jimhines

October 10 is Mental Health Awareness Day. If you’re a regular reader, you probably already know I’ve been dealing with depression for a while now. Got the official diagnosis back in April of 2012. Started on antidepressants the next month. Began seeing a counselor shortly after that.

The depression had been there a lot longer. I remember feeling suicidal as a kid, and getting close enough to scare myself at least twice. Looking back, I can see stretches where the brain weasels got the best of me in college too, and they had a good old time messing with my head the year I spent living in Nevada.

The pills helped to stabilize my mood and get me back to a healthier baseline. The counselor helped me make some changes with my life. Neither of these things actually fixed or cured the depression. Like my diabetes, it’s still there — I’m just doing a better job of managing it.

Unlike the diabetes, I can’t take a drop of blood and measure how Depressed I am today. Wouldn’t that be nice? “My Depression Level is 193. Better watch a half hour of kitten videos.”

A big difference in my pre- and post-diagnosis life is that I now know the brain weasels are there. I’m better at recognizing when I’m just having a lousy day vs. when the Depression is getting the upper hand. Being able to identify the problem, knowing it’s real, helps a lot.

But it doesn’t make the problem go away. I know it’s there, and I know there are cracks in my mental health the brain weasels can sneak through. To choose a totally hypothetical example, say a book I’m working on is going a lot more slowly than I want…

One of the best things I’ve learned over the past six years is that I’m not alone. Since I started talking about the depression, I’ve spoken with a lot of people who are fighting the same disease. Others are battling different mental illnesses. And none of us are alone in that fight, even though the brain weasels will totally lie and try to make you think you are.

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Lesson One: Depression lies. It says you’re alone, you’re unworthy of love, your failures are deserved and your successes are flukes, your happiness is fleeting but sadness is eternal, your problems are inescapable, and things will never get better. It’s all lies.

Lesson Two: Mental illness is real. You know, I had zero problem going to the hospital for my diabetes back when I was diagnosed. My blood sugar was over 600 at one point. It didn’t matter how strong or determined or optimistic I was if my pancreas was taking early retirement.

Mental illness is just as real and valid as any other. Willpower won’t make my pancreas start working. Willpower also won’t rebalance the chemical makeup of my brain. There are things I can do to help — exercise can be a useful tool for both diseases — but it won’t cure the problems.

People get sick. That doesn’t make you a failure, and it’s not your fault.

Lesson Three: Getting help is … helpful. Going to the doctor and the counselor was hard. Really hard. But it made a huge difference. It may have saved my marriage. It helped my relationship with my kids, and with the other people in my life. It helped my writing.

It may take time to find a doctor and/or therapist who’s the right fit. If you go on medication, it may take time to find the right dosage and the right med or combination of meds. And some health insurance plans can be a nightmare.

But if you can, it’s worth reaching out for help.

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For those in the U.S., Mental Health America has what looks like a good set of tools for getting started, including screening tools and steps to find help. MentalHealth.gov has some resources as well.

Be kind to yourself. You deserve health and happiness.

Mirrored from Jim C. Hines.

I blogged a week ago about mental illness and antidepressants, prompted by an exchange I had with a troll on the #imnotashamed hashtag on Twitter.

I like and support the stated mission of Team Notashamed: “to spread the message that mental heath conditions are nothing to be ashamed of … [and] helping end the harmful stigma associated with mental heath conditions and advocating for better and more accessible healthcare.”

But good intentions don’t mean you never screw up. Rose Lemberg pointed out the following post on the I’m Not Ashamed Twitter feed.

And…no. Just, no.

I have no problem with some of the comments here. Mental illness is not a character flaw. It can be incredibly helpful to know you’re not alone. But some of the others are a mess, and problematic as hell.

I am creative and smart. I am, in all modesty, both creative and smart, yes. But this has nothing to do with my mental illness. Depression doesn’t make me creative or smart. My creativity, my work as a writer, these things happen in spite of my depression, not because of it. Depression is an obstacle I’ve had to overcome in order to be productive and creative. Please stop spreading the bullshit myth that creativity and intelligence are in some way enhanced by mental illness.

I’m so strong because of it. Maybe you are. Great! Maybe you’re not. That’s okay too. I do believe it takes strength to survive any sort of chronic illness, but does that mean the illness makes you strong? Because to be honest, there are times I wish I could put that strength toward other things instead of spending so much of it coping with depression. I don’t see my mental illness as some sort of gift, one I should be grateful for because it makes me stronger. If you choose to believe that for yourself, fine. Don’t push that on everyone else.

