Night pt. 2

“The radio stays on all the time.”

Those were the words spoken to me by David when I entered the room.

He was pointing at a shower radio on the windowsill, one given out by the thousands by a local radio station as a promotional item. It could only get one station. The volume was turned up all the way.

I was being assigned a room with David after my Covid test came back negative. Although I had coverage for a private room, the sheer number of patients being held alone in rooms while waiting for their test results throughout the entire hospital meant I would have to stay with another patient.

David didn’t say it in a menacing way, more matter-of-factly. He was about six-foot three and weighed about 260 pounds. I wasn’t going to argue with him but I went to see a nurse.

“David says the radio has to stay on all the time,” I said.

“Oh, right. He needs it on or he becomes agitated and it gets hard to control him,” she responded.

“But how am I supposed to sleep?” I asked.

“Don’t worry. I can get you some earplugs.”

She went behind the counter at the nurses’ station and handed me a little cardboard box that contained a set of squishy 3M earplugs.

“Seriously?” I asked, looking down at the box in my hand.

“I’m sorry, but you’ll have to do your best to deal with it.”

I left the room with its blaring music and walked down the hall. That’s when I remembered something from my previous stay back in 2011—the zombie shuffle.

At any time during the day patients roam the halls. Some do it periodically, others like clockwork. For the most part they shuffle along, head bent, lost in their own thoughts. Racing thoughts, jumbled thoughts, glacial thoughts, anxious thoughts, blackened thoughts.

Up the hall, down the hall, hour after hour.

That’s because there is very little else to do. There is an activity room which consists of word-find puzzles and colouring books. There are dozens of Crayola markers and coloured pencils, although the pencil sharpener barely works, chewing the ends and splintering the wood.

There are also jigsaw puzzles. Dozens of them. All mixed together, impossible to solve.

I had brought a book on the history of the Eastern Front during the Second World War, probably not the best selection for someone mired in a depressive episode. In the end, it didn’t matter as I couldn’t concentrate enough to read.

I joined the zombie shuffle. 

***

The Dutch painter Vincent van Gogh was in and out of metal hospitals—asylums as they were known back then—many times in the years before his death.

He even painted the interior of a ward in Arles, something that isn’t possible today. They take your phone away on admission for “privacy reasons.” They don’t want you taking pictures of other patients and making them public.

This adds another layer to the boredom.

I began to feel it acutely as Saturday dragged on. Vincent, during one of his hospital stays, wrote in a letter to his brother Theo, “The surroundings here are beginning to weigh me down more than I can say... I need some air, I feel overwhelmed by boredom and grief."

I was becoming panicked at the thought of never getting better, never being able to leave the unit.

My depressive episodes are like walking through a tunnel. As I enter and get further in, the darkness in front of me grows and the light behind me fades. Soon, there is only darkness. I can’t see the entrance or the exit.

This is the most dangerous, dreadful time.

This is what Virginia Woolf, one of my favourite writers, wrote in her suicide note to her husband Leonard,

Dearest,

 I feel certain I am going mad again. I feel we can’t go through another of those terrible times. And I shan’t recover this time. I begin to hear voices, and I can’t concentrate. So I am doing what seems the best thing to do. You have given me the greatest possible happiness. You have been in every way all that anyone could be. I don’t think two people could have been happier till this terrible disease came. I can’t fight any longer. I know that I am spoiling your life, that without me you could work. And you will I know. You see I can’t even write this properly. I can’t read. What I want to say is I owe all the happiness of my life to you. You have been entirely patient with me and incredibly good. I want to say that – everybody knows it. If anybody could have saved me it would have been you. Everything has gone from me but the certainty of your goodness. I can’t go on spoiling your life any longer.

I don’t think two people could have been happier than we have been.

Woolf then filled her overcoat pockets with stones and waded into the River Ouse. 

She was in the middle of the tunnel and saw no way out. 

I couldn't see the exit yet. 

"When you're in hell, keep going," Winston Churchill once said. (He coined the phrase 'black dog' to describe his depression.)

I kept trudging blindly forward.

