An OCD Diaries Primer

A collection of posts that form the back story of this blog.

Mood music:

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The Long History of OCD

An OCD Christmas. The first entry, where I give an overview of how I got to crazy and found my way to sane.

The Bad Pill Kept Me from the Good Pill. How the drug Prednisone brought me to the brink, and how Prozac was part of my salvation.

The Crazy-Ass Guy in the Newsroom. Think you have troubles at work? You should see what people who worked with me went through.

The Freak and the Redhead: A Love Story. About the wife who saved my life in many ways.

Snowpocalypse and the Fear of Loss. The author remembers a time when fear of loss would cripple his mental capacities, and explains how he got over it — mostly.

The Ego OCD Built. The author admits to having an ego that sometimes swells beyond acceptable levels and that OCD is fuel for the fire. Go ahead. Laugh at him.

Fear Factor. The author describes years of living in a cell built by fear, how he broke free and why there’s no turning back.

Prozac Winter. The author discovers that winter makes his depression worse and that there’s a purely scientific explanation — and solution.

Have Fun with Your Therapist. Mental-illness sufferers often avoid therapists because the stigma around these “shrinks” is as thick as that of the disease. The author is here to explain why you shouldn’t fear them.

The Engine. To really understand how mental illness happens, let’s compare the brain to a machine.

 

Rest Redefined. The author finds that he gets the most relaxation from the things he once feared the most.

Outing Myself. The author on why he chose to “out” himself despite what other people might think.

Why Being a People Pleaser is Dumb. The author used to try very hard to please everybody and was hurt badly in the process. Here’s how he broke free and kept his soul intact.

The Addiction and the Damage Done

The Most Uncool Addiction. In this installment, the author opens up about the binge-eating disorder he tried to hide for years — and how he managed to bring it under control.

Edge of a Relapse. The author comes dangerously close to a relapse, but lives to fight another day.

The 12 Steps of Christmas. The author reviews the 12 Steps of Recovery and takes a personal inventory.

How to Play Your Addictions Like a Piano. The author admits that when an obsessive-compulsive person puts down the addiction that’s most self-destructive, a few smaller addictions rise up to fill the void. But what happens when the money runs out?

Regulating Addictive Food: A Lesson in Futility. As an obsessive-compulsive binge eater, the author feels it’s only proper that he weigh in on the notion that regulating junk food might help. Here’s why the answer is probably not.

The Liar’s Disease. The author reveals an uncomfortable truth about addicts like himself: We tend to have trouble telling the truth.

Portable Recovery. Though addiction will follow the junkie anywhere in the world, the author has discovered that recovery is just as portable.

Revere (Experiences with Addiction, Depression and Loss During The Younger Years)

Bridge Rats and Schoolyard Bullies. The author reviews the imperfections of childhood relationships in search of all his OCD triggers. Along the way, old bullies become friends and he realizes he was pretty damn stupid back then.

Lost Brothers. How the death of an older brother shaped the Hell that arrived later.

Marley and Me. The author describes the second older brother whose death hit harder than that of the first.

The Third Brother. Remembering Peter Sugarman, another adopted brother who died too early — but not before teaching the author some important lessons about life.

Revere Revisited.

Lessons from Dad. The author has learned some surprising lessons from Dad on how to control one’s mental demons.

The Basement. A photo from the old days in Revere spark some vivid flashbacks.

Addicted to Feeling Good. To kick off Lent, the author reflects on some of his dumber quests to feel good.

The lasting Impact of Crohn’s Disease. The author has lived most of his life with Crohn’s Disease and has developed a few quirks as a result.

The Tire and the Footlocker. The author opens up an old footlocker under the stairs and finds himself back in that old Revere basement.

Child of  Metal

How Metal Saved Me. Why Heavy Metal music became a critical OCD coping tool.

Insanity to Recovery in 8 Songs or Less. The author shares some videos that together make a bitchin’ soundtrack for those who wrestle with mental illness and addiction. The first four cover the darkness. The next four cover the light.

Rockit Records Revisited. The author has mentioned Metal music as one of his most important coping tools for OCD and related disorders. Here’s a look at the year he got one of the best therapy sessions ever, simply by working in a cramped little record store.

Metal to Stick in Your Mental Microwave.

