black therapy dog with pointy ears laying on side raising head with one eye closed while covered in dry grass

My Unofficial Therapy Dog

I’ve started bringing my dog to therapy. Does she sit with me and look patiently into my eyes while I cry? No, definitely not. She spends 10 minutes wandering around, smelling the smells of the week with great vigor. She pokes the diffuser with her nose, sticks her whole head in the trash can, and squeeeezes behind my therapist’s chair to not-so-sneakily smell her belongings. Then, she goes back and forth between the window and relaxing on the rug, ears perked up, listening for outside sounds. She comes over to me for pets and cookies every once in a while, but mostly, she’s just nice to have around as my unofficial therapy dog. She’s completely oblivious to my human problems. Looking at her blissful ignorance during therapy is like a brain palate cleanser.

You can’t help but wonder what she thinks of this development. Here we are, in this room we come to sometimes for no discernible reason. Pretty comfy. New smells since last week. 8/10. Would be better if I got second dinner. All that matters to her is that I feed her, walk her, and let her sleep at the foot of my bed. She’s a simple creature – intensely curious and frustratingly smart – but simple in that she really doesn’t need a lot to be happy.

She shares some of that innocent joy with me. She makes me smile every single day. It doesn’t matter how depressed I am – she does something goofy or sweet and has no clue that I find her antics ridiculous. Like how she leads with her face when encountering snowdrifts, or her exasperation at me taking constant photos of her, or the many, many hilarious faces of Sleeping Stella.

Sometimes, when I try to change something in my treatment(s), my depression says, “No, thank you.” Changing my medications has not gone well for me in the past, but I continue to clutch my personal dream of reducing the number of things I pick up from the pharmacy. I recently added a drug which required me to get off of something else, which overall, does not seem to have gone well. The options now are complicated and I don’t particularly like any of them, but I still have Stella! The routine, obligatory outdoor time, and turbo-boosted zoomies have done me immeasurable good. She demands my attention and action, and there’s really no telling her to just go entertain herself. Our walks are sacrosanct to her. No replacements. And no skimping on length, either!

This was part of my goal in adopting her, and it worked in more ways than just the responsibility of it. I thought that it would be healthy for me to be forced to get out of bed and do things, but that the emotional reward of that would come during my good times. I wasn’t expecting my unofficial therapy dog to be able to careen through the fog of my depression and make me smile every single day. A smile or laugh every day certainly doesn’t fix everything, but it’s something to be thankful for.

upside-down photo of woman and black dog lying next to each other showing movement in photo
“We’re snuggling! This’ll be cute.”

light-and-dark-blue-in-close-up-of-glacial-ice

The Subtleties of Water: The Ketamine Chronicles (Part 27)

I’m always looking up at the sky when the water closes over me. This time, it was cold, and an eggshell-thin layer of ice formed above me while I watched. Gentle waves followed one another, freezing over the previous layer and leaving a frosty texture on the surface. Darkness spread from the periphery of my vision until I strained to see through the last window of light, the only notable image being the shadow of a person standing above me on the ice.

I didn’t put a lot of effort into remembering this infusion. I know there were graceful, disembodied hands dancing amid blue and red lines, swirls, and dots. There was more water – ripples and waves, mostly. There was a pyramid with a circle above it, which turned into a blinding white light. I’m certain that there was a lot more, but it’s faded away from me by now.

My mental health is declining. I’m not sure why. Ketamine doesn’t seem to be working as well for me, now. Every day, I have to rate my mood on a ten-point scale. It’s hard to capture how I feel in numbers. Potatoes are easier, but still not quite enough. Honestly, sometimes words themselves seem too limited. How can I describe how I feel? This morning, I woke up at 4. I got dressed in the cold – same clothes as yesterday – and went to the kitchen for some food. I walked the dog when the sun came up, but we came home quickly because of the sharp, cold air. My eyes feel heavy. Not the lids – the actual eyeballs; they sit heavy in their sockets, like wet marbles or enormous caviar. I wonder, if I tip my head forward, will they fall out? When my depression is worsening, I often notice this feeling in my face. Everything is heavy and hard to move, and I’m sure my expression is grim. I think the clinical term is RDF – resting depression face. At least my pandemic mask covers most of it.

