Sunday, March 15, 2009

My Mental Health

I was born in Rijswijk, Netherlands, in 1951, near the peak of the baby boomer generation. I was the third of five children and have an older brother and sister and a younger brother and sister. Something possibly quite significant, which I will come back to at the appropriate time in this story, happened to me as a baby.

In 1954, my father joined the great Dutch post-war emigration, moving his family to Canada. We landed at the port of Halifax at Pier 21, now a very meaningful immigration museum. My family fell in love with Nova Scotia and stayed. After working for a couple of years, my father bought a farm and slowly built a business growing vegetables.

My childhood was very ordinary. We were poor but so were all our neighbors. As kids, none of us seemed to mind our circumstances and we were only vaguely aware that some in our community had much more than we did. Looking back, I believe it was a very good way to grow up because I learned that if I wanted something I had to work for it. I wanted a bicycle, so I worked and saved and finally bought one, a red CCM. I have no memories of being unhappy before my teen years.

In 1967 all of Canada was excited about celebrating one hundred years of nationhood. Our high school, like many others across the country, planned a class trip to EXPO in Montreal. But we were poor and my parents could not afford the expense, and I was saving for my first car. Yet it seemed that everyone was expected to do something to join this big national birthday party. Everyone was expected to have a Centennial Project and I decided that I would keep a diary. I recorded every day of my life in 1967 as a fifteen, then sixteen year old teenager growing up in rural Nova Scotia.

January 1, 1967
I’m in the middle of one of my many moods of depression and dread the thought of going to school again in a couple of days.

April 21, 1967
I feel very depressed today. Sometimes, like now, I don’t see much sense in living and feel like jumping off a cliff…

April 22, 1967
I am still in depression. Life seems but a useless existence. I wish I could see a definite purpose for living more clearly.

May 19, 1967
I feel hollow, lonely and depressed now. One song expresses my mood well:
He’s a real nowhere man
Living in his nowhere land
Making all his nowhere plans
For nobody.


November 24, 1967
…I felt pretty miserable and went to my room and broke down into tears wishing for someone, anyone to talk with.

The three years of high school were the unhappiest of my life. I had few friends and felt different from those around me. I was interested in different things from my classmates. I was very interested in world affairs and greatly enjoyed reading Time Magazine. I read non-fiction. I was interested in thinking about why I was born. These were not typical teenage activities. I was very awkward around girls and experienced much angst for not having a girlfriend, and thought I was the only boy who didn’t. I was very lonely.

At home I lived in a different world from my parents. This was the 60s and there were big generational differences between parents and children in our family. There were cultural differences because we were Canadian but our parents were Dutch and old-fashioned. There was much tension and little meaningful communication. My parents had no idea of the thoughts going through my mind. I don’t think my father ever understood me, then or later. I was not close to my brothers or sisters at that time. Our family was not loving nor emotionally sustaining, but it was decent and both my parents had many excellent values.

During these years I lived as though I was walking through a fog, a common metaphor often used by those who are depressed. I was often tired and I often had headaches. I read a lot because I loved to learn and because it was an escape from the real world. But I was able to function well enough at school to earn good marks. I was very focused on graduating and leaving home.

Early in 1967 something happened that profoundly impacted my life, and my mental health, for a long time. For the next twenty-five years much of my mental stability and my ability to cope reasonably successfully with life came from being a member of a benign cult!

February 7, 1967
I listened to a program “The World Tomorrow” on the radio. I liked it. This man forecasts things in the future on the basis of the Bible. He seems like a good Christian.

By keeping a diary I had also accidently discovered the benefits of journaling and continued writing down my thoughts the following year.

January 5, 1968
Last year I kept a diary on a daily basis. It began as a Centennial Project – one I look back on as a very good one indeed. The diary offered a means of expressing myself, a substitute for expressing myself to other human beings. When no one else would listen or understand, my diary would.

A rather innocent entry in my journal late in 1968 recorded the beginning of a life-long activity that has had a great positive impact on my mental health.