Man of God

The Better Angels of My Nature. Why I let Christ in my life.

The Rat in the Church Pew. The author has written much about his Faith as a key to overcoming mental illness. But as this post illustrates, he still has a long way to go in his spiritual development.

Absolute Power Corrupts Absolutely. The author goes to Church and comes away with a strange feeling.

Running from Sin, Running With Scissors. The author writes an open letter to the RCIA Class of 2010 about Faith as a journey, not a destination. He warns that addiction, rage and other bad behavior won’t disappear the second water is dropped over their heads.

Forgiveness is a Bitch. Seeking and giving forgiveness is essential for someone in recovery. But it’s often seen as a green light for more abuse.

Pain in the Lent. The author gives a progress report on the Lenten sacrifices. It aint pretty.


Hell Isn’t for Children (But Some Get Stuck There Anyway)

The author hears a lot from parents with children suffering from mental disorder. Seeking his advice might not be wise, though. Here’s why.

Mood music for this post: “Sweet Chols ‘O Mine,” by Guns N Roses:

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Since starting this blog, I’ve been hearing a lot from parents. They’ve read about the trials of my own childhood, see things in their own children that cause worry, and want my advice.

Not a good idea for a few reasons:

Every child’s experience is different.

I don’t think I was born with a mental disorder. I’m pretty sure it developed over time, the result of the damage disease inflicted on me physically, mixed with a lot of death and strife I had to go through which, in turn, led to self-destructive behavior that knocked my brain chemistry out of whack.

Parents I’ve talked to have kids with clinical mental disorders right now, whether it’s OCD or ADD.

If your child is among them and is seeing a good therapist — and if you as a parent are doing everything possible to help the child through it, you are already doing the right thing and don’t need advice from me.

If there’s turmoil in your house that is difficult on a child — divorce, abuse from the other parent or from someone outside the family, a recent death, a serious illness — that’s stuff I can relate to, but even there no two experiences are the same.

Here’s the good news, though. Very good news:

The understanding and treatment methods for mental disorders are head and shoulders over what was available when I was a kid. Back then, kids with emotional problems were often written off as troublemakers or “slow.” Not in every case, but more so than what we have today.

I remember, back at Theodore Roosevelt Elementary School, being put in a special class with other kids. The troubles were mixed. A couple of us were way behind in our reading skills and needed extra help. A couple others were prone to wild behavior.

Looking back, we probably had a mix of problems that weren’t the best fit for that kind of class. I don’t fault the teachers and administrators, some of whom are good friends today. I think they did the very best they could with the information they had back then.

Today the information is much clearer, the action items much more solid and targeted to the child’s specific needs.

Parents are given better direction on things to do at home.

Medication is much more effective.

As a result, you don’t have nearly as many kids being written off as damaged goods. In that sense, this is a great time to be a parent.

I also consider myself pretty lucky because the work I’ve done on my own problems has made me a better parent. When my children go through some difficulty, I have the mental muscle and coping tools to share with them.

If you think your child is suffering from mental illness, don’t come to me first. Talk to a doctor first. Your child will more often than not be led to the right kind of help that only trained professionals can give.

Then, after you’ve done all that, I’m happy to share some war stories. Sharing is what I have to give, but it’s always going to be colored by my own strange history.

But this much I can tell you:

If your child might be having mental health issues or you’ve just found out he/she does, be patient. That child is going to need a lot of positive reinforcement and some days it’ll take every scrap of strength you have. It’ll tire you out, which makes you more prone to yelling and throwing up your arms in frustration.

Remember that you can’t take care of your children unless you take care of yourself. That means eating properly, getting enough sleep and avoiding self-destructive behavior at all costs.

Take it from me: If you have addictions and let them run wild in an attempt to comfort yourself, you will be an absolutely shitty parent and spouse.

These things can put a marriage through the test as well, but if you make a point of having the frequent “date night” with your other half, your chances of surviving increase substantially.

You also have to take some time every day to get quiet time with your spouse. I can’t take credit for that revelation, though. I learned that one from my wife.

If you don’t have a hobby or other form of relaxation, you need to find one, because that will also help you cope. For some it might be model-ship building or surfing. For me, it’s Heavy Metal and History.

And here’s the most important thing: You need to have Faith. The saying “Let Go and Let God” is something I love.

