Sam

Age at interview: 23
Age at diagnosis: 19
Gender: Male
Outline:

Sam (age 23) was raised in a religious family. His symptoms started with his loss of faith at age 14. After inpatient treatment, he dropped out of college and therapy to pay the debt, but still uses what he has learned to control his symptoms.

Background:

Sam works as a young professional to earn money to resume his university studies. He lives in an apartment with a roommate. He is White.

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Sam has been living with depressed feelings on and off since age eight. Early on, he had no words for “depression or mental illness,” but spent “many nights lying awake in bed feeling this kind of gnawing emotional pain without an overly identifiable cause”. Raised in a conservative religious family, Sam thought about his angst “primarily in religious terms … that I was not pleasing God or God was not happy with me.” Throughout early childhood Sam tamped down these feelings. Sam credits his religious upbringing for instilling in him that “my fundamental purpose was to make other people happy” and thus made him “a significantly less angry and abrasive person”. His first bout of severe depression occurred at age 14 when he decided, “I no longer believed in the tenets of the religion I was raised in”. He was living with this “nagging fear of ‘what if I’m wrong, what if I go to hell’?” He also realized he had been “sacrificing too much of myself in order to meet the needs of other people”. These repressed feelings anger, fear insecurity combined to spark “a very long depression that lasted a couple of years” in high school. Sam now sees the experience as “an important step in my maturing and being able to empathize” with others. 

Sam entered the university and began studying theater, but says he “had not begun to deal with the issues that had driven me to feel depressed before”. His first romantic relationship that started in high school was “marked by codependence on both of our parts”, and it became “clearly unsustainable” when his girlfriend threatened suicide toward during his first year of college. He ended up “dropping all of my classes that quarter” and “spending hours a day in my room, sometimes never leaving my room”. Sam had been seeing a counselor with the university for most of that year. At first, they discussed “very surface” matters; later, during a series of “emergency” visits, he felt “this sense of being overwhelmed was overwhelming”. At that point, he was referred to an in-patient psychiatric hospital. He says his entry was somewhat disingenuous on the grounds that, “I was deemed a danger to myself and others”. But he credits that the therapy combine with Prozac, “really forced me to take stock with my life and to kind of delve into the issues of my past that have led me to this point”. But stresses from the expense of the unexpected hospital stay “took a toll very quickly,” Sam says, and created a sense of “shame and stigma”. That, compounded by further bills, “sent me into kind of the same spiral that I had been in when I was 15 …and processing my deconvergence from Christianity.” Sam decided that, “come hell or high water,” he would earn the money to pay his debt and resume his studies. 

Sam is now on leave from the university to earn enough to pay his debts, he. He can no longer afford therapy session or his Prozac. To sustain his mental health does artistic work in theater, and continues to study things he enjoys. He is also drawing on his experience and personal resources to control his depression. He says from therapy, “I gained a vocabulary in which to engage with ideas about what it is I’m experiencing and why I experience it and how to navigate it”. Further his “access to education about my symptoms” has allowed him “to develop plans and methods for dealing with them.” Sam acknowledges that he been “privileged” by various “mitigating factors”. He appreciates that depression is “taken seriously more than most” other mental illnesses, and that he has “been in a supportive environment”. Finally, he values having “close friendships that allowed me to work through my symptoms in a healthy way.” For all of these reasons, Sam says he is now “happy with the person that I am today”.

 

Sam says his depression began at age 8, and that he first thought his emotional pain meant God was not happy with him.

Sam says his depression began at age 8, and that he first thought his emotional pain meant God was not happy with him.

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I've been living with depression on and off since I was eight years old, I'm 22 now. Of course at age eight, I didn't think of it in terms of depression or mental illness or anything of that nature, but I recall at that age spending many nights lying awake in bed feeling this kind of gnawing emotional pain without overly identifiable cause. At the time, I framed it in terms of feeling vaguely empty inside and not knowing why. My parents suggested, like, maybe you're hungry or you have a stomachache or something like that. And, at the time, as this went on, I thought it primarily in religious terms because I was raised in a very conservative religious house. I thought that I was not pleasing God or God was not happy with me or something of that nature, and I wasn't sure what to do about those feelings, so I just kind of tamped them down, and that happened on and off throughout my early childhood.