September 20, 1968
Nothing else of importance worth noting happened since my last entry. Oh, except I have started a program of exercise, running – 2.1 miles six times a week if weather permits. I ran six times this week. I have completed two weeks of exercise.

I had read and been influenced by a book entitled Aerobics, written by Dr. Kenneth Cooper. I soon gained several important insights. I learned that I loved running and that running calmed my mind and helped ward off depression. Back then, jogging had not yet become popular and many people mocked what I was doing. Seeing me running along the road in rural Nova Scotia in 1968, the neighbors thought I was a strange boy indeed. I remember my grandfather being very concerned, believing everyone was given a fixed number of heartbeats and that I was using up mine much too quickly. But I also discovered that I didn’t much care what others said, and so I ran. I still love running today.

In 1969 I left Nova Scotia. With my few worldly possession piled on the back seat, I drove my red VW beetle across Canada and settled in Alberta. I wanted to get away from a girl friend who was beginning to talk about getting married. I wanted to get away from my family, none of whom understood me. But most of all, I wanted to join a church, which I did, thinking I had found meaning and purpose for my life. It would be many years before I realized that I had joined a cult.

That church was the Worldwide Church of God, led by a very charismatic father and son team, Herbert W. Armstrong and Garner Ted Armstrong. Their vehicles of evangelism were the free Plain Truth magazine and The World Tomorrow radio program, which I had stumbled upon. They also founded Ambassador College which had three very beautiful campuses and I aspired to attend this institution. Much later I became very, very grateful that my applications were rejected.

I now understand that during this period of my life, while I thought I was responding to God's calling, in fact I was the victim of a benign cult. While there was a huge cost, financial and otherwise, it had its benefits. The church was very controlling, but this provided me with much needed stability. Within this closed society I was able to build some social skills and I found and married my wife, Pat. We are still together. Also, believing one has found the ultimate truth can have a remarkably positive effect on the mind, even if it really is a lie. Thus as a young adult, I was able to focus my energy on building a career and decided to become an accountant. I benefitted greatly from making a suitable career choice at only nineteen years of age.

Although I continued to have bouts of depression which I will describe, generally I was making my way in life with sufficient success for life to be worthwhile. Looking back, the church was a crutch, but better to walk with a crutch than fall on your face. Eventually I was able to walk without a crutch and I realized it was time to stop dragging it along.

My twenties were better years than my teens, and my thirties were better yet. Most of the time I had good mental health. But several times a year I would have bouts of depression. The usual pattern was for depression to hit suddenly, with no apparent triggering event. I was back in the fog. Slowly over a period of a few days the fog would lift. These bouts were difficult for my wife because I would become extremely withdrawn and barely talk to her. Neither my wife nor I had much understanding of what was happening. Other than my wife, very few friends or colleagues were aware of my depression. Those who were reacted with the observation that I had a good life and nothing to be depressed about. To me it was all quite discouraging.

I still clearly remember one particular episode. My employer had asked me to attend a two day conference being held at the very beautiful Kananaskis Village resort in the Canadian Rockies. It was always fun to get away from the office for a couple of days and the conference was interesting. Life was good. Suddenly, during an early conference session, depression! On one level I was still hearing the presentations and interacting with the other participants. But on another level I was withdrawing, turning inward, feeling very unhappy. I have often been amazed at how easy it is to function on two levels at the same time, hiding depression from others.

But this fog was thicker than most. I felt as though I was trapped inside an expanding house with rooms within rooms and I was going ever deeper and deeper inside. I remember being scared, afraid that I might never find my way back to the outside. But eventually the fog again lifted.

I was tired of living like this and decided I needed to do something. But what? At the time, we had a church pastor that I related to quite well and I decided to seek counseling from him. He introduced me to the book Feeling Good by David Burns. This book was the popularization of cognitive therapy and helped me a great deal. As much as anything, it gave me hope that I could do something about these dark periods that overcame me from time to time. Just understanding that by controlling my thoughts I could control my moods helped a great deal. There was considerable improvement in my mental health. But there continued to be occasions when the darkness and the fog overwhelmed good theory. During a bout of depression, even the knowledge that controlling my thoughts would make a difference didn’t help. I did not have the energy nor the will to do so and simply suffered and endured. “Think positive” or “Snap out of it” is very trite advice to give to someone who is depressed.

