Pandemics and Depression are Common Bedfellows

 The pandemic has caused many people to struggle with mental health, primarily anxiety and depression.  Everyone is scared, sad, touch-starved, struggling to make ends meet, all the things that go along with this dumpster fire of a year.  Even my husband, who has never had mental health issues (and in fact has trouble relating to them), is definitely experiencing some depression.  I've experienced a resurgence of my depression, and it's taking a different form than it ever has.

Typically, my depression comes out as anger and irritability.  This year, I've encountered those as well as changes in appetite and sleep patterns, which have never been things I struggled with before.  I've also attained a level of apathy and lack of motivation that I always thought was a myth.  My children roller skate in the house.  I don't care.  My 10-year-old hoards candy in his bedroom.  I don't care.  I have no clean clothes.  I don't care.  There's no food in the house.  I don't care.  Christmas shopping has been a total nightmare, even though I did it all online.  And now that all the gifts are here, I wonder how much I would have to pay someone to wrap them for me.  I have completely lost touch with my wardrobe.  I wear scrubs at work (one less decision to make), and when I come home I take a shower (at least I still do that!) and put on my pajamas.  At 3:00 in the afternoon.

I'm retreating.  I'm isolating.  I'm hiding.  All signs of bad brain action.  Honestly, the hardest thing about this whole situation has been forcing myself to do the things I need to do.  There are days when all I can do is go to work and go home.  No laundry, no errands, dinner ordered in.  I have a very autonomous job, and most days it's up to me to get things done on my own schedule.  Most of the time I like that, but right now I kind of need someone to hang over my shoulder and remind me to do things.  I mean, things other than sit at my desk and play Candy Crush.

Everything takes so much energy, so much strength, so much work.

People think depression is being sad or despondent.  For some people it is.  But it's also lack of motivation, lack of pleasure in things you used to love, the inability to prioritize or make decisions.  I increased the dose of my antidepressant, and that helped some, but mostly I've just been putting one foot in front of the other, trudging forward, hoping it will pay off one day.  And hoping that when this all ends, and we all go back out to the world, it won't linger.

Because the thing is, it's normal to be depressed right now.  I'd be a little weirded out if I weren't.  It's not normal to continue to be depressed when the circumstances change and we get back to living.  I've realized how many of the things I did were coping mechanisms for this same depression.  Now that they've been taken away, I see why I did them.  They got me out of the house and out of my head.  They allowed me to interact with people and be social.  They allowed me to have something to ground myself.

Every now and then my husband will randomly ask if I'm okay.  I always tell him I am, while simultaneously wondering why he's asking.  Last night I realized that he asks that because he really doesn't know.  I've retreated so far into myself, began listening to my own internal monologue so much, that I often don't talk.  So the days blend together, one after the other, all the same, and I just keep plodding.  Hoping something will change.  Hoping something will break.  Imagining... what?  What will the world be like when we all surface again?  I like to think we all learned something about how to relate to each other, how to be kind to each other, how to see things in a new way.  But I know humanity.  American humanity in particular.  We're very resistant to change and learning.  We don't learn from our past experiences, which is why history really does repeat itself.

One thing I know for sure: I'm not the only one.  In fact, for perhaps the first time in history, mental health is affecting more people than not.  I have a group of friends, we call ourselves the Crazy Moms Club.  We all have issues with anxiety, depression, bipolar disorder, body image, you name it.  All of our husbands are what we like to call neurotypical, meaning they don't have mental health issues at all.  We are all abundantly thankful for our "normal" husbands because they give us perspective.  They tell us when we're being crazy.  They pick up extra slack around the house when we don't have the energy.  They remind us to feed the children.  And when we get together, our conversation almost always revolves around the difficulties we face being moms with mental health issues.  Some people may say it's commiserating.  Maybe it is.  But it's also therapy.  It reminds us we're not alone.  We get ideas on how to cope.  We remind each other of our worth.  I love those Crazy Moms.  But right now, we can't get together.  We can (and do) FaceTime or Zoom, but anyone with kids knows how that goes.  You spend half the time talking to your friends, and half the time dealing with the kids.  It's less helpful that way.  But what else are we supposed to do in these times?  So we grit our teeth and move forward.