 ***

I spent the rest of Saturday wandering from my room, to the activity room to a lounge at the end of the hall. The TV didn't work so it was always empty. I sat there for hours on Saturday, alternating between bouts of sobbing and silent stupor, numb to the hardness of the institutional furniture.

I tried to do the word search puzzles but I couldn't make sense of the jumbled letters. I wouldn't have been able to pick them out if they were highlighted in pink neon. I tried colouring for a while but it was also hard. Like a child I struggled to stay within the lines.

Afternoon dragged into evening dragged into night. 

I was given my 9 p.m. medication, put in my earplugs and climbed into bed.

The radio stayed on.

Night pt. 1

"Dad, I'm really sick."

I could barely get the words out through chest-heaving sobs. 

I knew this was coming after a night of racing thoughts, panic attacks and overwhelming feelings of impending doom. 

The only way I can describe it to someone who hasn't experienced it is like this...

Think of a time in your life when the mental anguish was almost too much to bare. Perhaps hearing about the death of a loved one, or some other earth-shattering event like the loss of a job or the end of a relationship. I experienced that for almost 10 hours straight with no respite.

The crisis point had come.

Dad has—unfortunately—a lot of experience in dealing with this. He drove over and I was soon sobbing in his lap as he tried to comfort me.

After a short discussion we agreed I needed to go to the hospital. I called my manager and said I would need extended time off, shuffled upstairs and packed a bag with enough clothes for a week. The last time I received in-patient treatment in 2011 I stayed three days. I had no idea how long this stay would last.

"And what brings you here today?" asked the emergency room intake nurse when I arrived at Royal Victoria Hospital in Barrie.

"Self-referral for a mental health crisis," I answered.

I was given a wrist strap and within 30 minutes they started the intake process.

The first thing they do is place you in a safe room next to the ER and give you a nasal swab to test for Covid-19. The room is bare except for a a slab-like bed with anchor points for restraints if needed. By the screaming coming from a couple of adjoining rooms I suspected some other patients were being held down. 

There is a security camera on the ceiling and nothing else. They took away my bag and boots and I was given a set of orange scrubs. This is done for a couple of reasons. 

First, to take away anything that could be used to hurt yourself or others, like shoelaces or a belt. 

Second, so that you're easily identifiable as a mental health patient. I found out later that, as a self-referral, I was permitted to wear my street clothes. Only those who were committed involuntarily were required to wear the scrubs. (Although they wouldn't let me wear my Blundstones, even though they are pull-ons. I brought my slippers, which turned out to be fortunate as you'll see in the next entry.)

I sat on the bed and tried to calm my racing mind. It wasn't easy due to what was happening just outside my room. The woman in the room next to me was highly agitated, pacing up and down the hall. She was muttering to herself. Several times nurses told he she needed to wear her mask when outside her room. This made her more agitated and she was soon yelling about being controlled. Suddenly half a dozen security guards appeared. Two nurses were trying to calm her down. She eventually did and when I peeked out my door she was sitting in the hall with her face in her hands. 

She looked like—pardon the stereotype—a typical soccer mom you'd see cheering her child on from the sidelines. Mental illness doesn't discriminate. 

After about an hour the in-patient psychiatrist stopped by to see me. She had a very thick folder with my case history in her hands. She asked what brought me to the hospital and how I was feeling.

"Frustrated. I can't believe this is happening again," I said with tears of rage welling in my eyes. "I biked 13,000 kilometres last year. I take my medications religiously. I practice CBT (Cognitive Behaviour Therapy) every single day. And none of it seems to fucking matter."

"Stop," said the psychiatrist while raising her hand, palm out, and smiling a gentle smile. "Yes, you're doing all those things. But after reading your history I think it's an issue with your medication. You would probably have been here a lot sooner if you hadn't been doing all those other things."

She explained I'd been on my main anti-depressant Effexor for almost 20 years, seven at my current dosage. I was also started on Seroquel during my last stay as an "augmentor" to the Effexor. It too had been at the current dosage for seven years. I wrote about my experience first taking anti-depressants in a previous blog entry. You can read it here.)

She went on to explain she wasn't a fan of Seroquel in cases like mine so she was recommending we eliminate it completely while adding a new one, Mirtazapene. The Effexor would continue at the same dosage. 