It doesn’t mean give up, stop trying, go lie in the corner and let God sort it out.

To me, it means accepting that you can’t control most of the chaos around you, but for those of us with Faith, there’s peace in the foregone conclusion that the Man has a plan, and if you trust Him it’s all going to work out.

Call that crazy if you will. But my experience is that it’s true. And experience is all I have to share here.

Understanding Mental Disorders: The Brain as an Engine

I’ve written a lot about my use of Prozac as just one of many tools to treat my OCD. [See The Bad Pill Kept Me From The Good Pill]

Mood music:

As a result I’ve gotten a fair amount of questions about the true value of anti-depressants. I’m not a doctor, so don’t take my perspective as Gospel. Also remember there’s no one-size-fits-all solution here. What I write here is based on my own personal experiences. What works for me may not work for the next person.

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The more I read up on depression, mental illness and the drugs prescribed for it, the more I see the human brain as an engine. Comparing it to an engine makes this whole think easier to understand.

We know that the engine of a car is made up of many small parts and when one part gets worn out the rest of the engine can fail. We know that a car needs just the right amount of oil, transmission fluid, brake fluid etc. to function properly. If the oil runs out, the engine seizes up. If the brake fluid runs dry, the breaks fail. On the flip side, too much of these fluids can harm the engine.

We also know that the auto mechanic uses many different techniques to keep engines healthy or fix them when they break.

The brain works much the same way.

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Think of the different drugs as different tools to deal with very specific problems in the engine.

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In my case, Prozac addresses the very specific fluid deficiencies that spark OCD behavior. The effect is not as simple as the image below suggests (though I do like the image and need to find the artist so I can properly credit him/her):

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It may also be useful to think of the therapist as the auto mechanic who is well versed in how to regulate the different engine fluids and pinpoint specific fixes for specific problems. It’s also true that there are good mechanics and bad mechanics who sometimes make the problem worse. [More on this in my previous post: Have Fun With Your Therapist (A.K.A.: The Shrink Stigma)]

In the brain, when certain fluids are running low, the engine stops working properly. The result is depression and a host of other mental disorders.

Since OCD is essentially the brain pumping and spinning out of control, I like to think of my specific problem as a lack of brake fluid.

But the good folks at WebMD explain it much better than I ever could. Here’s some WebMD wisdom I included in a previous post, Prozac Winter:

How Antidepressants Work

Most antidepressants work by changing the balance of brain chemicals called neurotransmitters. In people with depression, these chemicals are not used properly by the brain. Antidepressants make the chemicals more available to brain cells like the one shown on the right side of this slide:

Photo Composite of Neurotransmitters at Work

Antidepressants can be prescribed by primary care physicians, but people with severe symptoms are usually referred to a psychiatrist.

 

Realistic Expectations

In general, antidepressants are highly effective, especially when used along with psychotherapy. (The combination has proven to be the most effective treatment for depression.) Most people on antidepressants report eventual improvements in symptoms such as sadness, loss of interest, and hopelessness.

But these drugs do not work right away. It may take one to three weeks before you start to feel better and even longer before you feel the full benefit.

And, just as weather can impair the performance of your car engine (my father‘s car went for a swim when Revere got flooded out in The Blizzard of 1978 and never worked properly again), too much bad weather can keep the brain from working properly:

Why do I seem to get so gloomy each winter, or sometimes beginning in the fall?

You may have what’s called seasonal affective disorder, or SAD. The condition is marked by the onset of depression during the late fall and early winter months, when less natural sunlight is available. It’s thought to occur when daily body rhythms become out-of-sync because of the reduced sunlight.

Some people have depression year round that gets worse in the winter; others have SAD alone, struggling with low moods only in the cooler, darker months. (In a much smaller group of people, the depression occurs in the summer months.)

SAD affects up to 3% of the U.S. population, or about 9 million people, some experts say, and countless others have milder forms of the winter doldrums.

So this worsening of mood in the fall and winter is not just my imagination?

Not at all. This “winter depression” was first identified by a team of researchers at the National Institute of Mental Health in 1984. They found this tendency to have seasonal mood and behavior changes occurs in different degrees, sometimes with mild changes and other times severe mood shifts.

