Huffington Post: On Depression
There are all these articles coming out: “How to Deal with a Depressed Spouse.” “What Depression Feels Like.” “What Not To Say To Someone With Depression.” Etcetera...
Lots of stock images of people sitting cross-legged on the floor in dark rooms, heads in their hands.
I read one of those articles that tried to explain the really blurry science of depression.
There was a graphic of a super bummed out looking guy, and arrows pointing to different highlighted areas of his brain. From what I could gather, it’s a bunch of chemicals, and neurotransmitters and things.
I was having trouble sleeping, feeling generally bad, a lot, and the things that I supposedly enjoyed doing, that should cheer me up, weren’t cheering me up. I’d rather stay at home alone in my pajamas and eat than do pretty much anything else.
My therapist had me take multiple-choice quizzes. A was always a little too disconnected, B was normal, C was depression and D was suicidal/sociopathic.
She said things like... “Well... those are signs of depression,” and “You’re depressed.”
For a while, I thought she meant it in the way we all say it. Like, at the lunch table at work, like “Ugh, Susan, holiday shopping is so depressing.”
But finally, she just said, “No, I mean, you have depression.”
“What do you mean I ‘have’ depression? Like, it’s not going to go away? It isn’t just some holiday blues?”
“No,” she said, “but there are coping mechanisms you can use.”
My brain rebelled.
Oh, good. That’s the life I want to lead. “Hey, how are you doing?”
“Oh, I’m COPING.’”
“What’s wrong?”
“Oh, I have depression. You know, bummed out disorder. I know my life is great! Roof over my head, great career, great family, great boobs... but, I’m just kind of bummed out. A lot. For no obvious reason!”
It feels pathetic and petty. Like a kid that dropped their ice cream cone.
It also feels shameful. So many people are going thru seriously shitty stuff, and you’re just being mopey.
Get it together.
One of my biggest fears, when going through a particularly bad bout of depression, was that the people I worked with would “find out” and that they would look at me differently, like think I was so sad all the time, pity me, you know?
I worried that they would see it as a weakness, and my professional opinions as clouded by this thing — playing devil’s advocate could just seem like I was just being negative. Or if I had a bad idea, they maybe might not want to be too hard on me, because I might fall into a tar pit of sadness.
I’ve been diagnosed, but there isn’t anything to actually SEE. It’s not like my doctor can cut into my head, pull out this little black piece of brain tissue and say,
“See, here. Here it is. This is it, this is your depression. This real, physical, thing, that we’re both looking at, this is what’s causing all of this... stuff.”
There were no brain scans, no biopsies. Just therapists with multiple choice quizzes, and psychiatrists, and off brand antidepressants. And obviously, I’m feeling these... feelings.
But now that I know, it almost makes it worse. Now, when I feel upset, I’m not sure why:
“Is it that invisible thing in my head, or am I unhappy in my relationship or my job? Are these feelings based in reality?”
And then when your internal dialog turns to a conversation of what is real, and what isn’t, you begin to feel even crazier.
That inability to trust your feelings affects your decision-making. Ordering at a restaurant is a source of anxiety. I’ll ask people around me to give me their suggestions, because if I order the wrong thing, then it’ll bum me out and remind me that I’m not in touch with myself.
All this over a veggie burger with a few friends.
I do push thru it most of the time, but there’s this repeating mantra in my head of “I don’t wanna, I don’t wanna, I don’t wanna.”
I don’t want to die — I don’t — but the idea of everything just stopping, for while — can sound really nice sometimes.
Those are real shitty thoughts. So then you wonder: Do I have depression, or am I just a self-absorbed asshole?
But they say not to make any major decisions in your life while you’re depressed.
So, if I think it’s one aspect of my life that’s upsetting me, triggering my depression, assuming I can actually make a decision, this thing is also going to cloud my judgment?
But meds can help....
They also serve as a daily reminder that I’m ‘bummed out.’
I’m on a daily dose of Wellbutrin, it’s described as a mood stabilizing antidepressant, and I think it’s working for me.
That, and doing a bunch of yoga, making sure I take care of myself, keeping negative people out of my life, and reminding myself that those feelings are just this thing I carry around. An ornery, little grumpy me taking up residence in my head.
I try to be an observer of those thoughts instead of a participant.
During another particularly depressing bout of depression last year, my psychiatrist suggested a pill to help me sleep, called Trazodone, as well as continue with the mood stabilizers I was on. Then, he suggested we add Effexor (the off brand name is Venlafaxine). We were hunting for my perfect “cocktail.”
He told me not to Google Effexor so I wouldn’t freak myself out. Maybe I should have seen that flag, sure — but I just wanted to feel better.
I really, really wanted to feel better.
Effexor is way more powerful than Wellbutrin. It’s an SNRI inhibitor — meaning it targets your serotonin and neurosomthing levels. Some people have side effects when easing into the medication. A little dizziness, maybe nausea, or a headache.
