Category Archives: depression in the workplace

The Thought

As I’ve mentioned before, I’ve been doing really well these past few months. I’ve had the most emotionally vibrant period I think that I’ve ever had in my life. However, the other day, I got an abrupt reality check.

I’d had a fantastic weekend before I experienced what I’ve come to refer to as “The Thought”. Valentine’s Day was probably the best I’d ever had. My partner and I had an amazing time going out to dinner and a show, and the next day I spent some time away from home with her and her family. Life was good. Great, actually.

Then, early on Tuesday morning, I was driving home when a thought crossed my mind. “I want to swerve this car into a rock and crash. I want it all to end.” This thought seemed to come from nowhere. The weekend had been truly excellent. Then, I want to kill myself. What gives?

While the thought itself came out of the blue, it was not without warning signs. I mentioned once that trying to keep my dysthymia at bay is a little like playing Whack-A-Mole. Treating myself is like smacking a bunch of moles with mallets to keep them in their tunnels. Those moles are my dysthymia, and I keep smacking them down to keep the disease under control. Each of the moles comes out of a specific tunnel, representing the things I need to avoid to keep dysthymia at bay. Poor nutrition. Lack of exercise. Not enough “me” time. Whatever the hell’s going on chemically in my brain that requires a mallet laced with bupropion. Obviously the chemical issue has been a huge problem for me in the past, but my drugs, together with my other measures, seem pretty good at keeping that tunnel mole-free.

My ongoing nemesis throughout my life, and the tunnel from which I have the hardest time preventing moles from pouring forth, has been insomnia. I’ve never slept well in my adult life. Ever. Usually this manifested as difficulty falling asleep and inability to stay asleep once I finally did. When I did sleep through the entire night, it was not a restful sleep. I’d awaken feeling like I’d hardly slept at all.

So lately, moles have been streaming from the insomnia tunnel, although perhaps I didn’t recognize them for what they were. My sleep had been very poor the week and and half preceding the Thought. Those nights, I was getting maybe four hours of uninterrupted sleep, and then my body would wake up. The best I’d get after awaking would be intermittent snoozing. I often simply gave up at about five in the morning and got up to start my day. The night before The Thought, I was up at 3.00a in a state of panic over my lack of sleep, wondering how I was going to make it through my very busy upcoming three months. In other words, I was exhausted. Still kind of am, actually, though I’ve been catching up. I haven’t yet ascertained the reason for my lack of sleep, although I hope that my upcoming doctor appointment can help me figure it out.

Despite the lack of sleep, I still had energy. Large amounts of it, at least to me. Even with sleep deprivation, being on bupropion and treating myself correctly has given me far more energy than I had when my dysthymia acts up. So I hadn’t noticed the lack of sleep affecting me overly much.

Obviously it did, though. I wasn’t prepared for this fleeting suicidal thought; it hit me like a semi. If I’m feeling generally down, I can steel myself for the inevitable deluge of morbidity. But I wasn’t prepared this time. That short moment scared the shit out of me. I didn’t see the warning signs. Aside from my early morning fretting, I still don’t know what the warning signs were, if there were any to see at all. And that scares the shit out of me even more.

Perhaps, by allowing it to scare me as it has, I give The Thought too much power, though. Lately I’ve been listening to National Public Radio‘s fantastic new podcast Invisibilia, about the crazy parts of our brains that govern so much of what we do and who we are. In their inaugural episode, hosts Lulu Miller and Alex Spiegel use the dark thoughts that sometimes pop into our heads as a way to explore the history of psychotherapy.

The main frame of the show is a man who keeps having thoughts of wanting to violently kill his wife. That thought is used to explain how different therapy approaches try to handle the issue. Do you logically challenge the thought? Confront it directly? Push it aside as a random firing of synapses? The way the show explained these different approaches fascinated me. I’d used each of those strategies before to deal with my own dark thoughts. I’d challenge them. I’d confront them. I’d push them aside. But just like those moles, they kept popping back up.

