Beyond Blue: Surviving Depression and Anxiety and Making the Most of Bad Genes

First Chapter

Beyond Blue

Center Street

Part I

Drink, Pray, Cry

My Story

Chapter One

Prayer, Piety, and Panic

Depression in My Younger Years

There is a Buddhist tale about a group of blind men trying to describe an elephant from different perspectives.

“Surely an elephant is like a pot,” said the man touching the elephant’s head.

“No,” said the man holding an ear. “An elephant is like a winnowing basket.”

The man feeling the tusk said it was a plowshare; the one clenching the trunk, a plow; the man at the foot, a pillar; the back, a mortar; the tail, a hose; the tuft of the tail, a brush.

That’s what it’s like describing my bipolar disorder.

I could tell you about my manic cycles, which my husband, Eric, says are like a litter of puppies running around in circles and chasing each other’s tails. Or I could recount the details of my suicidal eighteen months, when I clutched my medal of St. Therese so hard it almost became embedded in my palm. I could start with my soul, my dark night, and how the light trickled in the way it does at dawn. Or I could describe the battlefield of my mind, where today team NIT (negative intrusive thoughts) is killing team PT (positive thoughts) 57 to 2.

I’m going to start with the elephant’s girl parts, in particular its womb: with me, the fetus, sitting uncomfortably inside my mom’s womb in my native town of Dayton, Ohio. Because the truth is that I don’t ever remember not being anxious and depressed.

That’s not to say I don’t have happy childhood memories. There are plenty of those, and they are all documented in the cool photo albums my mom gave me and my sisters for Christmas three years ago: those autumn afternoons my twin sister and I would jump into a massive pile of leaves, undoing the hours of raking our neighbor did; summer trips to Baskin-Robbins and Friendly’s, where my sisters and I would split a Reese’s Pieces sundae with extra whipped cream; Easter Sundays, when the big rabbit would fill my basket with enough chocolate and jelly beans to last me to next year’s basket; and magical Christmases. Given the estrogen levels at our house—produced by four sisters within three years of each other—we should have had Greek symbols over our garage, because it was like a sorority house on many occasions.

But I never remember a time when I was without angst.

My mom called me her “Velcro kid” because I stuck to her. As a preschooler, I remember being scared to death she was going to die every time she left the house: I loathed seeing her apply her very red lipstick because it signaled an imminent departure and the clickety-clack noise of the garage door raising sounded like taps. I would say good-bye forty times, and that was never enough.

Severe separation anxiety isn’t abnormal for young kids. Especially those who are as ultrasensitive as I was. What delivered me into the weirdo category were the intrusive thoughts that made no sense: that I had to compliment the waitress on her curly perm or her yellow polyester uniform—or else something terrible would happen to me, like I would have to wear that yellow polyester uniform for the rest of my life, even to the prom. I obsessed about bizarre details, like where my tongue was positioned when I swallowed, as if I was somehow to blame for the Atlantic Ocean–sized gap between my two front teeth. Some preoccupations drove me to rituals like turning out the lights 2,876 times, washing my hands five times before dinner, looking under my bed for my shoes even though I had already checked eighty-seven times before, or skipping over and counting the cracks of a sidewalk on the way to school.

Even as a young child, I complained of “feelings” that stalked my every move—of being unworthy, afraid, and terribly ashamed—and obsessing about death as if it were a real option if I got that desperate. When I was thirteen, I wrote in my journal:

I can’t keep these feelings in any more. My mom doesn’t understand. She tries but she doesn’t. The world seems terrible to me. I think I need a psychologist badly. I have to keep busy to stay away from my feelings, and lately I haven’t been busy. I have thought about suicide many times. It seems to always be on my mind.

Now sprinkle an ounce of Catholicism on top of that chemistry, and you have, voila! a religious nut!

Growing up Catholic, for me, was both a blessing and a curse.

A blessing in that my faith became a refuge for me, where my disordered thinking could latch onto practices and traditions that made me feel normal and secure. For this reason, I’ve always maintained that Catholicism is the most suitable religion for the mentally ill. Think about it. There is a saint for every neurosis: St. Joseph takes care of those prone to panic attacks while traveling. For twitching, Bartholomew the Apostle is the dude. Those roaming the house in their sleep can call on Dymphna. The venerable Matt Talbot is patron saint to those struggling with alcoholism and drug addiction. And, of course, St. Jude covers the hopeless causes.