At mid-life I went through a few years of classic male mid-life crisis. This was a time to re-evaluate choices made during the years of early adulthood. Some choices were to be reaffirmed, others rejected.

Our church was experiencing considerable organization upheaval and went from being a source of stability to a cause of anxiety. Rapidly changing long-held sacred truths begged questioning. But I went much further than questioning the church; I questioned the very foundations of my faith. Desperately wanting to re-affirm my Christian beliefs, I fell to my knees and prayed to God for his guidance in my spiritual journey. Those prayers were never answered. After several years of mental turmoil, I left my church and became an unbeliever.

I remember lying awake at night for hours wondering how it could even be possible to live without faith. What if there is no God who cares about us? What if there is no life after death? What if there were no absolute values? How could one live sanely with such knowledge? How could one find any purpose at all for living?

Unless experienced, it is probably difficult to understand the degree of anxiety that can accompany a transition which results in a radical change of core beliefs and values. It certainly was not all negative. There were times of great excitement as whole new ways of thinking opened up.

Leaving a cult in which one found love and marriage was complicated. While I had come to clearly see myself as a willing victim of a benign cult, my wife continued to be a true believer, although she did have the beginnings of doubt. Pat and I were rapidly growing apart and I knew this could be the end of our marriage. More anxiety! In one of the best decisions of my life, I decided not to leave the cult but instead stayed by my wife’s side. About a year and a half later, we left together.

From mid-life on, I probably have had more struggles with anxiety than depression. Mostly it was low-level but constant anxiety, experienced as difficulty feeling relaxed and calm. It also meant difficulty sleeping well.

One particular Saturday I had a puzzling experience. It was an ordinary week-end day. Nothing unusual happened and I was not depressed or anxious. At the end of the day, my wife went to bed first and I was in the bathroom getting ready to retire for the night. Suddenly, while looking in the mirror, I saw it! There was a big blotch on my skin. Why had I not seen it before? I had skin cancer! I was going to die! I was too young to die. My heart raced. What was I going to do?

I went to bed but hardly slept. The next morning, I got up early and went immediately to the bathroom and looked in the mirror. Yes, it was still there, but maybe just a bit smaller. When Pat got up, I hardly spoke to her. As the morning wore on, I kept looking in the mirror at my chest. The blotch was looking less like a blotch and more like a big freckle. Pat finally asked, “What is the matter with you this morning?” Already beginning to feel silly, I explained everything. Pat looked at the spot and quite pragmatically suggested I have my doctor look at it. I agreed.

By Monday morning going to a doctor seemed like a waste of time but Pat insisted. In a way, my doctor was wonderful. No big deal, let’s just take a biopsy and send it to the lab. A few days later, I got the now expected all clear. Looking back, it is hard for me to conclude that my doctor did not see this incident for what it really was. But there was no probing of my mental state. I was not asked to describe the circumstances leading up to the visit to the doctor’s office. It was a physical examination concerned only with ruling out a physical problem.

During the 1990s William Shatner hosted a reality show called Rescue 911. The show consisted of re-enactments of real life emergency situations. One episode regularly comes back into my mind, causing anxiety. A beautiful little girl was visiting her grandparents, running around in great excitement in an unfamiliar house. She ran through a closed glass door. Shattered glass penetrated her body between her ribs and punctured her heart. Paramedics responded quickly and a battle to save a life ensued. Finally the battle was won in a hospital operating room. Although based on a true story, this was just a television show and one with a happy ending. Yet over and over again, from time to time it comes back into my mind and upsets me emotionally.

