The Depression

November 2017

I’d never felt so “heavy” in my life.

Dragging myself out of bed felt like a monumental accomplishment and all I wanted to do was sleep.

At first I attributed this to mere jet-lag, but the feelings of heaviness did not disappear – in fact they got worse over the next few weeks. I had never experienced anything quite like this before; I wasn’t even sure what it was.

I couldn’t go to work, leaving the house was a struggle, and it was miracle if I accomplished anything more than taking a shower and maybe washing the dishes.

I didn’t feel emotional – in fact I felt kind of numb.

I didn’t feel like crying either – I just wanted to sleep.

It had been such an emotional year that the minute I got home from America and just stopped, I suddenly crashed – mentally and physically.

It was like the ground was trying to swallow me and my muscles felt like dead weight. My eyelids were heavy and no matter how hard I tried, I was unable to force myself to get anything done on my to-do list. Normally I would have been consumed with feelings of guilt over my lack of motivation, but I was just too tired to care.

It took a phenomenal amount of energy to attend my pre-scheduled appointments with the fertility clinic and the pelvic pain specialist. And to make matters worse, I was getting bad news again (my apparent pre-destined baseline) which didn’t help the situation.

“Your oestrogen levels are really low and your luteinizing hormones are really high,” the nurse from the fertility centre informed me. I had only one precious frozen egg from my  two IVF cycles and we were attempting a natural frozen cycle this month.

I was devastated, but not surprised, by the news. The nurse said I could go ahead with the cycle if I liked, but I was appalled by the advice. I was not going to put that embryo in unless my hormone levels were PERFECT – I had worked too hard for it! I told the nurse that I’d rather try next month, that maybe my hormones would be better then.

I felt so deflated by this news, which seemed to make the “heaviness” even worse.

My pelvic pain had also flared up from the long periods of sitting during my travels, so I was excited to FINALLY be getting an appointment at the “Chronic Pelvic Pain Clinic”.  My amazing gynea surgeon, Dr.M, had recently started this clinic comprising of gyneacology doctors, anaesthesiologists, physical therapists and psychologists (all specialising in pelvic pain) and they were even offering botox injections placed directly into the pelvic floor muscles to stop the painful spasming and promote relaxation.

I arrived at the clinic and a young female doctor called me in. “I’m so confused, why are you here?” she asked.

I informed her that I’d had surgery with Dr. M but still had pelvic pain and that I’d been on the waiting list for the “Chronic Pelvic Pain Clinic” for 6 months.

She excused herself to talk to the front desk. After a few minutes she returned, another form in hand. “This is the wrong clinic,” she informed me. My eyes widened in disbelief – I had waited for 6 months to get into the wrong clinic?

“But I’ll do another referral for the right clinic,” she was apologetic, “I am sorry about this.”

I was speechless. I had been so excited about this appointment, desperate for appropriate care and pain relief.

And as usual, she put me in a low category (which I found out later when I received a letter confirming my referral) stating that my pain was not that severe and I could wait ANOTHER 12 months before being seen in the clinic.

To this day, I don’t know why I haven’t learned my lesson about being more “dramatic” when seeing doctors. For some reason I assume that when I report that my pain is moderate to severe, that it should be taken seriously, but that doesn’t seem to be the case; in fact I have heard nurses and doctors actually label girls with endometriosis as “drug seekers”. Nothing infuriates me more. You cannot win – if you’re not dramatic enough, they don’t take you seriously, but if you make a big deal about your pain you run the risk of being labeled as a “drug seeker”. Either way, the care we receive is dismissive.

This mindset is a major hindrance to the appropriate diagnosis and management of endometriosis – leaving us to suffer 10-15 years longer than we should before receiving appropriate treatment and care.

So I walked home completely deflated – and then I went to bed.

The days dragged on and I wasn’t improving. I was starting to wonder if I would ever feel normal again.

“I don’t know what’s wrong with me,” I lamented to my sister-in-law.

Karissa, though, knew exactly what it was, “I think you might be having an episode of depression,” she informed me.

Depression? I felt shocked by this realisation.

I’d had many episodes over the last few years where I felt “depressed”, but nothing quite like this. In fact, I wasn’t even sure I felt sad – I just felt unbelievably tired – and that is what confused me.

Karissa could relate; she had recently gone through a major depressive episode herself and said that she had felt the exact same way – taking long naps every day and barely able to drag herself out of bed.

How could I not have known that I was depressed? It highlighted the fact that depression is very complicated, and I felt so ignorant.

I was astounded by the fact that I hadn’t identified these unbearably heavy feelings as depression: I naively thought that depression meant that you felt, well, depressed, sad, teary, or “down in the dumps”; whereas I felt NOTHING – just an excessively debilitating exhaustion.

I was so grateful for Karissa’s insight and support. During her own depressive episode she had seen a Psychologist, so with that in mind she started checking up on me daily; sending little texts of advice, encouragement and empathy.

