Yes, I Have A Mental Health Disorder, No That Doesn't Mean I'm Crazy!

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"Mental illness is nothing to be ashamed of, but stigma and bias shame us all." ~ President Bill Clinton

The following is a very basic textbook lesson on anxiety disorders and depressive disorders or depression. All of the information below I obtained through self education. I gathered a lot of my facts from websites such as The National Institute of Mental Health, the International OCD Foundation, Centers for Disease Control and Prevention, The Mayo Clinic, National Alliance on Mental Health as well as some others. The information provided in this blog is for informational purposes only and is not professional medical advice, diagnosis, treatment or care, nor is it intended to be a substitute therefor. Always seek the advice of a physician or other qualified health provider properly licensed to practice medicine or general health care in your jurisdiction concerning any questions you may have regarding any information obtained from this blog and any medical condition you believe may be relevant to you or to someone else. Never disregard professional medical advice or delay in seeking it because of something you have read on this blog. Always consult with your physician or other qualified health care provider before embarking on a new treatment, diet or fitness program. Information obtained in the blog is not exhaustive and does not cover all diseases, ailments, physical conditions or their treatment.

Ok - now that we got that out of the way, let's get to the point of this post!!

I am an advocate for many causes and people, including myself, I would not be here today if I didn't advocate for myself. I also advocate for the 350 million people who suffer from depression and the 40 million adults in the US who suffer from some sort of anxiety disorder.

Depressive Disorders & Anxiety Disorders are not the same. Depression is a condition in which a person feels discouraged, sad, hopeless, unmotivated, or disinterested in life in general. For people with anxiety disorders, worry and fear are constant and overwhelming, and can be crippling. They can cause such distress that it interferes with a person's ability to lead a normal life. It is not uncommon, however, for someone with an anxiety disorder to also suffer from depression or vice versa. Nearly one-half of those diagnosed with depression are also diagnosed with an anxiety disorder.

There are several types of anxiety disorders, including panic disorder, social anxiety disorder, specific phobias, post traumatic stress disorder (PTSD), obsessive-compulsive disorder (OCD) and generalized anxiety disorder (GAD).

The exact cause of anxiety disorders is unknown; but as scientists continue their research on mental illness, it is becoming clear that many of these disorders are caused by a combination of factors, including changes in the brain and environmental stress.

Depression or a Depressive Disorder is a type of mood disorder and there are two main categories; major depressive disorder and dysthymia or Chronic Depression. There are also some less common types (Seasonal Affective Disorder (SAD), Psychotic Depression, Postpartum Depression, Premenstrual Dysphoric Disorder (PMDD), 'Situational' Depression, Atypical Depression and manic depression also called BiPolar.

People with depression often experience symptoms similar to those of an anxiety disorder, such as nervousness, irritability, and problems sleeping and concentrating. But each disorder has its own causes and its own emotional and behavioral symptoms.

Depression is caused by a combination of genetic, biological, environmental, and psychological factors.

Depressive illnesses are disorders of the brain. Theories suggest that important neurotransmitters—chemicals that brain cells used to communicate—are out of balance in depression.

Anxiety disorders & Depressive Disorders are not the result of personal weakness, a character flaw, or poor upbringing.

I suffer from both an anxiety and depressive disorder.

I have dysthymia or Chronic Depression. Dysthymia is considered a “milder” form of depression than a major depressive disorder (MDD) because its symptoms usually last much longer than in MDD. However, it can often be the most debilitating of the two diseases. Dysthymia may be intermittent, with patients feeling better for a period of time. Typically, however, these bursts of “normalcy” last no more than two months. Chronic Depression is a highly treatable condition, but left untreated, dysthymia may develop into major depression.