"Let's see how things go over the next few days on this combination,"she said before heading off to her next patient.

About 30 minutes later I was taken upstairs to the mental health unit. 

I was given a private room at the end of the hall behind a barrier that said 'no unauthorized personnel past this sign'. I was being placed in quarantine for the first night since it would take some time to get my Covid test results back. 

The sun was sliding down the sky. I guessed it was close to 6 pm. The room was, like all the others in this unit, bare. There was a standard hospital bed, side table, a closet, a bathroom and nothing else. I lay down to try to get some rest. Being in a state of non-stop mental agitation is exhausting. 

I looked out the window to try to orient myself but in my confused state I couldn't even tell north from south. This really concerned me as I'd been in the hospital literally dozens upon dozens of times due to my illness and my mom's many stays. I felt rootless, untethered. 

I noticed someone had scratched lines in the wall marking the days. That's one of the things you quickly come to grips with in a mental health unit. Time soon loses all meaning. There are no clocks in the rooms. Patients wander the halls at all hours. The only thing that happens with any regularity over weekends are meals which are delivered to your room on trays, like any other patient. 

Well, except for a couple of things. No caffeine is allowed. The coffee and tea are decaffeinated. For one thing, they don't want people who are usually in an agitated state to have access to stimulants. Second, many of them are on potent combinations of medications and mixing them with caffeine is not recommended.

The other thing is the cutlery. No knife, no fork. Only a spoon.

I barely touched my dinner the first night. I can't even remember what it was. 

I lay on the bed, still filled with anxiety and dread and fearing the next few days.

Around 9 p.m. a nurse delivered my first dose of Mirtazapene. I placed it under my tongue and waited.

Night fell again.

Twilight

"Why did you wait so long to get help?"

The question, from a family member, came after I was released from hospital and doing better.

It wasn't asked in anger, frustration or exasperation. 

He simply wanted to know why, if things were so serious, I had to admit myself to the hospital once the crisis hit instead of seeking treatment earlier when the symptoms started to appear.

I spoke to another friend who is currently being treated for cancer.

He found himself in an analogous situation. Seemingly random infections. Pain that came and went. Fatigue. A general feeling of being unwell. Since they didn't necessarily happen all at once, he initially shrugged them off as the trials of getting older. Maybe too many beers and wings while watching hockey at the pub.

When the symptoms became more frequent and concurrent, he made the appointment that eventually lead to the cancer diagnoses.

Those of you who know me well will probably say, but wait, you've experienced the symptoms of depression and anxiety since you were a young boy. How could you not see this coming?

For one reason, I never have a symptom-free day. Many of the symptoms are so ingrained in my brain they are always there like the tinnitus I have 24/7 in my left ear.

Some days they're almost silent, other days they scream.

These include feelings of self-hatred, guilt, imposter syndrome and mental exhaustion.

When things get more serious other symptoms appear. Loss of interest in things I normally enjoy doing. Overeating. Brain fog. Hopelessness.

And, when things are blackest, not wanting to live anymore. (Just a side note here—I am not and was not suicidal during this latest breakdown. I will talk about suicidal ideation, passive and active planning and the difference between them in the next post).  

Over the past several months, I had kept up my indoor cycling but I no longer looked forward to climbing on the bike. 

I had completely stopped reading and would watch Seinfeld to try lighten my mood but it didn't help.

I suspected something was going seriously wrong when I started struggling at work. I used to be able to knock off a news release in 20 minutes. Now when faced with writing one I would stare blankly at the blank screen. I would choke out a sentence or two and then run out of steam. 

Words I knew the definitions to looked strange. I would have to look them up to make sure I was using them correctly. 

What used to take 20 minutes now took more than an hour.   

I would attend virtual hour-long meetings and not be able to follow the conversation. I became confused, disoriented and retained little, if anything, from the meetings. 

Normally I would take notes and then use them to finish a task later. I was reduced to doing the task in real time during the meeting because my notes made little sense when I consulted them later. 

The darkness that had been gnawing in at the edges grew darker, stronger. 

The last embers of the dying twilight faded.

Night fell.

Close call

Well, I guess after running more than 3,000K it was bound to happen -- I got clipped by a car this evening.

First off, I'm fine. Really.