Maybe the person above me on the ice in my ketamine dream is me. I’m on thin ice. Skating across a just-frozen lake in my wool socks at 4am. Someone else is waiting beneath the surface, straining to see through the darkness. Is she also me?

__________

My recent ketamine infusions have all featured water, and I’m often drowning in it. It’s not scary – it’s peaceful. It’s soothing. I’ve never stayed up by the surface before; always finding myself sinking into the dark, quiet depths. But this time, I was floating – pressed against the underside of the ice, trying to see through it to the person on the other side. I was curious about this person, but the darkness closed in before I could begin to unravel what was happening, and then I found myself in a different scene, which I do not remember.

I’m fascinated by this recurring theme of water, especially because in my regular life, I’m not a big fan of it.

I have sensory processing disorder, and as a young child, I flat-out refused to swim. I was overwhelmed to the point of tears by the splashing, the echoes in the pool, the temperature change from air to water, and most of all, the fear of people touching me. I eventually came around to the idea, but never enough to take lessons. So, having never properly learned how to swim, I nearly drowned at a friend’s birthday party when I was 8. I remember being uncomfortable going into the deep end, but my friend was insistent. I lost my grip on the side of the pool and began to sink. When people say that drowning is not a dramatic event – there’s no splashing or screaming – they’re right. My head tilted back instinctively as I went under, and I could see my hand, extended above me, slip under as well while the rest of my limbs flailed uselessly underwater. A panicked hopelessness overtook me as I choked on chlorinated pool water. Then, my friend’s hand broke the surface, reached down, and grabbed my wrist.

I have never felt relaxed on or in water, and it’s not just the near-drowning that explains it. The same sensitivities that kept me from participating in swimming lessons have persisted into my adulthood. I dislike the unsteadiness of water, the unpredictability of how it will splash, the feeling of water on my face. And yet, when I’m reclined in my doctor’s office, ketamine moving into my bloodstream, visions of water are soothing. I can feel the cool, constant pressure of being underwater without the anxiety or the sensory overload. I can feel myself standing on the deck of a boat, watching the foamy water beneath me leap forward and recede, and I feel peaceful. I’ve seen whirlpools, rivers, melting glaciers, and the unbelievable enormity of oceans. It’s a strange experience to suddenly realize what water might be like for other people, as those feelings are foreign to me in my waking life.

I feel as though, unhampered by the symptoms of my sensory processing disorder, I can connect to a larger, evolutionary interest in water that I am unable to find under normal circumstances. Humans have been fascinated with water for millennia. In fact, some evolutionary anthropologists believe that nearness to water supported the development of large brains – that we are, in part, the heritage of small, coastal communities of early humans whose lives revolved around the movement of water and the food within it. To this day, many island and coastal cultures retain great reverence for the ocean. When we gaze out upon a watery horizon, it is difficult to not be awed by the vastness before us. In my eye, to find our place in relation to bodies of water is akin to our struggle to find our place in the vastness of space. Questions of identity and survival are found in the depths, and I believe we carry the answers within ourselves.

My depression is a constant in my life. It is all-encompassing, lonely, and feels like drowning. I’m not one to find meaning in every dream, but the images of water that I experience during ketamine infusions have begun to feel profound. What does it mean? Certainly not that I should give in, wave a white flag and let the water crush me. Nor should I wait breathlessly under the ice, squinting as if to look through a frosted pane of glass, uncertain if I’m even above or below. Rather, I believe my visions of water are windows into the nature of the human experience. Perhaps they’re snapshots of how I feel – how depression feels to me. My mind is an ocean, and at times, it’s oppressive. I sink within myself, finding it easier to let the water cradle me as I descend than to keep swimming. At other times, I find comfort in accepting the changing nature of my illness. Like a river flowing downhill, impermanence is unstoppable, and the emotions of being a human move inexorably back and forth. When we crest the top of a wave and begin to fall down the other side, we wait for the next one, just as we take each arriving day. And when you are drowning, reach up. A helping hand may be just about to break the surface.

To start at the beginning of my journey with IV Ketamine for treatment-resistant depression, check out Part 1

hand-touching-pink-flowers-outside

Self-Compassion When Living With Depression

I had a conversation the other day about the balance between recognizing that treatment-resistant depression is chronic and pushing oneself to do difficult-but-healthy things.

It started with a question: What advice would you give someone about dealing with depression?