Another recurring memory goes back to the 1980s while working for Alberta Wheat Pool, a large agri-business cooperative. During a third round of necessary but painful cost-cutting, a colleague with twenty-five years of service was terminated. Even though we have not maintained contact, the memory of his sad face with tears running down his cheeks continues to haunt me. I continue to feel anger because only four employees were willing to attend his farewell lunch. An organizational culture had developed in which terminated employees were to be avoided as if they had a disease that others could catch.

I seem to absorb and retain the angst of others to a degree that does not seem normal and that does not reflect good mental health. At the same time, this sensitivity helps me intuitively see clearly what is strangely obscure to friends and colleagues.

All things considered, the 1990s, the decade of my forties, were the best years of my life. At one point I even thought that my bouts of depression and anxiety were gone forever. But the darkness and fog returned and the sequence of events taking me downward again are very clear.

In 2001 I was working as Director of Finance for the YWCA of Calgary. This is a very fine organization and a good fit for me both in terms of skills as well as values. But the job became extremely stressful. The organization had a million dollar operating fund deficiency that made financial management very challenging. On top of this, a capital project went out of control, escalating from a budgeted $2.1 million to an actual $3.4 million. The difference was unfunded and I had to lead repeated re-negotiation of bank loans while organizational credibility was sinking. Worse yet, the fundraising department was not meeting targets. This was real stress based on real circumstances, for none of which I was responsible. During such a period in an organization’s history, the behavior of otherwise well-intentioned individuals seems to become more selfish and opportunistic.

Then in August, 2001 there was a pivotal week for me. Every day that week the computer system at the YWCA of Calgary went down. I had been hired to lead a much-needed system replacement initiative which was on hold because of a lack of funds. The organization was running on borrowed time with a poorly maintained, out-dated computer infrastructure. I was going to work every day in a high risk environment with no access to resources to fix the problem. That week it became necessary to revert to manual ways of work which were inefficient and frustrating for many employees.

This situation is a good case study of how much responsibility an organization should bear for damage caused to an employee by workplace stress.

Stress had been building up over months and reached a peak that week. Every night I slept poorly, worrying about work, worrying about my employer. The stress and insomnia I experienced that week resulted in a permanent change in my sleeping patterns and I have never regained the ability to sleep soundly without aid.

A few weeks later on September 5, 2001 I collapsed on the sidewalk. My wife and I were at a restaurant enjoying dinner with close friends. I remember remarking how nice it was to relax and have a break from job stress. After dinner, I suddenly began feeling very dizzy. We had paid our bill and I wanted to get outside for some fresh air. While walking to our car, I passed out.

I regained consciousness just as the ambulance came around the corner. The paramedics quickly took charge and began monitoring vital signs. Concerned by my very low blood pressure readings, they decided to take me to emergency at the Foothills Hospital. I was treated with priority over those in the waiting room and a wide range of tests were conducted. Then there was a wait for a doctor that lasted for hours. When he finally arrived at around 3:00 am, I was feeling much better and my blood pressure was back to normal.

All the test results were normal. There was no evidence of stroke, no heart problems, no blood sugar problems. I could go home. I asked the doctor why I had fainted for the first time in my life. Sometimes these things just happen, came back the unsatisfying reply. The doctor asked if anything unusual had occurred in my life recently. I replied that I was experiencing severe job stress. I may as well have said nothing because this was clearly of no significance or interest to the doctor. Again, only ruling out physical causes was important and I was discharged.

There was another troubling aspect to my emergency ward visit that endures in my memory. Sometime during the hours waiting for the doctor I overheard a conversation close by that was emotionally upsetting. In very matter-of-fact tones a couple was being informed of “do not resuscitate” options and a decision was made to let a life end. Only curtains separate patients in emergency and conversations are not contained by such walls. But there seemed to be no awareness of what impact any emergency room activity could have on the mental state of others nearby.

Fainting was a wake-up call for me and I concluded it was caused by job stress. I decided I could not continue to cope and saw only one way out. I resigned from my job.