Second, it had nothing to do with me running in the snow, running in the winter or running in the late afternoon. There was very little snow falling and it was still light out. I'll get back to this in a bit.

I was running on the sidewalk towards traffic on the south side of Yonge Street near Big Bay Point. I was just starting to cross the entrance/exit of the new Meridian bank when I saw a car leaving the parking lot. The driver was signalling to turn right on to Yonge and was looking left to see if there was any traffic coming from that direction. There wasn't so she started to pull out to make her right turn.

One problem -- she hadn't looked right to see if anyone was approaching from that direction on the sidewalk.

As her bumper started to make contact with my left leg I jumped on her hood, TJ Hooker-style, pounding on it with my fists yelling 'Stop!! Stop!!'

She stopped and I slid off the hood.

She gave me the obligatory hands-up-I'm-sorry gesture but I was in no mood to let her off with an it's-okay wave. 

"This is a sidewalk!" I yelled. "Open your eyes and look both ways!" (And, yes, there were some expletives included.)

That sidewalk is usually busy with students from the high school, residents from the co-op housing down the street and plenty of mothers pushing strollers.

Thankfully all she hit was someone who was able to jump just high enough to avoid being dragged under the car.

Now I know some of you may be shaking your head, saying to yourself, 'What did you expect when you took up running?'

I know that because I used to be the same. I would see those "crazy" runners out there and shake my head.

Not anymore. You know why? Because I have as much right to be out there as anyone else, whether they are running, walking, pushing a stroller or hauling groceries home.

And I am anything but crazy when it comes to safety. I only run on sidewalks, wait at all lights and only cross at crosswalks. I wear reflective clothing and flashing LEDs if I'm out at twilight or later.

I am extremely conservative and overly cautious.

Despite that, I've still had many close calls and only recently had some jackass yell at me to "get moving %%$@^@^!" when I was crossing with a green light and white walk sign. He didn't like that I was holding him up from making a right turn. (I let loose one choice expletive at him. Paula expressed concern at that to which I replied, "I'm running. What's he going to do, get out and chase me?")

So why the strong reaction tonight? Because I'm sick and tired of drivers who are so careless, so clueless, so obviously oblivious to what's going on around them they are a danger to others, especially those of us on foot.

Hopefully at least one of them will now check both ways before pulling out into traffic.

I'm hoping the dent in her hood from my fist will serve as a reminder.

Hard truth

I used to think we'd come a long way in reducing the stigma associated with mental illness.

I made a very personal choice to be open about my condition, in the hopes it would help others understand that those who have a mental illness can still love, laugh, live and contribute like any other person.

I've been kidding myself.

And I'm afraid being open about my condition has actually made things worse for me and, by extension, my family.

Oh, for sure there is a lot more talk about mental illness these days.

Bell trots out its 'Let's Talk' campaign every year and we congratulate ourselves for how tolerant, how progressive, how down-right civilized we all are when it comes to mental illness.

But in the end, I've come to believe people are willing to be tolerant of those with mental illness -- just as long as they don't have to work with them.

Which means all the talk about tolerance and understanding is nothing more than window dressing.

A former employer asked me -- after I had been off work on short-term disability with depression -- how I could guarantee him I wouldn't relapse again.

I asked him if he asked that of a co-worker who was off with cancer, went into remission and was welcomed back with open arms.

"But that's different," he said.

And there you have it.

I've interviewed at five different organizations over the last six months, making it to the final round at two of them.

I'm still unemployed.

Of course I can't prove my public disclosure has given pause to any potential employer. There may have been other candidates more qualified or a better fit than myself.

But one thing became crystal clear to me today when I received my latest rejection.

If my illness was cancer and my blog was my story of overcoming it I would no doubt be more attractive to an employer doing research on me when considering hiring me.

In fact, it could be almost anything other than mental illness (and possibly addiction).

"He lost his leg to flesh-eating disease but came back to run a half-marathon. What courage! We need people like him!" they would say.

"He had a rare form of cancer but battled it and won the battle! We need people with strength like that!" they would say.

But I don't have cancer or flesh-eating disease.

I have major depressive disorder.

And until I can say that in an interview and not have it held against me, we aren't any further along than in the days when you didn't talk about it at all.