 

 

Sam says that during bad periods of depression, his experience of being overwhelmed is itself overwhelming.

Sam says that during bad periods of depression, his experience of being overwhelmed is itself overwhelming.

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I was spending hours a day in my room, sometimes never leaving my room. And that was the second period of extended, prolonged depression that I felt. I’d been seeing a counselor with the university for most of that year, but they were very surface level chats in which I would say, yeah, this happened to me in my childhood, but I hadn’t really processed how it was still affecting me. And, all of a sudden, that changed on a dime, to be constantly coming in and setting up emergency meetings. Not because I was actively suicidal, though I was experiencing suicidal ideation at that point, but just because this sense of being overwhelmed was overwhelming and I didn’t have any other outlet with which I could articulate that.

 

When Sam began to question his parents' religion, he grew more distant from them while also struggling with growing fears about what the future might bring.

When Sam began to question his parents' religion, he grew more distant from them while also struggling with growing fears about what the future might bring.

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I believe that each individual constructs their own sense of purpose and meaning in life, constructs their own system by which they judge themselves to be valuable or not valuable. I absolutely think that religious faith can be an appropriate and healthy and good and beneficial way in which someone can construct their view of the world and of themselves. I also think that it is possible for religious faith, like any framework of looking at the world, to be unhealthy or destructive or negative.

Around age 14, I went through an experience that made me question my devotion to the Christian faith, and, ultimately, I decided that I no longer believed in the tenants of the religion I was raised in, and that was when my first bout of depression that had lasted many, many months occurred, due to a variety of reasons: The stress of having to conceal what I knew my parents would not approve of from my family and from the rest of my community; my nagging fear of what if I’m wrong, what if I go to hell, I don’t want to go to hell, which is a thing that tends to make people uncomfortable. And along with that just the typical growing pains of adolescence of, you know, I was raised to believe the world is, I wasn’t raised to believe that. I grew up thinking that the world is very safe and secure place and I’m now starting to sense that in some cases it is, in some cases it is not. Magnified, in my particular case, by the extremity of the stakes that had been attached to my religious beliefs.

 

Because his parents favored religious over psychological counseling, Sam's depression wasn't diagnosed until after he'd moved away from home.

Because his parents favored religious over psychological counseling, Sam's depression wasn't diagnosed until after he'd moved away from home.

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My parents decided the seek alternative religious counseling instead, and my religious counselor was similarly disinclined to diagnose me with depression but, rather, to diagnose me with being sinful which was a whole can of worms, but. Yeah. I didn’t really arrive at the conclusion myself that I was depressed until that summer after my first year of college in which it was pretty hard to deny, in which I was not leaving my apartment for sometimes days on end.

 

Separating from his parents' faith posed challenges for Sam in retaining his sense of self-worth.

Separating from his parents' faith posed challenges for Sam in retaining his sense of self-worth.

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I was instilled with the values of a person’s purpose in life is to glorify and serve their divine creator, and if one is not able to do so, one is not doing anything valuable with one’s life. Which I didn’t completely grasp in those words when I was four or five years old, but I think sat with me and did, in some ways, though I no longer explicitly subscribe to them, still do guide me. So very early on when I was sensing that I was not living my life in 100 percent devotion to my divine deity because I did not believe in this divine deity that caused this disconnect between what I felt like would make me, would give me value, and the actual value I was perceiving in myself.

 

Sam has learned that depression can always be made better by using one of several specific coping mechanisms.

Sam has learned that depression can always be made better by using one of several specific coping mechanisms.

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I would absolutely want to give the message that, not that it gets better because that’s not a thing that magically happens, but there is almost always the means with which a situation can be made better. Sometimes that involves extricating yourself from situation that are unsalvageable. Sometimes that involves taking an honest and sometimes painful, look at your own self and your own behavior and making a determined effort to change it. Sometimes it involves trying to unlearn very painful but powerful ways of looking at the world that are not the most healthy and trying to relearn new ones in their place. Sometimes it involves just eating an ice cream cone. There is almost always the possibility of a situation being made better it involves a lot of work, but it can be done.