Personally, I find it helpful to remind myself that depression gets in the way of my ability to think clearly. Depression brain is a liar. It makes me think that I’m a stupid, horrible burden and that everyone would be better off without me, even if they say otherwise. It makes me think that feelings are forever, and that I must be too weak to effectively change myself.

It’s really hard to change the way you think, especially when depression is sitting on you, yelling into your ear about how terrible you are. Sometimes it helps to remember that I have a disorder that skews my thinking. But that doesn’t mean that I shouldn’t push myself. It’s a difficult balance; to recognize that my symptoms explain my behavior, but they aren’t the be-all-end-all of what I do.

You know how frustrating it is when a well-intentioned but misinformed person tells you that if you’d just try barefoot ultra-marathon running or hot goat yoga at 5am, you wouldn’t be depressed? That person is inside my brain all the time, and because I know that it’s unreasonable to expect myself to just *poof* try harder and not be depressed, I’ve always struggled to write something on this subject. I don’t want it to come across in the same way that my brain talks to me, because I would never, ever talk to anyone about their depression in same the way I think about my own. My brain says stuff like this:

“Yeah, you feel pretty crappy today, and you know why? Because you only ran one mile. Maybe if you’d run THREE, you’d feel better. You only have yourself to blame.”

The example that I’d like to set as a person who writes about mental illness is something more like this:

“I still feel crappy, even though I went for a run. I’m glad I did it, though, because I know that it’s helpful – even if it doesn’t feel like it.”

That kind of thinking is really hard to implement, and I won’t lie – I’m pretty far from doing it naturally. It’s hard in part because we know that things like exercise, being outside, and social connection are helpful for depression. How much pressure should I put on myself? How much am I capable of when I’m depressed? Should I be expecting these things to “fix” me? Whenever I ask myself these questions and get bogged down in the details of how much I’m doing, my plans for doing more, why I should be doing x, y, z, I miss the obvious point.

I’m mean to myself.

I’m trying to convince myself that it doesn’t really matter how much I decide to do in miles, minutes, or step-by-step sequences. It only matters that I did a little bit more than I wanted to. It only matters that I did something because it’s good for me, not because I bullied myself into it. It’s good to set goals (or clams, if you’re being fancy) for yourself, and it’s fine to go at a pace that works for you under your current circumstances. I know that for me, I often fall into the trap of expecting myself to function at the same level that pre-depression me did. Sometimes I worry that if I don’t berate myself enough, I’ll get complacent and stop striving to improve. In reality, I know from experience that the motivation to grow returns naturally when I’m feeling better. It’s tough to believe it, but my first priority should be to treat my depression, and everything else will fall into place.

If you’re hard on yourself for not meeting your own expectations while depressed, I relate. A lot of people relate. After all, feeling bad about yourself is itself a symptom of depression. And to be clear: trying to be nicer to oneself is not advice intended to invalidate that symptom. It’s not to say “you’re doing it wrong, just be nicer to yourself”, it’s that combatting negative self-talk with positivity (or at least positive-tinged neutrality) is a strategy intended to treat that symptom.

I’m not very good at it yet, but I’ll keep working on it. Gently.

small-songbird-sitting-on-white-surface-with-white-background

Working on Depression

Sometimes I feel like a bird that can’t figure out how to fly. I periodically get launched out of a cannon (in this metaphor, that’s ketamine), then flap and flap to no effect. I’m trying to make progress, but gravity is always there. Eventually, I sink lower and lower, just exhausting myself with all that flapping.

That’s how it feels, but I don’t think that’s entirely accurate. Yeah, ketamine wears off eventually, and yeah, my brain has a biochemical problem that means I can’t fix depression just by flapping. But the flapping is doing something. All that work I put into therapy and maintaining a routine and getting exercise must be functioning in tandem with the ketamine to push my little bird wings just a smidge farther.

I know this because my mood still dips pretty low sometimes, but on the whole, I’m in a better place than I was a few months ago. Perhaps it’s that I bounce back faster, now. Or maybe it’s just knowing that it won’t last forever.

And now, being able to look back and see that I’m flippity flapping on my own a little makes it just a little bit easier to continue. Chipping away at something day by day is tedious and frustrating, but all of that work adds up. If you can look back at where you were a little while ago, it helps to notice that you have made progress, even if it’s just in the personal growth or a skill you’ve learned or the support you’ve gotten.