Symptoms can include:

  • Sleeping too much
  • Experiencing fatigue in the daytime
  • Gaining weight
  • Having decreased interest in social activities and sex

SAD is more common for residents in northern latitudes. It’s less likely in Florida, for instance, than in New Hampshire. Women are more likely than men to suffer, perhaps because of hormonal factors. In women, SAD becomes less common after menopause.

I’m still learning the science of mental illness, and remember I’m not a doctor. I just share my personal experiences and explain what works for me.

Class dismissed.

Lost Brothers

When my older brother died Jan. 7, 1984, a trend began where I would befriend people a few years older than me. A couple of them would become best friends and die prematurely themselves. It was also the day that sparked a lifelong fear of loss.

It’s been so long since Michael was with us that it’s sometimes hard to remember the exact features of his face. But here’s what I do remember:

We fought a lot. One New Year’s Eve about 30 years ago, when the family was out at a restaurant, he said something to piss me off and I picked up the fork beside me and chucked it at him. Various family members have insisted over the years that it was a steak knife, but I’m pretty sure it was a fork. Another time we were in the back of my father’s van and he said something to raise my hackles. I flipped him the middle finger. He reached for the finger and promptly snapped the bone.

We were also both sick much of the time. He had his asthma attacks, which frequently got so bad he would be hospitalized. I had my Chron’s Disease and was often hospitalized myself. It must have been terrible for our parents. I know it was, but had to become a parent myself before I could truly appreciate what they went through.

He lifted weights at a gym down the street from our house that was torn down years ago to make way for new developments. If not for the asthma, he would have been in perfect shape. He certainly had the muscles.

He was going to be a plumber. That’s what he went to school for, anyway. During one of his hospital stays, he got pissed at one of the nurses. He somehow got a hold of some of his plumbing tools and switched the pipes in the bathroom sink so hot water would come out when you selected the cold.

He was always there for a family member in trouble. If I was being bullied, he often came to the rescue.

I miss him, and find it strange that he was just a kid himself when he died. He seemed so much older to me at the time. To a 13-year-old, he was older and wiser.

He was close to a kid who lived two doors down from us named Sean Marley. After he died, I quickly latched on to Sean. We became best friends. In a way, he became a new older brother. Sean died in 1996 and the depression he suffered has been one of the cattle prods — next to my own fight with mental illness — for this blog.

A year after Sean died, I found another, much older brother named Peter Sugarman. He died in 2004 after choking on food.  His death sent me over the cliff with the OCD firing in every direction. That was the year I realized I needed help.

I was lucky to have known these guys. They certainly helped shape the person I am today. I am forever thankful for that, because I have a life that’s Blessed far beyond what I probably deserve. I would not have reached this point without their lessons and love. Even in death, they each taught me to see the things that truly matter.

Thanks, guys.

Fear Factor

In this installment, the author describes years of living in a cell built by fear, how he broke free and why there’s no turning back.

“The only thing we have to fear is fear itself.” — Franklin Delano Roosevelt

This morning I led a meeting of Over-eaters Anonymous, a task that included standing before a room of people for 30 minutes to tell my story of OCD, addiction and recovery.

It was my third time “qualifying” at an OA meeting this past year. Meanwhile, I did a fair amount of public speaking for my day job as senior editor of CSO Magazine. I sat on panels at security conferences and did solo presentations in front of various information security groups around the country.

Five or so years ago, the notion of me getting up to speak in front of people would have been laughable.

I was too busy hiding in my cage of fear to do such things. Fear will rob you blind, forcing you to avoid life and retreat into the sinister world of addiction.

Breaking free of it was a gift from God. But it took a long time to figure out how to unwrap it and realize my potential.

For me, fear was one of the many byproducts of OCD, something that went hand in hand with anxiety. It kept me away from parties. It scared me out of traveling. I turned down a lot of living in favor of lying in my bedroom watching TV. There are a couple examples in particular that I’m not proud of.

1991

One summer night I was hanging with two friends in front of Kelly’s Roast Beef, a popular eatery on Revere Beach. As we started walking the mile back to my house, we noticed we were being followed by some 15 punks. It was clear they were looking for trouble. I panicked and ran to a nearby bar. As I looked back, I couldn’t see my friends.

The punks had circled them and started kicking and punching their guts in. I called the police and the beatings ended quickly, but I couldn’t get over the fact that I ran away. Worse, it marked the end of my walking along the beach at night for many years to come.

