The phrase "when depression hits" came to mind a few moments ago, and I decided to sit down at the laptop and write, which I rarely do, despite the thoughts that constantly swarm inside my mind. The thing about depression, though, is that more often than not, it doesn't "hit" at all. It creeps up on you, and if it isn't your first battle, you either start making excuses as to why it's not, in fact, "happening again," or you find comfort in it. I realize this sounds absolutely ridiculous to anyone who hasn't been through it. The truth is, when depression shows up, to someone who has been through it a time or two (or five), while it's painful and soul crushing, it's also familiar. Sometimes, the familiar, even when it's the worst possible familiarity, can be comforting just because we understand it.
This last time around, however, depression really did HIT. The trigger was chemical. I'll try to keep the background brief: Celexa in doses over 40mg has been known to cause abnormal heart rhythms. This resulted in revised guidelines for Celexa a couple of years ago. I found out about this recently and since I was taking 60mg per day, at the time, I decided it was worth trying something new. If I have to go through a med change, might as well really give it a shot right? Ok, let's try Brintellix. Effective for treatment resistant people with low tolerance for side effects. Not effective for me.
I did a one month trial of a lower Celexa dose with Wellbutrin because insurance companies don't like to pay for expensive drugs if they don't have to. That wasn't effective enough. So then I got to try Brintellix. I gave it a solid month. I really wanted it to work.
Depression manifests differently for different people. I would venture to say that no two experiences are the same. For me, I often experience high levels of irritability and an extremely short fuse. I have had two major experiences where this was my dominant symptom. I have also had a bout of depression where it was all I could do to go to work and keep my job. Hell, it was all I could do to lift an arm to get the TV remote.
This time, though, it started with the irritability and impatience. The things that would set me off are still things that I might find mildly annoying, hurtful, frustrating, etc. on any other day. During the transition, when I was reducing Celexa while simultaneously increasing Brintellix, I started feeling pretty good. I thought this might actually work. Then I stopped the Celexa. That's when I became more and more fragile. The smallest thing unglued me. It would feel like electrical charges were racing through my veins. I would simultaneously have these bursts of anger. I wanted to punch things, and throw things, and scream. Then, before long, I would start to cry, feeling so hopeless and incapable of doing even the most ordinary chore like house work.
I was supposed to start a new class six weeks ago. The pre-work was simply to read chapters and prepare notes/talking points for in-class discussions. I couldn't do it. I couldn't get through a paragraph without distraction or feeling overwhelmed. Then I would begin to think about all the work ahead for the next six weeks. I know I'm a strong student. I always have been. I give it my best shot, even when the class is less than fulfilling. I could not bring myself to get through those two chapters. The idea of going to class that first night seemed impossible. So, as much as it made me feel like a failure to do it, I withdrew from that particular session. I took the last six weeks off so I could get back to myself. I'm glad I did it but I have had mixed feelings about it, and I'm actually embarrassed to admit it here, but painting the picture of what mental illness really is takes precedence over my own little bit of shame. So there it is.
Depression is more than feeling sad. It's more than feeling tired. It's one of those things that seems so impossible to explain now that I'm on the other side of it. Of course, when I was in the throes of it, I thought about writing about it about 10 times, but couldn't bring myself to get up to do it.
As if the irritability and near total lack of energy isn't enough, there are also the thoughts in your head telling you you are not good enough, you are a failure; you are not worthy of love, respect; you can't even get out of bed sometimes. What kind of loser can't get up in the morning? Just get it together, already; You're about to be 33 years old, just be responsible and get to work on time and stop slacking. I mean work is like the one thing you are good at, it's not like you're ever going to find someone to spend your life with. And kids? Ha, like you can even handle raising a kid, you can barely take care of yourself. You would probably have panic attacks like all the time.
Do I believe some of those things about myself even when I'm well? Maybe on a bad day. Even when you know it's depression, it still seems so logical and real. Your brain just conjures up every negative thing you've ever thought about yourself and even some you have never thought of. And you can't get away from it. It's not like you can take a break from your brain.
That. That is depression.
p.s. Obviously, Brintellix was not the drug for me. That doesn't mean it doesn't work for others. I am in no way saying that it's not a good drug. I can't say what is or isn't right for anyone else out there. So, back on Celexa I went, only this time my doctor added Abilify. I'm actually feeling a little TOO good, with more energy than I have time to burn. So the dose might be a smidge high, but that's something I can deal with and experiment with using my doctor's guidance. I'll take too happy over feeling virtually incapacitated any day.