Keep flapping, everybody.

small-brown-and-white-owl-with-head-turned-to-side-and-large-yellow-eye

Owl Eye: The Ketamine Chronicles (Part 25)

I felt it quickly this time, the room beginning to sway and bend even before I fully settled in and closed my eyes. Still, I only saw darkness for what felt like a long time but was probably only a minute or two. Then, subtle lines took shape, and my mental lens zoomed in on an owl’s face. The eye was my focus – although the steely beak caught my attention as well. The image rotated slowly before fading away, the owl’s eye staring back at me.

IV ketamine infusions are one of multiple treatments I use for my treatment-resistant depression. We’re still adjusting it and trying new doses as things change, which makes for interesting little self-experiments. Last time, we went without propofol and discovered that it was fine for me; in fact, I preferred it. This time, I forgot to check for refills on my scopolamine prescription, so I didn’t use any prior to my appointment. With no propofol, no scopolamine, and a slightly higher dose, this ketamine infusion felt remarkably vivid. It was much like the first few infusions I had, which were dominated by immersive scenes and imagery that constantly changed.

After the rotating owl, the sounds of the room made an appearance in my mind. The gentle chug chugging of the infusion pump reminded me of a train, and I soon saw one on the horizon of my internal view. It belched smoke – an early, coal-powered one – and rumbled closer and closer. The black smoke filled the air, blocking my vision until all that remained was a small view of the front of the train as it trundled by. Black smoke, liquid, or goop filling my vision was something of a theme in this infusion. On other occasions, it expanded from small blobs until they met and pressed against one another, filling whatever volume my mental space contained while I tried to see through a narrowing hole.

If I’m correctly piecing this together from my garbled and typo-riddled notes, which I took in the car on my way home, the sensation of being smothered by the black smoke brought my awareness to my mask. This, in turn, created an image of cloth above my face, an illegible tag sewn into the seam (a common theme in my infusions is not being able to decipher letters or numbers). My mind then conjured up a lovely memory of building a couch fort with my brother as kids. The memory itself was jumbled and consisted of snapshots – balancing the cushions just right, sliding head-first over the arm of the couch and down into the fort, and sitting with my knees pulled up in the dark confines of our shared space. The most convincing parts of the memory were the sensations. I could feel the texture of the couch upholstery and the give of the stuffing in the cushions. I noted the darkness with cracks of light where the cushions didn’t meet, and the feeling of the seat cushion grazing the top of my head. I don’t think I’ve ever re-experienced a memory during a ketamine infusion before. It was a comforting feeling to be returned to the experience of being a kid, entranced in the moment by the fantasy of a simple couch fort.

As usual, water made an appearance in my ketamine dreams. This time, it began with a slowly spinning whirlpool of green/yellow water, lit from within to make the water glow. Soon, I was in the whirlpool and it turned into the ocean. The water swelled around me and wave after wave overtook me until I was underwater. It was not frightening, although in describing it, I realize it sounds a lot like I was drowning. Once underwater, I saw an apparently incredible scene which I do not remember but my notes describe as, “Turtle? Fish on lines like balloons. Underwater city of fantastical things.”

If only I could remember. What treasures have been lost in the depths of my brain? (Water puns fully intended.)

I returned to the room several times during this infusion, convinced that it must be over soon, only to find that the people had swapped or left or reappeared. My mother had gone to run an errand and had dropped me off, but returned partway through my infusion. I saw her sitting in the corner maybe four feet from me, yet it seemed that she was very, very far away. It was a little like looking through the wrong end of binoculars. I tried to read her expression – was she even looking at me? The more I tried to settle my gaze on her, the more my eyes refused to cooperate. They jumped around and made double images, and eventually, I admitted defeat and closed them once again.

The scenes and images I was seeing were so numerous that they seemed to be packed into time in an unbelievable manner. It’s strange to think that I could experience so much in such a short amount of time, but even after all of that, there was more. I remember walking over a mountain range with an enormously tall man – I was also enormous – while he proudly described in great detail how he made the mountains. In another scene, a golden dog (I think it was a statue?) was hidden in a room packed with items. My notes reference my teeth feeling soft, something about lizard scales, and robotic cats. “What if they found my head underneath San Francisco?” must have been in response to an extremely bizarre episode of Star Trek that I recently watched in which Data’s head is found during an archaeological dig underneath – you guessed it – San Francisco.