This will all be over someday.

Today I Got Some Insight

 I have mental health issues.  I have Borderline Personality Disorder.  This is a complicated disorder, but it all comes down to a shaky sense of identity: I never really know who I am.  There are some other things that come into play, like depression, anxiety, abandonment issues, perfectionism, all-or-nothing thinking, and a number of other things.  I've been dealing with this for about 10 years, but I've only known what it is for about 2 of those years.  The rest of the time has been spent trying to figure myself out.  Why do I do the things I do?  Why are my personal relationships so complicated?  Why can't I figure out what I want?  Ever?  Once I figured out the BPD thing, I could begin decoding these things.  I could start to see my motivations for behavior.  It's rough.  It's a battle.  I'm lucky.  I have a superb support system, an understanding and supportive husband, and I'm surrounded by educated people who also want to help me understand.

One thing has always mystified me when it comes to my own case of BPD. Most people with BPD have suffered some sort of childhood trauma that involves a role reversal.  Maybe they had a parent with mental or physical illness they needed to care for at a young age.  Maybe they were the child of working parents who had to be responsible for younger siblings when they still needed their own parents.  Maybe they were abused in some way, and had to find ways to cope with adult situations as a child.  That's what usually leads to the identity difficulty.  They see other kids their age doing kid-things, and they can't relate.  They're children in a world that is asking them to be an adult.  

I don't have any of those things in my past.  I had a healthy, happy childhood.  I was raised in a Christian home by both parents, and had a stay-at-home mom.  I have never been in an abusive relationship, and while I've always been a little socially awkward, I have always had friends my own age.  But for some reason, I developed the same borderline tendencies as someone who experienced significant childhood trauma.

So it's a lifelong search, really, trying to figure out what the trigger was.  Does it matter?  No, not really.  In the end, the result is the same: I have BPD.  But, I have always wondered how I got to be such an outlier.  The other day, I had an epiphany.  There have been 3 significant life events that account for my identity issues.

The struggle with infertility

All my life I've wanted to be a mom.  I used to be a preschool teacher, and I would often find myself fantasizing about what my own children would be like.  My husband and I agreed that we wanted children.  We had multiple discussions about how we would raise them.  We were looking forward to it.  We were the classic young married couple dreaming about being parents.  When we were finally ready, we tried.  And tried.  For 2 years.  Then we saw a fertility specialist who (after running some diagnostics) informed us that while I was 29, my ovaries were 40.  While we were trying to have children, my reproductive system was aiming toward retirement.  She told us our only chance of getting pregnant was in-vitro fertilization with a donor egg.  

A donor egg.

That would mean that if we chose to pursue this road, our child would only be half ours, biologically.  We decided that to move forward with fertility treatments would be (for us) trying to get pregnant, not trying to have children.  The distinction is important.  Pregnancy is a one-time event.  It happens, and then it's over.  Having children is a lifetime commitment.  Having children means shaping and training someone to be a productive member of society.  It's a lifelong process.  It was that process we wanted, not the event of pregnancy.

So now I knew I couldn't get pregnant.  That was a big identity blow to me.  As a female raised in a traditional Christian home, one of my "jobs" was to produce children.  Not my only job.  Not my only purpose.  But it was certainly one of them.  And now I couldn't do that.  It felt like a very cruel cosmic joke.  Who was I if I couldn't do this thing that I both wanted to do and felt I was expected to do?  How was I supposed to fulfill my purpose?

The failed adoption

We decided to pursue adoption.  We applied through the foster system in our county, and went through the process of becoming foster parents (a requirement in our state for adoption).  We were matched with a sibling set of two: a brother and a sister.  They were with us for 7 weeks before a family member stepped up and volunteered to take them.  Federal law states that any biological family member within 5 degrees of separation can take custody of the children and be their foster family.