There are good reasons why these strategies don’t always work for me. First off, depression isn’t logical. Challenging the thoughts certainly is useful, but I’m not really in a logical state of mind when having them. The asshole is too loud, too imposing. Confronting my suicidal thoughts also is of limited use in the moment. Death isn’t something I’m fearing, it’s something I’m welcoming. What use is confronting it?

My chosen method is usually pushing aside the thoughts. Ignore them. Bury them. Distract my mind so much that it doesn’t have the opportunity to wallow in darkness. That’s where working has helped. Work has helped keep me from following through on suicide in a few ways, one of which is that it distracts me. Rather than focusing on the train wreck of my life and the morass of my mind, I focused on work. There, I had some control. There, unlike my life, I could improve things. There, I could make others happy, even if I couldn’t do so for myself. Work was my escape from The Nothing.

My reaction to The Thought was similar, although I was far more cognizant of what I was doing. The Thought was fleeting, but my fear of and focus on it was not going away. Was all that work I’ve been doing over the past several months for naught? Before I went into work, I stopped by my partner’s house. She was a rock, someone dear on whom I could focus, to remind me of the happiness of which I was capable of feeling. But we both had to go into work, so I once again forced my mind into work. I had a particularly interesting challenge on which to focus at work, a complex, fascinating one involving our Code of Conduct and a future ordinance and public forums. I threw myself into it with gusto. And it worked. The Thought fell by the wayside.

After work, I was still rattled by this minor relapse. It wasn’t something that would have phased me much before, as it was fairly common. Despite my newfound happiness and positivity, I thought I was still abundantly aware that I have an illness that likely will never go away. The Thought showed me that I must not have really believed it. Now I do. I have The Thought to thank for that. I still don’t know where The Thought came from. Perhaps it was just my dysthymia saying, “Hey, remember me? I’m still here. I can still fuck with you.” And yeah, now I know it’s going to continue fucking with me. But I’ll be ready for the little bastard next time.

Will the real Buzzy Nielsen please stand up?

For pretty much all of my post-undergraduate life, my identity has always been tied inextricably to my job. “Hi, I’m Buzzy, and I’m a librarian”, or something along those lines. This connection has been enhanced due to the circumstances of my current job, as it’s high profile in both my community and the Oregon library profession. I’m “the library director” or “the librarian that reopened that library”. It’s flattering, certainly, as people seem to respect me for my work, but it has also become fundamental to my public identity.

Identifying closely with your profession certainly isn’t something specific to dysthymia. While I don’t really have statistics on it (how would you even collect them?), the topic is at least common enough to be covered by the Wall Street Journal, among others. Work is such a significant part of what we do as adults that it’s only natural that we become associated with it, both to ourselves and others. I’d imagine this is especially common among childless adults like myself.

Despite its frequency among  many people, I feel that my dysthymia has contributed to the overzealous job identity in my own life. Let me say that I’d likely be susceptible to this phenomenon even without a mental illness. But said illness likely contributes in a couple of ways. First, I invest a lot of energy into my work face. I realize that kind of sounds like begging the question, but consider this. I’m inclined to identify strongly with my job anyway. Because of that, I’m also inclined to invest a disproportionate amount of my limited energy resources into that job, and therefore into the mask I wear to do it. It creates a circular relationship: as I invest more of my meager reserves into my job, I become yet more identified with that job, which makes me want to invest even more energy into it. And on and on and on. A vicious cycle, surely.

The second way dysthymia relates, though, is the way it infests your personality and makes you think you are it and vice versa. As Robert M. Miller says,

“Dysthymia is also an interesting disorder from the neurobiological perspective because it is often difficult to discern from other personality disorders, such as a depressed or gloomy personality.” (source)

For most of my life, I assumed that being an emotional eunuch was just who I was. The times that I saw some passion, some emotion, some small degree of color, were not terribly promising. In other words, the potential “real me” scared the shit out of me: an angry, bitter, guilt-ridden, dejected shell of a man. Why would I ever want to learn more about that part of my identity? And in some twisted confirmation bias, I conveniently ignored the few good, emotion-rich years I’d had when I was married, where the actual real me probably flourished. So I thought my dysthymia was my personality, was my personal identity, was … me. Rather than exploring that reject who I seemed to be, I retreated into my job, where I seemed to have some success and respect; that guy I was while at work actually seemed like a decent human being.

