“I don’t have a tangible disease.”  That’s what I told the resident psychiatrist at UT Southwestern.  I didn’t have health insurance that covered psychotherapy, so I was paying a small amount to talk to senior psychiatry residents as part of their education.  “You know if I had cancer, people would get it,” I told him.  People want to know what’s my problem.  There’s no causation for my depression.  Well, yes and no.  I’m a complex person.  I always knew things knocked me down harder and longer than most.  And did I take grief for that.  “Get over it” was the mantra I heard whenever I wanted to express my feelings.  Things would stay bottled up as a result, and I would just build resentment toward whomever that would later manifest as hostility.  I’m a get things off my chest kind of gal, but I’ve also romanced ruminating my problems to the point of no return.

“You were the most miserable child” I recalled my sister saying to me later in life. Yeah, I really was.  I saw evidence of that after my mother’s passing in 2016.  Surfing through the pictures that had been buried throughout the contents of our family’s home over the years, I found two where I was smiling.  Yep, two. I remember an episode of Monk when his assistant found a picture of him and his brother smiling, but he said they were just practicing for the camera. I’ve often compared myself to Mr. Monk.  I’m an extreme perfectionist, and  I didn’t realize how noticeable it was to others until later in life when I was reaching my peak states of perfecting not just my appearance from head to toe, but also how I conducted my life.  Some of the more flattering comments about it were  “I thought you were the most perfect person I ever met” from a co-worker who turned into an unlikely friend as she was as country as country could be.  “Will we be invited to Jolene’s wedding?” the daughter of an employee had asked her mother.  When her mother asked why she wanted to know, she replied “because Jolene does everything right.” And then from a colleague “In my next life I want to come back as you.  You really have your act together.”  That was a lot of pressure to put on myself.

Hindsight Really is 20/20

Now looking back, I see how much life I lost to that and to depression without even realizing it.  It was always there lurking in the background.  “Why are we here?” That was the existential question I was asking my young self lying in bed at night when most grade school-age kids are concerned with less intense universal issues.  And “why do people treat each other this way?” was the other.  That was something most noticeable to me.  My default is set at shy/introvert, I had a lot of time to notice things.  I didn’t understand why anyone would intentionally want to make another person feel bad. 

I would think and think about how I could shape myself into this perfect person with this perfect life.  My physical appearance was something I torture myself over longer than I could remember.  Being tall, thin, with curly red hair seemed to be such a curse when all my other Italian-American friends looked more authentically Italian than I.  I was the anomaly, but later in life being different meant being exotic which is how I was often described.  I could spend hours analyzing my appearance figuring out how to deflect flaws and highlight the assets.  I would often joke that I wasn’t a natural beauty, I just used 28 products to look like one.  I was blessed with good bone structure, a tall, lean, athletic body, but I still focused on the imperfections and how many years I had in front of me to correct those before it was too late.  Too late being I would be the age when I was considered irrelevant.  I could no longer wear all the hip clothes by pricey designers that I could now afford due to my lucrative business.  I looked at aging as a disease that people let happen to them, and how could I be one of those people?  How does this perfectionist mindset even begin? 

My First Leap of Faith

I left my corporate job at 30 to launch my own business competing against my former employer. Looking back on it now, it seems totally absurd that I would risk my future like that. I wasn’t married and had no second income to fall back on. My then-boyfriend lived in Miami (I was in Dallas), so he was moral support but certainly wasn’t paying the bills. I worked in the jet engine sector of aerospace, and back in the ’80s and ’90s, it was still very much a good ole boys’ network. Getting a loan to buy inventory or working capital got you a catatonic stare from a banker. So, I had to rely on my contacts from my 11 years in the industry to give me credit and throw me some bones. In my first month, I made half of my annual salary from my corporate job, and my business hit the 7-figure mark in 9 months. For the first time in a long time, I saw the old me starting to come back. The old me was creative with a passion for art, design, architecture. I wasn’t surrounded by my former colleagues on a day-to-day basis talking shop all the time. I really forgot this part of me ever existed, but I also forgot other parts of me that had.