So one day, my husband and I took our two beautiful children and handed them over to the county to be placed with their family member.

I was so angry.  So angry.  I yelled, I threw things, I sat on the floor of my little girl's nursery and cried.  I could accept that I wasn't supposed to have biological children of my own, but to have them taken away?  What had we done wrong?  Why would God do that?  It's a good thing to want to adopt children from an unhealthy environment and raise them in a healthy one.  How could this be what was best for them?

Again, I was faced with the possibility that I may never be a mom.  Again, I struggled to understand who I was, if not who I was expecting to be.

It sent me into a crisis of faith, that lingers to this day in some ways.  I was sure God couldn't be real.  If He was, how could this be what He wanted for me?  He wanted me to give up my children?  He didn't want me to have any?  Why had he given me the desire for children, if I was never going to have them?  My head spun with questions, doubt, anger, bitterness, and despair.

Eventually, we did adopt two children, though not biological siblings.  But my questions about God and the universe lingered, even though I had been granted that privilege.  I made an effort to ground myself in the here and now.  I had been wrong.  God wasn't taking that opportunity away from me.  He was granting it in a different way.  Had I been allowed to suffer along the way?  Sure.  But without suffering there would be no compassion.  

Losing music

The third thing that happened was a blow I still haven't completely worked through.

I have been singing in choirs, musicals, plays, and worship bands since I was 5 years old.  I have always been involved in the music ministry at every church I've ever attended.  Music was how I dealt with a lot of my mental health issues, particularly depression.  Music was how God spoke to me the majority of the time.  Both my parents make music, and it featured large in our family.  I didn't make a career out of it (I always knew I wouldn't), but it has always been part of me.  A symbol.  Not just fun, not just challenging, not just rewarding.  It was ME.  I did music.

For a couple of years, I sang with the worship team at my church.  One day, I abruptly received an email from the music pastor informing me that he didn't want me to do it anymore because I don't play an instrument.

Now, here's the thing: I don't play an instrument.  I've never played an instrument.  I play the piano just enough to help me with my singing.  In elementary school I played the flute, but only for a couple of years.  In high school I realized that my voice was my instrument.  So I focused on that.  I studied voice the way other musicians study their instruments.  I took lessons, I sang in academic choirs, I studied difficult pieces for my recitals.  It made no sense to play a guitar or drum or piano because I already played an instrument.  One I could take with me everywhere I went, practice at any time, and find multiple ways to share with others.

I honed my ear and learned to create harmonies on my own, on the fly.  I sang with friends and family, with church members, with professors, I've recorded a few times.  In the midst of everything that happens in life, I always found a way to have music.

Had we not had children, we would have looked for a new church where I could do music.  But, our children have friends at church, and our church is very invested in families and what they need.  I felt we needed to stay here to maintain stability for our kids.  But that means I have to figure out my role.  I don't get music anymore, so who am I?  

And THAT is the basis of my identity issues.  I have had more than one experience that showed me I'm not who I thought I was, and no answers as to who I really am.  Things outside my control happened that dismantled who I thought I was.  These were not choices I made, they were unexpected happenings.  That is what makes them so devastating.

Now, knowing this doesn't fix my issues.  It doesn't tell me who I am or what I'm supposed to do.  But it does tell me that I have had some life experiences that strike at who I am on a fundamental level.

If you or anyone you know has experienced something like this, please listen: be there for them.  They will push you away.  Stay.  They will say things that make no sense.  Listen.  They will try to manipulate you to do things their way.  Calmly tell them you will not be manipulated, and you love them.  Love them.  Read about this condition.  Talk to people who know.  Try to understand. 

We euthanized our control yesterday

At the end of any research study, the animals are euthanized.  This is because they need to be autoposied so the scientists can figure out what changes happened inside the animal during the study.  They take sample of all the major body systems (heart, lungs, liver, spleen, pancreas, and kidney, as well as some connective tissue in this case) and analyze them.  I'm not involved in analysis, but obviously I am there for the euthanasia part.  More than just being there, I'm the one that gave the injection to euthanize the animal.  The animal was then immediately taken to the pathology center so tissue samples could be taken, blood drawn, and the carcass disposed of properly (cremated).