So who I was increasingly became identified with what I did. I was a librarian first and foremost. That was how I related to the outside world. That’s still a large part of how I relate to the outside world. It probably always will be a significant part of how I relate to the world. But in contrast to needing to converge my many masks, I need to diverge my identities. I am not my job. I also am not my dysthymia. I’m not precisely sure who I am, but my treatment is helping me investigate. And discovering who that person is will help me not only be better at my job, as I’ll be more balanced, but more importantly it will help me be, well, me, and the best me I can be at that. So slowly I’m divesting some identity currently tied up in my job and am reclaiming it in the personal sphere. I’ll let you know how things go.

Better living through chemistry

Bupropion and trazodone pills

Walgreen’s is my dealer.

These are the pills that keep me sane, or at least keep me in the world of the emotionally-vibrant. They consist of 300mg of bupropion (brand name: Wellbutrin) taken in two pills daily and 50mg of trazodone (brand name: Oleptro) taken at night about an hour before bed. Bupropion treats the symptoms of my dysthymia, the emotional dullness and tendency to lapse into major depression. The trazodone, while technically a very weak antidepressant, helps me sleep.

I was diagnosed with dysthymia by my primary care physician in 2012. It seems like people who receive disease diagnoses fall into one of two categories: glass half empty or half full. The former see the diagnosis as a tragedy, yet another misfortune they must tackle. You’d think, as someone with a depressive disorder, that I would fit squarely into that category. Strangely, I did not, nor do I now. Despite my condition, I’m relatively optimistic. Thus, my reaction was a half full one: now I know what the hell’s been wrong with me all of these years and can take steps to fix it. The diagnosis explained why felt like an emotionless golem. It explained why I often felt intensely sad for no apparent reason. It explained why my mood could be completely divorced from the wonderful things happening in my life. It explained that my emotional distance from the world was not a personality trait, but rather a disease.

Bupropion was the first antidepressant the doctor wanted me to try. There are various reasons for this. Most common depression drugs fit into one of two categories: Selective Serotonin Reuptake Inhibitors (SSRIs) and Serotonin and Norepinephrine Reuptake Inhibitors (SNRIs). SSRIs include drugs such as Lexapro, Zoloft, Paxil, and Prozac, and SNRIs include drugs such as Cymbalta, Effexor, and Pristiq. The Mayo Clinic pages to which I link explain them far better, but briefly, these drugs work by adjusting the levels of neurotransmitters in the brain. Both SSRIs and SNRIs have many common side effects: nausea, decreased libido, insomnia, and more.

My antidepressant of choice fits into neither category. In fact, to make things more fun, researchers don’t really fully understand exactly how bupropion works, though they have a general idea. But before I get into bupropion and how it helped me, I should probably explain how I got to the point of getting the prescription in the first place. My doctor’s visit was precipitated by a terrible bout of major depression, one where I got the closest I ever had before to committing suicide. My friend encouraged me to go, and I am so glad that she did. The doctor said that my symptoms are consistent with dysthymia, a word I’d never heard before. She also said, because of the disconnect between my mood and what was happening in my life, that I was a good candidate for medication. She prescribed bupropion.

Before I started the bupropion, I had hardly any energy. After work, I’d come home, collapse, and just read random things on my phone until I gave in and decided to attempt to fall asleep, usually unsuccessfully. When I first started taking bupropion, I felt amazing. It was like I’d been seeing the world in greyscale and suddenly could see in color. These emotions that I’d experienced in full only periodically in my life came flooding in. I don’t think that I really understood the stunning beauty of the Columbia River Gorge, where I live, until I started taking medication. The vibrant green forests, sheer sculpture-like rock faces, and shining river hit me with a wave of emotion. I never really thought of beauty as an emotional attribute before, but that experience changed my view of it.