My depression is also a huge anxiety trigger. I get upset and frustrated that I am feeling depressed. I live a very fortunate life, I have a loving family, a home, I can afford the necessities and many luxuries, I am in good health, I live in a great place, etc. So I feel guilty for being depressed. That guilt is what made me realize that I am, for the most part, powerless over my depression. It comes when it wants to come and many times it hits me without any warning. I can’t cure it, the only thing I can do it fight it. I cannot prevent it entirely, even with medication. The medication helps me fight it because it lessens the strength of the depression attack, however, the medication is like a bullet proof vest, it can help but it is not foolproof.

I suffer from two types of anxiety disorders, PTSD and OCD. PTSD develops after a terrifying ordeal that involved physical harm or the threat of physical harm. The person who develops PTSD may have been the one who was harmed, the harm may have happened to a loved one, or the person may have witnessed a harmful event that happened to loved ones or strangers. People with obsessive-compulsive disorder (OCD) feel the need to check things repeatedly, or have certain thoughts or perform routines and rituals over and over. The thoughts and rituals associated with OCD cause distress and get in the way of daily life.

There are a lot of misconceptions with both PTSD and OCD and I will try to better educate you on both.

PTSD was first brought to public attention in relation to war veterans, but it can result from a variety of traumatic incidents, such as mugging, rape, torture, being kidnapped or held captive, child abuse, car accidents, train wrecks, plane crashes, bombings, or natural disasters such as floods or earthquakes.

Scientists are focusing on genes that may play a role in creating fear memories. They include Stathmin, a protein needed to form fear memories, GRP (gastrin-releasing peptide), a signaling chemical in the brain released during emotional events and a version of the 5-HTTLPR gene, which controls levels of serotonin — a brain chemical related to mood-that appears to fuel the fear response.

PTSD symptoms can be grouped into three categories:

1. Re-experiencing symptoms such as Flashbacks, Bad dreams and Frightening thoughts.

2. Avoidance symptoms, including staying away from places, events, or objects that are reminders of the experience, feeling emotionally numb, feeling strong guilt, depression, or worry, losing interest in activities that were enjoyed in the past, and having trouble remembering the dangerous event.

3. Hyperarousal symptoms that include being easily startled, feeling tense or “on edge,” having difficulty sleeping, and/or having angry outbursts.

It’s natural to have some of these symptoms after a dangerous event. Sometimes people have very serious symptoms that go away after a few weeks. This is called acute stress disorder, or ASD. When the symptoms last more than a few weeks and become an ongoing problem, they might be PTSD. Some people with PTSD don’t show any symptoms for weeks or months.

People with OCD have frequent upsetting thoughts that are called obsessions. The term “obsession” is commonly used out of its real context. If you enjoy something to the point where you feel obsessed about it, it does not mean you have OCD. People with OCD try to control their obsession and feel an overwhelming urge to repeat certain rituals or behaviors called compulsions. According to the National Institute of Mental Health, “People with OCD CAN’T control these obsessions and compulsions. Most of the time, the rituals end up controlling them.”

When most people hear the term, OCD, they often think of people who are obsessed with germs or dirt, who have a compulsion to wash their hands over and over again or a person who needs to organize things according to some kind of attribute such as color or size.

But OCD encompasses so much more. For instance, a person who has an obsession with intruders often locks and relocks their doors many times before going to bed. People with OCD may also be preoccupied with order and symmetry as I mentioned above, but it can also entail counting while performing a task where you need to end on a “good,” “right,” or “safe” number.

Some people with OCD need constant reassurance so they will often ask the same questions over and over again in order to receive it. ("are you mad at me?"  "are we ok?"  "did I do something to upset you?" "are you sure?")  

Some people with OCD have the inability to decide whether to keep or to discard things which result in the accumulation of or hoarding unneeded items. Compulsive shopping and clutter can be forms of OCD.

Religious compulsions are another form of OCD and might include a concern with offending God, concern about blasphemy and excessive concern with right/wrong or morality. People with OCD perform their rituals even though doing so interferes with daily life and they find the repetition distressing.