Catholicism provided me with a safe place to go for comfort and consolation, to hear I wasn’t alone, and that I would be taken care of. I kept my picture book of saints bookmarked to St. Therese of Lisieux, who, when she was dying “pressed her crucifix to her heart, and looking up to heaven said, ‘I love Him! My God, I love You!’” and to Joan of Arc who was “taken to the marketplace of Rouen and burned to death. With her eyes on a crucifix, she cried out, ‘Jesus, Jesus,’ through the flames.” The saints have experienced much deeper agony than I have, I reasoned as a young girl. I should turn to them with my pain. Because if I can gaze at Jesus like they did, I will be protected from my thoughts.

It made perfect sense that I would turn to the stories and ceremonials of my faith, because that was where my mom journeyed in her darkest hours, when I was eleven years old and my dad called a family meeting to announce he would be sleeping in a separate apartment for a while; that turned into three years and was followed by the devastating news that he was never coming home, and was, in fact, going to marry a woman seventeen years his junior. His younger bride, I suspect, tolerated his drinking scene more than my mom and didn’t burden him with so much religion: weeping statues of the Virgin Mary on the bedroom dresser, the image of the Sacred Heart in the kitchen—which I still swear to this day smiled at me every time I cleared the table—the novenas to all the saints, and, oh, let’s not forget the mammoth rosary hanging over the living room mantel, each bead the size of a grapefruit.

My mom named me after her favorite saint, St. Therese of Lisieux, or the Little Flower, because I am her favorite daughter. Not! Truthfully, she swears she hadn’t felt so compelled to name her other babies in the way she was with me. Something about me even in utero, she vows, matched perfectly with the name Theresa.

The year of my parents’ separation—when I was in fifth grade—I first witnessed the power of a novena to St. Therese. On the fifth day of five consecutive days of prayers—when tradition holds that the person praying will receive a shower of roses—our neighbor Mr. Miller, who kept an impeccable garden, was pruning his rose bushes. As he trimmed off the fully blossomed flowers to make room for the tender buds, he noticed my twin sister playing soccer in the backyard.

“Give these to your mom,” he said, handing her at least eight dozen stunning roses: in vibrant shades of sapphire, indigo, daffodil, primrose, coral, and indigo, most of the petals perfectly formed and having just opened. With the determination and skills of an artist, my sister went back and forth, from his garden to our kitchen, arranging all the roses until she ran out of vases and counter space, making the place look like a Monet painting.

My mom dragged herself into the kitchen from the garage that evening, distraught and forlorn as she was so much of the time the year my dad left—the pangs of abandonment visible on her face—to find what looked and smelled like a heavenly rose garden. I’ll never forget the tears of hope she cried when she remembered it was the fifth day of her novena.

But my religiosity was also a curse in that with all of its stuff—medals, rosaries, icons, statues—my faith disguised a serious mood disorder as piety. So instead of taking me to the school psychologist or to a mental health professional, the adults in my life considered me a very holy child, a religious prodigy, with a curiously intense faith.

Almost every anxiety and insecurity I felt as a kid fed into one fear: I wasn’t pleasing God and was therefore going to hell.

I did everything in my repertoire of Catholic traditions and devotions to prevent that, of course. My bedtime prayers lasted longer than those recited by Benedictine monks; by the second grade, I had read the Bible start to finish, memorized key passages and made imaginary friends of all the primary characters: Jonah, Abraham, Moses, David, Joseph, Mary, and Elizabeth; I attended daily Mass, walking to church by myself each day; and every Good Friday I would camp out for five hours in my dad’s den in the basement as I reenacted the Passion of Christ starring me as Judas, Jesus, Veronica, Simon, Mary, and every other major personality of the crucifixion scene.

During our closing liturgy at St. Charles Borromeo Elementary School in Kettering, Ohio, grades one to eight would sing “Let There Be Peace on Earth” for our principal, Sister Marie Karen. The last words of the song, “and let it begin with me,” stuck to the gray matter of my brain and haunted me throughout the summer, so that I felt personally responsible for the cold war between the United States and Russia, and for the apartheid plaguing South Africa.