Most importantly, I had my energy back. Within three days of starting the drug, I not only had enough energy to mow the lawn of the house of was renting, but also the one of the house I was buying and my neighbor’s lawn. In one day. This was unheard of for me. I cleaned the house. Work tasks were dispensed with efficiently and effectively. I felt like a person again, with emotions, motivations, and energy. My initial experience with bupropion made me realize that so much of who I thought I was – that person I hated and criticized – was not actually a part of my personality, but rather an illness.

The honeymoon lasted a few months with bupropion. The first couple of weeks, it ran me through a cycle of side effects. Initially it was the nausea. Then it was the insomnia. Last it was the irritability. Little things would annoy me, things I’d brush off before. Once those few weeks past, it was pretty smooth sailing. Weirdly, though, after a few months, I started getting panic attacks. I would lie on the couch, shaking. They had no apparent cause, and it scared the shit out of me.

Given that strange side effect, my doctor thought it best to try me on other antidepressants. Initially it was escitalopram, an SSRI. Honestly, it didn’t really do much for me. I went back to my emotional dullness within weeks of starting it. Next up was venlafaxine, an SNRI. It seemed to do a reasonable job at elevating my mood, but I was tired constantly. I slept long stretches in an almost coma-like state, nine to ten hours a night, and woke up feeling like I hadn’t slept at all. I took three hour naps on my days off. So despite that my mood was decent, it was hard to notice due to constant exhaustion.

That’s when I decided to go back to the bupropion. This might seem like an odd decision, given the panic attacks, but I thought that 1) now that I knew they were coming, maybe I could predict and control the attacks better and 2) the bupropion’s side effects overall seemed better than the other two drugs. And the bupropion did work better when I began taking it again. The panic attacks never came back; I still don’t know ultimately why they happened. Eventually, the bupropion settled into giving me mild insomnia, for which the doctor prescribed trazodone. However, I didn’t pair my medications with other self-treatment measures. That lack of self-care, and my increasing forgetfulness at taking my medications, led me into major depression, the effects of which were brutal.

After I broke, I got more serious about my treatment. My doctor gave me the option to double my bupropion intake, to 300mg/day, which I decided to try. It made an amazing difference. This time, though, I took on other measures. I started eating better. I bought a rowing machine to exercise indoors during the cold, wet winter months. I improved my sleep habits. After doing some research and consulting with my doctor, I limited myself to one drink per day (bupropion interacts with alcohol even more poorly than other antidepressants), although I was never really a heavy drinker.

Probably my most interesting self-imposed treatment, though, is I require myself to have at least one in-person social interaction per day. Sometimes that interaction involves going out to listen to music or hanging out at the brewery. Sometimes it might just involve interacting with a clerk in a store. As an introvert, I can easily go through an entire day without interacting with anyone, thus further isolating me and exacerbating my issues. My social interaction rule, however, helps keep me connected. Already, that rule has brought some amazing new people into my life

Now that I’m on a positive path of treatment, it’s like I’m discovering the real me. I’m not sure that I’ve ever met him in his entirety, only glances. He’s optimistic. His mind is agile. He loves to hike. He enjoys musicals. He’s a devoted Whovian. Now, all of these things – and more – are coming to the fore. It’s pretty exciting to get a chance to revisit who you really are in adulthood. Chemistry is helping make that happen for me.

My harshest critic

I’ve always really identified with the song “Call and Answer” by the Barenaked Ladies.

I realize that the song is about a romantic relationship, but I’ve always thought of the song as somewhat of a metaphor for the warring parts of myself. These lyrics particularly speak to me.