I've worked in a field that utilizes euthanasia for most of my adult life.  Veterinary medicine employs euthanasia as an option in some cases, where medically appropriate.  This is not the place to debate whether or not euthanasia as a practice is ethical, acceptable, or whatever.  My contention is that it exists, we use it, and it's a reality of my job.  I'm not making (nor inviting) a judgement call about the practice, just acknowledging its existence.  A lot of veterinary professionals site euthanasia as the reason they suffer from burnout and compassion fatigue.  Again, I'm not here to debate that fact, although I will say that I have had compassion fatigue in the past, and it wasn't really related to euthanasia.  It wasn't really related to anything having to do with the animals, actually.  It was usually because of the rudeness of pet owners (I got accused of not loving animals more times than I care to remember) and the unrealistic expectations of some doctors I worked with.  So I'm not opposed to the idea of euthanasia in general, and in fact most of the time it's the most loving thing we can do for a pet who is suffering and has spent their life being a companion to us.  We tell them thank you for being a good pet, and we let them go.  

But euthanasia in my current job is different.  These animals aren't sick.  They aren't dying.  This is their contribution to science.  It's their job.  One of the reasons I don't have an issue with euthanasia is because I take it seriously, I treat the animal with respect, and that makes the experience less routine.  I've developed a mantra of sorts that I frequently will say over animals as I euthanize them: "Black god take you gentle, Weiryn keep you safe."  These are both Pagan gods, the Black God is the god of death, Weiryn is the god of animals.  In Pagan tradition, the Black God escorts the dead (of any species) across the veil to the next life.  Weiryn protects animals who have died and makes sure they have all the blessings they might have been missing in this life.  With this job, I added, "Thank you for your sacrifice."  

The animals I'm responsible for will die. They have to.  It's how we'll learn from them.  You may have a personal issue with research, euthanasia, or animals in captivity at all (remember that includes pet ownership), and that's fine.  You don't have to agree with me.  But I have to find some way to make that okay for me, or I will definitely get burnout or compassion fatigue or just bored.  One of the guidelines I've developed for myself is to acknowledge that euthanasia is routine.  Routine means that we do it frequently, and we have a formula for how it's supposed to go.  But that doesn't mean it has to be mundane.  We can still take it seriously, we can still treat an animal with respect, we can still thank them for whatever contribution they have made, whether to science or as a companion.  So I thank them appropriately and I move on.  It's the best thing I can do.

Black God take you gentle, Weiryn keep you safe, thank you for your sacrifice.

Being part of an essential research department during a pandemic

We're all familiar with the COVID-19 outbreak, I don't need to go into that.  I started my current job in a research department of a university right before the "shelter in place" orders went out.  I believe I had two weeks of "normal" before the order went into effect.  In response, the university closed its campus, and all the students and faculty began working from home.  Classes are being conducted online, conferences and other on-campus events were canceled, and anyone not deemed "essential staff" was ordered to work from home.  I don't have a lot of contact with students or faculty, so I can't say how that end of things is going, but from what I understand of the administrative part of the staff, working from home is working wonderfully for them.  

Active research was deemed "essential", so I keep coming to work every day to do my job.  A job that is quite nebulous regarding its requirements and daily responsibilities.  The big picture is that my job is to make sure animals are being treated humanely and appropriately.  That divides itself into a number of things ranging from monitoring anesthesia to doing daily drug administration to socializing and caring for the animals.  There is a separate animal care staff that is responsible for food, water, cleaning, etc.  If we happen to have surgeries on any given day, that is my primary responsibility, if not, then I focus on socialization, administering drugs, and inventory/administrative tasks (document, document, document).  I also have to clean and maintain all our surgical instruments and equipment and keep track of inventory and ordering.