It was a huge fear-inflicted injustice. I grew up on that beach and loved the place. I walked its entire length daily. It gave me peace and clarity. And I allowed some punks to scare me away.

2001

A week after the 9-11 attacks in New York and Washington, Erin and I were scheduled to fly to Arizona to attend a cousin’s wedding. The night before were were supposed to leave, I gave in to my terror at the prospect of getting on a plane and we didn’t go. It’s one of the biggest regrets of my life.

There are smaller examples in between and in the years after, but those are two of the more vivid memories.

Fear also fueled the binge eating and kept me from standing up for things that were right in the family and workplace. It was better to keep my trap shut, I thought. To do otherwise would put my job in danger or have me blackballed.

Then there was the fear of loss I wrote about a few blog posts back — fear that if I didn’t overprotect my kids I might lose them to some imagined beast; that if I spoke my mind during a spousal spat my wife might walk out on me. In hindsight, these were foolish ideas. But in the grip of fear, you think this way and act on it even though you really know better.

When I began getting treatment for the OCD the fear actually accelerated for a while. If a toe went a little numb I’d think I was suffering from a blood clot. A headache would leave me wondering if a tumor was growing inside my skull. A pain in the chest became fear of a heart attack.

I can’t remember when the fear finally began to lift. I think it was in early 2007, shortly after I began taking Prozac. Once the medicine untangled the chemical imbalances in the brain, situations I had feared suddenly seemed manageable. It was pretty weird, actually. I didn’t know what to do with this new feeling. Or maybe it was the year before, when I converted to the Catholic Faith and increasingly let God into my life. When you have God on your side, there’s really nothing to fear, right?

Then little milestones came along. There was a business trip to California that would have consumed me with worry a few years before. There was the first time giving a presentation in front of a room full of security people who were almost certainly smarter than me. The computer holding my PowerPoint presentation went on the fritz and I was forced to present sans slides. I told the audience that I was just going to wing it and that broke the ice.

Today, I look for opportunities to give talks in front of crowded rooms. I have work to do on my speaking skills, but I want more. The more I do, the more my confidence grows and the smoother and more organized the presentations get.

I look for opportunities to fly as well. And though I work hard on the business at hand, I ALWAYS make a point of building in a day to go out and explore, especially if there’s a piece of history to see up close. I want to see it all. Staring at the hotel room TV will no longer do.

Sometimes I worry that the fear will return and I’ll again retreat to my old cage. I don’t think that’s going to happen, though, for one simple reason — the world has been opened up to me. I’ve experienced too much joy these last couple years to go back to the way I was.

I couldn’t go back if I tried. Not that I would want to try.

To be clear, I still worry about things. But I don’t let it shut down the rest of my life. Instead of being engulfed, I can put the concern in its proper mental compartment and move along with my life.

There will be difficulties ahead, I’m sure. That’s life. But I feel more ready to deal with what may come than I’ve ever been before.

The Bad Pill Kept Me From The Good Pill

In a previous post I mentioned that I take medication for OCD: Prozac. It’s been extremely helpful, but it took a long time for me to even consider trying it. Here’s why:

Mood music:

As a kid sick much of the time with Chron’s Disease, I was often put on the maximum dose of a drug called Prednisone. The side effects were so horrific that I forever after resisted the idea of taking medication until I reached a point in my OCD treatment where I felt so desolate I was willing to try anything.

Prednisone does an excellent job of cooling down a Chron’s flare up. If not for the drug, chances are pretty good I wouldn’t be here right now. More than once the disease got so bad the doctor’s were talking about removing my colon and tossing it in the trash. Each time, the medication brought me back from the brink.

But there was a heavy price — literally and figuratively.

The drug quadrupled my appetite, which was already in overdrive because of the food restrictions imposed upon me during times of illness. It contributed mightily toward the binge eating disorder I wrote about a few posts back.

The drug also fueled vicious mood swings and introduced me to a lifetime of migraines, many of which were so bad I’d end up hunched over the toilet throwing my guts up.

So when I started to confront my mental disorder and specialists started talking about different medications available, I balked. In fact, I told one therapist to go screw.

I focused instead on building up an arsenal of coping mechanisms. That helped tremendously, but it wasn’t enough. I found myself against one final brick wall; one I couldn’t seem to punch through.