But I’m warning you, don’t ever do
Those crazy, messed up things that you do
If you ever do, I promise you
I’ll be the first to crucify you

Source: MetroLyrics

Before I mentioned I am my harshest critic, and that that critic is a real shithead. As the song says, I’m the first person that will crucify myself if I do something wrong or, as is more often the case, if I perceived that I did something wrong. Many people with depressive conditions like mine judge themselves very harshly, often cripplingly so. Allie Brosh of Hyperbole and a Half depicts this self-destructive tendency brilliantly in her post “Adventures in Depression“. I’m no psychologist, but I think my harsh criticism of myself is amplified in my weaker moments by a warped form of projection bias, namely in that I project my own harsh judgments of myself into other people’s heads; they’re judging me as harshly as I judge myself. My perceived slights against humanity are then amplified, as I fear not only the assholish observer’s judgment, but also the criticism from all of those other people who feel the same way he does.

This feedback effect comes through in my work. When my dysthymia is largely under control, I would say that the criticism is more “tough love”; it makes me work harder, better, faster, stronger, driving me to shut that asshole up and do work about which I can be proud . When I’m not in a good place, though, nothing that I do is right. Case in point from this week: I recently re-designed the website of a local organization with which I’m involved as part of my job. I emailed the membership about the changes and requested suggestions. Someone responded back with a good suggestion. So what do I do? Rather than seeing the suggestion as it was – a good idea that I didn’t happen to think of – I started mentally kicking myself about it. That was so obvious, I said to myself, how could you have missed it? What an idiot.

I’m not an idiot, of course. Or at least I wasn’t in this specific instance; I make no claims on my idiocy in other contexts. I’m human. Sometimes I miss things, and that’s okay. What I am is recovering from a bout of major depression from last month, and hints of it still rear their ugly little heads. Fortunately, since I’m recovering, the better angels of my nature prevailed. That’s what happens when I’m a good state: self-criticism still arises, but the more logical part of myself quickly determines that most of those self-criticisms are crap.

If I give credence to all of those self-criticisms, though, my productivity plummets. Those criticisms suddenly don’t just originate from me; they originate from everybody. All of the membership thinks I’m an idiot for missing that obvious suggestion for the website (a suggestion, I’ll add, that was only sent to me and one other person, but far be it from my addled brain to bring in that fact). Everything I write is awful. I handle every staff interaction horribly, and the staff know it. I don’t do things quickly enough, and everyone notices. I don’t get enough done, and everyone again notices. The self-replicating cycle of criticism gets to the point where I’m only really comfortable doing the things I’m pretty sure that I can’t screw up: getting rid of unneeded items from the collection, going through donations, and getting the bills paid. I’m good at those things. Even I can’t screw them up too much. I hope I never, ever have to go through my rather involved evaluation process when I’m in this state; I’d be suggesting a demotion for myself.

These judgments aren’t based in reality. Everyone is not judging me as harshly as I am. My work isn’t as terrible as I think it is. If my work is suffering, it’s because of the negative feedback loop being created by my diseased mind that makes me scared to even try. As I further learn to recognize when I have valid criticisms of myself and when it’s the dysthymia talking, I’m coming to a better state of mind and a better approach to my work life. It’s proven much more challenging in my social life, but I’m working on that, too. Partly why I enjoy “Call and Answer” so much is it encapsulates many of my experiences into a mere four minutes. It encapsulates not only my tendency to crucify myself, but also my tendency to pick myself back up and keep going. And it’s that tendency that allows me to continue to succeed despite my illness.

I think it’s getting to the point
Where I can be myself again
I think it’s getting to the point
Where we have almost made amends
I think it’s the getting to the point
That is the hardest part

If you call, I will answer
And if you fall, I’ll pick you up
And if you court this disaster
I’ll point you home, I’ll point you home

Moments of lucidity

Oftentimes, I have moments. These moments arise because, I don’t know, I’m taking my medications regularly, I’m taking care of myself, the stars are properly aligned, whatever. These are my moments of lucidity, the times when I feel happy and “normal” and like I’m the “true” me. I know that I’ve used a few fuzzy terms there, but I really don’t know how better to describe these times. Sometimes these moments last hours, sometimes days, and sometimes, just sometimes, even months. Last week has been such a moment. Of course it had to happen during a short work week <sigh>.