I knew from experience that my level of stress would not be judged by others as worthy of either a short term or a long term disability claim. And at the YWCA of Calgary at that time, in an organization that did so much good work helping so many with great need, a culture that rose above the norm in terms of employee support did not exist. Only one leader at the YWCA of Calgary expressed any concern or willingness to help me personally. During an organizational crisis, the needs of individual employees hardly get noticed. But surely the organization should have assumed more responsibility for the stress that had impacted me to a degree that quitting seemed like the only option.

Collapsing on the sidewalk became a symbol for the deterioration of my life. I was completely burned out. For several months I did not have the energy to even begin looking for another job. I had had enough of financial management and was disillusioned with my career. The depression and anxiety that I thought I had conquered returned. I was fortunate to have a wife with stable employment. I was fortunate to be living in a nice home. I was fortunate to have a few supportive colleagues.

One dear colleague at the Canadian Mental Health Association firmly told me that I could not handle my mental health problems by myself and I had better get some help. She recommended the Outpatient Mental Health Program at the Colonel Belcher Hospital. Armed with this knowledge, I asked for and received a referral from my family doctor.

What happened next is a common story. Nothing. Nothing happened. About six months later I received a letter acknowledging my referral and advising me I had been placed on a waiting list. After another six months went by I received a phone message asking me to book an appointment. Almost exactly one year from my visit to my family doctor, I had my first appointment!

From the beginning, I did not like the psychologist assigned to me. I found talking to her about all the negative stuff in my life anything but a positive experience. I never felt understood at all by her. After one particular session, I left feeling very angry and believing I had been deliberately provoked. After six or seven sessions, this psychologist wanted to refer me to a psychiatrist. She told me that unless I received medication and intensive cognitive therapy and discovered the cause of my depression and anxiety, I would never be free of it. I told her I wasn’t interested. Her response was that there was not much more she could do to help me. I never went back. A few weeks later I received a letter informing me that if they did not hear from me within three weeks they would assume I was doing well and would close my file. The one helpful thing I did learn from these sessions is that I have an intense, unhealthy fear of being alone.

Sometime during this period I hit a very low spot. One Saturday morning, life barely seemed worth living. In fact, I thought about two more specific things that were bad and could happen. I decided that if they did, I would end my life. I knew I should not be thinking this way but instead, I deliberately chose to think it through. I would buy a gun; that shouldn’t be too difficult. I would make sure to buy the right bullets that would inflict maximum damage. I would research proper positioning of the gun. I would stick it in my mouth and blow my brains out. I would drive out to Kananaskis Country and hike up a favorite trail. Somewhere off that trail would be the end of John Stokdijk.

The two things I feared never happened. I don’t know if I would have actually followed through on my intentions. I do know that at that time I was very wrong about myself and my life. Still not feeling confident enough to handle life without professional help, I began utilizing my wife’s Employee Assistance Program. This time I quickly received an appointment. And I instantly liked the psychologist assigned to my case.

From the start she seemed to understand me. She was totally supportive and completely non-judgmental. I have since remarked to a few friends and colleagues that this would be an incredible experience for anyone including those with no mental health problems! We had great conversations about experiential angst. We talked about not expecting affirmation for living from work. Even though she was openly Christian, we talked about leaving religion. We talked about my feelings towards my father. We talked about 9/11 and world affairs. All of these topics related to my mental health. In hindsight, she helped me recover what I needed most. Hope. Hope that life, my life, would get better. Hope that life, my life, was worthwhile.

One day I arrived at a session in what I thought was a very good mood. My psychologist had never seen me like this and seemed very surprised. Have you ever heard of cyclothymia, she asked. I had not. But typical for me, my curiosity was aroused and I found a book about it. I learned that cyclothymia is a mild form of bipolar disorder. During this period of my life I manifested many of the diagnostic criteria of cyclothymia.

We also discussed the work of Elaine N. Aron who wrote The Highly Sensitive Person. Her self-test makes twenty-three statements and twenty-one of them are true for me. More than anything I have found, this describes the real me.

