Living with Depression

As I’ve mentioned in response to excellent posts on a couple of other sites, I struggle with depression. Although I don’t usually talk about personal topics here, nor am I as entertaining and eloquent as Dooce on the subject, I do want to collect and share my thoughts in this forum.

I have battled depression since adolescence, probably since I was 14 or 15. I didn’t know what it was back then, and wasn’t diagnosed until my mid-20s, but it seriously impacted me. I was quite a handful, my moods must have given my parents and college roommates whiplash.

There is a difference between situational depression (my dog died so I’m down in the dumps) and clinical depression (which is ongoing, intractable, not responsive to the ups and downs of life). The variables are usually duration and severity – but please, if this at all applies to you, visit a trained mental health professional to help with that evaluation!

When I first started getting counseling, and later was prescribed medication, it helped. A lot. After that particular depressive phase was over, I went off my medication. Just a few months later, I crashed again. And the next year, again. My doctor gently suggested that I had “chronic, major depression”. To maintain any kind of mood management, I needed to look at taking long-term, consistent antidepressant medication, as well as develop a long term, as-needed relationship with a counselor.

That was a bitter pill to swallow. What the hell was wrong with me that I couldn’t bootstrap my way out of this? Why was I not strong enough, resourceful enough, to manage my moods independently? Was I flawed, defective, less than fully capable? If I couldn’t keep my thoughts & feelings under control, was I a failure? It’s taken a very long time to make peace with those questions.

Depression, at clinical levels, is a mix of biochemical and behavioral factors. The predisposition can be genetic, but environment is significant. All the women in my family struggle with the mood disorder to one degree or another. Is it because of our genes, or because of our family and cultural programming, or all of the above?

Untreated depression is different for everyone. In my case, I constantly felt hopeless, unable to face the requirements and obligations of everyday life. I held it together and was able to function at work, marginally, but nowhere else. I couldn’t sleep when I needed to, but was exhausted & groggy when I was supposed to be awake. I felt constantly fatigued and had little initiative. I was excessively irritable, very withdrawn, unable to laugh or enjoy any facet of life. I was faintly paranoid, carrying around an anxious feeling like I was in trouble about something, even though I was not. My well of creativity and problem solving ability was bone dry. I just plain hurt, it felt like I was walking around with a lead blanket over my head and broken glass in my heart.

Part of the solution for me was medication. The antidepressant I take does not numb me nor cost me my ‘edge’. At different times, I’ve been on Paxil, Zoloft, and Wellbutrin, but the last seems to work best for me.

Because I’m a geek, I’ve graphed it, mapping mood swings from a low of 1 to a high of 10.

Mood Comparison

Depression treatment doesn’t quite improve my moods to the range that a non-depressed person might experience. Anti-depressants also smooth the extreme mood swings a small amount, so that I no longer am likely to spend as much time in the highest highs and lowest lows.

Medication, though, is far from being a magic bullet. It simply lifts the dark cloud far enough that I have less pain and more space, initiative and clarity to address the absolutely essential attitude and behavior issues. The classic mood-management suggestions for depression include:

  • Manage stress effectively
  • Get physical exercise regularly
  • Learn to set boundaries appropriately – work on assertiveness, saying yes all the time is not healthy, but neither is saying no
  • Learn to express emotions appropriately – don’t clamp down anger and sadness
  • Develop some outlet for emotions – writing, art, physical activity, therapy
  • Maintain a network of supportive friends and family
  • Participate in activities that you find pleasurable and rewarding
  • Be of service to others in your community – helping others dramatically improves perspective

Can you see the inherent flaws here? If you’re exhausted, hopeless and withdrawn, you’re sure not likely to head to the gym or call a friend. Self-starting any of these very beneficial suggestions is always a challenge; medication helps.