I help others now. This one didn’t fishhook my attention as much as the previous two until I saw a few Tweets by Corey Alexander, talking about the imagined trajectory of “graduating” from trauma to helping others, and the pressure on helpers to focus their energies on others to the exclusion of themselves. It got me thinking back to working with sexual assault counselors, and how many of those wonderful, kind, dedicated people had been through their own traumas. Some were still suffering from PTSD. But the emphasis was always on helping others. I think it’s great if you’re able to help others, and being able to draw on your own experiences can make you a more effective helper. But as Rose Lemberg pointed out, the word “now” makes it seem like you didn’t/couldn’t help people before? Or that this is the trajectory everyone should be on. There’s just so much to unpack here.

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I’m not going to go through everything. But all right, I get it. Someone wanted to post something feel-good and inspirational. So they Tweeted something problematic, and various folks on Twitter called them out about it.

At which point it sounds like I’m Not Ashamed began blocking people who had a problem with the Tweet. As far as I can tell, they never responded or addressed people’s concerns; they just went straight to blocking.

ETA: They blocked me less than an hour after this blog post was published.

I asked them about this, but haven’t yet gotten an answer. The Tweet that started it all is currently pinned as their top Tweet. We know they’ve seen the criticism, since they were blocking people, so this feels like a pretty clear message that they’re choosing to ignore that criticism.

And that’s the bigger problem here. This is a group that’s set themselves up as advocates for people with mental illness…while ignoring feedback from the very group they claim to support. I don’t know the individuals behind Team Notashamed or their situation, but this feels like symptoms of Toxic Ally Syndrome, where you’re so determined to be an “ally” of Group X that you ignore or argue with members of Group X because you know best. This is often followed by choruses of, “Why are you getting angry at me? I’m your ally! Fine, if you’re gonna be so ungrateful, I’ll just take my allyship and leave!”

I hope it doesn’t go that route. I hope they read and respond to the critiques from the people they’re claiming to want to support, rather than ignoring and blocking.

ETA2: One of the members of that group Twitter account informed me that “All leaders of team not ashamed personally deal with mental illness.” This doesn’t change my sense that it feels like Toxic Ally Syndrome, but I don’t want to erase that these people also either have or deal with mental illness themselves. Hopefully that makes sense?

I’ll wrap this up with a Storification of Rose Lemberg’s Tweets last night about mental illness and identity and the pressure to feel or act certain ways, generally for the comfort of others.

Mirrored from Jim C. Hines.

It’s been a bit over three years since I was officially diagnosed with depression and started with therapy and medication. I can say without hesitation that overall, my life is much improved over 3+ years ago.

I can say with equal certainty that I haven’t been “cured” of depression, any more than insulin and regular visits to the endocrinologist cured my diabetes.

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I mentioned Christine Miserandino’s spoon theory over on Twitter earlier today. Spoon theory is an analogy about living with chronic sickness or disability. I know the analogy doesn’t work for everyone, but I’ve found it helpful in understanding and talking about and explaining some things.

What I’ve been finding in recent months is that I don’t actually know how many spoons I’ve got when I wake up in the morning. On any given day, I might be able to deal with the pressure of a looming book deadline, a crisis at work, a puppy destroying something important, an unexpected bill, a family argument, and whatever else comes my way. On another day with similar troubles, I could end up burning out like Biggs Darklighter over the Death Star.

I’ve gotten a bit better at recognizing when it’s happening. Just like I can generally feel when my blood sugar starts to drop too low, I can feel when I’m all out of cope.

It’s not a pleasant feeling, mind you. It’s a cold, congealed soup of anger and despair and exhaustion and shame. And recognizing it doesn’t necessarily mean I can do anything to fix it.

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My wife took me out for dinner and Jurassic World on Sunday. This was a good thing. I needed to get away, to relax and recharge and just enjoy myself for a few hours. It’s self-care, and as such, it’s something I wouldn’t necessarily have done on my own.

Medication is one thing. I’m pretty good at remembering to pop a pill every night, checking my blood sugar regularly and doing the math to match insulin to carb counts. But self-care is a murkier kind of medicine, one that takes more time and effort than programming an insulin pump. It’s also one I’m more likely to assume I can blow off.

Oh sure, I haven’t been getting enough sleep, but I’ll catch up on the weekend. I’ve missed some exercise, but I had other important things to do. I haven’t socialized much, but I’ll get to that as soon as the book is turned in.

How do you quantify self-care? How do you prescribe a given dose to be taken daily? (Those questions are rhetorical, by the way — I’m not asking for advice right now.)

