As far as mental illness is concerned, I have three separate diagnoses: major depressive disorder (MDD), adult attention-deficit/hyperactivity disorder (ADHD), and dermatillomania, a skin-picking (excoriation) disorder that is associated with OCD.
My journey toward better mental health began amidst one of the most trying times of my life. During the junior year of my undergraduate career, I was desperately unhappy. In addition to some new and difficult family dynamics, a year-long course required for my degree was purposefully taught in a negative atmosphere, adding to my mounting anxiety. I began treatment for depression in the spring semester of 2012 after experiencing prolonged periods of sadness, regularly oversleeping, losing interest in my studies, feeling worthless, and crying excessively. Although I was not formally diagnosed with MDD at the time, medication was prescribed by my general practitioner based on both the symptoms I was having and an extensive history of depression and bipolar disorder on both my parents’ sides of the family. After trying two types of antidepressants over the course of two-and-a-half years, I saw improvement in my mood and outlook on life but experienced weight gain of 50+ pounds and sustained concentration problems that greatly interfered with nearly all facets of life.
In the fall of 2014, I finally decided to work with a psychiatrist and a counselor at my university’s health center in order to figure out what was going on. I discussed my past medical, family, and personal histories with them, and we decided to try a new antidepressant in cooperation with psychotherapy. A few months passed. Although my appetite decreased, my issues with staying focused remained. I started to research some of my symptoms—problems with concentration, a lack of organization, a huge sense of being overwhelmed all the time, difficulty remembering things, difficulty keeping a routine, extreme distractibility, falling behind in my classes—and discovered that my symptoms pointed toward ADHD. As a primary and secondary student, however, I made all A’s and never got into trouble; this apparent lack of symptoms did not match the widespread assumption that one must exhibit symptoms in early childhood in order to have ADHD. I mentioned all of this to my counselor in January 2015, and to my surprise, he couldn’t believe that he hadn’t thought of this earlier. According to him, my way of explaining things was oftentimes hard to follow since I would jump from one topic to another and back (view diagram), and even though I had been an exceptional student prior to college, without the previous familiar structure of school and home, it was possible that my outward symptoms had simply been suppressed until college. He recommended that I get evaluated for ADHD.
It took a couple of weeks to arrange an appointment with an educational psychologist, but I eventually met with a lady who conducted an interview of my history and symptoms and did a series of tests that measured my academic, social, and emotional functioning. This testing occurred within the span of about three hours, and I had to wait another two weeks to receive my psychoeducational evaluation report. The results of the testing (which cost $125 in total) showed that I had high clinical levels of inattention; despite this, I was told that my depression was the root cause of my symptoms and was thus dismissed. It was money wasted, I thought.
I felt completely lost and confused at this point. I knew something was wrong with me since my symptoms were a huge interference in my life. I also knew that depression could cause issues with attention and memory. I had tried so many strategies to get organized and back on track, though, and nothing was working. So, I went with my only option; I returned to my psychiatrist and my counselor and gave them copies of the report that I had received. Thankfully, my counselor read the report and was astounded that a diagnosis had not been made based on the testing scores alone. We discussed my symptoms further, and he decided that an ADHD diagnosis made sense. He talked to my psychiatrist about the report and his findings, and my psychiatrist then prescribed a low dose of Adderall afterward. I had huge breakthroughs after starting the medication: I was finally able to focus on tasks without constantly being distracted; I became better organized; and I thought and communicated more clearly. Eventually I switched to Vyvanse, since the side effects weren’t nearly as pronounced and it was taken only once per day.
In addition to depression and ADHD, I have been picking at my skin since I was a child. Picking at my face, nose, ears, lips, and scalp was pretty normal for me, and I had never thought it as being abnormal since several of my family members did it, too. When I began creating sores all over my scalp and in my ears and nostrils, however, I became concerned. Picking at my scalp became particularly problematic during my comprehensive exams in the first week of March 2015. I would spend hours doing it rather than typing my papers, and I really couldn’t stop myself, especially when I paused to think about what I wanted to write. At first I thought I should probably just talk to a dermatologist about it, but when I searched online about dry scalp remedies, I came across an article that mentioned the skin-picking (excoriation) disorder. The more I read about it, the more I could relate it to what was happening with me. I also discovered that it is fairly common and typically hereditary. Once I talked to my psychiatrist, she recommended that we increase the dosage of my antidepressant because it is also widely prescribed for people with anxiety and OCD. Thankfully, it did help at the time, but I still continue to pick at my skin when I become overwhelmed with stress.
I often think about these mental illnesses with which I’ve been diagnosed and ask myself, “How are you passing as a normal, functioning adult? People have to think that you’re pretty ‘out there,’ you know.” Whether or not that’s true—honestly, everyone is a little strange in some way, right?—there is no obligation for those dealing with mental illness to “pass as normal.” Being “normal” is a subjective term based on relative and ever-changing ideals. Who cares what others think? “Normal” as a cut-and-dry category does not exist; it never has, and it never will. What does exist, though, are people (like me!) who are willing to listen and help without judgment. Life will almost certainly give you lemons. Let’s go make some lemonade. 🙂