Friday, October 7, 2011


I never realized before how almost-impossibly fucking hard it can be to ask for help.

When I went back to seeing a diabetes team (nurse, dietician and endocrinologist) over two years ago, they asked me if I thought it would be helpful to see a psychologist.

At first I resisted - resisted for nearly a year - but eventually agreed, so they put in a referral.

The first referral fell thru completely.

I missed the phone call looking to book me the first appointment. When I called back, the receptionist couldn't find the info for the referral, and I didn't know how to explain what it was supposed to be for.

The nurse persisted, and eventually got me a few appointments with one psychologist (who had to go on maternity leave after about 4 visits) and then another one. We explored the issues. I very slowly and gradually began to open up.

From the very beginning both psychologists asked if I was depressed, suggested medication. I vigorously denied it. Yeah, I get upset sometimes. Doesn't it make more sense for it to happen more office in front of a psychologist who is asking the tough questions about emotional issues?

I explored the idea that there are problems in my marriage. I have been feeling more and more distant, more disconnected with my husband for quite some time now. The more I investigated my feelings, the more obvious the problems there seemed.
But along with the marriage dynamic other problems, other issues that had always been present were dragged to the forefront.

I have never been a social butterfly. Issues with bullying long in my past have left me uncomfortable with strangers, and I don't make friends easily. Questions from therapy began to make me see how I avoid social situations - and becoming more concious of how I avoid them did not make it any easier to confront this, or to take part in gatherings I might have tolerated briefly, uncomfortably before.

Feelings of stress from work, from home, from kids, from school began to pile up on me. I found myself near tears for seemingly no reason, and it recurred over and over for more than a week. In a moment of despair, I found enough clarity to realize that even though I loved my job I desperately wanted less of it, at least for this period. So I reduced my hours from full-time to 3 days/week, and bought myself a reprieve.
But the reduced stress did not bring back the balance and clarity I was hoping for. I found myself constantly irritable. My sleep was suffering - it took forever to fall asleep, I slept very restlessly, and it took more and more effort to drag myself out of bed every morning. I had heart palpitations, and stomach issues, and often felt like I could not breathe.

My psychologist told me he thought I was depressed. Faced with the mounting evidence not only in my state of mind, but the reactions of my body I felt compelled to agree. He then told me gently that this was more than he felt qualified to deal with - his mandate was to help people make the positive changes required to better deal with a metabolic illness (diabetes). He was not a counsellor specializing in depression or anxiety issues, and I would likely deal better with a psychiatrist or an MD who could prescribe medication. He is still following me to make sure I get the help that I need, but this was where the REALLY HARD part started.

He told me a psychiatrist would require a referall from an MD, and told me to go through my family doctor. I have a family doctor, but do not feel it is a very good relationship. She is not someone I feel comfortable talking with, and I have some leftover resentment from over a year ago when I went to her about the first of my heart palpitations and chest pain. All I really wanted was reassurance that this was nothing to worry about. Instead, she suggested that it was panic attacks (Not really what I was feeling in my head at the time. In retrospect it may have been the first harbinger of my current mental crisis, but at the time I was not willing to admit that it had anything to do with my mental health, and I resented her implication. Still do - perhaps even more if it means she may have been correct!) tried to give me a prescription for it, then nailed the coffin shut by finishing the exam with "you know these are signs of a heart attack. If it happens again, go to the ER." which provoked a thoroughly embarrasing emergency visit where I was diagnosed with heartburn (also something I don't - or at least didn't tend to suffer from).
So I made an appointment with my family doc. It surprised me how much a struggle it was to call to make the appointment, and how much my heart pounded and my head hurt in showing up for the visit. I managed to mumble out that my psychologist thought I was depressed and I should look for drugs or a referral to a psychiatrist. She asked if I wanted drugs. I told her that I would very much prefer to avoid that route. So she checked my symptoms and agreed that I was depressed, and wrote me a very nice letter confirming that fact.
I left the office, and slowly the results soaked in. The appointment was the exact opposite of anything I had hoped to get there. I didn't need a letter saying I was depressed. In fact one of the reasons I had resisted acknowledging for so long that I was depressed was because I was afraid of the possible repercussions of being diagnosed with a mental illness. What I needed was for someone to find me a psychiatrist and make me an appointment with them so I could begin to fix the problems in my head. And there was no way I would be able to go back to my doctor and ask her to do that. I was screwed there. On to plan B.