And of course, there’s that other voice arguing that your self-care isn’t as important as those other people’s needs. It’s not as important as Doing All the Things.

I know self-care is important. As Morpheus said, there’s a difference between knowing the path and walking the path. But here comes Red Riding Hood to remind you that walking the path is all well and good, but it’s even harder to stay on that path once you’ve started.

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I remember growing up without email. I think email is an amazing tool, one that’s made my life so much better and simpler in so many ways. I remember getting my first email account as a college student, and how amazing it was to reconnect with a friend who’d moved to MIT.

I also hate email. I hate the neverending inbox, and that nibbling sense of failure that comes with every message that sits there waiting too long for a response. I hate that it takes spoons to answer some fucking emails, and knowing if I don’t, people will feel disappointed or hurt, or will wonder why I answered one email but not the next, and will start to second-guess whether they did something wrong when it’s just me trying to juggle a bunch of damn spoons without dropping any.

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We’re going on vacation soon. That will be a good thing. It won’t be 100% stress-free, but the stresses will be different, and hopefully fewer.

I’m also looking at some potentially big changes later this year. Stressful and anxiety-making, but potentially very good in the long term.

In the meantime, I was Guest of Honor at a convention last weekend, did a radio interview last night, was part of a Baen podcast recording today, and am getting ready for my 11th novel to come out in just over a month. All wonderful, amazing things I only dreamed about when I was younger.

Good things can use up spoons too.

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It’s easy to take progress for granted.

I’m not fine. I am, however, doing a hell of a lot better than I was three years ago.

I just need to remember that it took a lot of work to get here, and that if I want to stay here — which I do — I need to keep doing the work.

Mirrored from Jim C. Hines.

Congratulations to Ariela, who won the audio book of Libriomancer in last week’s giveaway.

We’re down to a mere seven days until Unbound [Amazon | B&N | Indiebound] comes out. It’s possible the book might already be showing up in some brick & mortar stores. Eep!

Coincidentally, Sarah Chorn at SF Signal just posted her 2014 look back for her excellent Special Needs in Strange Worlds column about disability in SF/F. She lists her top ten posts for the year, and coming in at number two is my post about Writing with Depression, in which I talk about both my own depression and that of Isaac Vainio in Unbound:

“In the beginning of Unbound, [Isaac is] on the verge of losing his job at the library. He’s not sleeping or eating enough. All of his time and energy go into trying to undo certain mistakes from the last book. He’s irritable and angry at himself, his loved ones, his friends…pretty much everyone and everything.”

Given the events of the first two books, it made sense to me that Isaac would be struggling hard at this point. He’s won some impressive victories, but each one has come with a cost.

To be honest, writing Isaac as depressed scared the hell out of me. Characters are supposed to be likable, right? Well, on those days when I’m losing the battle against the Depression Brain Weasels of Doom, I don’t like myself that much:

“Isaac’s depression is truer to my struggle. I worry that he’ll be too unlikeable…because that’s how I felt at the time. I worry people will say he’s too weak, that this character should just man up and get over it, because that’s how I felt. That’s what I expected to hear if I talked about it. I worry about readers who don’t understand that depression isn’t something you just snap out of.”

I can reassure readers that Isaac does end up in a better place, and that there’s still plenty of smart-ass humor, not to mention Smudge the fire-spider doing his thing with flair and style. And I’ll say that I’m proud of the book. I’m proud of Isaac’s personal journey, as well as that of Lena and Nidhi. (Nidhi gets one of my favorite scenes early in this one.) I’m also proud of where Unbound ends up, which is a place I’ve been working for three books to reach. But I’m still scared of how readers will react.

I’ll end with one last quote from my column:

“Unbound is a book about battling monsters. Some of them are human. Others less so. Isaac has spent two books fighting monsters out there in the world, but sometimes the toughest monster is the one inside your own head.”

Mirrored from Jim C. Hines.

My therapist shared something interesting earlier this week. With the caveat that this is all a bit simplified, and human brains don’t fit into neat lines and graphs, it still helped me to think a little differently about depression and anxiety and stress, and to understand both myself and certain other people in my life a little better.

She started by drawing the following graph:

This fits pretty well with my experience. There’s a relatively straightforward relationship here. The more depressed you are, the less productive you are. (Giving lie to the myth of the tortured artist who’s most productive when they’re depressed.)

Next, she drew a graph of anxiety.