Not surprisingly, these moments of lucidity are my most productive both at work and at home. So a question arises: how do I best use these productive moments, especially considering that I have no idea how long they might last? I can really use these moments to get a lot of great things done. They’re when I write grants to get cool things for the library. They’re when I plan and arrange neat projects. They’re when I catch up on my backlog of employee evaluations.

Screenshot of my inbox

I may find your views intriguing, but I really don’t need to be subscribed to any more newsletters.

On the other hand, my office and home are littered with half-completed projects begun during my good moments. Cases in point: the rooms in my house with only half of the wallpaper removed, the nearly 5,000 unread messages in my work inbox, the detritus of my plans for a big restoration project of the historic Hood River Library (now happily moving forward once more!), my poorly-maintained heirloom rose garden with plants older than my mother, the general state of my office (that just means that I “break free from tradition” and “produce fresh insights”, right?). I could go on, but I’ll spare you, and maybe spare myself any further guilt.

I don’t have a specific plan to harness these moments, admittedly, but I wish I could figure out a good way to do so. Even if my dysthymia is acting up, I have a decent sense for what I should prioritize at work. Make sure you get people paid. Ensure that the finances are on the up & up. Fix safety hazards immediately. Maintain the work face, even if it isn’t at full strength. Put the library on a positive path to achieve its strategic goals. I think I’m lucky in this respect, as I know that prioritization can be an issue for others with depression.

So basically what I end up doing in my moments of lucidity is jump into things with gusto, as much as I can healthfully muster, to take advantage of them. That’s when my inbox count drops precipitously and I get all those grant applications I’ve been thinking about out the door. Am I burning myself out more quickly by doing things this way? Probably. That habit could even make my worse dysthymic episodes arrive faster. But what else can I do? I know it’s trite to say, but I am truly my harshest critic; I’m pretty brutal on myself in my self-evaluations at work. I come pretty close to saying I suck on some matters where an objective observer might just say I need some work. Thus, when I’m at my best, I want to get my best work out. Along with my personal relationships – and because I’m childless by choice – my work is the legacy I leave. My moments of lucidity are what allow me to leave a decent one.

A need to know basis

One of the things about which I thought deeply after I was diagnosed was whom to tell. On the personal side, the choices were fairly easy; I told a few trusted friends and family members. On the library side, it was more challenging. I wasn’t actually worried about losing my job, although it’s definitely still a valid concern for many with mental illness. My performance evaluations were good, I received positive comments from my bosses and the public, and I’d just helped bring our library district out of a difficult time. Even so, there’s still a lot of stigma attached to mental illness. As noted in the articles linked above, people could look at you more skeptically and judge you more harshly if they’re made aware of your condition.

As a librarian, I know that information – the good, the bad, and the ugly – has a tendency to spread whether you want it to or not. Wrong information has a particularly bad habit of ferreting its way around. (See: fictional connection between autism and vaccines) By telling people about my dysthymia, I lose control of that information. With my friends and family, I could choose to tell only those I trusted. With the workplace, I wouldn’t get to be so discerning. Would those I told tell other people without my permission?

There was another odd quirk I had to consider: I’m the boss. We’re a small independent library district, with fewer than twenty employees. As library director, I’m responsible for human resources and nominally in charge of the district. I do have a supervisor, five of them, to be exact. Special library districts in Oregon are independent governmental entities overseen by elected five-person governing boards. They’re kind of like a city council, but they just focus on the library. (Or whatever the focus of the particular district. Did you know that vector control districts are a thing? I didn’t until I got this job.) That board also supervises the executive director, i.e. me. However, the Board only serves policymaking, fiscal, and strategic planning functions; they’re not responsible for day-to-day library operations.

So, to get back to the question at hand, whom do I tell at work? My illness could adversely affect the library’s operations pretty dramatically. I didn’t feel like I needed ADA accommodations for my mental illness (that link applies to men, too, by the way), but there could be times when my work suffered. Do I tell the whole board? Just the board president? And whom among the staff should I tell? If I’m falling down on the job, they’re the ones that will have to pick up the slack. Will they question my motives for telling them, like I’m trying to cover up for poor job performance? Will they think I’m just looking for pity? Will they believe me in the first place?

