Depression

TW: Thoughts of self harm and suicide

I've been depressed for a long time. I didn't take care of it. I didn't take care of myself. I prided myself on my ability to set aside my feelings and do what I needed to help others. I can't worry about my life collapsing around me, my employer needs me to ship this feature! I can't worry about my own internal pain, my partner is struggling with me coming out as trans. I need to look out for her! I can't stop to think about my own needs. My family needs me to bail them out of debt. Now isn't the time for me to think about my gender. My sibling just discovered a serious health complication. I need to support them! Yes, it hurts to put figuring out my gender identity on hold, but it can wait.

None of the people I was helping expected me to set aside my own issues to help them, and I bet that if they were aware of my internal turmoil things might have gone differently. I didn't really give them the choice. I just assumed I could take on their burdens in addition to my own.

The thing is, I didn't know how to take care of my mental health, and I got progressively worse. I always felt like I could take more weight and more pressure. On some level, I think I believed that once my internal pain was removed, I'd be all better. I just needed to keep going until I got there. I was careful to always watch my physical health. I always carefully monitored my use of alcohol and drugs. I didn't want to develop a habit of using a coping mechanism that would do long term damage to my body, but I didn't really appreciate the damage I was doing to my mind.

I didn't even recognize it was happening until I was laying on the floor of my apartment trying to hold my breath until I passed out while pulling out my hair. Tears running down my cheeks, I just kept thinking "I need to become unconscious". My brain was rebelling against me, and I needed to silence it. As I was imagining cutting off my fingers or jumping off bridges, I kept thinking I needed a way to turn off my mind without doing any harm to my physical body. You'd think that would be an eye-opening moment where I learned the importance of taking care of my mental health, but the next morning I went to work as though nothing had happened. My team needed me. I could figure out my mental health issues when I got home.

At that point, I thought that all I needed to do was survive. The internal turmoil would be lessened once I started hormones. I just had to hold out a bit longer. If I could just fix my physical body, then my mind would follow. I don't know how I can possibly describe the desperation behind my anticipation of starting my transition. I knew that I couldn't hold out much longer. I had reached my limit. I was unraveling.

Starting my medical transition absolutely helped. Even though Spironolactone is an awful anti-androgen (i.e. testosterone suppressor), I very quickly felt a calm descend over me. A pain I'd lived with since puberty had finally started to abate. It was small, but I felt more like myself. Despite the effects of Spironolactone being miniscule, it was a massive relief. I saw hormone therapy as my only life-line. If hormones didn't help me, if transitioning didn't help, then I'd just be a broken person without any visible path to being whole again.¹

I wish I could say that starting my transition cured me. I wish I could say that finally putting my needs first and having the right hormone in my blood helped me get back to being happy. That's how I wanted to believe it would work at the outset. Remove the pain and you'll be happy again! On some level, I knew it wouldn't be that simple, but I wanted to believe it so bad. Instead of magically bouncing back, starting hormones mostly just meant I stopped getting worse. It wasn't a cure-all, but it was the first step in a long journey of healing.

Here I am, 492 days after I took my first pill, and I'm still depressed. I'm better than I was, but I am still not done. I've still got injuries on my psyche that I'm still trying to heal. The effect that estrogen had on my mood was immense and overwhelmingly positive, but it only removed some of the pain, and it certainly didn't undo the damage. My depression was only partially caused by dysphoria. Even if I magically and instantly felt at home in my body, I still had subjected myself to a long period of intense pressure while completely ignoring my own needs. The wounds from an experience like that don't fade so easily!

I'm trying to be better to myself. I'm trying to give myself the space to heal. I'm trying to listen to my needs. I'm trying to ask for help when I need it, and separate myself from things that hurt me. I feel like I'm finally treating my mind and mental health with the care they deserve. The healing process is a terrible and long road. Sometimes it can be hard to appreciate the progress I'm making, but when I reflect on where I've been, its painfully obvious to me that I'm in a better place now than I was a year or two ago.