 

Sam says his depression has not disappeared, but he has learned from books, other people and therapists some useful ways of dealing with his symptoms.

Sam says his depression has not disappeared, but he has learned from books, other people and therapists some useful ways of dealing with his symptoms.

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Which brings me to where I am today in my journey with depression. I still feel symptoms of depression fairly often. Sometimes it’s just a feeling more down than usual for a day, sometimes it is this feeling that everything is hopeless and why should I even get out of bed. But with this kind of time to process the new perspectives on my life and my illness that I have learned from other people I’ve met, from books that I’ve read, from professional therapists, who I intend to begin seeing again as soon as I am back at the university. I think that I’m able to recognize those symptoms when they start to emerge and “deal with” is a vague term that means different things, in different scenarios, but try out new and fall back proven for me, coping mechanisms to navigate my life, and my work with those symptoms.

Having a sense of structure in place, in terms of a systematic vocabulary with which to view my illnesses, with which in terms of a step by step practical plan with which to address my symptoms. Having a sense of structure has been a very powerful and concrete way of combatting the abstract and vague, but just as powerful idea that nothing makes sense and there is nothing that I can do. Having a sense of structure has given me maps on which I can definitely locate myself in where I am and where I want to be.

 

Sam says he will probably have symptoms of depression his whole life, but is learning to process them better with time.

Sam says he will probably have symptoms of depression his whole life, but is learning to process them better with time.

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I don’t know with a 100 percent certainty what the rest of my life is going to entail. It would not surprise me, based on my experiences with depression so far, what I’ve read of academic studies of depression, and what I’ve learned of other people’s experience with it, it would not surprise me if I continued to feel these symptoms for the rest of my life. But it also would not surprise me if, as life went on, even if I do experience more severe episodes than what I’ve experienced so far, I’d get, hopefully, better and better about recognizing what goes on in my brain and enacting consistent and healthy, and … I feel like there should be a third adjective, but I can’t think of one, so, consistent and healthy plans, and coping mechanisms with which to, not get rid of them, but process them in a beneficial way.

 

Having a partner struggling with mental health issues worsened Sam's negativity about himself.

Having a partner struggling with mental health issues worsened Sam's negativity about himself.

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I was dating this girl who was extremely, visibly, broken from the abusive environment in which she was raised. So, I would think to myself, “Yes, of course, I do need to be there for her, six, seven hours a day, on Skype, because, like, otherwise, how is she going to function in the world?” Which stemmed from another way co-dependency manifests itself, which is the sense of, “I need to give and give and give and give and give, because that is what my value in the world is.” But it was also, in a way, very controlling. The sense of, like, “I am the one who will take care of this person. It is on me, no one else can do it.” Which leads to a lot of stress, because that is not a stable way to have a relationship. It leads to feelings of anger and resentment that, you are being taken advantage of even if you put yourself in a situation in which you allow yourself to be taken advantage of. It leads to feelings of worry, because you have made another person’s problems your problems, but, ultimately, it’s on the other person to take care of their problems. And, if they are not doing it, there’s no way you can make them. And it can lead to this, all of those bad feelings and unhealthy ways of viewing oneself, can lead to this sense of feeling mired in depression, feeling like everything is hopeless, feeling like your best efforts are not good enough, feeling like you don’t have any value, feeling like you are worthless.

 

Sam says depression allows him to engage with art on an emotional level.

Sam says depression allows him to engage with art on an emotional level.

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For a long period of time, in my first couple years of school in which I was extremely depressed, it did make doing theater work, which is the kind of art that I most want to create with my life, made it somewhat unfeasable. Theater does demand a consistent and rigorous commitment to attending rehearsals regularly, to being vulnerable, to the somewhat extreme emotional demands that working on a story can take you to. It does necessitate open and frequent communication with many, many other people, but in a way it has also given me this unique perspective that I have that noone else does with which I can tap into certain stories and certain characters and certain moods and tease them out of other actors, out of myself if I’m acting or other actors if I’m directing, out of designers and out of anyone who works on a show. It gives me this ability to engage with the art I want to make on an emotional level that I don’t think I would be able to access if I weren’t drawing from this pain in my past.

