Jacob

Age at interview: 25
Age at diagnosis: 18
Gender: Male
Outline:

Jacob, 25, noticed symptoms in early high school and was diagnosed with depression and social anxiety in his first year of college. He takes medication and is about to resume therapy to continue improving his work and romantic relationships.

Background:

Jacob is a software engineer at a large company. He lives with his girlfriend and a cat. He is White.

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Jacob first noticed symptoms of anxiety and depression in early high school. Though he thought that everyone experienced them, he felt he did “not fit anywhere”. He wasn’t “necessarily sad all the time”; but had chronic “dissatisfaction with where I was and what I was doing”. A “well regarded” student and athlete, he says, “I would go to lunch with people and laugh and all that stuff and I would go back afterwards and whoa! That was a thing that happened but it didn’t really mean a whole lot to me”. Jacob figured out how to mask his feelings with a chronic smile. “If you’re this kid who just walks around with this stern face all the time, people are gonna kind of wonder what’s going on. But no one’s gonna question a kid who’s smiling all the time”. He was very introverted and so his parents didn’t pick up on anything when he sequestered himself in his bedroom.

Despite having a very supportive family and friends Jacob didn’t tell anybody about his feelings while in high school. In part, he wanted to protect his family, “My mom in particular is very sensitive, she is the type of person who will blame everything on herself”. Jacob also felt that “Depression was sort of this loaded word that you sorta just kept to yourself”. Because he had no resources and his parents did not know he had a problem, he was unable to get help. But at college, he “felt a little more independent” and sought counseling, where he was diagnosed with depression and social anxiety. In therapy, mostly prefers a cognitive behavioral approach. When he finally told his parents, about 3 years post diagnosis, they were very supportive. Jacob also has told the people close to him.

Jacob still struggles with a “futurist” orientation — that happiness will arrive with he reaches the next milestone. “I thought college would make me a real person. And then after I got to college, I thought, well, once I’m self-sufficient, I have a job or a steady income … then my real life would start. And then after that…once I find a serious relationship, long-term relationship then that would be the thing. I have all those things now and I’m still in the same situation of ‘okay what’s next, now what do I do?’”

Jacob now takes medication and is using strategies he learned in therapy, entailing doing social things that are just outside his comfort zone. “You kind of just work your way up until suddenly you do all these things that you didn’t think you would be able to do before”, he says. Jacob also credits his personal drive, especially related to academics, to overcome his lack of motivation. “I’ve always sort of been that way. …I like to learn new things and try things. … I get sort of antsy and agitated when I’m not doing anything or learning something. … It basically is what helps me combat depression, I think, if I didn’t have that I think I would be in a much worse situation then I’m currently in”.

 

Jacob says as he grew up his brain matured and he got better at managing his depression.

Jacob says as he grew up his brain matured and he got better at managing his depression.

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In the very beginning, it was absolutely chaotic and I had just a jumble of information and feelings and thoughts and emotions and worries. And I had no idea how to kind of package that up in a manageable way. And, and address it. And I feel like a lot of people a lot of younger people with depression are going to go through the exact same thing. And part of that is because being young, you just, that’s how your brain works. Your life is like that. It’s very chaotic and it’s not, it’s, it’s very hard to manage even without depression. So then you add that on top of it and it makes it even more difficult. So as you get older, and I hate to say that because that’s what my parents always said, but like, you get older, you get better at managing situations. But there will be a point where things start to just naturally clear up, because your brain develops and you’re able to just process information better, more effectively. And there will be a point where it starts to clear up a little bit, and then you can make decisive actions and then you can see the results of those and either continue that or try something else. And eventually it will get to the point where you, you figure out what works and what doesn’t. And once you get there, then it’s just maintaining it. It’s just, keep doing what you’re doing. You’ve figured it out so now it’s just, just keep going.

 

When he was depressed, Jacob didn't feel enjoyment: he just felt empty.

When he was depressed, Jacob didn't feel enjoyment: he just felt empty.

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So I was doing all the right things, I was doing really well in school, I was on a bunch of athletic teams, I had friends, so there was nothing really wrong per say with what was going on. I just felt like I didn’t really understand why I was doing all these things I was supposed to be, people were supposed to enjoy high school and I didn’t. I just went everyday kind of begrudgingly and I mean, I didn’t feel like I was getting anything out of it. I was like what was the point of what I am doing here? And I didn’t get a whole lot out of my social relationships either, you know, friendly or romantically. I felt like I was just going through the motions and doing what typical high schoolers do. But I wasn’t, I wasn’t feeling the impacts like I thought I should be. Everything just felt sort of empty.

 

When he was depressed, Jacob didn't feel enjoyment: he just felt empty.

When he was depressed, Jacob didn't feel enjoyment: he just felt empty.