Plan B. He gave me a phone number for a service called 'Access Mental Health'. Telephone services for people in crisis. Was I in crisis? I didn't feel like I was in crisis yet, but I could feel myself getting closer and closer to a breaking point.
Sweating and shaking and feeling like I was swimming through drying cement, I called the number. It led to a recorded, voicemail message - if you need immediate help, call 911 or go to emergency. Then a voicemail menu to wade thru, then I was put on hold.

To be quite honest, the first time I called I hung up before speaking to anyone.
Then I called my family doctor and made the appointment for the stupidly unhelpful visit described above.

So after striking out with the doctor, I called again. I waited for a time and place I could be alone, fairly certain no one would interrupt or overhear. I used my cellphone, trying to keep my home line and my home life away from this thing. The physical symptoms of terror were absolutely present throughout the call. I don't know why but it was as if my mind and body were fighting against me taking these steps, against me trying to overcome the darkness that was invading my mind and creepingly consuming my life. The call itself was relatively ordinary, aside from trying to find the words to explain why I was seeking help, what I hoped to accomplish. The result of the call was another phone number, to be called to try to book an appointment with the local mental health services. They also gave info about urgent appointments, available for walk-ins on various dates and times.

I didn't feel (yet) that I needed an urgent appointment. I tried calling the phone number but it led to another voicemail menu, and not a real person to talk to but a voicemailbox, with the note that calls would be returned within 3 days. I just could not handle the thought of the message at that point, so I hung up without leaving one.

All of this seemed to be surrounded by deteriorating mental and physical health. The realization that I was depressed - not just sad, not just going through a phase, but a diagnosed, definite mental disorder - had thrown my precarious mental balance completely off-kilter. I did not feel I could talk to anyone about it. The problems with my husband were worsening, I did not want to burden my kids or other family members, I did not have any friends close enough to disclose this secret. So I tried - and I think, failed miserably - to continue as best I could with a day to day life that felt increasingly out of control.
I took several long walks, not for exercise but simply to escape from home, family, and as much as I could from all the things I couldn't face, couldn't handle.

On one of these walks, I plunged forward far enough to actually leave a message - name, city, and phone number (cell phone of course). The phone call did not feel easy to make, but afterward it was somewhat of a relief, knowing that the next step was now somewhere within 3 days away, and for the moment, not my responsibility.

Only, there was no return phone call. I knew it was possibly my fault - maybe I had not been clear enough in the message I left, maybe there was a problem in the cell reception. But it was another body-blow in a process that was already one of the most difficult things I had ever done. I wanted to just simply give up so often. I'm not even certain exactly why I kept trying, but there didn't seem to be much for alternatives, and I wasn't quite ready for suicide yet, although thoughts of death recurred over and over, and I found myself oddly hopeful for a serious traffic accident or other physical health crisis to give me a different reason to take a break from reality.

I ended up at one of the urgent, walk-in appointments for the mental health services. Once again, an action required on my part that was REALLY FUCKING HARD. Like the emotional me was battling the rational me for control. Rational me just wanted to get better. Emotional me just wanted to RUN AWAY. Run where? Anywhere. Away. Hide in a corner. Drive where no one could find me. Just get into a spot walled off from everyone else and stay there. Not a sustainable course of actions, but emotional me seems to be short on what comes next.

At the urgent appointment, a counsellor listened, discussed, and analysed for me. I'm not sure what I took from that appointment. I left with the feeling she was pushing an agenda that didn't really apply in my case (I have problems with my marriage, but it felt like she must specialize in abuse, because she framed it all in terms of my husband mentally abusing me, which I still feel is not completely accurate, and not what I see in terms of his motivation) but she brought me to a point of decisions and actions with regard to my marriage that I had not reached before.

Frustrating once more, I could not progress from an urgent appointment to regular appointments. I had to call the number, and leave a message, and wait for a call-back to get a regular appointment. Why the hell is everything SO FUCKING HARD??

At least this time, leaving a message resulted in a return phone call. I had a small breakdown at work, and was sent home for the rest of the day betweent the urgent appointment and the return phone call. But I now have an appointment for follow-up mental healthcare. And I am moving forward.

I am cautiously optomistic. My mood seems to have temporarily risen back above the darkest depths that I reached in this struggle. I try not to consider whether this might be only temporary, or how much of an internal struggle it might become to show up for the appointment I have booked, or the last follow-up with my original psychologist to reassure him that I am getting the help that I need.

I just needed to vent on the struggle to get this far. Because it really was, and continues to be, VERY FUCKING HARD to reach out for mental help. And maybe some of it just shouldn't be this difficult.