Cognitive therapy is a school of behavioral science that suggests that the way we talk to ourselves helps determine how we feel and how we see the world. It’s not a falsely positive approach, rather, a realistic approach. For example poor self-talk says:

My tax bill just came, and it’s a disaster. I’ll never be able to pay all that. Dammit, I’m such an idiot for not planning better. What a disaster – the IRS will take everything!

Instead, I could say:

My tax bill just came, and it’s huge. That really stinks and I wasn’t prepared for it. I am pretty determined, though, and I can make myself sit down, go through my money and figure out how I can either pay it or get help if I can’t. I’ll also work on a way to prevent this nasty surprise next year.

To some degree, beyond choosing how to respond, attitude management is about developing some core beliefs: I am a strong survivor-type who can handle anything; Life’s not fair but I’ll get over it; and that current circumstances may suck but I can choose to respond constructively.

What I achieve, what stuff I accumulate, and what people think of me matter very little; what’s truly important is how well I love, give, create and make a difference in this world.

I have a long way to go on some of those, but my current frame of mind is cautiously positive. I’m thankful for the love and support of my family. They’ve been inordinately patient and infinitely supportive, and I couldn’t have kept going without them. I am blessed.

8 Responses to “Living with Depression”

  1. Janiece Says:

    What’s truly important is how well I love, give, create and make a difference in this world.

    Because you can always replace “stuff.” People, not so much.

    I’m glad you’re on the right track.

  2. Michelle K Says:

    Thank you.

    It’s always good for those of us who suffer to know we aren’t going it alone, because even if one cognitively knows depression is a biological disorder that is suffered by millions, so many people are afraid to talk about what they have gone through because they fear social stigma, we end up feeling alone, or like freaks, or like weak creatures who are simply unable to cope.

    Well that’s bullshit. We’re not weak, and we’re not alone. And if people can’t accept us for that–their loss.

  3. Brenda Says:

    Depression is one of those things people just want to ignore, when it’s actually so treatable. So great to know you have all the help you need in order to function. And Dooce? What an inspiration, not only for those suffering from depression, but for everyone.

    Thank you for sharing… I especially liked seeing the ‘geeky’ graphs. (Visuals are always a good thing.)

  4. Beast Mom Says:

    This is a GREAT post.
    It is so well thought-through and honest.

    Thanks for writing this. I’m going to forward it to some friends who constantly struggle w/ the isolated/what’s wrong with me feeling. Sometimes it’s the sense of community from people who struggle alongside, and not outside, that makes all the difference.

    I love the way your mind works.

    -bm

  5. Beast Mom Says:

    BTW, I want to hear all about the CBC show if you did the recording of your Ficlet! That was a super cool comment to get on your writing. ;) Your mini-story made me shiver…

    -bm

  6. Jeri Says:

    Janiece, I totally agree. Stuff doesn’t matter at all in the long run!

    Michelle, actually, when I mentioned it on your blog was the first time I had talked about my depression challenges in a public forum. After making references in a couple of places, I decided it was time to tell my story – not to dwell on it or whine about it, but as you said, to let others know they’re not alone.

  7. Jeri Says:

    Brenda, our minds work alike sometimes. :) Thanks for the encouragement!

    BM, I appreciate your input. You’re one of my blogging heroes. ;) It’s thorough because, like any self-respecting geek, I made an outline of my subject matter first. How’s that for OCD?

    On the CBC show, I think I’m recording for them on Monday. It won’t be the piece I posted here, but a different one. I’m a little nervous about it, but I’ll post about it then! It seems like a really fun opportunity.

  8. Michelle K Says:

    Jeri,

    Cool!

    It’s a scary thing to do, First, because you’re putting yourself out there for everyone to stare at. Second, there’s always a possibility that someone will think badly of you because they misunderstand mental health problems.

    I don’t know if it gets easier–I still feel uncomfortable writing about my mental health, and I’ve been doing it for quite awhile now, because sometimes it *does* feel whiny. But it’s important, and I guess the important things are hard.