Late last Friday, I sent a text to my psychiatrist. It was a long message, one laced with explanations and apologies. “I’m sorry to bother you,” I wrote. “But I can’t call right now. Kids.” It was a confusing message. My words were contradictory. I told him it wasn’t important but, in the same breath, begged him to reschedule my appointment. I couldn’t wait until Tuesday. Getting through the afternoon had been a chore. And that is because the crux of my message came down to three little words.
“I’m not okay,” I added. Not. Okay.
I don’t know why I am struggling. I mean, I do. I have anxiety disorder and bipolar disorder. While the former causes me to panic—it makes me sweat and shake—the latter is characterized by manic highs and crippling lows. According to the National Institute of Mental Health, bipolar disorder (it used to be called manic-depressive illness or manic depression) "is a mental disorder that causes unusual shifts in mood, energy, activity levels, concentration, and the ability to carry out day-to-day tasks." The NIMH estimates that 4.4% of adults in the U.S. will experience the disorder at some point in their lives.
Today I am down and sad. The world is in chaos. My family's financial well-being is collapsing. My husband took a (substantial) pay cut. My work as a freelance writer has begun to dry up. I don’t know if and when we will fall sick. I worry about the health of my loved ones and the world.
I don’t know when I lost control. I was laughing, dancing, singing karaoke, and downing tequila shots a few months ago, and this month I am struggling to get out of bed. But no matter when it started—or why—one thing is clear: Living with depression during the uncertainty of a global pandemic is tough. Scratch that: It is damn near impossible.
You see, social isolation exacerbates my symptoms. "Social isolation increases stress levels and loneliness levels and decreases social supports—both of which definitely exacerbate mental health problems and prior mental illnesses across the board," Gail Saltz, MD, associate professor of psychiatry at the New York-Presbyterian Hospital Weill-Cornell School of Medicine and host of the Personology podcast, tells Health.
The coronavirus pandemic has increased my social isolation. No alarm signals the start of my day. I do not have anywhere to go or have any reason to get dressed, so I don’t. I’ve been wearing the same pair of red Christmas pajamas for three days. There is no schedule to keep so I sleep. I’ve dozed off at 8 in the morning and 3 in the afternoon and headed to bed at 6 p.m.
And while my children keep me going—I still have to educate my oldest and feed and care for my youngest—even those duties are slipping. My daughter’s homework is (almost) always late. It’s been days since I’ve showered, brushed my teeth, or eaten the food off my plate, and time is a blur. The sun rises and falls but the days feel the same. My life revolves around talk shows, late-night shows, and biweekly trash collections. My mind races quickly, rapidly.
Thoughts swirl like alphabet soup. I struggle to cry. I want to. My eyes burn and my face feels flushed but nothing comes out. While fear and pain are persistent and present, I am also numb.
But the most terrifying aspect of being depressed during a pandemic is that my safety net has been removed. My therapist's office has been closed. My psychiatrist’s office has been closed, and the things I usually distract myself with are gone. Work is disappearing. The gym has been shut down, and that scares me. Without an over-scheduled schedule, I am alone with myself and my thoughts.
Are these problems trivial in the face of COVID-19 and the fallout from the pandemic? Maybe. Probably. I am ashamed of my depression. Of my paltry needs and desires. (I can imagine some of you rolling your eyes.) I also feel like a burden to my family, my friends, and my doctor. After all, what do I have to complain about? My loved ones are well and safe. I am #blessed. But I cannot tell if my shame is valid or a symptom of my illness. Guilt and depression go hand in hand.
So while I do not have a plan to “get better,” I do have a plan to get up, to get going, and to keep the pain at bay, and that plan is based in structure and routine. I have started setting alarms which say “eat” and “shower.” My calendar is now filled with standing appointments not to work but to be with (and care for) myself. I breathe at regular intervals. I tell my daughter in the morning we are going to go for a bike ride or take a walk because she will keep me accountable; she is six and hates the word no. And from reading and cooking to baking and texting friends, my to-do list is full.
My psychiatrist is also in the loop; we have a weekly phone session. And I'm taking three medications intended to manage my mood and anxiety and keep my depression at bay.
Does it work? Sometimes. When my Apple watch vibrates, I make it a point to sit up, to get up. I do get off the couch or get out of bed, but admittedly, I drag my feet. It takes me hours to finish a meal. Sometimes I wash my hands instead of cleaning my hair or face because the showering seems daunting. I’ve also numbed out. I complete chores because I have to, not because I want to. But I’m trying.
I wear two bracelets—one that reads “nevertheless she persisted” and one with the saying “prove them wrong”—to remind myself I am trying. And that is everything. I log little victories in the “notes” section of my iPhone.
So if you are struggling today, know that it’s okay to feel anxious and down. Realize that you are not alone; I am right there with you. I am not okay. But I will keep moving forward because I am worth it. We are worth it, and because mental illness is and always will be a battle. During this crisis we have to make a choice: To stand. To fight. To get out of bed.
For more information about mental health programs and resources, contact SAMHSA’s National Helpline at 1-800-662-HELP, call the National Suicide Prevention Lifeline at 1-800-273-8255, or text “START” to 741-741 to immediately speak to a trained counselor at Crisis Text Line.
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