Tuesday, May 3, 2016
Wednesday, February 24, 2016
starting again
It's beyond time for me to resurrect this thing. A while back, I decided to rename the blog and I also changed the url... I wanted to feel like I could write about anything, not just the mental health stuff, though that piece of my life is still very important and I plan to continue to talk about it. Once in a while, though, there are other things that I think are important to discuss. I wanted to have a place to talk about those things as well.
However, today I actually do want to talk about the mental health stuff. Once in a while, I am reminded that sharing my story can make a difference. I frequently find myself thinking that my story isn't so bad, that other people have it worse. I don't know why I think that way. I have a tendency to be harder on myself than I have any business being. My negative self-talk tendencies are the biggest things that still hold me back, emotionally. I'm working on it though. I think I'll always have things I want to work on. Figuring out why I feel the way I feel is often what leads me to grow. So while it isn't always easy to get through, change and fighting against my natural mental tendencies are vital to keeping myself put together.
That leads me into the current state of things. I've been on Celexa for several years now. It is the best of the serotonin based drugs that I've experienced so far. Recently, though, I've had a couple of doctors tell me that my dose was higher than the revised recommendations from the FDA, because of abnormal heart rhythms in people on higher doses of Celexa... nothing to mess around with. So, I was going to try a new drug on the market, but there are other drugs my insurer wants me to try first (because Brintellix is hundreds of dollars for 30 days.... I won't get started on pharmaceutical costs...). Anyway, since I'd never been on Wellbutrin, I had to give it a shot to see if it would work. So now I'm taking a lower dose of Celexa with Wellbutrin AND Buspar as boosters. I mean, honestly. How many chemicals does it take for my brain to act right?! Ugh.
I'm on week 4 now, and so far it's not quite taking care of all of my symptoms. I feel a lot of what the professionals like to call "breakthrough symptoms" which basically means you still feel anxious and/or depressed even though you are taking meds for it. In this particular situation, I'm feeling a lack of motivation and a loss of energy. This is the stuff that makes depression so debilitating.
It's not as intense as it has been at other times, which is good, but it's still there. Telling me to go take a nap on Saturday afternoon after sleeping ten hours on Friday night. My body isn't tired. My body is rested. My brain is telling it to sleep. It's not so easy to distinguish the two in the moment, though. It's not just about being sad. It's not a bad day, or a bad mood. It's inexplicable heaviness. Excessive sleepiness, even though you slept nine hours last night. It's the feeling that it doesn't matter, because you'll never really be happy anyway. These are all messages my mis-wired brain sends me. I feel less equipped to deal with depression because it's usually my secondary condition. I have battled anxiety much more often and more intensely over the 10 years that I have been working through mental health challenges. My anxiety is about 85% controlled right now, which is pretty good. Maybe even 90% on a good day. Just little breakthrough moments here and there. This depression stuff is rearing it's ugly head lately.
Something that I have heard for years and that I know to be true is the positive effect of exercise on the depressed/anxious mind. I'm terrible about exercise. I don't like doing it and I'm great at making excuses not to. Recently, a friend encouraged me to rejoin the gym. I was hesitant because I've been through this cycle before. It starts out great, then I'm stuck in a contract and paying for a gym I don't use. One would think the money aspect would motivate me to go, but so many times that has not been the case. Luckily, I was able to get in on an affordable month-to-month membership. I have only been a few times in the last couple of weeks since joining. What I have been doing, however, is pushing myself to use the nice treadmill I bought a year ago when I opt not to go to the gym. I don't go crazy, I'm going at a pretty slow pace, but it's exercise. It's movement. It's more than I'd be doing on the couch. And it does help. The people who really know me know that it must be true if I'm saying something positive about exercise ;) Seriously, though. Give it a shot if you don't already.
I'm working on pushing myself to move a little extra on most days. As it becomes routine, I'll push a little harder, be able to do a little more. I just have to keep trying. I think I've started to really doubt that I will ever truly feel great all of the time, but I try to believe it's still possible because depression sucks and it keeps me from living my life, so I keep fighting and trying new drugs and keep going to therapy. It's worth the fight to me. It's so easy to get discouraged, believe me, I know.
