How My New Shrink Brought Me Back from the Brink

My downward spiral started late last year, with a dark and hopeless mood that awaited my awakening each morning and was accompanied by a feeling of anxiety that followed me around throughout the day. For me, anxiety is more than a general sense of unease or nervousness; it feels like I’m being pulled by an electrified wire – sometimes low-voltage and other times high – moving toward a source in the distance that I can’t define but am fearful is a waking nightmare from which there is no escape.

It had been 20 years since the last time I’d felt it this badly. A major move from the city to the suburbs, coupled with a new role with increased responsibility at work, triggered a reaction that seemed to switch off whatever regulates the sense of well-being in my mind.

I contemplated closing the garage door of my suburban home and locking myself in my car with the engine running. Even though the prospect of falling into an oblivion whose unknown endpoint terrified me, it seemed worth the risk to escape the torture.

My wife grew weary of watching me disintegrate and insisted I return to my therapist’s office. When I did, he pleaded with me to start drug therapy – something I’d long resisted. I finally relented, and after about eight weeks at increasing doses, the medicine kicked in. I felt immense relief the first morning I awoke without those terrible knots in my stomach. I began to breathe free again. I recovered and felt reborn as a more patient, resilient and hopeful person. I never expected to face the demons again.

Ambushed
I guess I should have considered 20 years a pretty good run – especially for someone with suicide in his family and a track record of repeated mood deterioration. But I felt ambushed when those horrible feelings returned.

In retrospect, it doesn’t seem all that surprising. I had recently come to the end of a 35-year professional career that had culminated in 16 years as an ex-pat in Europe. After that idyllic period of steady work, a regular schedule and abundant world travel, my wife and I returned to a vastly different America, and I felt adrift with no more work routine to anchor me. The feeling of being on vacation in my beloved New York morphed into a sense of being stranded on an island of ambiguity that I had to scramble to find my place in, just as I had when I began my professional life, back in the same city, decades earlier.

I wanted to continue working but made rookie mistakes, saying yes to everything, taking on projects whether they suited me or not, and subjecting myself to ridiculous deadlines. Having completed a stressful and demanding professional career without ever coming close to burning out, here I was, perilously close to the brink, when there was absolutely no reason – economic or otherwise – to be putting myself through this ordeal.

But this time, returning to my longtime shrink was not an option. He had died of multiple myeloma, likely related to his proximity to Ground Zero, just south of the Tribeca loft where he lived and saw patients.

Rescued
A friend thought her therapist might be a good fit and referred me. After an exploratory phone conversation and about 15 or 20 minutes of listening to my story in his office, my new shrink delivered his diagnosis and recovery plan with heartening assurance.

The term he used for my condition – both to help me understand it and for the formality of filling out my health insurance claim form – was “adjustment disorder.” The 5^th edition of the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders, known as DSM-5, defines it as a cluster of emotional and behavioral symptoms, such as anxiety and suicidal ideation, brought on by identifiable stressors. In my case, the desire to bury myself in sleep and complete loss of appetite when I was awake were also prominent. Pounds evaporated in just a few weeks in both of my episodes.

His first piece of advice was to read a book called “Adaptation to Life,” by George E. Vaillant, a psychoanalyst and research psychiatrist at Harvard. The book, covering his study of how a selection of 268 men coped with challenges throughout their life cycles, is considered a classic. I hope to get to it someday, but at that point in my tailspin, I was not up to tackling its nearly 400 pages of tiny print and dry academic tone. Luckily, his other recommendations were more digestible. In summary, here’s what I’ve learned and applied.

1. Remix Your “Happiness Cocktail”

“Your core needs in life are out of balance and in conflict,” my new shrink told me straight away. Everyone has a happiness cocktail that requires a combination of specific ingredients mixed in specific amounts. Mine was complex and out of whack. I began working on this immediately, in conjunction with taking a low dose of a selective serotonin reuptake inhibitor (SSRI). I started saying no to any projects or clients that weren’t in sync with the type and amount of work I wanted to be doing. It meant adding much, much more breathing space to my lifetime for thinking, reading, and recreation.

The “No Initiative” quickly made me feel more in control on the outside, and the drug soon began to work its magic on the inside. Before long – I’d say a couple of months — I felt the first inklings of looking forward to things, which, in itself, seemed like a blessing.