It’s not the worst thing ever if you were to sleep and read all day. Can/should you do it forever….no, but you’ve pushed yourself so much that it’s probably time that you just rest, give yourself some space to heal, sleep and zone out. Give your mind and body a break.

Her mere act of giving me permission to rest had a profound effect on my mental health. I tried to be more gentle with myself and allow space for what I was experiencing.

I would try my hardest to leave the house to get some sunshine but the furthest I ever got was the lawn in front of our apartment. I’d go lay outside on a blanket, book in hand ( with honourable intentions to read), but I was just too tired to read – so I slept instead.

Luckily my husband was gentle with me during this difficult time; he doesn’t clearly remember this episode, but he just remembers thinking that I was allowed to rest after the horrendous year I’d had. I was so grateful he didn’t nag me to be more “productive”.

My sister-in-law continued to faithfully check in with me on a daily basis, making sure I was ok. Her texts were the therapy I needed.

Set a goal to just do one little thing each day that gives you joy.

Physical – move your body in even the smallest of ways.

Achievement – something you have to do, that gives you a feeling of a “win” aka unpacking the dishwasher, replying to one email.

Intellectual – something that uses your mind. One article, one sentence of a book, one minute of a podcast.

Fun – Something just for the heck of it. Painting, watching a movie with Jarod, or cooking.

Especially now that you’re trying to get your body prepared to do IVF, I think you just need to put rest and healing at the top of your list. Let your body kick out of that fight or flight state you’ve likely been running on achieving all these amazing things you’ve been pushing yourself to do.

I internalised her wise words and tried to congratulate myself for taking a shower or putting the dishes away (instead of beating myself up for being “lazy” and not accomplishing anything on my ever growing to-do list).

It took a phenomenal amount of energy to do what she said, but with each day there were subtle improvements, though the progress was painfully slow and with each week that passed I wondered if I would ever feel normal again.

I was just so grateful for Karissa’s support. My sister-in-law and her high school sweetheart (now husband) were only 21 when we embarked on our treacherous journey of infertility. They were both studying in Sydney at the time, and even though they were far away they somehow always made an effort to be there for us.

Nothing can prepare you for infertility, and there is no manual on how to handle it (neither for you nor your support system) but Tom and Karissa somehow managed to support us in the exact way that we needed throughout each complicated stage of our journey.

If you were to ask them how they did it, they would just shrug and say “We actually have NO idea what we’re doing. We’re trying our best, but we’re floundering.”

And yet, somehow, in their early 20’s, they both displayed profound maturity and empathy toward a situation so complicated that even adults with much more life experience could not navigate it.

Karissa listened empathetically – for YEARS. I don’t know how she didn’t get burned out. It was YEARS of ups and downs, with absolutely no outcome in the end. She listened intently and without judgement as I expressed the same set of emotions over and over and over again.  It must’ve been exhausting to listen to this repetitive rant and feel so helpless, but she did what she could.

Even though she was studying Occupational Therapy, she started blogging about fashion on the side (her childhood obsession and passion) and eventually became well known on Instagram. She would frequently spoil me with clothes, accessories and other gifts; she took me shopping and made me feel beautiful; she took me to launch parties and other events in Sydney; she took me Glamping in Byron Bay; she took me to one of the hippest yoga studios in Sydney – she spoiled me rotten in the best way she knew how.

She couldn’t take my pain away, but she did whatever she could to inject my life with a little bit of happiness. Most importantly, though, were the HOURS spent in Vegan cafes debriefing about life over scrumptious food and soy lattes.

Whatever we needed, Tom and Karissa did it.

If we needed space, they left us alone (no offence taken).

If we needed an empathetic ear, or a distraction, they would be by our side.

They became our main advocates and spokespeople – communicating with the rest of the family when we were too emotional to express our needs.

They even became our “medical representatives” – Tom (now a doctor) and Karissa (an occupational therapist) now had the medical background and knowledge to explain some of the complicated medical procedures I was undergoing to close friends and family (relieving me of the pressure to try to explain it myself, as I had no energy left).

To this day, they still maintain the humble attitude of “We seriously have no idea what we’re doing”, but I cannot fault them.

And as the journey progressed and years went by, it got even more complicated – we got to a point where we had NO idea what we needed anymore – so Karissa decided for me and bought me a Ragdoll kitten before going on an extended trip overseas; making sure she was not leaving me alone and that I had something that would bring me daily joy – this was my “prescribed therapy” from my personal occupational therapist.

And now, here she was checking up on her depressed “patient” everyday; not in a clinical way, but in a way that only one who has suffered from depression themselves could truly understand.

One of the hardest aspects of this profound lethargy was not knowing when it was going to end. It had been weeks and I’d only left the house for doctors appointments: I was starting to feel hopeless, wondering if I would every get my energy back.

