related to my Depression. But most of all, it would necessitate a level of introspection that I had avoided. That I have always avoided. I would have to see my own beauty and worth and begin to tear down walls erected in my late teens and college years. SCARY STUFF, as I preferred to see the beauty in others. Never myself.
So, to my friend, I say, challenge accepted. And to Cloud…bitch, you need to find another mistress. I am 47 years old and Clinically Depressed, battered, bruised, incomplete, but not defeated. May soothing rain fall on me and help me chase Cloud away.
Thank you Ed Sheeran for sharing Foy Vance’s angst-filled lyrics, that moved me beyond words and allowing me to cry real tears of pain for the first time in over eight, or more, years. “Make it Rain,” indeed.
I am thankful for my Nursing school friends, who have become like family. They are some of the most amazing, caring, patient-centered people, I have ever met and I am blessed to be among them.
Today, we took our last exam as Level IV student, and are waiting for the result. For many of us, our final grade hangs in the balance of the outcome of this exam. May we all pass the Level, our End of Program exam, Nursing Care Management and finally, the NCLEX. Namaste.
November 1st – I am thankful for an amazing Level IV clinical group. These are 11 of the most patient-centered, thorough, compassionate people I have ever met. I am blessed to have done my last ADN school rotation with them and would be happy if any, or all, of them were my, or a loved one’s, nurse.
November 2nd – I am thankful for my Husband and Zeke, Hannah Bean and Charlotte (aka. Charlie), my K9 kids. They are all keeping me company as I study for my Level IV Final Exam and I am feeling the love.
I was FINALLY able to relax on the patio of Cajun Cafe on the Bayou (Pinellas Park), and enjoying a couple of beers, after the end of Nursing Level III. Grades were officially posted and I have a little time off, before next semester.
Cajun Cafe is a local legend, and provides the closest to New Orleans, Creole and Cajun cuisine in all of Florida. It is the only place I have found, that makes boiled crawfish like you would find in Louisiana.
The Cafe also features items from local and craft breweries. I have found a new taste for freshly brewed, IPA (India Pale Ales and sours. Why order something brewed in a factory, when you can sample a delicious, handmade beer?
Yesterday I celebrated getting through Nursing III and Psychosocial/Mental Health Nursing. Nursing III, at my ADN program is a combination of Medical Surgical Nursing and Pediatrics. The other component is Psychosocial Nursing, or what I like to call, “MY PEOPLE!” My celebratory drink of choice was a Sangria, with copious amounts of red wine.
Before starting the program I knew I would be most attracted to Psych Nursing. After all, my B.A. and graduate work was in Criminology and Public Administration. So, not only am I already interested in the subject matter, I am fascinated at how our minds work. The complexities of the brain are endless.
I had the honor of being placed in the clinical rotation at our local Veteran’s Administration hospital, a place I am familiar with, as the wife of a Gulf War-Era Veteran. The experience, as a Student Nurse, did not disappoint. In fact, it has been, bar none, my best clinical experience in Nursing School. I live in an area with outstanding teaching hospitals. And, I attend the ADN program with the best local reputation, for preparing students well. Better than the four-year colleges.
The VA was a dream clinical assignment. Everyone, from the Veterans and their families, to the nurses and doctors were welcoming. I was asked repeatedly, “When are you graduating? Are you coming to work here? We need more nurses, here, you know?” All I wanted to say was, “I WANT to work here!!” Because I do. Specifically with mental health and/or PTSD patients.
Next Semester, my final semester, I have the opportunity of going back to the VA. In fact, there is a strong possibility that I can go back to the same unit I worked on this semester. Not only will I already know the charting and MAR systems, I will know the nurses and may likely select a Nurse Preceptor from that group. My other option is to select a different clinical site, to learn another system and expand my professional circle.
For now, however, I am enjoying some much needed time off! My pedicure is scheduled for tomorrow and I am volunteering at the Pinning Ceremony for the Spring 2013 graduates. I will bid them good luck and Godspeed and prepare myself for Level IV.