The slides of the starving people in Uganda—their protruding cheek bones and crooked teeth—shown as part of the Stations of the Cross during Lent, stayed with me well past Easter. On the weekends that my dad had us, he would give my sisters and me quarters to go play Pacman, that stupid arcade game, but I couldn’t do it. Waste money that could feed a family in Somolia? The guilt was unbearable. So I saved my coins and gave them to Unicef. Besides, watching a big yellow dot gobble up smaller yellow dots fed my anxiety. Back then, I was a communist who found consumerism disturbing.

Two and a half decades later, I can see that to my junior high brain, having money—having the luxury of worrying about pimples and mean cliques in lieu of hunting for clean water and food in some African village—meant that I had no right to complain, and that I should always, without exception, wear a happy face. The fact that folks were hungry and dying of poverty in Zimbabwe translated into a no-tell policy that I was in great need of some counseling. Because money should cure all. This was America! Anything but a Colgate white smile was unacceptable. So I begged God to be poor. Because then, and only then, I could disclose my pain.

For much of the same reason I desired to be a mystic. I looked at all the pain caused by my parents’ divorce—in their lives and in my sisters’ and mine—and I decided that I would never rely on anyone but God. That prescription for happiness was a perfect match to my interpretation of the Bible: that God needs to be Numero Uno, the Big Cheese, Mac Daddy—okay you get the point. So when we were roasting marshmallows during our first camping trip, and my Girl Scout buddies asked me who my boyfriend was, I replied, “God,” which won me so much popularity and approval in those circles that I had no buddy with whom to go pee in the middle of the night. Apparently all the other Scouts had real boyfriends and didn’t yet appreciate the benefits of befriending a Christian mystic.

“If you don’t stop crying, I’m taking you to the hospital,” my mom said to me when I was seven. She was scared herself, and she didn’t know what to do with her daughter who would shriek with terror in the middle of the night, sitting up in her twin bed with beads of sweat dripping from her forehead as she held a pink plastic rosary in her hand.

You’d think the Hail Marys and Our Fathers I uttered while trying to fall asleep would protect me from the terror produced by my recurring dream. But it didn’t. As soon as my head hit the pillow, the image was always the same: strings of rope or yarn swinging from left to right in a slow, methodical tempo like the needle of a metronome, gradually becoming entangled. They begin to creep toward me like the arms of an octopus. And then try to strangle me. I run away. And lose my breath. As all the rhythm evaporates into a rushed madness, I find myself perched atop balls of crinkled trash. I rest there for a moment, thinking I’m safe from the octopus arms. Until the balls come alive and try to crush me.

“It was only a dream,” my mom would tell me, as I trembled and sobbed in her arms. “Dreams can’t hurt you,” she said, as she combed my thick hair with her fingers and wiped the tears from my eyes.

But I knew better. My dreams were prophecies… of fears that would come true, of order that would end in chaos, of messes that would destroy me, of my future.

I was afraid I would become my godmother, my aunt Mary Lou, who was my only exposure to mental illness.

In my mind, Mary Lou’s responsibility to me as my godmother was far greater than catechism lessons, ensuring I received a proper religious education. She needed to do more than guide me spiritually and hold me at my Baptism. As a pious little girl whose biggest day of her life was her First Communion, I believed that one’s godmother held the spirit of her goddaughter.

The way I saw it, my soul was eternally tied to my aunt Mary Lou’s.

Which was terrifying.

Mary Lou started her life as a beauty. With dynamic features similar to Audrey Hepburn’s, she was gorgeous. The second oldest after my mom of seven kids, she was the tallest, at five foot ten. And because of all her competitive ballet training, her height only added to her grace. In fact, she modeled through her adolescence, into high school.

All that changed when she went off to college. She fared okay at the small, all-women’s college she attended in St. Louis. But during her junior year, the semester she spent in Rome, let’s just say she did not do as the Romans do. She did as crazy people do in Rome: tossed her travelers’ checks off the balcony to whomever was beneath; built an altar in her studio apartment there, believing that she was getting married; seeing and hearing things that were not there; and pretending she was different people, changing personalities every time the pope waved from his balcony.

