Monday, February 28, 2005

depression, shaking off that black cloud

hmmm. i wish it were as easy as shaking off something. it's not.

this is a very long post, sorry about that guys, but it's an important one too, there is a call for help at the end and it would be great if you could heed it.

those long time readers and those who know me in my personal life know that i have chronic clinical depression. i'm okay right now. i'm medicated and i have spent lots of time in therapy learning coping mechanisms and dealing with issues. i'm not in therapy right now, but i don't for a second think that i'm 'done'. i know i will be back there at some point, and although therapy can be kind of scary, it is also very rewarding, and in some ways i look forward to when it is time for me to return.

depression is something that surrounds me in my friends and family. i have a theory that depressed people seek out other depressed people to be around. i don't mean on any kind of concious level, but for instance, john and i, who have been together almost 11 years, are both depressed. when we got together neither of us were diagnosed. the flip side of this theory is that maybe there is a certain personailty type that is more prone to depression and these personality types tend to flock together. in which case it would appear to be geeks (computer, sci fi, stuff like that) and artsy people, bonus points if you're a geek AND an artist of some description. okay, i might be making up the geek part, it's just that john and i are both geeks...

anyway, this time of year depression is all around. those who have been living with mild depression for ages and just kind of coping and getting by (gee, that sounds like a fun life) suddenly feel despair. the bloody cloud is getting darker and bigger. it blocks all the light out of their life.

also, since there have been so many changes, so many uncertainties, so many nights of not enough sleep, i start to worry that i am depressed again (it's why my mum and i call 'breakthrough depression', when you get depressed even though you're on your meds). in an unfortunate twist of fate, one of the side effects of feeling like this is that i become much less diligent about taking my meds (i.e. i forget, all the time, and when i remember it seems like a pain in the ass to walk all the way to the bathroom (for those who have not been to my house, it is a bungalow, the bathroom is not far away from any part of the house - oh, except maybe the basement since there are no stairs right now, but i wouldn't be in there, 'cause, well, there are no stairs right now...)

so, depression is on my mind right now.

i also know some people who are struggling with it right now, dealing with a relapse, dealing with going to a doctor about it for the first time, dealing with trying to figure out if what they're going through is depression, it runs the gambit.

this is me talking out my ass, but i believe depression is a disease that is characterized by certain symptoms, which can be addressed *in part* through medication. there is not a ton of point of taking meds and not going to therapy because then you're only addressing one part of the equation. i remember reading an interesting theory that the chemical imbalance in the brain that the meds address is not a cause of depression, but rather is caused by depression. i have no idea, but it is an interesting theory. anyway, in the same way that taking meds without therapy isn't addressing the whole issue, going to therapy before taking the meds can prove to be counterproductive. when i had my first breakdown, when i was first diagnosed, my doctor said to me that she wanted me to start seeing a therapist (she pointed out that she wanted me to see a smart no-bullshit therapist because i had spent some time convincing therapists i was just fine, she said she needed someone smart enough to see through me, she was totally right) but she didn't want me seeing a therapist for at least a month and a half. that's how long it would take for the drugs to get into my system and for me to start experience the world in some kind of 'normal' way. she said otherwise i would just sabotage myself because when you're depressed even if you don't admit it outloud you tend to think that you're not worth helping, that you don't deserve to be better, that things can never change so why even bother trying. so, it is my belief (and my doctor's) that you have to get rid of that particular set of symptoms before the therapy can be of any use.

so, back to these people i was talking about earlier, people i'm encountering who are facing depression right now... a few of those people are uncomfortable with the idea of taking medication for their symptoms. one thinks it is weak, that she should be able to just snap out of it (this unfortunately is a view that is often held by society too, and the feeling is compounded when you're depressed because everything seems to be your own fault and of course you are only depressed because you're weak and you should be able to just beat it without meds and therefore taking meds is really embarassing and demoralizing...). the other is concerned about side effects and is uncomfortable with the idea of taking drugs that will affect his brain.

i have no answer for these people. it kind of breaks my heart to hear the reluctance to the meds because it is something that can bring hope and life back into people, something that can let people get to a place to deal with other underlying causes. it makes me sad that this is not going to happen for them and that they feel they have to suffer through this, take the long arduous road up the steep hill instead of taking the stairs, neither of which are easy, both of which may eventually get you to the top (but that path can be muddy and slippery and sometimes people don't make it to the top), but one that is easier than the other. i use the age old analogy "if you had type 1 diabetes would you feel like it was wimpy to inject yourself with insulin, that your sick and you should suffer the consequences of that?" i remember my mum using that with me when i was first diagnosed. i've used it many times since. it's old, it's cliche, but it's also true.