I looked forward to every session with anticipation. Even after I felt strong enough to let go of this support, she agreed to continue with occasional sessions just to maintain contact and just in case my life took an unexpected downturn. After commencing my employment with the Mental Health Commission of Canada, my dream job, I went back one more time and somewhat reluctantly said goodbye.

Sometime during these difficult years, I was reminded of the value of sharing problems with close friends. One of my psychologists mentioned this and I had read this in one of my many self-help books. I told five close friends that I was experiencing serious mental health problems. And that I needed help. One friend ignored this overture for help from me but he has a wife who suffers from bouts of depression and helping her, understandably, is his priority. He has enough on his plate. Another friend of mine has a good heart but lacks the skills to help me. There is a friend who continues to disbelieve that I need help. I am puzzled by the lack of response from one very nice, long term friend. Perhaps because we are able to be very open with each other anyway, more is not needed. The best response came from the friend from whom I least expected help, more than making up for all the others. To this day, he regularly follows up, making sure I am all right. We have long conversations. He probes, going well below the surface. This is real support, genuine caring and it helps so much.

In 2003 I was invited to a presentation about how minor automobile accidents occasionally trigger serious mental health problems. As expected, it was interesting but then took an unexpected turn that made the hair on my neck stand up! The presenter made a comparison between the anxiety displayed by some adult accident victims and the anxiety experienced by adults who suffered medical trauma as babies. For the first time I saw a possible answer to the question “why?” Why have I suffered from depression, anxiety and other mental health problems? Why was I flawed?

As a baby I had three operations, probably mastoidectomies, before my second birthday. Learning that a severe ear infection could cause death if it reached the brain was startling. My mother told me I suffered from very severe earaches and screamed long and hard to a degree she could barely stand. I’m sure operations on babies in the 1950s were much more invasive than they are today. Could all this trauma have been at a level that impacted my brain development and left me damaged? I wonder and am still interested in finding some expert opinion on this.

In my opinion, the seriousness of a mental health problem or a mental illness is best determined by the degree of impairment it causes in a life. All things considered, my life has suffered only very minor impairment. Twice in my career I reached a point where I could no longer continue working. Twice I recovered. I have a very good life but I also believe it could easily have been very different. My life could have been a disaster or ended prematurely.

2008 was a very good year for me and my mental health was excellent all year. In many ways it was one of the best years of my life. The only impairment was with sleeping. Often I woke up too early, between 3:00 and 4:30 am. But with a mug of strong coffee and a couple of Advil, I could have a normal day most of the time. A few times I would have only two or three hours of sleep and on those occasions the next day was tough.

On weekends I take amitriptyline as a sleep aid and I have a good night of sleep. It leaves me wonderfully lazy in the morning and it takes time to get going. Vacations are also a time when I can take it several days in a row and recharge.

Today I am enjoying life to the full. Mostly I am full of hopes and dreams. My grandmother lived past her hundredth birthday. My mother is still going strong at age 89. I would like to follow in their footsteps.

3 comments:

  1. Thank you very much for sharing some of your story.

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  2. John,

    Thanks very much for sharing.

    I also had a head injury, falling out of a moving car when I was about 3 years old. I developed schizophrenia in my 4th year at university and ended up with my B.Sc. a year and a half behind schedule. My twenties were a bit of a struggle. I switched to working with people and have had steady work for 20 years.
    My faith has given me inspiration.

    Richard

    ReplyDelete
  3. Hi John,

    I have just read your story on your blog and I want to thank you for sharing it with me. I truly feel, as you do, that the tipping point has arrived within Canada in terms of the social movement and message that will serve to have mental illness viewed in a way that all Canadian's can relate to without the stigma and discrimination that has been attached to it. This is happening due to brave folks (such as yourself) who are now wishing to share their stories, for in so doing, we put in place the safe culture necessary for all to share their stories without fear of being discrimated against. This is happening, thanks to the commission's vision and mandate and I am so honoured to be part of this history making time.

    best, Joan

    ReplyDelete