 

As Sam and his friends matured, they were better able to support each other to cope with depression in healthy ways.

As Sam and his friends matured, they were better able to support each other to cope with depression in healthy ways.

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A good number of my close friends do also deal with symptoms of depression, not all. And as we have gotten better about managing our symptoms and looking at them in a healthy way, the relationships have become mutually beneficial in which neither party is taking too much from the other party, in which we are both supportive of each other and understanding of each other and sympathetic toward each other, but in which we also have other frameworks of support in addition to each other, which I think has been really key for me.

 

Sam says compassion, contribution, and connection to others helps him organize his thoughts about what it means to be a valuable human being.

Sam says compassion, contribution, and connection to others helps him organize his thoughts about what it means to be a valuable human being.

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I believe that each individual constructs their own sense of purpose and meaning of life, constructs their own system by which they judge themselves to be valuable or not valuable. I absolutely think that religious faith can be an appropriate and healthy and good and beneficial way in which someone can construct their view of the world and of themselves. I also think that it is possible for religious faith, like any framework of looking at the world, to be unhealthy or destructive or negative. In my personal experience, I was raised to value, loving God, and compassion for other people above anything else. And while that mixed in with the unhealthy behaviors and dynamics that I’ve learned from my family and from other families in the community which I was raised, those values manifested themselves early on in me as the sense of needing to sacrifice myself to an unhealthy [inaudible] for God and other people. And while I no longer believe in God or explicitly subscribe to the idea that I have to give myself beyond what is reasonable, compassion and empathy, forging connections and understandings with as many people as possible in as many degrees as possible to as deep level as possible is something that gives my life a great deal of meaning. And something that I find a great sense of comfort and in pursuing.

 

Sam was not looking for in-patient treatment, but found it very helpful when his outpatient program forced him to go.

Sam was not looking for in-patient treatment, but found it very helpful when his outpatient program forced him to go.

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Going into summer, I was on academic probation from the university. Yeah. With threat of academic suspension. I had no real structure. I had a job that I was consistently calling out of because I was not able to get myself up in the morning to go to work. Things were generally not good, and I was making constant emergency visits to student counseling, who eventually told me, hey, this is not a sustainable. They recommended that I begin an intensive outpatient program…

In retrospect, I believe that I was referred to this hospital, somewhat, disingenuously. When I checked in to ask about the intensive outpatient program, I was deemed a danger to myself and others and committed involuntary to psychiatric holding for about a week, which ended up having a net positive effect on me. It really forced me to take stock of my life and to kind of delve into the issues of my past that have led me to this point in an extremely intensive setting environment. So, while I don’t think that I needed hospitalization at that point, I do think it was a huge help.

 

Sam says he stopped taking his medications because he did not have a way to pay for them.

Sam says he stopped taking his medications because he did not have a way to pay for them.

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So, I stopped taking medications, not on the advice of my therapist, but out of financial necessity, and that did not do wonders for my mood. I would not recommend stopping medications that have been prescribed to you without a doctor’s authorization if you can help it. Again, financial and class privilege plays a huge role here. In terms of my life going forward, once I return to the university setting, I will, again, have access to the resources of student health and student health insurance, which will allow me to resume taking antidepressants, if I and my therapist think it necessary.

 

Sam says he will probably have symptoms of depression his whole life, but is learning to process them better with time.

Sam says he will probably have symptoms of depression his whole life, but is learning to process them better with time.

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I don’t know with a 100 percent certainty what the rest of my life is going to entail. It would not surprise me, based on my experiences with depression so far, what I’ve read of academic studies of depression, and what I’ve learned of other people’s experience with it, it would not surprise me if I continued to feel these symptoms for the rest of my life. But it also would not surprise me if, as life went on, even if I do experience more severe episodes than what I’ve experienced so far, I’d get, hopefully, better and better about recognizing what goes on in my brain and enacting consistent and healthy and I feel like there should be a third adjective but I can’t think of one, so consistent and healthy plans and coping mechanisms with which to, not get rid of them, but process them in a beneficial way.