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So I was doing all the right things, I was doing really well in school, I was on a bunch of athletic teams, I had friends, so there’s nothing really wrong per say with what was going on. I just felt like I didn’t really understand why I was doing all these things. I was supposed to be, you know, people were supposed to enjoy high school and I didn’t. I just went everyday kind of begrudgingly and I mean, I didn’t feel like I was getting anything out of it. I was like what was the point of what I am doing here and I didn’t get a whole lot out of my social relationships, either friendly or romantically. I felt like I was just going through the motions and doing what typical high schoolers do. But I wasn’t feeling the impacts like I thought I should be. Everything just felt sort of empty.

 

Jacob describes how achieving milestones left him feeling unsatisfied and led to his lack of motivation.

Jacob describes how achieving milestones left him feeling unsatisfied and led to his lack of motivation.

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There were some days where I just couldn’t motivate myself really to do anything. Mostly because I couldn’t, couldn’t see the point cause I had achieved enough milestones and seen those milestones actually don’t make me feel any better. So at that point I realized that maybe, maybe this isn’t a thing that’s even fixable and then you get into the cycle of why do I even bother then so it’s just sit here and do nothing. But it’s not even a conscious choice to not do anything. No matter, even if you want to you just can’t cause you can’t physically bring yourself to do it. So I’ve definitely been there, luckily that sort of fades.

 

Jacob describes how social anxiety impacted his ability to seek help.

Jacob describes how social anxiety impacted his ability to seek help.

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I didn’t start that right away is because I have some social anxiety mixed in with my depression. Which made it very difficult to do anything other than just sort of reflect personally on it and I still haven’t gotten past the phase of, I don’t know if embarrassment is necessarily the right word , but I still had that reluctance of talking to anybody about it, I just wanted to keep to myself at the time.

 

Jacob thought each milestone would bring welcome change to his life, but altered circumstances had little effect on his depression.

Jacob thought each milestone would bring welcome change to his life, but altered circumstances had little effect on his depression.

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Yeah I think milestones like at first I thought college would make me a real person. And then after I got to college, I thought well once I’m self-sufficient, I have a job or a steady income and things like that and then my real life would start. And then after that as well and maybe once I find a serious relationship, long term relationship then that would be the thing. I have all those things now and I’m still in the same situation of “okay what’s next, now what do I do?”

 

The process of setting goals and then achieving them keeps Jacob's depression at bay.

The process of setting goals and then achieving them keeps Jacob's depression at bay.

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I have bouts where it’s really bad and I feel like everything is falling apart but then my drive kicks back in and I’m able to kind of get out of that rut and move towards the next goal. It’s like the constant goal setting and achieving of those goals that keeps me from staying in a rut.

 

For Jacob, having a job creates a positive feedback loop: interacting with others lessens his depression, which in turn creates more motivation to excel at work, which lessens depression yet more.

For Jacob, having a job creates a positive feedback loop: interacting with others lessens his depression, which in turn creates more motivation to excel at work, which lessens depression yet more.

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I got a, a job that I actually, just like, technologically speaking, enjoy. I’ve always been in soft-, in the software engineering field, but now, it’s a, slightly more interesting branch for me. So that, at least set me up for success. And then, probably the, the constant evolution of me and my anxiety, helps a lot, because I’m far more social and far more interactive than I was in past jobs, which makes my depression easier to deal with, which means I have more motivation, which means I can excel and excelling, also combats my depression. So, it just kind of feeds on itself.

 

Jacob says his employer is pretty supportive when it comes to mental health issues, and he thinks there is less stigma in other workplaces, too.

Jacob says his employer is pretty supportive when it comes to mental health issues, and he thinks there is less stigma in other workplaces, too.

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There is much less of a stigma now, I would say, which is fantastic. I feel like a lot more people are seeking help. In my company, in particular, I know of, of people who have actually taken a medical leave for it. Things just get overwhelming and they need some time off. They’re not as effective at work anymore because of it, and they take, you know, a couple weeks to, sort of recover. So there is absolutely more support for the condition than there used to be. And I think just in general, socially, people are a lot more willing, myself included, to then, to talk about it.

 

Cost has been a barrier in getting couples counseling for Jacob, but he has the capacity to pay for it if he cuts out other expenses.

Cost has been a barrier in getting couples counseling for Jacob, but he has the capacity to pay for it if he cuts out other expenses.

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Is there any kind of health and support that you don’t have right now that you wished you’d had?

I could probably benefit from seeing a therapist again specifically in the relationship department. I’ve thought about starting some couples counseling not because we have problems, because I want to prevent problems. We’re, we’re doing just fine. I have no worries about that and I want to keep it that way. And I want to make sure that my depression doesn’t, you know, compromise that. So I would like some advice on specifics, you know, how do you deal specific situations? I think that would be very helpful.

Is there anything preventing you right now from getting that?

Not really. Maybe, maybe finances, but I’ve learned that that’s a terrible reason, because it doesn’t matter, doesn’t matter what your financial outlook is like. That’s getting help for depression is more important. So there are things that I am sure I can cut out to make room for that. And I actually have been doing some research on specific therapists for that reason. So I am actively moving in that direction.