And still I resisted.

I had plenty of excuses. I knew many people who had gone on antidepressants and were still depressed most of the time. Some had gained weight — a problem I already had. I just didn’t see the point.

I also couldn’t shake the memory of a dear friend — a man who essentially became an older brother after my real older brother died in 1984 — who had been on medication for depression but ultimately committed suicide anyway. I walked away from that nightmare with the theory that antidepressants made people worse rather than better.

Finally, I resisted because the depression that often sprung from my OCD wasn’t the suicidal variety. Truth be told, I’ve never once considered taking my own life. It just never occurred to me. Mine is a depression in which I simply withdraw, saying little to people and spending as much time as possible on the couch zoning out in front of the TV. To me, medication was for people in far more serious condition.

And so I resisted until I was so desperate I was willing to consider anything, no matter how extreme or stupid.

After researching the various medications and consulting the doctors, I started taking Prozac in January 2007. The results were almost immediate.

I stopped re-spinning old anxieties in my head. I automatically stopped obsessing over things I couldn’t control, like the possibility that the plane I was on might crash en route to a business conference. Suddenly, I had an overwhelming urge to experience all the things I used to fear.

I fell in love with travel. Work challenges became fun instead of something to dread. I finally became comfortable in my own skin.

The compulsive tendencies still surface on occasion. I still get batty over getting chores done. I still get bent out of shape if my sons use my desk and move a few trinkets out of place.

But the fear and anxiety went away in 2007, and haven’t returned. For that, I am grateful beyond words. Nothing robs a person blind quite like fear. You spend all your time hiding from all the beautiful aspects of life.

The medication also gave me the last little push I needed to stop living my work life in a way that was all about pleasing others and maintaining some imagined golden-boy image. By the time I moved over to CSO Magazine to be a senior editor, I was well past that sort of thing. While there, I’ve never had a problem speaking my mind, expressing ideas forcefully and simply enjoying the heck out of the work itself. I’m certainly lucky in that I work with a wonderful group of people. I truly like everyone I work with.

I did do some research on anti-depressant medication and found that there is an actual science to it all. I learned that while personal history is certainly a factor in the things that trigger mental disorder (a history of child abuse, for example), the root cause if often an imbalance in the fluids that direct traffic in the brain. The WebMD website explains it pretty well:

“One common theory is that depression is caused by an imbalance of naturally occurring substances in the brain and spinal cord … Major depression affects about 6.7% of the U.S. population over age 18, according to the National Institute of Mental Health. Everybody at one point or another will feel sadness as a reaction to loss, grief, or injured self-esteem, but clinical depression, called ‘major depressive disorder’ or ‘major depression’ by doctors, is a serious medical illness that needs professional diagnosis and treatment.”

It goes on to say that most anti-depressant medicines improve mood “by increasing the number of chemicals in the brain that pass messages between brain cells.” That’s a key point. Mental disorders that are often viewed as stereotypical insanity and craziness are rooted in a chemical imbalance. When the brain chemistry is out of whack, the thinking process is disrupted. In my case, side effects of that imbalance included compulsive behavior and the inability to move on from certain preoccupations.

A good example: In 2005, when I was still at the beginning stages of dealing with my OCD, the hype about bird flu started to circulate. There was endless talk about that strain evolving into a pandemic as deadly as the 1918 Spanish Flu; far worse than the H1N1 pandemic we are currently experiencing.

I spent the following months in blind, silent panic. I feared for my children. I scanned through three pages of Google News results per day to keep track of the bird flu deaths in Asia and elsewhere.

When I started taking Prozac, that sort of thing stopped.

Make no mistake: Medication does not turn us into uncaring, numb and slap-happy beings. I still worry when my kids get sick. I still worry when the economy tanks and layoffs occur all around me.

But instead of stewing over these things around the clock, to the point where I can focus on little else, I’m able to function and still enjoy the precious present despite the mental burdens of the day.

Medication isn’t for everyone. I have no doubt that a lot of people on antidepressants don’t need to be. But in my case, the diagnosis was dead on and the prescription has done wonders for me. Three years ago, the concept would have been absolutely absurd.

The ultimate lesson: If you are in the grips of mental illness and you face the prospect of going on medication, don’t be afraid.