I’m so glad that I took notes on my phone immediately after the infusion, because I find that the memory of it fades over time unless I can remind myself of what I saw. I was functioning pretty well after my appointment, and was able to get myself to take notes rather than close my eyes on the way home. The rest of the day was fairly pleasant. I greatly prefer infusions without propofol both because of its effects during the infusion as well as because of how it alters the rest of the day. Of course, I wasn’t entirely myself until several hours afterward. I took my shoes off somewhere in the house upon getting home and promptly lost them. I could not figure out where I put them until I found them the next day in a closet. Why would I put them away?! In a closet?? Absurd.

drawing of landscape with tree and river and words about self-compassion

Art for Mental Health Awareness Month

May is Mental Health Awareness Month, and Mental Health America has several initiatives to spread awareness during May. One of these is #mentalillnessfeelslike. Peruse different categories on their website, where MHA has compiled Instagram posts from people participating in the hashtag. It’s always comforting to find validation in others’ experiences.

The hashtag got me thinking about my own attempts to represent what mental illness feels like to me. This blog is mostly writings that describe my experiences with depression, anxiety, and their various treatments. So, for something different and a trip down memory lane, I thought I would take a jaunt through some of the art I’ve made on the topic of mental health/illness.

The following slideshow was my attempt to depict a strange sensation brought on by an antidepressant I no longer take. It left me feeling “better”, but in an artificial way, as if I could feel my depression just outside the boundaries of myself. It was sort of like being squeezed into a neutral mood that didn’t fit.

Depression 1Depression 2Depression 3Depression 4

And then we have The Potato Scale of Depression, born when I responded to “how are you” with “everything is mashed potatoes”. What I meant by that was that the world was dull, my senses felt mushy, and seeing past any of it felt impossible. The beauty of the potato scale is that it opens the door to describing your mood in a creative, silly way, while still communicating a serious topic. And, you get to have eye-opening conversations about how you and your conversation partner rank various types of fries. Of course, this is an abridged version of the scale; there’s a whole world of poorly-prepared potato dishes to choose from. (Soggy latkes, undercooked gnocci, etc.)

Potato Scale

Clearly, analogies are my favorite way to say how I feel. This next one is a good reminder for present me.

Balance

The rest are simply some depictions of what mental illness feels like to me.

 

collage-of-flowers-and-words-from-magazine-spelling-it's-going-to-get-better-with-watercolored-woman's-face

 

Moth Wings: The Ketamine Chronicles (Part 15)

As I was pulled into mesmerizing moving images of purple and white half-circles, I remember pouring the words “please fix me” over and over into my mental space. Maybe if I asked it nicely, it would last longer. In a strange mixture of thought and vision, the words became part of the image, and they fanned out and seeped into the fabric of my mind. Ketamine continues to be the best treatment for my treatment-resistant depression I’ve tried, but like anything else, it’s not perfect. Arriving at each appointment feeling depressed once again gives me a sense of hopelessness all its own. I know the infusion will help, but it may not last. We’re still trying to arrange the best combination of dose, timing, and medications that could help things remain more stable. 


Puzzles, Puddles, and Skyscrapers

I closed my eyes and settled back, listening to the “atmospheric piano” playlist I had chosen for yesterday’s infusion. Eventually, my awareness of my hands and arms disappeared, and I spent some time wondering where they had gotten to. The gentle piano music was relaxing, and tucked under my blanket and weighted lap pad, I began to feel like I was being enveloped in something. I imagined myself being zipped into a giant pea pod, and the image was comforting. “Nothing can get me in my pea pod,” I thought. There were times during the infusion when noise outside the room intruded on me, so I just imagined my soft pea pod and retreated within it again.

There were at least two scenes involving puzzle pieces and building skyscrapers. We’ve been working on a 2,000 piece puzzle of Monet’s garden, and the pink, purple, and white pieces are haunting my subconscious. The puzzle pieces came together to form an endlessly tall building; I craned my neck back to see it disappear into the clouds.

At some point, everything dissolved. I was “looking” at a computer screen, and as I tried to read it, the contents of the page began to melt. The lines ran together, words sagged under the force of gravity, and eventually, the entire laptop softened and melted into a puddle. I began to melt, too. I slipped into the puddle of digital sludge- it looked like an oil slick- and soon accepted my new form. I was too tired and heavy to do anything.