This is going to sound cliche, but it's really quite important to remind those of us fighting against mental disorders. If you are struggling, please remember you are not alone. It will get better, and it may get worse again too. Do not give up. Try a new med until you feel better. Don't settle for the first thing you try if it's not enough to let you be yourself again. Try therapy, keep trying until you find someone who helps you. Try online support groups, whatever it takes. Just don't stop fighting.
However, today I actually do want to talk about the mental health stuff. Once in a while, I am reminded that sharing my story can make a difference. I frequently find myself thinking that my story isn't so bad, that other people have it worse. I don't know why I think that way. I have a tendency to be harder on myself than I have any business being. My negative self-talk tendencies are the biggest things that still hold me back, emotionally. I'm working on it though. I think I'll always have things I want to work on. Figuring out why I feel the way I feel is often what leads me to grow. So while it isn't always easy to get through, change and fighting against my natural mental tendencies are vital to keeping myself put together.
That leads me into the current state of things. I've been on Celexa for several years now. It is the best of the serotonin based drugs that I've experienced so far. Recently, though, I've had a couple of doctors tell me that my dose was higher than the revised recommendations from the FDA, because of abnormal heart rhythms in people on higher doses of Celexa... nothing to mess around with. So, I was going to try a new drug on the market, but there are other drugs my insurer wants me to try first (because Brintellix is hundreds of dollars for 30 days.... I won't get started on pharmaceutical costs...). Anyway, since I'd never been on Wellbutrin, I had to give it a shot to see if it would work. So now I'm taking a lower dose of Celexa with Wellbutrin AND Buspar as boosters. I mean, honestly. How many chemicals does it take for my brain to act right?! Ugh.
I'm on week 4 now, and so far it's not quite taking care of all of my symptoms. I feel a lot of what the professionals like to call "breakthrough symptoms" which basically means you still feel anxious and/or depressed even though you are taking meds for it. In this particular situation, I'm feeling a lack of motivation and a loss of energy. This is the stuff that makes depression so debilitating.
It's not as intense as it has been at other times, which is good, but it's still there. Telling me to go take a nap on Saturday afternoon after sleeping ten hours on Friday night. My body isn't tired. My body is rested. My brain is telling it to sleep. It's not so easy to distinguish the two in the moment, though. It's not just about being sad. It's not a bad day, or a bad mood. It's inexplicable heaviness. Excessive sleepiness, even though you slept nine hours last night. It's the feeling that it doesn't matter, because you'll never really be happy anyway. These are all messages my mis-wired brain sends me. I feel less equipped to deal with depression because it's usually my secondary condition. I have battled anxiety much more often and more intensely over the 10 years that I have been working through mental health challenges. My anxiety is about 85% controlled right now, which is pretty good. Maybe even 90% on a good day. Just little breakthrough moments here and there. This depression stuff is rearing it's ugly head lately.
Something that I have heard for years and that I know to be true is the positive effect of exercise on the depressed/anxious mind. I'm terrible about exercise. I don't like doing it and I'm great at making excuses not to. Recently, a friend encouraged me to rejoin the gym. I was hesitant because I've been through this cycle before. It starts out great, then I'm stuck in a contract and paying for a gym I don't use. One would think the money aspect would motivate me to go, but so many times that has not been the case. Luckily, I was able to get in on an affordable month-to-month membership. I have only been a few times in the last couple of weeks since joining. What I have been doing, however, is pushing myself to use the nice treadmill I bought a year ago when I opt not to go to the gym. I don't go crazy, I'm going at a pretty slow pace, but it's exercise. It's movement. It's more than I'd be doing on the couch. And it does help. The people who really know me know that it must be true if I'm saying something positive about exercise ;) Seriously, though. Give it a shot if you don't already.
I'm working on pushing myself to move a little extra on most days. As it becomes routine, I'll push a little harder, be able to do a little more. I just have to keep trying. I think I've started to really doubt that I will ever truly feel great all of the time, but I try to believe it's still possible because depression sucks and it keeps me from living my life, so I keep fighting and trying new drugs and keep going to therapy. It's worth the fight to me. It's so easy to get discouraged, believe me, I know.
This is going to sound cliche, but it's really quite important to remind those of us fighting against mental disorders. If you are struggling, please remember you are not alone. It will get better, and it may get worse again too. Do not give up. Try a new med until you feel better. Don't settle for the first thing you try if it's not enough to let you be yourself again. Try therapy, keep trying until you find someone who helps you. Try online support groups, whatever it takes. Just don't stop fighting.
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