This blog post was initially published in Turkish on March 1st, 2013. For the mental health awareness month of May 2019, I decided to translate and share it here (it has very little edits from the original). This year, I have been encouraged to be more open about my mental health struggles, and my path to a more stable and happier life as an adult and academic. I still struggle, learning and growing never ends. But I have learned how to manage my mental health. I am so thankful to everyone else sharing their stories openly. Just like their stories helped me, I hope my story will help you.
My Mental Health Under My Own Microscope
The last time I posted here, I was in a great mood thanks to having started working out regularly. Since then, I have continued my regular workouts. So much so that, I even decided to run a half-marathon in Washington D.C.! For a while, I would either run or swim in the mornings on weekdays. But nowadays I am down to working out 3 days per week. Every day I run or swim I feel so much better (though there are exceptions, which I will talk about below), even if I wake up feeling down on that particular day. I even lost some extra weight at a healthy rate. So, it is good so far. No, not just good, it is wonderful!
However… I was hoping my mood swings, my brain’s “short-circuits”, my depression and anxieties were going to disappear with regular exercise, or at least would get largely under control. I was so excited about this new life prospect! Unfortunately, things didn’t turn out to be that way.
First of all, I am going through a tough time, when I am particularly vulnerable to feel depressed and anxious. We have funding issues at the lab I am working at. I have been aware of the situation since the summer, and my advisor and I tried to get more funds to close this funding gap. Unfortunately, our efforts did not pan out. Because of all this, I have been living in uncertainty since August: For how much longer will I be able to stay here at this lab, and in the US? Will this other application come through? (No) How about this other one? (No)… I tried to focus on 2-week-long aims and tried not to get paralyzed with worrying about the future. I continued to exercise regularly so that I would not lose my mind.
Meanwhile, two things happened: First, I started journaling my mood, and my exercise and meditation routine. Every night, before going to sleep, I recorded how I felt during the day (before and after exercise/meditation). At first, I didn’t have a particular aim in mind for journaling, I just wanted to have a record of all this. Second, I’ve been to Japan. (I’ll explain why I’m telling you this detail in a minute).
These were the circumstances when I periodically found myself in severe depression (3 times that lasted a couple days each, since November), even though I had been exercising and meditating regularly. Perhaps “severe depression” is not the right terminology, please feel free to correct me in the comments section. Here is what I mean by it: crying all day long and not being able to do anything else. Can rarely get out of the bed. This lasts several days. Eventually recovering and feeling normal. While depressed, feeling completely hopeless, seeing nothing but darkness in my future, feeling like a huge failure, feeling worthless, so so so worthless. But the weird thing is, this same person on “non-depressed” days (the days other people see and know me) is a person who feels strong, who is hard-working, self-confident, a person who sees the opportunity in hardship, who is able to think that things will be all right. You can imagine how confusing it is to experience these swings, both for me and for the people around me who are close enough so I let them see my mood swings.
At last, about two weeks ago, when one of those depression fits held me by the legs again like a cruel giant, and slapped me to the wall, I said “That’s it!” and gave my therapist a call. I had not seen him in a while. He squeezed me into his schedule immediately. On the morning of my appointment day, I took my mood journal, and to better understand what’s happening to me, I decided to make a summary of my entries. While working on that summary I noticed “Wowowowow, I collected actual data!” It was one of the rare moments when I wanted to hug myself. I’m a scientist! I collect data! Transferred all the data points to a spreadsheet. Plotted a graph. Applied the days I had my period onto this mood score graph. Marked the times I had the nervous breakdowns (i.e. severe depression periods). And “Eureka! There is a pattern!” Here it is:
The blue line in this graph represents my mood score from negative to positive (black line is “zero”). The magenta star represents the nervous breakdowns, the salmon/pink columns are the days I had my period. The obvious pattern is that, during this time frame, I had 3 nervous breakdowns right before my periods. I didn’t have a nervous breakdown only before one period, though my body/mind certainly attempted but could not succeed breaking me down (16-18 December). And to me it is so clear why I was off the hook that month: I was traveling in Japan for 10 days (represented by the bar in teal green) and I had a great time. I always feel better when I travel to a new place. My body must have stocked up on serotonin so much that I was in a better mood in general that month (as you may have noticed from the blue line being above zero mostly that month). The months after this have the repeating pattern of “normal-ish” or “meh“ moods followed by a nervous breakdown the week before my period starts.
With my very strong findings, I went to my therapist. “This is the situation dear Tom”, I said. He paused for a bit and he said, “My dear, you have PMDD”. “What the heck is that?!”, I asked. “Premenstrual Dysphoric Disorder”, he replied. Careful! This is not your usual PMS (which is already horrible). PMS is something most women experience to varying degrees. “PMDD is exactly what you describe. You feel pretty normal until it hits about 10 to 7 days before your period, and your mood changes drastically, much more severely than it would in PMS. If regular exercise isn’t helping (looks like it isn’t in your case), the other options are trying to go on birth control pills or going back on being antidepressants.” NOOOOOOOO NOT ANTIDEPRESSANTS!* I worked so hard to quit them. Ok let’s try birth control pills. (In theory, BCPs were to regulate my hormones, and potentially then prevent PMDD).
So, this is what’s been going on. I wanted to share all this because it is important to me. I feel like people take mental health issues too lightly or stigmatize. If you struggle with mental health problems, you may be afraid of being seen as “weak” or “spoiled” or “lazy” or whatever, fill in the blanks with negative verbiage. A lot of times, it is not just the fear of others calling you these things, but you yourself believing in these, and you end up hating yourself and beating yourself up. I am sharing my experience to bring more awareness to these issues. Please do not hesitate to get professional help (if you have the means). Please spend the time to know yourself, your patterns. If by sharing this I can help a couple of people, I will be so happy.
I have an appointment next week with the women’s health center to discuss birth control pills. We will see if they will help. I’ll share my experience as I go. And I will continue to journal my mood.
PS: Here is an article that explains the difference between PMDD and PMS.
An update to this blog post (in 2017): Birth control pills didn’t do it for me. I felt terrible on the one type of pill I tried. Eventually, what ended up helping was getting an IUD (intra-uterine device) in 2014 (I got Mirena). These hormonal IUDs release hormones locally, and they do not have the systemic effect the pills have. I miraculously stopped having the severe swings, though I still have light PMS-type mood changes. I also do not have cramps anymore as a bonus! Everybody reacts differently to these different options. The bottom line is, spend the time to try different options and hang in there! You’ll find a solution.
*Another update (in 2019): Even though my IUD helped a lot with getting some part of the troubles under control, after starting my new faculty position, I started having insomnia very regularly. (I had been suffering from this to some extent while in Paris, but it was manageable.) Even though at times I felt like I never felt happier in my life (thanks to being with my wonderful partner, finally living in the same place together, and having the dream job), I also started having to deal with lots of new anxieties that came with the new job. After spending a year trying to remedy the insomnia through not drinking coffee except in the morning, trying not to eat things that upset my stomach in the evening, mindfulness, reading books and staying away from screens once in bed, and therapy (I cannot thank my therapist enough for the growth she helped me achieve)… I mean I tried, and tried, and tried, and finally decided that it is time to go back on antidepressants. And life has been so much better. I am on a low dose, which helped so much with my sleep, but didn’t lose my motivation like it happened the first time.(this was one of the main reasons I had quit antidepressants back then). I hope you find your solution, and strength to look for a solution, whatever it may be.