I was far, far, far away when I heard the PA, Erin, ask if I was ok. Finding my mouth and giving it words to say was too difficult, so I nodded and hoped that my head was actually moving. It must have been, since she seemed to accept that as an answer. A little later, she sneezed, which startled me. At the sudden noise, I instantly saw moths with shattered wings, like glass with spiderweb cracks. They fluttered around and came closer until their soft, broken wings were all I could see.

Post-Infusion Confusion

Coming back to the room was much harder than usual. I felt a little like I was wearing 3D glasses; everything was in relief with subtle red and blue auras. When asked, I said I felt like “someone else is talking,” meaning the words were mine but the sensation of talking seemed foreign. Erin said I seemed pretty lucid, to which, in relief, I said “Great- I’m pulling it off.”

Walking down the steps to the first level of the parking garage was challenging. I clung to the railing and stepped carefully, feeling like I was walking on pillows. I’m usually fine to walk after a ketamine infusion; I could fall asleep at any second, but I generally feel pretty with it. This time, though, I felt a lot like this:

stoned fox

In an effort to make the effects of the ketamine last longer, I took some Tagamet before yesterday’s infusion. It’s an H2 blocker used to treat heartburn, but anecdotes suggest it might slow the metabolism of ketamine and give patients more time between infusions. I’m usually tired after infusions, but this was different. I got home around 4 (I think) and by 6:30, I still felt like I was periodically dissociating and then coming back to the room and remembering I was in the middle of something. Walking was hard for a couple of hours. I was off balance and wobbly and had mild vertigo. I think it’s safe to say that the Tagamet is doing something. This morning, I woke up with a mild headache and am still incredibly tired, but the sun is out and our near-impossible puzzle will provide hours more entertainment.

P.S. I remember making a mental note that Shrek appeared briefly during my infusion, but I cannot for the life of me remember how/when. It’s such a bizarre thing to remember, though, that I am sure it really happened.

 

How Do I Love Thee? A Haiku About Meds

New bottle of pills

Contains capsules, not tablets

Let me count the ways

 

Three of my nighttime pills are tablets, and I like to take them all at once to minimize the horrible dissolving-pill taste as much as possible. One time, two went down but one got stuck to the back of my tongue and began to dissolve. It was like purifying the essence of every cruciferous vegetable and mixing them with charcoal, then pouring the horrific concoction down my throat. Immediately, my esophagus’s movement reversed direction and it took serious effort not to hurl right then and there. Instead, I had to force myself to chug water and think about anything but my poor tastebuds. To this day, the memory makes me shiver in horror.

And now, a change in the formulation of one of my meds means that I have received capsules instead of tablets. It’s the little things.

green-mug-with-steam-rising-sitting-on-side-table-with-rumpled-sheets-on-bed-in-background

Taking Stock of My Life with Depression

text about not having energy for anything
Not my meme. Not sure whose.

In my experience, severe depression creates a kind of tunnel vision whereby the non-essential tasks of life get shuffled to the edges and only the act of surviving can be focused on. It’s not that you don’t know what’s on the edges, you just don’t have the energy to expand your field of view and look directly at them. I’m in an increasingly healthy place right now, and I’m taking stock of the state of my life with depression. I always knew that I was “falling behind” in my self-imposed timeline. In fact, I’m acutely aware of how much time has passed without me accomplishing the milestones and achievements someone my age is expected to be doing. My life looks very little like what I hoped it would by this point, a fact that is heavy with self-judgment and regret.

I still struggle to believe that depression happened to me. That it wasn’t poor planning, laziness, or a lack of ambition that kept me from moving forward, but an illness. I think that there are two helpful ways of looking at this. In one, the state of my life is a result of severe depression, a disorder that has kept me from functioning at the level I used to. This view helps stop me from blaming myself for every perceived inadequacy and from expecting too much from myself too soon; I do, after all, still have a serious mental illness that requires daily management.

On the other hand, I try to consider the state of my life to be in spite of severe depression. I didn’t do nothing while horribly depressed, I fought for my life. I studied and graduated, I worked part-time, and I adopted a dog. I went to therapy and tried medications and pushed myself to do things when I just wanted to sleep. Most importantly, my life – even as a life with depression – has continued. The things that I consider important for young adults to do or have mean nothing if there is no life to be led.