For me, loud noises and crowded places in general trigger my PTSD and OCD. Too much stimulus cause my brain to overload and I get very anxious. Music concerts, clubs, bars, restaurants, sporting events, airports and large, crowded stores seem to be the biggest noise triggers. Even at home with my three loud and rambunctious boys triggers my PTSD. I choose to avoid these places as much as I possibly can but for obvious reasons that is not always possible.

My fear of getting lost is also a trigger for my anxiety. When I am in an unfamiliar place and I do not know where I am going I get very irritable and panicky. So I like to know in advance where I have to be and when I have to be there so I can research it, plan and get as familiar as possible. I also like to give myself plenty of time, especially if I am driving to a place I am unfamiliar with. I am a very punctual person, because of this and most of the time I arrive early so I spend a few extra minutes in my car – thank goodness for the invention of smart phones. Now I can at least check email or Facebook rather than just sit and watch the traffic pass me by.

There are other things that trigger my social anxiety, but they are not as severe and include telephone phobia (why I prefer to text or email), public speaking, meeting new people or being in a situation where I know very few people or no one at all. Most of these triggers result in me being very introverted and to some extent, socially awkward, so my home is where I prefer to be as much as possible.

The OCD symptoms that I often exhibit include needing to end on a specific type of number when performing a task (usually a number ending in 0), constantly asking or needing reassurance ("are you mad at me?"), an inability to decide whether to keep or to discard things which result in accumulation or hoarding of unneeded items, too much clutter and according to my husband, I am a compulsive shopper however, I rarely buy things for myself so if I am a compulsive shopper at least others are benefiting from it more than I am. Letting go of an object for me is a long and painful process which requires discussing it at length in therapy and also compromises that I often make with my very minimalistic husband. 

I know these are obsessions of mine, however, as stated above, I CAN’T control these obsessions and compulsions, they control me. I am, however, trying to understand them more so I can be aware of them when they occur. It would be great if I had a personal psychologist follow me around all day and tell me when my anxieties are doing the talking but I don’t. So that is why I have to be my own advocate and educate myself. I also rely on the people who know me and my disorders, my family and a close friend, to gently point this out to me when I am being more rational.

These are conditions I do not wish on anyone. It doesn’t matter how wealthy you are, how beautiful you are, how fortunate you are or where you live. Depressive and Anxiety Disorders do not discriminate.

For me, I know many of these issues stem from the Traumatic Brain Injury (TBI) that I sustained in 1997. It took over 12 years for me to get a proper diagnosis so I spent a long time wondering what was wrong with me. Now that I am aware that these conditions are mostly due to my TBI, I am able to manage them better. I am also my own advocate.  If I didn't bring these disorders up to my physicians, I don't think I would have ever have been evaluated let alone diagnosed. I am constantly reading up on the latest research and I question my physicians and health care providers. I guess you can say I have an OCD about my mental health.

It's a very lonely existence because those who do not suffer from depression and anxiety really have no idea what it is like. My family doesn’t and the very few close friends that I still have don’t understand. Sometimes when I meet new people I want to introduce myself like, “I’m Amy and I have a TBI, PTSD and OCD so please do not take offense to anything inappropriate that I may say and please have a little empathy about my anxieties. Also, let me apologize in advance because if you do still decide that you want to be my friend, I will surely do or say something that will upset you. Please give me, many more than just a second chance, I will need hundreds of chances.”

I am very thankful that my family and the few friends that I do still have, give me the support that I need to live with these disorders. I know it is very hard on them too, and it would be much easier for them to run away from me. There have been many people in my life who have but, I no longer fault them for it because I now understand the burden, emotional drain and the frustrations that are my baggage.

I will do another post about some of the things that friends and loved ones can do to help support those of who suffer from depression and anxiety. I can only speak from my own experience, however many others have expressed the same desires.

If you are suffering from any of the above symptoms and think you may have an anxiety or depressive disorder please see a licensed medical professional. You are not alone and just because you may have a mental illness, that doesn’t mean you are crazy. Be strong, be courageous and be brave and get the help you need and don't hesitate to reach out to me.