 

Jacob got a dog to cope with his depression, but found it was too hard to care for him as needed. The cat he got later requires less work and is a better match.

Jacob got a dog to cope with his depression, but found it was too hard to care for him as needed. The cat he got later requires less work and is a better match.

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a Norwegian Elkhound. That has a sad ending to the story, because I, I got him to help cope with my depression, because I was living on my own and that was when I was done with school and living in an apartment on my own. No relationship at the time. And so I got him for that reason, and found out that I just wasn’t in a very good place to take care of him. I was very busy at work. The depression, instead of him helping my depression, my depression made him less happy and satisfied, because I wasn’t able to attend to him the way that I needed to. So I ended up finding a new home for him. But now I do have a cat now. Much lower maintenance, pretty self-sufficient, and helps, because my partner and I, I are living together with the cat so we can tag team it. So it’s not just one responsibility all on me and it absolutely helps, because it was for a span for about three weeks when we were moving around and so the cat stayed with friends, and I missed him a lot. And I could tell, because I gotten the habit of coming home from work and him being right there and you’d pick him up and you love on him for a little bit. And it absolutely helps.

 

Even though Jacob was reluctant to try medications, he decided to take them after realizing depression was affecting important relationships.

Even though Jacob was reluctant to try medications, he decided to take them after realizing depression was affecting important relationships.

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I was not taking medication for quite a while actually. I’ve sort of always been anti-medication. I didn’t want to rely on a substance to get me through. I liked the idea of just figuring out what was wrong and fixing it sort of on my own naturally. And then, I, it just wasn’t working even with my, my therapies because my, my depression often manifests as anger and agitation. Some people get you know, sad and dysfunctional. I get upset and angry and irritated. And it was, it was hurting my personal relationships, especially my romantic relationships, just getting confrontational and irritable. No one wants to be around that and I didn’t, I wouldn’t want to be around that either. And so when I was single, I didn’t really put much stock in it, because I was just getting mad at nobody. Just mad in general, at myself, but once I started targeting another person, that’s when I realized that I, that’s not okay, and its going to end up derailing relationships so I needed, I needed to get some outside help even if it made me a little bit uneasy.

 

Jacob didn't know what to expect from therapy, and found he had to get used to all the individual attention he got when he went.

Jacob didn't know what to expect from therapy, and found he had to get used to all the individual attention he got when he went.

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It was very nerve-wracking. I had, I had no idea what to expect. I had never been to any sort of counseling or therapy before and the, the word counselor or therapist especially had, you know, they have stigmas and I didn’t know at all what to expect and so I went in and it was a I think she was a, like an in-training therapist, so she was shadowed by a supervisor or something, but it was still one on one with me and her. And I wasn’t very good at, well I didn’t think I was going to be very good at talking to a person about this. Especially one on one. One on one encounters make me a little bit anxious just because there’s nobuffer, there’s no other people to take the attention off of me. And so it felt a lot like you know, therapist up here and me down here and she’s just asking me questions, trying to figure out what my problems are.

 

A diagnosis of depression came as a surprise to Jacob, because he thought his fortunate life circumstances meant that he could not be depressed.

A diagnosis of depression came as a surprise to Jacob, because he thought his fortunate life circumstances meant that he could not be depressed.

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It actually took a while because when I was, when I turned eighteen and went to college that was sort of when I started actually taking concrete steps towards getting help, prior to that I sort of suspected that I needed help and I was doing a bunch of research to see if anyone else had these same symptoms and what you would categorize that as, because I never thought, I knew of the term, depression, I knew what that was all about but I never really considered that I might actually have depression because I had this idea that I couldn’t possibly because of my life circumstances. I had a great, supportive family, I was financially stable, I was getting an education, I was active, I had friends and no major life traumas, so I figured how could I possibly have a disease like depression, without any sort of precursors. It turns out it’s entirely possible and I didn’t realize that until I started really seeking help.

 

Jacob says as he grew up his brain matured and he got better at managing his depression.

Jacob says as he grew up his brain matured and he got better at managing his depression.

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In the very beginning, it was absolutely chaotic and I had, I had just a jumble of information and feelings and thoughts and emotions and worries. And I had no idea how to kind of package that up in a manageable way. And, and address it. And I feel like a lot of people, a lot of younger people with depression are going to go through the exact same thing. And part of that is because being young, you just, that’s how your brain works. Your life is like that. It’s very chaotic and it’s not, it’s, it’s very hard to manage even without depression. And so then you add that on top of it and it makes it even more difficult. So as you get older, and I hate to say that because that’s what my parents always said, but like, you get older, you get better at managing situations. But there will be a point where things start to kind of just naturally clear up, because your brain develops and you’re able to just process information better, more effectively. And there will be a point where it starts to clear up a little bit, and then you can make decisive actions and then you can see the results of those and either continue that or try something else. And eventually it will get to the point where you, you figure out what works and what doesn’t. And once you get there, it’s just maintaining it. It’s just, keep doing what you’re doing. And you’ve figured it out. So now it’s just keep going.