Self-Awareness in Depression

I have chronic anxiety and periodic depression. My anxiety is rooted in my schoolwork, research, and other aspects of my professional life. My depression is brought on by pain in my person life.

Over the past few weeks, I have been struggling through a breakup from someone I really cared about. The reasons for the breakup will stay between him and I, but I want to be open about how it’s affect me and what I’ve been going through.

When I am depressed, I can’t tell my own feelings, especially the pleasant ones. It’s like there is a fog hiding my happiness and positive emotions from me, so that I can’t access them. I can laugh and smile, but those emotions are only genuine for an instant.

I don’t have the energy or desire to do optional activities. Even though I love cooking and it normally grounds me, depression makes me only go for easy-access food. My poor diet and incessant mental wanderings make it very difficult to fall asleep. Problems compound when I need to be in the lab early in the morning after having only slept for 3 hours. As I’ve written before, I get frustrated when personal life struggles bleed into my professional life.

I think that the people who I’m closest to can tell that something is wrong but I’ve never been fully open with them about what is happening. I think this is partly because I know they have their own problems and partly because I can’t explain things fully to myself, let along someone else. It’s far easier to isolate myself from others and attempt to occupy myself with why I’m upset.

I’m now self-aware enough to know what is happening to me. I can’t do anything to make it go away – only time can do that – but I have some activities that offer a temporary respite.

Trips to the gym for cardio-intensive workouts facilitate endorphin releases that alleviate some of the mental burden. Fresh fruits and vegetables are a godsend. They are easy-access foods, but are far more nutritional than anything in the pantry. Plus, bingeing on these foods are far less likely to lead to undesired weight gain.

My final tool used to make myself feel better is to be honest with myself about what I’m going through. Putting my thoughts and emotions into words is an underrated way to move forward. Words mean that I can explain things to myself and others. As much as I may want to run away from what I’m going through, I can’t.

I plan to start seeing a counselor this week, which will likely become a regular occurrence leading up to my candidacy exam in a couple months. I need to be honest with myself that I will have a much healthier and easier time if I don’t try to go through this alone.

The good news is that I can feel the fog lifting. I cooked for the first time in a few weeks and am looking forward to activities that I’ve been avoiding. I am taking the right steps to get past this, but a need a little more time.

I Make People Uncomfortable

I recognize that I have an imposing stature. I am 5’11” (1.80 m) tall and was, up until a year ago, fairly overweight. Outside my family, I grew up surrounded by people who were smaller than me. Between my size and my love of school, I became a social outcast at a very young age. I had friends, but I never really felt accepted. I didn’t find a group of people who I connected with until my junior year of high school and I am still very close with them to this day. Unfortunately, my social awkwardness has never gone away.

I don’t mean to, but I intimidate people. I cannot hide my size, I maintain an athletic physique, and I don’t hide my intelligence. Growing up, it wasn’t cool to be smart, especially for girls. I tried to hide my intelligence for a short while but quickly realized I would never be “cool”, so I moved on and did my own thing. I, like most people growing up, tried to change things about myself to be more likable. It wasn’t until the past couple years that I truly embraced my awkwardness, focusing my energy on becoming person I wanted to be, rather than who everyone else wanted me to be.

I am not good at small talk. I find it to be an inefficient form of communication. However, I recognize that it is necessary for general social interactions, so I deal with it for as short a time as possible. I love talking to people, I just prefer to have meaningful conversations because I find those foster the interpersonal connections that lead to genuine, lasting friendships.

As a result, I have very little hesitation about bringing up topics that have made other people uncomfortable. These topics commonly include politics, religion, philosophy, morals, and personal information. I share my perspective for every topic I bring up, so it is never a one-sided conversation, nor do I every want it to feel like I’m interrogating the person I’m speaking with.

Recently, the conversation topics that make people visibly clench are feminism, women’s rights, and sexual assault. Not that those topics were regularly discussed before, but their presence in the news has people extremely on edge. That hasn’t stopped me. I want to know what people think. I want to know who in my life is paying attention to it and who is choosing to stay out of it. For the latter, I want know why those people don’t want to be informed or have an opinion.

I recognize that there’s a lot to keep up with, but I think it’s incredibly important to stay informed and have an opinion that can be defended.

No matter how difficult the conversation, I want people to know that they can talk to me about anything. I do my best to express my opinion without judgement or accusation, but my perspective is relative to my own experiences. More importantly, I respect that others have had different experiences from me.

The more people are willing to have uncomfortable conversations, the more normalized those topics become. Maybe if these topics were normalized, people wouldn’t be afraid to express their opinions, tell their truths, or share their stories.

Seeking A Balance

I am not great at hiding my emotions. I tend to wear my heart on my sleeve. As a result, people who know me well can quickly figure out when something is wrong.