Because if you can only disclose it in situations that really don't matter, the stigma is still as strong as it's ever been.

And that makes me sad and discouraged beyond words.

Cloudy with a chance of showers

*DISCLAIMER* 

As bleak as this one may read, I've written it out of frustration, not because I'm giving up. Tomorrow's another day.

"Those long, long days of no escaping." 

-- If Only, Queens of the Stone Age

I have been alive for 15,597 days.

If I had to guess how many of those days I have been completely symptom free, it would be a very small number.

There have been hours I have been symptom free.

But never a day.

I can honestly never remember a day when I woke up, made it through the day and went to bed without experiencing at least one symptom.

Each and every day I experience at least some negative self-talk, low self-esteem, low energy, feelings of guilt, hopelessness and despair, anxiety or depression.

Sometimes a combination of these, sometimes all of them.

Contrary to what many may think about depression and anxiety, they do not start and stop like a cold or a broken limb.

They are always there, sometimes raging through mind and body, sometimes fading into the background so as to be almost silent and invisible.

Almost.

Tonight has been a difficult night because of the frustration I am feeling knowing I will never be cured, never made whole.

I started thinking about this after hearing former NHL goalie Clint Malarchuk on the radio this week. For those who don't know, he played most of his career in the 1980s and came within a hair of dying on the ice during a game when a skate cut his throat.

Quick action by the training staff saved his life that night. However, he ended up becoming seriously mentally ill, attempting suicide later on.

He has just released a book on his career and subsequent mental illness.

During the interview he repeatedly spoke about how there is no cure for his condition and that he has experienced serious relapses.

I'm not fond of using the term relapse because it implies the person is symptom-free before becoming ill again.

That's never been my experience. For my entire adult life -- and as far back as I can remember of my childhood -- I don't think I've had a symptom-free day.

Each and every day I experience some aspect of my illness, some days more strongly than others.

Today, for example, was the first time since Sept. 7 I've run 10K. Rather than be happy with my result, I immediately started to beat myself up for going so long between 10K runs (never-minding that I've done three 100K bike rides and several short runs in that time).

This leads me to thinking things like, "Big deal. So you ran 10K. How about getting a job? How's that going?"

That leads me to thinking about how I haven't been in an office for three years and the fear I'll break down under the pressure of a new job.

And all of this happens in less time than it took you to read about it.

So then I have to start the process of positive self-talk to try to redirect my thoughts.

It's exhausting.

I wish just one day my brain would work like it should.

Just one day.

I've tried everything -- medication, one-on-one therapy, group therapy, in-patient treatment, out-patient treatment, cognitive behaviour therapy, dialectic behaviour therapy, endurance training. Just about everything short of electroshock therapy.

Most days I feel like Sisyphus, rolling that rock to the top of the hill only to watch it roll back again.

So what keeps me pushing it up that hill day after day?


Claire.

Paula.

My family.

My friends.

A good book, a long run, a snowstorm, a day by the water.


Life.

The wall

I'm in a slump.

I've been so down the last three weeks I've only been out for two runs and two rides in that time. It's like I've hit the proverbial wall.

I used to look forward to my runs and rides but lately I have no motivation at all. I've put five pounds back on and I'm wallowing in self pity.

I keep telling myself, tomorrow's Day 1 and then I come up with excuses to not run/ride. I feel like I'm sliding back into my old ways.

It's so frustrating because I had kept up with it for 16 months. It's like a switch went off in me somewhere.

The runs themselves are getting more difficult too -- not so much physically but mentally. I used to consider anything less than 10K a waste of time and now the thought of running further than 5K seems overwhelming.

I think looking for work for the last six months is starting to take its toll. I've got an interview Monday but it would entail relocating which I'm not sure I want to do for a bunch of reasons.

I just want to get back to loving running.

Maybe I need to find some new routes and put some new music on my ipod. I think I may have negative associations with them now -- I hit the wall mentally at the same spots on my standard route.

I don't think this is my depression getting worse. I'm still getting up, getting dressed, looking for work, spending time with Paula and Claire, eating (too much lately!) and generally trying to get on with my life.

But damn that wall seems high these days.