Ultimately, I chose to tell the two people whom would be impacted the most: the board president and the assistant director. I trusted both individuals, and my trust has proven well-placed. The decision was made easier when I started thinking about it as like telling them I had a physical or neurological disorder. It’s common courtesy to tell those most affected at work about times your work performance might be impacted. Since telling those two individuals, I’ve become much more open about my dysthymia. Several other staff know now. I mean, it’s not like I sent out a library-wide email or anything; I really, really don’t recommend sending out a company-wide email. Sometimes the issue would arise in personal conversations, though, and people have been very accepting.

I look forward to the day when choosing whom to tell about your mental illness is as unremarkable as telling people you have epilepsy or a peanut allergy. Until that day comes, though, speaker discretion is advised.

The work face

Back in October, I read a Slate article about an amazing photography series called Dualities by Portland-based artist and instructor Liz Obert. The series explores how people with mental illness mask what they’re thinking and feeling from the outside world. To do this, she took two photos of each participant, one of how they present themselves to the world and the other as they are alone when in the throes of their illness. The images depict people in their homes, showing a concept likely very familiar to those with mental illness: our very different private and public personas, or “faces”, as I like to call them. The results are poignant and stunning.

Images of Jason from Liz Obert's series Dualities

Funny, my feline roommates are filthy and unemployed, too.

Obert’s project presents incredible visuals showing the different faces we show the world. In my experience, I have far more than just two faces. Like Obert’s subjects, I have a private face. I also have a social face, a work face, and the face I show only my dearest friends (which is probably the closest anyone will ever see to my private face). If I think about it longer, I could probably come up with even more. I’ve got a whole kabuki drama worth of faces.

My work face is probably the one I wear more than any other than my private face. It is wholly unlike any of the other faces that I wear. The work face is confident, even arrogant. It’s talkative, eager, and full of initiative. With my work face on, I present at conferences, I participate in tongue twister tournaments, and I even get interviewed for local television programs. These are things there’s not a ghost chance in hell you’d catch me doing in any other context. In social situations, I don’t even particularly enjoy being in photographs or hearing the sound of my own voice, let alone getting up in front of other people and doing things.

I’m a classic introvert. My batteries only recharge when I’m alone or with a small group of friends. The work face therefore requires a lot of energy for me to wear, kind of like Ryu’s dragon form in Breath of Fire. (Why yes, I am a nerd. Why do you ask?) This isn’t so much a function of my dysthymia as it my personality.

Everyone, not just those of us with mental illness, has multiple faces they present to the world. If you’ve ever worked a customer service job, you’ll know what I’m talking about. Still, the work face makes me wonder: how can I have exude such confidence and competence in one setting and completely lack them in another? In my worse moments, the very existence of the work face makes me question whether I have a mental illness at all. Part of the perniciousness of mental illness for many is that the illness, combined with the still-present social stigma about mental health, sometimes makes you question whether you’re truly sick. “You’re trying to pass off your deep character flaws as mental illness”, I sometimes think to myself. After all, the very existence of the work face shows that I’m clearly capable of being the things my mind tells me that I’m not. With the work face on, it seems like I can do anything.

To borrow from Dr. Seuss, though, except when I don’t, because sometimes I won’t. When I fall into a major depressive episode as I did recently, even the almighty work face loses its strength. It takes incidents like that to remind me that my different faces are just roles that I play, consuming my stockpiles of introvert energy as I wear them. One of dysthymia’s common symptoms is lack of energy. If I’ve been managing my dysthymia poorly, I lack the energy to do much of anything. When I have limited energy, I end up putting a lot of it into my work because my identity is so tied up in it. But that’s a discussion for another time.

The challenge I’ve set for my treatment is how do I get those faces to converge a bit? How can I get some of that initiative and eagerness when I’m not at work? As an introvert, I realize that my different faces will never completely converge, nor, quite frankly, should they. But some equalization surely would help me both privately and publicly.