What is especially weird is coming to campus day after day when there's basically no one here.  Security is here, as well as shipping and receiving, and a handful of researchers.  A small handful.  My desk is an unused open bench in the lab.  As I type this, there is one other person here, a researcher I don't know, doing work I'm not familiar with.  The whole thing is like a setting for a zombie apocalypse movie.  Every morning I arrive at work and enter my building through the loading dock.  Why?  The key card system used to lock the front doors of all the buildings has been turned off.  The only way to get into any building is with a key, and only security has those.  So I have two options when I get to work in the morning: flag down a security guard and ask them to let me in, or go through the loading dock.  I typically opt for the loading dock because I don't have to bother anyone for that (not that they're bothered, they don't want to be sent home).

Once I'm in the building, if I see more than 4 other people in a given day it's an event.  My floor of my building is only for research, so there's no reason for anyone else to be here.  Most days I'm the only one in the lab.  It's also a biosecure facility so in addition to no one NEEDING to be here, no one can actually get into the lab or the vivarium (where the animals live) without authorization and a key.  The key is actually a chip embedded in my badge which I use to open any doors I need to enter.  Out of curiosity, the other day I went exploring on the other floors of my building, which are classrooms, offices, and study rooms.  

They were categorically empty.

Now, I'm an introvert who also happens to have social anxiety, so the fact that I never see anyone doesn't really bother me.  It is, however, creepy AF.  These rooms that used to house groups of students studying, professors giving advice and criticism, and lectures and presentations now stand empty and dark.  The cafe on campus is closed until further notice, so that social center is quiet, dark, and unpopulated.  I couldn't get in there if I wanted to.  I keep expecting Norman Reedus to jump out from behind some corner, but sadly, he never has.  Campus walkways that are usually filled with students, both current and prospective, are deserted.  Outdoor seating areas have been abandoned.  And obviously the parking lot is a virtual ghost town.

All of this inactivity makes me curious about what will happen when we can again go back to "normal".  My personal hypothesis is that there will be a new "normal".  I don't know what will be new, but things will not go back to the way they were.  Employers have learned that employees can telecommute, event to do things they didn't previously think could be done at home.  The food service industry has encountered new ways they can serve their customers from takeout to delivery to allowing customers to buy grocery items from them.  What, then, will happen when the order is lifted?  Like I said, I don't know.  But I'm very interested to see what the evolution of this situation will be.

Until then, my job is still my job, and I'll keep doing it while also maintaining social distancing, wearing a face mask when I go into public spaces, and staying home when I can.

I got a job in animal research. Here's what happened.

First, a little background.

I'm a Registered Veterinary Technician and I've been a college instructor for the past 6 years.  I teach vet tech students.  I teach anatomy and physiology, small animal medical nursing, clinical pathology, exotic animal nursing, and laboratory animal nursing.  It's great, I love it, but I never get to do anything medical anymore.  Recently my supervisor left the college, and it seemed like a good time to see what else was out there for me.  Am I even qualified for anything else anymore?  I accepted a job in animal research.

Now, I haven't even started this job yet, but when I told people I had accepted it, I was met with something I should have expected: divisiveness.  I should have expected it because I know this topic is divisive.  I should have expected it because I know most of the public suffers from the same misconceptions about animal research that I used to have.  If you knew 16-year-old me, you would know this is a serious violation of what used to be my very firmly held (if uneducated) beliefs.  But for some reason, I expected the people I'm friends with to accept this about me.  To maybe ask me questions about why I decided to go this route.  To take an opportunity to find out what animal research is really about.

Instead, people have been expressing sentiments that range from supportive and congratulatory to disgust.  The word "disappointment" was used.  Interestingly, none of the negative reactions have been directly to me.  Most of them have been in passive-aggressive comments to other people in my hearing, negative memes posted on social media, and text messages to other people in my circle.

I wasn't aware that I had to consult my friends when searching for a new job.  I wasn't aware I needed their approval.  And I REALLY wasn't aware that some of them would decide not to be friends with me anymore. 