This one also made sense, once we talked about it a bit. If you have absolutely no anxiety, you end up with a lot less motivation to produce anything. Take away all of my deadlines, and I’m definitely less productive and more likely to spend an evening bumming around on the couch watching Doctor Who. Not that there’s anything wrong with that.

On the other hand, too much anxiety can be crippling, with the far extreme being someone who can’t even leave their room or home.

So basically, we want to minimize depression and find a healthy and moderate level of productive anxiety. Got it. So far, so good.

What gets interesting, at least for me, is looking at the implications of the two models. If depression is more of a linear thing, it means you have that straightforward goal of getting as far to the left as possible. This also means small steps to fight the depression are more likely to have small steps in improving your productivity. It tends to be a long, slow battle.

I’ve been in therapy and on medication for depression for about two years now. This has had a pretty large impact on the depression, and when you look at my productivity these days … well, I’m doing two books in 12 months instead of my usual one. Smaller improvements have led to smaller changes in productivity, like being able to keep up with washing the dishes. Again, it’s not a perfect graph, but it makes sense to me.

I sketched in two sample changes in mood. If the depression improves by X, productivity also improves by X. That tends to hold true whether you’re really depressed or in a generally good space. (Yes, I’m simplifying the math and assuming a 1:1 slope.)

Anxiety, on the other hand, resembles a bell curve. That means any given change in your anxiety can have drastically different results, depending on where you happen to be on that curve.

Look at this next graph. Both of the horizontal lines, indicating a change in anxiety, are the same. The vertical lines, showing change in productivity, are not.

For someone near that ideal middle-ground, a small increase in anxiety of amount X could have a relatively small impact on productivity, perhaps X or even X/2. On the other hand, if you’re more anxious, the same increase of X in your anxiety could have a much larger impact, hurting productivity by a factor of 2X, 3X, or more.

Likewise, for someone who’s struggling with anxiety, removing just a small stressor could have a very large impact, and help exponentially.

And the exact same increase in anxiety can actually boost productivity for someone to the left of the curve as much as it hurts someone to the right.

This was an AHA moment for me. I spend a fair amount of time working with people and trying to motivate them, whether it’s my employees at the day job or my children at home, and looking at that Anxiety graph helped to crystallize why the same tactic can have very different results for different people … or even for the same people at different times.

Someone on the left side, who seems to be slacking because they don’t really care? Maybe their anxiety needs to be turned up a bit, by talking about potential consequences. On the other hand, for someone on the right side of the graph who’s already close to a panic attack, potential consequences are likely to push them even further, making things that much harder for them. In that case, trying to take a little of that anxiety off their shoulders can help tremendously.

I see some of the same effects with the way stress and anxiety intertwine in my life. There’s a certain middle ground where I can add or remove things I need to get done, and it doesn’t have much of an impact. But once I hit that tipping point, just a small increase in stress can drag me down hard.

Like I said at the beginning, this is a bit of an oversimplification. Human beings tend to be pretty complicated and messy. But seeing depression and anxiety drawn out like this was really helpful for me, so I figured I’d share it in the hope that it might help a few of you as well.

Mirrored from Jim C. Hines.

In some ways, talking to a psychologist was even harder than starting antidepressants. In both cases, I was admitting to a problem that comes with its own baggage of shame and stigma and perceived weakness. But with counseling, it felt harder. This was more than hitting my doctor up for a prescription. I would be walking into a stranger’s office and spending hours explaining how I’d lost the ability to deal with things in my life, how I needed help to figure out things I feel like I should already know how to do.

That’s what it all comes back to. I feel like I should be able to handle this stuff. I should know how to be a good father and husband, how to balance the demands of writing and the day job, how to maintain my emotional balance in times of increased stress, and so on. I know how deceptive and nasty the word “should” can be, but that didn’t stop all the crap from swelling back through my brain when I thought about making that first appointment.

I made it anyway.

Eventually.

I’ve had three sessions so far, and while I’m not going to go into as much detail about them, I’ll say it’s been helpful. The first session or two were mostly a get-to-know-you sort of thing. I got an official diagnosis of dysthymia. As I understand it, this is a milder form of chronic, long-term depression. I.e., I’m in a lousy mood most of the time, but I’m not jumping off the Mackinac Bridge.

The funniest moment came in the first session: I was describing my life, the jobs and the writing, taking care of the kids after school, the work I did around the house, and so on.

Doctor P: What do you do for fun?

Jim: …?

Doctor P: When do you take time to just get out and enjoy yourself?

Jim: …I’m sorry, I don’t understand the question.