i remember a friend once asking me what was the difference between an alcoholic and a person on anti-depressants. (he was of the belief that drinking or smoking up were no different than taking anti-depressants, it was an interesting evening...) i told him the difference was, people drink or even smoke up, to be released from the real world for a bit. people drink to escape. people take anti-depressents to re-enter the real world. people take anti-depressants to get back to a 'normal' state, not to alter the 'normal' state. i do to an extent understand his question, they're both things that have some effect on brain function, but to me they are so very very different it's quite unbelievable that someone would ask that question out loud (to a friend who they know is on anti-depressants).

my experience with medication has not been all positive, but it's been all worth it. right now for instance i don't have a health plan and anti-depressants are bloody expensive. also, when i started i started on paxil when i was 18. i gained 40lbs when on paxil (side effects can include weight loss or weight gain) and never lost i. i went off paxil because this was before the diagnosis of chronic. then after a relapse i went back on paxil, gained another 40lbs like clockwork, also didn't lose that. (yep, i'm a fat chick *grin*). so, i gained 80lbs thanks to my anti-depressants (this is probably complicated the fact that i am hypo-thyroid, so don't panic, if you go on anti-depressants you're not going to gain 80lbs). and, well, that sucks, it's hard to buy clothes, i walk slower than others, i feel self-concious at the gym, all that kind of stuff. but you know, i would also WAY prefer to be fat than depressed. the other interesting thing is that fat is a way bigger deal when you're depressed, before i gained all that weight i used to think i was a whale, i was way less comfortable and happy with myself than i am now. but i was also depressed. so i couldn't see that actually i was pretty cute with a pretty fun bod, i was by no means skinny, but i was also not a whale. my perspective was so out of whack when i was depressed.

anyway, other than the weight gain (which, like i said, was totally worth it) i haven't had any noticable side effects. my mum had some sleeping pattern issues when she started, but she just figured out when to take her meds when that started. john has a fun side effect of increased sweating. which really is okay because it makes him fit in better with me and my family of people who sweat massive amounts. and again, better to be sweaty than depressed. i don't know anyone who has had adverse reactions from anti-depressants, or rather, not adverse enough to outweight their benefits. there was a lot of stuff a little while ago about some specific kind leading to suicide in teens. i don't remember much about it, but i do remember when i dug a bit deeper the risk was sooooo minimal it probably wouldn't normally be mentioned. it's the whole more likely to die from crossing the street, taking a bath, cooking dinner, that kind of thing.

actually, there is some evidence that some people attempt suicide after starting their meds, generally within the first couple of weeks. my mum and i have a theory about that, and we did talk to a psychologist who agreed with us and said that it was what was happening, although i haven't seen any published literature about it. sometimes when you are depressed you are completely apathetic. you have no motivation. you have no will to do anything. you may wish you were dead. you may tell yourself the world would be a better place without you. you may think that things would have been so much better if you'd just never been born (that was my common thought when i was depressed, i think of it as my little cowardly suicidal thoughts, you know, i shouldn't be here, but i don't want to take any responsibility for that...). but as much as you may think or wish these things, the idea of getting your shit together enough to act on any of it, well, it's beyond you. but once you start taking your meds, in that period where they're starting to work but they haven't pulled you out yet, you get some of that motivation back. you pull yourself together enough to buy those pills or plan whatever other way you are going to do it. in fact, the attempted suicide is in a warped kind of way a good sign. it means you have the ability to act for yourself again, you care about something again.

anyway, i know loads of people who have gone on various different types of anti-depressants and not one of them has ended up trying to kill themselves or having any dastardly side effects. all of them have benefited, have been able to learn to enjoy life again, have been able to allow themselves to be sucessful at what they're doing.

so, with the proliferation of depression that's out there right now, keeping all this in mind, would you tell me your story? remember you can post annonamously even if you are a regular poster here, i just want to hear about what has happened to you, to your friends, to those you know.

you can be pro or con on the meds thing, i'm just trying to get lots of stories, not trying to limit what kind of story. when i was depressed one of the hardest parts about it was feeling like i was all alone in this whole thing and that no one could possibly understand what i was going through. so, tell your story, tell your sister's story, tell your neighbour's story, but tell a story, show people they're not alone. show people what you've seen work and what you've seen not work.

thanks for stickin' through and reading this whole bloody thing guys. it means a lot to me. apparently i just spent an hour writing about this, so that means it will be stupidly long and a bit of a slog to get through. so i double thank you for reading it.

now, tell us your story...

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