If you’re struggling right now, give yourself some credit for the courage and persistence it takes for you to show up for yourself every day. There is no timeline.

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An Encounter with Contamination OCD

I haven’t been consumed by OCD in several years, something I’m immensely grateful for. That particular kind of mental torture is truly awful and not something I would wish on anyone. One of the subsets of OCD that I had was contamination OCD. My body and belongings had to be whatever my disorder deemed to be “clean”, or else some unnamed disaster would occur. There were often no actual illnesses I was afraid I might contract, I was just terrified of potential contamination by unknown germs/viruses/entities.

Beyond the fear, maybe the worst part of this obsession was how time-consuming it was. If something was “dirty” and it touched something “clean”, or if I touched the dirty item and then the clean item, they were both dirty. I spent a lot of time planning out sequences of actions that would combine touching dirty items because otherwise, I would spend half the time washing my hands raw so as to not contaminate anything else. My hands were always painful. I scrubbed them under hot water until I’d stripped them of any moisture barrier. Any movement cracked and split the skin open, which, ironically, made my bleeding hands perfect entry points for bacteria and viruses. But, OCD is not swayed by reason and rationality. It creates doubt that can’t be rooted out with reassuring facts.

For the most part, I don’t deal with OCD anymore, contamination OCD or otherwise. My day-to-day life is not consumed by it like it was before, but every once in awhile, I encounter something that stirs those obsessions up. My perfectionism around self-harm is one, and tapeworms appear to be another.

I’m not squeamish, despite what you might think after learning of my past with contamination OCD. Again, OCD is not rational. Parasites are fascinating and don’t bother me from afar, but when I found a tapeworm segment in my dog’s stool, I felt the familiar stomach twisting of contamination OCD. Once the initial shock passed, I found myself thinking about all of the things I would have to clean. First and foremost, the hand that held the poo bag. I must not touch anything between there and home, not even to put my hand in my pocket. The bed in her crate would need to be washed, and all of my sheets and blankets because she often snoozes on my bed. Should I wash her leash and harness? Perhaps I should stop petting her– would that be going too far? On second thought, that would be impossible. I’ll just wash my hands every time I touch her. So, like, 80 billion times per day.

Keep in mind, the most common species of tapeworm is passed to humans only when you ingest a flea that carries the tapeworm eggs. Not likely. There is also a species of tapeworm that can be passed from dog to human through ingested feces on unwashed hands, but it’s not common in the U.S., and I’m a frequent hand-washer as it is. In other words, it’s very unlikely that I would get tapeworms from Stella.

That night, I lay in bed, Stella at my feet, and tried to control my rising panic. The vet was closed for the holidays, so I had left a message. Having no idea when they would return my call, I did what any smartphone-wielding person would do; I looked it up. Unfortunately, Google played the role of the reassuring-but-clueless friend that says something terrifying right at the very end of the conversation.

“Oh, it’s very uncommon for people to get them? OH, you might not show signs until years after ingestion?!”

Not gonna lie, my concern for Stella was overshadowed by my selfish, irrational fear for myself. The thought of something living inside me usually doesn’t bother me. After all, we are made up of more bacterial cells than human cells. Maybe it’s an evolutionary adaptation to be totally wigged out at the thought of parasites taking up room in your gut, like some kind of lizard-brain fear of fire.

The good news is, I realized that I was obsessing about this right before I returned to the scariest thought of them all: “What if I already have tapeworms?” This is good news because it really kicked me into the best way to face OCD thoughts, which is to say “Yeah, and?” In the dark in more ways than one, with my tapeworm-host dog not three feet from me, I had to say “Maybe I do have tapeworms. What am I gonna do about it right now?” Just sitting with the uncertainty brings you to the stunning realization that there is absolutely nothing productive about rumination. So, with a little more deliberate relaxation, my hypothetical tapeworms and I went to sleep. Well, maybe not the tapeworms. Do tapeworms sleep?

I still don’t know if I have tapeworms, and it’s honestly probably something that I’ll worry about off and on for a while. I do know that I’m much better at squashing obsessions than I used to be, maybe because I know it’s something I’m prone to and can catch it early on. Stella is on a deworming medicine and continues to behave like a dog. That is to say, eats anything and everything with gusto and drinks water out of the Christmas tree stand when nobody’s looking.