How We Each Choose to Cope is Very Different

It’s been said that substance abusers will use to mask a deeper problem.  I think my busy corporate life with only time to think one way was suppressing my depression that has always existed in my life. I’ve always noticed it takes me a longer time than others to recover from life events. After a conversation with yet another psychiatry resident, she pointed out that I lacked coping skills. “Most people are born with the ability to cope or learn them through adolescence and adulthood.” That was spot on. I sometimes wonder if was an undiagnosed autistic. While others will abuse substances, I began to retreat from the world. I truly hated my business. It was never me. When you’re an entrepreneur, you have to be charged every day to get out of bed and conquer the world. When 9/11 happened, airlines were parking planes in the desert, and my business started slowing down. Of course, things turned themselves around, but my mind never did. I lost all my initiative to go after business, so it just limped along until I made the decision in late 2005 to liquidate it. On top of going through 3 romantic heartbreaks between 2001 and 2003, my brain had just had enough. I had always been upwardly mobile and didn’t even know how to comprehend going down. I felt lost because I had invested 28 years of my life in aerospace, so where would I go from here? I was creative but had no proof of it. What I still had was a large nest egg to enabled me to flounder to the point of having to sell my townhome that I spent so much time designing every aspect of the architecture and interior design. My brain couldn’t comprehend such a failure. I just went on a downward spiral of bad choices trying desperately to get my life back without a clear head to see the forest for the trees.

Ketamine or Special K as Known on the Street

They put me on medication after medication and a combination of medication after medication. I felt like a guinea pig as I was just declared as having medication-resistant depression. So, here’s the problem with depression, you have to be able to get to the point of being able to help yourself. And that is the proverbial Catch 22. I was someone that worked out religiously, but that desire went away. And if I can’t get out of bed to eat, what makes anyone think I can go torture myself at a gym? I was not functioning at all and couldn’t even recognize the person I had become. I was always someone that had a hard time relaxing. I couldn’t watch TV without simultaneously folding clothes or reading a book. I always had to be productive with my time. In 2017 I was told by a psychiatry resident at UT Southwestern in Dallas about a drug study for Ketamine. It was a bit of a surprise because I only knew it to be an animal tranquilizer and a street drug. It was being studied for the use of treatment-resistant depression, and that study became the next three and half years of my life.

The criteria were strict. I had to document all the antidepressants I had taken that proved futile. There was no faking your way through it. Out of all the applicants nationwide, only 224 were enrolled in four countries. After that came all the interviews with the study doctors at UT Southwestern and study coordinators and physical examinations to ensure you are healthy enough to undergo treatment. Each participant had to switch their antidepressants to one that was allowed for use in the study so for me that presented a new challenge. Some pharmaceuticals and over-the-counter supplements such as melatonin were prohibited for safety interactions. Participants are also screened for use of other substances such as opiates, amphetamines, and street drugs among others. During the study, the participants’ cognitive and physical health is closely monitored to the point of exhaustion. We had to take smell tests, memory tests, oral reports, written reports, computer tests, EKGs, blood draws, and urine collections. We received $75 for each visit plus transportation on days we were dosed.

The Future is Now

The experience for all of us varied as I would ask the study coordinators about the others’ feedback. It’s administered as a nasal spray, and at first, it was very intense. I had this out-of-body experience like I felt there was zero gravity. I never hallucinated, but my brain kept going back to the ’70s and ’80s. Maybe because that was a pivotal time in my life. Over and over again, I saw myself going up the steps of my first apartment here in Dallas after relocating from my home state of New Jersey. The feeling that I was not in control of my thoughts or my body gave me some anxiety. They monitor your blood pressure, heart rate, and oxygen and my blood pressure consistently went up during dosing. I was certain I didn’t get the placebo. Once the four-week twice-weekly study was over, I was then admitted into the open-label phase which is where I am now finishing almost three and a half years later. My last day was December 28, 2020, which was bittersweet for me. I have so much gratitude to the study team at UT Southwestern and their commitment to those suffering from depression. During this time I was able to start another business as a professional organizer and also served on the board of directors for the local chapter of my professional association NAPO. I have a whole new group of friends and colleagues who know nothing about my struggles. I’ve only started to mention that I’ve been in this study, but no one knows all the protocol and depth to roll out a treatment to market unless you’ve been involved in even one piece of it. I hope my participation has helped lives. Depression sucks, and I can promise anyone it is possible to start over even at 58.