Mary Lou’s behavior was so neurotic in Rome that the police were called to transport her to the closest psych ward, where she was locked up. My grandfather then flew over to Rome with two doctors and two nurses, secured Mary Lou in a straitjacket and loaded her on the plane, and flew back with her to Dayton, where she immediately received shock therapy.

That hospital stay began the first of about twenty. And we’re not talking the express version that yours truly had the benefit of. She was there for at least three months at a time, until a doctor could arrive at a diagnosis, most consistently bipolar disorder and schizophrenia, and a treatment plan. They’d eventually release her, sometimes after a year, once they felt she had stabilized. Sometimes she was able to hold a job for a full year. But usually it was only a few months before she ended up hospitalized again, strapped to the gurney, receiving electroconvulsive therapy all over again.

When she was manic, Mary Lou was the most generous godmother in the world. She would arrive at our doorstep bearing extravagant gifts. She bought me and my sisters 24-karat gold necklaces, gorgeous wool sweaters, and delicate porcelain dolls. I received twice as many gifts, of course, because I was Mary Lou’s godchild. But I couldn’t rip off the tags, because as soon as she dropped them off, my mom collected them from us and returned them to the stores, explaining that her sister was mentally ill and couldn’t afford what she had purchased.

Then there were those other visits. At three in the morning, when Mary Lou stood outside our door shaking in the snow with no shoes, paranoid that people were coming after her. Even when she was locked up at the psych ward, my mom couldn’t sleep soundly, because bars couldn’t hold Mary Lou in. Once she was locked away in an institution twenty miles or so away. Completely psychotic, she escaped and hitchhiked her way back to Dayton and rang our front doorbell until my mom answered.

As the eldest of seven, it was usually my mom’s job to take Mary Lou back to the hospital, to convince her that she needed to be treated again, even when the hospital treatments didn’t seem to work. Most often, my mom and my grandpa would have to find yet another long-term program because Mary Lou’s mom, my grandmother, was an active alcoholic at the time—and her drinking only escalated with Mary Lou’s problems.

Each transition—from apartment to hospital—was perilous.

Because Mary Lou could turn on anyone trying to help her.

On one occasion, paranoid about people coming after her, she crashed in the front door of her apartment. Completely psychotic, she accosted my mom and dad, convinced they were plotting against her. Thankfully, with the help of some strangers, my parents forced her into the car. And she didn’t jump out like she had done several times in my grandfather’s car—which was why typically four people would need to take her to the hospital, one to guard each car door.

Once hospitalized, my mom would visit her several times a week. Sometimes she’d drag me and my sisters along with her. We’d sit there on the floor with our backs against a sterile white wall and wait for Mary Lou to say something.

She never did.

The time I was there alone I sat with three patients. They were like white ghosts, with no hint of emotions, feelings, or life. To this day, I can still see their faces, those vacant eyes, and feel the chills of that moment: when I saw for myself what mental illness can rob from a person who is treated incorrectly.

Where have their souls gone? I wondered. How does a person get this way? Why does God do this to people?

I internalized Mary Lou’s cycles and her illness, in general, because I feared that therein lay my future: ordering off of a psych ward menu, with visiting hours from three to six. The wandering eyes, the blank expression… I’d get there one day, too.

“Am I like Aunt Mary Lou?” I asked my mom a million times growing up. “She was different. And I’m different like that, right?”

“No,” my mom would immediately reply. “You and Mary Lou are nothing alike.”

My mom had every right to deny the similarity: Mary Lou, her younger sister by two years, was schizophrenic, delusional, psychotic, and a host of other descriptions found in the DSM-IV. She spent more of her adulthood in a hospital room than in an apartment. From the time her illness fully exhibited itself at age twenty to the time she died at age forty-three, she was well for maybe seven years, if you lumped together all the good and stable times.

And her life ended in suicide, with a turn of the ignition key in my grandmother’s garage.

I was sixteen years old at the time.

And I was devastated.

Because I saw so much of myself in my godmother.

It wasn’t much of a leap for me to think I was crazy, too.