Not one of them asked me why.  Not one of them asked me what kind of work I would be doing.  Not one of them asked me what kind of research was going on.  No one bothered to gather any real information.  And you know what?  I'm fine with that.  If my job is a reason to stop being my friend, then we need to evaluate whether we were really friends to start out with.

So for fun, I found out some stuff we have because of animal research.  And I have to say, I'm pretty excited to be a part of something that may one day save someone's life, cure a chronic illness, or be the Next Big Thing in modern medicine.

1) Organ Transplants: Organ transplants used to be really complicated.  There were a series of genetic markers that had to match up, or the recipient's immune system would reject the transplanted tissue and the patient could die.  Then we found (through animal research) some drugs can suppress the immune response to the foreign tissue and make the recipient more likely to accept transplanted tissue that didn't match all the genetic markers.  The downside to this was that the antirejection drugs had to be taken lifelong, were very expensive, and suppressed other parts of the immune system as well, making the patient more susceptible to disease.  Now (also because of animal research, specifically with mice and rats) we have gene therapy that can target the triggers of the transplanted tissue and make it invisible to the immune system without drugs, and without suppression.

2) Balloon Angioplasty: This is a procedure where a surgeon threads a catheter through a blocked or partially blocked artery and inflates the balloon to open up the blood vessel and restore normal circulation.  The procedure was discovered and perfected using rat and pig models.  Currently, more than 200,000 people in the US receive angioplasty due to heart issues secondary to cholesterol build-up, and more and more babies born with congenital circulatory deficiencies are being "fixed" with this procedure.

3) Epilepsy: This one is a big deal to me, as a person who has a seizure disorder.  Certainly, we know that anti-seizure drugs are developed through the use of animal models.  But did you know that current research with mice has isolated a number of gene mutations that are linked to the cause of epilepsy?  Through this same model (mice) we've learned that certain types of epilepsy can be managed by including more of certain amino acids in the patient's diet, eliminating the need for drugs altogether.

4) Universal Flu Vaccine: Sounds like a pipe dream, right?  I know what you're going to say: "But the flu virus mutates every year."  And you're right.  It does.  HOWEVER, there are certain things in the DNA of the flu virus that make it influenza and not some other virus.  No matter how much the virus mutates, it will always be a flu virus.  That means, if we can find a way to create a vaccine against anything containing those DNA markers, we can create a universal flu vaccine that protects against all strains of the virus.  In 2015, a universal flu vaccine was developed that protected mice from 8 different flu strains.  The next step is to move on to ferret trials.  Why ferrets?  They live longer than mice, so immunity can be tracked over time to see how age affects the efficacy of the vaccine.

5) Parkinson's: Using mice and monkeys, we discovered that the neurotransmitter dopamine (more accurately a lack of it) is largely responsible for the tremors associated with this chronic and progressive condition.  Using that knowledge, we've been able to develop drugs that block certain neurotransmitters and enhance dopamine's action in the brain to control symptoms.  We've also learned using monkeys that Deep Brain Stimulation (a surgical technique used to direct electrical currents in the brain and control motor movements) is successful in patients who don't respond favorably to medications.

6) Stem Cells: I know it seems like stem cells are brand new research, but that's really because it only went public not too long ago, and people are understandably nervous about the ethical implications.  However, stem cells have been studied as far back as 1961 as far as how they may be applied to nerve damage (think spinal cord injuries and paralysis) to regrow nerve tissue and restore its function.  That research has continued, and we now know that stem cells in a certain type of tissue, rebuild that type of tissue.  Researchers are currently trying to develop cell therapies that involve transplanting stem cells into certain organs or tissues to rebuild and repair them in targeted locations.

So that's what I'm going to be a part of.  That's the legacy of this branch of medicine.  It's complicated and messy, and a bit of an ethical jungle.  But on average, humans in developed nations are living about 30 years longer than they did at the turn of the 20th century because of discoveries made using animal research.  And that's worth contributing to.