I continued to tackle Karissa’s set of goals, trying to tick off one small achievement each day. The “Intellectual” activity was desperately difficult, as every time I tried to read I would fall asleep, but as the weeks went by I slowly found myself able to read a little more each day.

I picked up a book that had been sitting on my shelf for years – Man’s Search for Meaning. 

It had been staring at me and taunting me for 5 years and I didn’t know why I hadn’t read it yet – until I started reading it and then I realised it was meant for such a time as this. 

I had never really wrestled with the WHY of my suffering, choosing rather to apply Radical Acceptance (as bad things just happen ALL the time with no rhyme or reason), but I definitely struggled with the length of my journey and the unbearable physical pain I endured on a daily basis (oh, if God could just give me infertility alone and not the immense physical suffering then perhaps I would have the strength to keep going).

But reading Man’s Search for Meaning suddenly catapulted me into new dimension – a place I had never considered (as my sole focus had been survival) – and that was to find meaning in my suffering.

Victor Frankl states:

When a man finds that it is his destiny to suffer, he will have to accept his suffering as his task; his single and unique task. He will have to acknowledge the fact that even in suffering he is unique and alone in the universe. No one can relieve him of his suffering, or suffer in his place. His unique opportunity lies in the way in which he bears his burden.

He also quoted Dostoevksy:

There is only one thing I dread: not to be worthy of my sufferings.

And Spinoza:

Emotion, which is suffering, ceases to be suffering as soon as we form a clear and precise picture of it.

I laid on the green lawn, staring at the vibrant blue summer sky, trying to digest these life-changing words. I had never asked “why?” because I’d seen so much suffering in my childhood in South America and in my career as a nurse that I just felt like this was now my turn to suffer (and why some people get luckier than others and experience very minimal suffering we shall never know – but I have also found that some of those lucky people very often create their own suffering and sadly live in a self-perpetuated hell).

But this, well…..this took WHY to the next level.

Victor Frankl explains –

The uniqueness and singleness which distinguishes each individual and gives meaning to his existence has a bearing on creative work as much as it does on human love. When you know the “why” for your existence, you will be able to bear almost any “how”.

A voice in my head rose through the chaotic noise in my mind and loudly stated, “The blog. You must share your blog.”

I felt my throat constrict and I immediately tensed at the thought being that vulnerable; both my mind and body rejected the mere idea of it.

“You must raise awareness for endometriosis,” it continued, completely disregarding my feelings of abhorrent rejection, “and help destigmatise infertility. You are a healthcare professional and you have a responsibility.”

I felt like I wanted to vomit.

I had started my blog in 2015 after listening to an online fertility summit about the power of journaling; this is also emphasised in books, podcasts and by my therapist – writing and analysing your feelings is supremely therapeutic and cathartic.

I wasn’t sure what I was going to do with the blog but I NEVER intended to share my story publicly with my friends and family – especially when I was so desperately vulnerable and in the depths of despair.

I was so fragile that I felt as though if one person said the wrong thing to me I would crumble to pieces, and yet here I was interrogating the idea of telling EVERYONE about my deepest, saddest, most vulnerable moments; laying my story out in the open for full judgement and criticism.

I couldn’t bear the thought of it.

I shook my head vigorously as if trying to forcefully and physically shake the voice out of my head – as well as emphasising a clear NO in the process.

“No, no no,” I uttered out loud, “I will share my journey when I’m not so vulnerable, when I’ve had success and its over,” I said with clear resolution, as if stating that I would do it someday would somehow eradicate the nagging voice in my head.

But then I suddenly felt sick at the thought of my uncertain future – for what if I NEVER had success?

The nagging voice heard my thoughts, “Then you will blog about the grief and loss,” it said matter-of-factly, “and you will share your journey as you come to terms with the disappointment.”

I gritted my teeth and grunted at this annoying, persistent voice in my head. I wish it would shut up, but instead it became louder and more insistent, “This ISN’T about you, can’t you see that?!!!!!” It almost screamed.

I became very still, a sudden chill running over my body.

Here I was so scared about what people might think of me, but the voice was right – this was so much bigger than me. The moment I realised this difficult truth everything changed. Brene Brown’s TED talk on vulnerability haunted me, and I found myself SLOWLY accepting the fact that I could not wait until I had “success” before sharing my story; I would have to somehow summon the strength to share my deepest pain whilst I was still in it – as this was the true test.

This moment of enlightenment – when I found meaning in my suffering – was the turning point in my journey; it also reached down and pulled me out of the deep dark depths of depression that I was stuck in.

My energy started to re-emerge, but so did the terror. I sat breathless at the computer, staring at the blinking line, my hands shaking as I started to type the words that would both immortalise and expose my painful vulnerability.

I was terrified, but little did I know how astoundingly different the actual outcome was going to be – nothing could have prepared me for the onslaught of love and support that flooded in once I dared to open the gates.