I was amused, but it was a good catch on her part. She gave me homework to do something fun just for me. I actually managed to do it, too. The trick now is going to be incorporating that lesson into my life on a more regular basis.

Doctor P has also pointed out some areas where I could improve things at home. We both recognize there’s a lot I can’t change — realistically, I can’t quit the day job; I can’t magically improve my wife’s health so that she can do more at home; and so on — so we’re concentrating on things where I can make changes for the better.

This whole process scares me. Eventually, I’d love to get off of the antidepressants, and I think counseling is one of the things that will help me do that. But given how helpful the pills have been since April, I’m also terrified of losing that crutch and slipping back into the swamp of who-gives-a-crap-about-anything. I guess I’m not yet completely trusting that it can help — or that I can change enough to really make a difference — in the long run.

This experience has also made me recognize once again how fortunate I am to have decent insurance that covers most of the medications and my weekly sessions. As hard as it’s been to admit I need help, how much worse must it be to realize you need help and have no way of getting it? [Rant about U.S. healthcare deleted because the goal is to not depress myself further.]

I’m cautiously optimistic. I like my counselor. She feels pretty genuine, and seems to get me. The first few sessions felt a little open-ended, but we’re talking about more concrete goals this week. Apparently we’ll also be doing a bit more cognitive work, teaching me how to win at some of my head games. I’ve had some speed bumps at home and at work, but overall, so far so good.

My thanks once again to everyone who’s been so encouraging and supportive.

Mirrored from Jim C. Hines.

A week ago, I went in for a doctor appointment, the end result of which was that I’ve started taking Zoloft for depression.

I feel like there should be a punchline here. “This is what I get for reading about Arizona politics” or “I blame the mess that is my current first draft.”

This hasn’t been a paralyzing, debilitating problem. I’ve been going to work, writing, taking care of the kids, going to karate … everything I’m supposed to do. But I haven’t been enjoying it. I’ve had less patience with my family. It’s gotten steadily harder to find the energy or motivation to do things. I’m spending more and more time feeling annoyed or apathetic.

It should not feel that draining or overwhelming to answer a simple e-mail.

I took any number of those depression self-assessments, most of which told me I was either mildly or moderately depressed. Even so, it took me close to a year to finally call and make an appointment to do something about it. Why did I wait so long? Probably the same reason I hesitated to blog about this.

I have no problem blogging about my diabetes. I’ve never felt ashamed of that disease, and I’ve never hesitated to talk about it, or to do whatever I needed in order to take care of myself.

This felt different. I’m diabetic because my pancreas took early retirement. That’s not my fault. But in my head, I was depressed because I wasn’t strong enough to deal with everything.

I know better. I was a psych major, and I’m married to a licensed counselor. I’ve watched people close to me start antidepressants, and I’ve seen how much of a difference it can make in their lives. I’ve never thought of them as weak, or of antidepressants as a sign that they’ve somehow failed at life.

It feels different when it’s you. There’s a double-standard. I know perfectly well that depression isn’t something you can simply will yourself through. I understand that neurochemical imbalance can be a physiological problem, just like a lazy pancreas. But I told myself it wasn’t really depression. I was just stressed. I needed some down time. I could tough it out. Eventually it would get better.

I can’t remember exactly when I stopped believing it would get better.

These aren’t things I’ve talked about online. There are aspects of my life that don’t make it onto the blog, and this certainly wasn’t what I wanted to project as Jim C. Hines, World Famous Author/Blogger/Cover Model!

We’re starting with a low dosage, and it will probably be a month or more before the medication starts to have an effect. Maybe longer. I was extremely hesitant about this. I don’t like the idea of messing with my brain … except that depression is a sign that my brain has already gotten messed up. I’m a bit worried about side effects too, though I’m told those should be minimal.

I have felt a little better this past week. I’d blame it on the placebo effect, except that I know perfectly well the meds don’t work this fast. Instead, I think it’s because I’m doing something. I don’t feel stuck, and there’s hope that I’ll get back to feeling like me again.

I am not asking for advice. If that changes, I’ll let y’all know.

Anyway, this is why I’ve been a bit slower to respond to e-mail, though I’m trying not to let anything slip through the cracks. This is why the rape fundraiser this year is a little less organized, and I didn’t get it posted right at the start of the month.

I’m not going to turn the blog into all-depression, all-the-time, any more than I blog about diabetes all the time. But given how open I’ve tried to be about the latter, it felt dishonest to not talk about the former, too. It felt dishonest to me. And, after all, the first step in solving a problem is acknowledgment, right?

Mirrored from Jim C. Hines.