At dinner with my parents last week, it didn’t take long for my mother to ask what was bothering me. I’m convinced that she always knows when something especially good or bad has happened to me. Thankfully, she doesn’t always ask for details because she trusts that I will tell her about what’s happening in my own time.

The thing bothering me last week continues to keep me down. I feel like I exist in two lives, and they don’t seem to want to go well at the same time. I have a professional life and a personal life, and they haven’t really intersected for the past couple years.

A month ago, my personal life was going well, but my professional life had slowed down significantly. On the flip side, for the past few weeks, my professional life has been going well, by my personal life has taken a dip.

This is not a shocking problem and I am far from the first person to be facing such difficulties. Unfortunately, this doesn’t make me feel any better.

My personal life had been going well because my grandfather had been pretty healthy and I had ventured back into the world of online dating, with some initial success. Everything else in my personal life stays relatively constant.

Just life every other foray I’ve had into online dating, it only took a few weeks for me to lose all confidence in the system. Between unsolicited dick pics, 30 year old guys still trying to figure out their lives, Trump supporters, and guys just looking for something “casual”, I started dozens of conversations that all ultimately ended up the same way.

A couple friends from school found their current significant others online, so I know it’s theoretically possible; I just haven’t been so fortunate.

My professional life hit a slump while I prepared for my first committee meeting and planned out my first experiments. Since my successful committee meeting, I have had the time to start my first set of experiments. They are nothing too exciting and things in the lab rarely occur as desired/intended, but I’m happy anytime I actively have work to do. In addition, I’m really looking forward to some upcoming academic events in the next month, so I hope this positive momentum continues for at least the next month.

As I wrote about recently,  my work successes have been juxtaposed by my grandfather’s declining health. This has undoubtedly made it more difficult to celebrate when things go well in the lab. My grandfather is doing surprisingly well, and I want with every fiber of my being for him to continue to improve, but every day brings new challenges and surprises.

My inability to find a positive balance between my personal and professional lives has required more of my energy than I have to spare. I want to find a balance where both of my lives are constant and moving in a desirable direction. I am not looking for perfection, just an improved status quo.

Watching From the Sidelines

Up to now, I had never had to watch someone close to me prepare for death. I knew it would happen eventually, but I had not considered how much it would occupy my attention, now how much I could learn from it. I am now watching my godparents and my grandfather, three people I am very clost to, handle the prospect of death very differently.

My godparents have spent the past few years putting their affairs in order, ever since my godfather was diagnosed with esophageal cancer at almost 80 years old. They have taken extensive measures to ensure that everything is arranged and clearly laid out for the people they will be leaving behind.

After surgery and radiation therapy, my godfather’s cancer has been in remission for a few years and my godmother is as healthy and active as anyone her age. I don’t think of either of them as people who are dying. Therefore, I have an enormous amount of respect and gratitude for their efforts to sort out their affairs while they are still able to do so.

My godfather recently pointed out that you don’t realize how much you own or are responsible for until you have to make arrangements for when you are no longer there. I keep hoping that I’ll use my godparents as inspiration to prepare my life for the event of my untimely death, but that hasn’t yet happened.

Watching my grandfather, on the other hand, has been a very different experience. Unlike my godparents, my grandfather has a terminal condition, congestive heart failure (CHF). In addition, he has a disorder called myelodysplasia (commonly referred to by the general term, MDS), which essentially means that his blood cells aren’t able to function properly. The combination of these conditions has caused his health to decline severely over the past 18 months.

For the majority of that time, his main ailments have been due to CHF, including weakness and fatigue. Very recently however, his improperly functioning blood cells combined with his weak heart have started to take a toll on his mental faculties. While CHF is a chronic condition, with no long-term treatment other than a heart transplant, MDS can be treated with bone marrow or hematopoietic cell transplants. Due to the immune rejection risks of these therapies, my grandfather has not been eligible to receive them. The best option for him is weekly blood transfusions, which he is undergoing.

I knew that watching a loved one’s health decline would be difficult, but I didn’t think about how it would affect me as a scientist. The research project I’m performing for my PhD could one day be used to develop a commercially available cell therapy to replace allogeneic (cells donated from another human) hematopoietic cell transplants.

The cells I study could supply his body with functioning versions of every type of blood and immune cell, without having to worry so much about immune matching. These cells could be readily available in hospitals for patients, meaning that my grandfather could have started receiving treatment when he was diagnosed with MDS 18 months ago. He would still have had CHF, but his blood cells would be doing their jobs properly, and he would, arguably, have not had nearly so much mental deterioration.

My inability to help him as both a granddaughter and scientist has left me with a feeling of powerlessness as I watch him from the sidelines. All of my science and training can’t do anything to help him.

I’m trying to use this experience as motivation to progress my research project, but I feel like I’m spending too much time worrying about my grandfather to make that happen.