I’m not like Mary Lou in that I’m not schizophrenic and my bipolar disorder is not as severe as hers was. I also have the advantage of thirty years of medical and scientific research. But I am like my godmother in the very way I feared I would be as a young girl: in inheriting genes that predispose me to mental illness and to a brain chemistry that could have very easily ruined me by now, genes that hardwire a mind for mental anguish so that I have to chase after sanity each day—sometimes several times a day—with a dogged determination and a fierce tenacity I didn’t know I had in me.

For Mary Lou’s sake and for folks like her, who haven’t been able to benefit from all the research and understanding of mental illness as I have, I dedicate my life to this cause: to making mental illness less scary for those who live it and to educating as many people as I can about mood disorders so that we can permanently remove the unfair stigma associated with depression and bipolar disorder.

I want to be Mary Lou’s ambassador in this world, just as she is, and will always be, my godmother.

SANITY BREAK

9 Ways to Stop Obsessing

The French call obsessive-compulsive disorder folie de doute, the doubting disease. That’s what obsessions are—a doubt caught in an endless loop of thoughts. But even those not diagnosed with OCD can struggle with obsessions. In fact, I have yet to meet a depressive who doesn’t ruminate, especially in our age of anxiety. Every day gives sensitive types like myself plenty of material to obsess about. So I’m constantly pulling out the tools that I’ve acquired over time to win against my thoughts, to develop confidence—the antidote to doubt—to take charge of my brain. Maybe they’ll work for you, too.

1. Name the beast. My first step to tackle obsessions: I identify the thought. What is my fear? What is my doubt? I make myself describe it in one sentence, or, if I can, in a few words.

2. Pencil it in. Awhile back, when I was especially tormented by some obsessions, my therapist told me to schedule a time of day where I was free to ruminate. That way, she said, when you get an obsession, you can simply tell yourself, “Sorry, it’s not time for that. You’ll have to wait until eight in the evening, when I give you, My Head, fifteen minutes to obsess your heart out.”

3. Laugh at it. Laughter can make almost any situation tolerable. And you have to admit, there is something a little funny about a broken record in your brain. I have a few people in my life who struggle with obsessions in the same way I do. Whenever I can’t stand the noise in my head anymore, I call up one of them and say, “They’re baaaaaack…” And we laugh.

4. Throw it away. One behavioral technique that works is to write out the obsession on a piece of paper. Then crinkle it up and throw it away. That way you have literally thrown out your obsession. Or try visualizing a stop sign. When your thoughts go there, remember to stop! Look at the sign!

5. Learn the lesson. I often obsess about my mistakes. I know I messed up, and I’m beating myself over and over again for not doing it right the first time, especially when I have involved other people and hurt them unintentionally. If that’s the case, I will ask myself: What is the lesson here? What have I learned? Then I will describe the lesson that I have absorbed in one sentence or less.

6 Reel it in. Buried within an obsession are usually pieces of truth. But other parts are as accurate as a juicy celebrity tabloid story: “Celine Dion meets ET for drinks.” That’s why you need some good friends that will help you separate fact from fiction. When I call up my friend Mike and tell him my latest obsession, he usually laughs out loud and says something like this: “Wow. Reel it in, Therese. Reel it in. You are way out this time.”

7. Imagine the worst. I know this seems wrong—like it would produce even more anxiety. But imagining the worst can actually relieve the fear triggering an obsession. Because you’ve hit bottom. You can’t sink any lower! Isn’t that refreshing?

8. Put it on hold. Sometimes I start to obsess about a situation for which I don’t have enough information. So I put my obsession on hold, like it’s a pretty lavender dress at a boutique that I saw and want but don’t have enough money to buy. So it’s there, waiting for me, when I get enough dough—or enough data.

9. Interrupt the conversation. An obsession is like a conversation over coffee: “This is why he hates me, and this, too, is why he hates me, and did I mention why he hates me? I’m sure he hates me.” So I can be myself and rudely interrupt. I don’t even have to say, “Excuse me.” I can ask a question or throw out another topic. And, best of all, no one will tell me, “Let her finish.”

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Excerpted from Beyond Blue by Borchard, Therese Copyright © 2010 by Borchard, Therese. Excerpted by permission.
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