On the first day I experienced all of those symptoms, in a big way. I was too nauseous to eat and I couldn’t go to yoga because I was so dizzy. I emailed my doctor.
(These are the actual emails).
“Hey!
So I tried one of the Trazodone pills last night and I felt half awake the whole night, so I’ll try two next time and see what happens.
I took the first 37.5mg tablet of Venlafaxine this morning, along with the 150mg Bupropion (that’s the mood stabilizer I’m on, Wellbutrin) and a Sudafed because my sinuses are mad right now...
I got the weird stomach thing you mentioned — queasy. I also feel an undesirable twitchy energy throughout my body, and I’m pretty dizzy.
I was supposed to go test-drive a car later today but if I’m still feeling this way, I’ll probably need to reschedule.
I also had a cup of coffee this morning and a glass of wine last night... so I’ll try avoiding both and see if that’s any better.
Do you know if this will happen every time I take Venlafaxine until my body gets used to it in a few weeks?
Thanks!
Sarah”
I decided to go on the test drive anyway. It turned out to be one of those ones with interior cameras and all that. I didn’t want a car — my friend just invited me to this event and they were giving out $200 Amazon gift cards to test drivers so I said, “sure.”
At the time, I didn’t realize just how much the medication would affect me, and by the time my turn to test drive came up, I was feeling pretty...spazzy, to say the least.
They told me to just say whatever came to my mind during the test drive, and I did. I must have been particularly entertaining (I remember saying the words “road trip butt” at one point), because they recently contacted me to say that they might use my footage of my test drive in a commercial.
I really hope they do.
I get home and as soon as I do, I start feeling even worse. I check my email. My doctor had responded with this:
“Hi — you are experiencing stuff that will go away once your body gets used to it. Also, do avoid alcohol during the ‘starting new medication phase’ that will help, I agree. This should totally get better in 3-5 days. Maybe even sooner! So glad we started using the low low dosing — aren’t you? Oh, yes, 2 Trazodone is ok.”
I respond with,
“Cool thanks — I’m also experiencing jaw clenching, lots of yawning, and my eyes are dilated like a crazy person, and there is ringing in my ears. Blarg! Okay, will wait and see where I’m at on Thursday :) Thanks doc!”
His next message started with “OMG” which you know is a good sign. He went on,
“That sounds really bad. Please email me tomorrow. Ear ringing can be a sign you forgot the med, and if that didn’t happen and doesn’t go away, we need to pay attention! Let me know about this ear ringing tomorrow.”
It’s been (over) a year and my ears are still ringing.
We talked on the phone the next day and decided to take me off the Venlafaxine, but we couldn’t do it cold turkey, even though I had only been on it for one day, We had to ease me off it. I send him an email on the second day.
“Hey Doc!
So my ear-ringing situation is going strong. Now it’s this lovely two-tone three-tone sound, even pulsing on occasion. Super festive...and slowly driving me crazy. I took half the 37.5mg pill today, will do half tomorrow and the day after before stopping....
I don’t mean to kvetch, but do you have any ideas about when the ear ringing will stop?
Thanks!
Sarah”
He called me and suggested we throw some Prozac into the mix because the ringing could be caused by serotonin withdrawal as I was coming down from the Venlafaxine.
Again, I just wanted to feel better.
I didn’t want to say “Prozac” out loud when I got to the pharmacy. I handed the guy my card and I waited to see his eyes scan a long list of prescriptions and wonder which one I was coming to pick up. I just said,
“It’s whatever the last one is.”
“The 24th?” he asked.
“Yes.”
He looked at me, I was probably imagining the empathy, but he just nicely goes, “Give us about 10 minutes, ok?”
Maybe he realized that the prescription was called in on the 24th, (it was now the 26th) so it’s been two days since my doctor told me to take Prozac. I feel like that’s usually a “right now” medication...
It was almost New Years, so I typed, “ringing in the new year” in the subject line of the email to my doctor:
“Heya Doc,
The festive pun opportunities are too good to ignore!
So the pharmacy was closed yesterday so I picked up the Prozac today and took one. My ears are still ringin’ strong. Right now I’m just feeling “weird” overall, but hopefully the Prozac will knock out the ringing.
Do you want me to continue daily with the Prozac? The bottle says do that but I’m just double-checking.
Thanks!”
He had me continue with the Prozac for a few days, and then checked back in, and when I told him that yes, my ears were still ringing; he said that we should stop the Prozac. He was concerned that the serotonin meds were causing my ear ringing and that it wasn’t a withdrawal thing anymore so let's stop the Prozac.
Then he suggested I go see the ENT (which I did, and I ended up getting hearing aids... read more about that here).
So with this new perspective on how my body reacts to medications — I very happily went back to my previously prescribed dose of Wellbutrin, which is where I’m at these days. Plus some Ambien if I need it.
So why detail this whole experience?
Well on top of the fact that I think it will satisfy many people’s morbid curiosity, I’m hoping that maybe people will relate and feel less embarrassed about the d word.
I feel like maybe I need to “come out” as a person with depression. So, here I am. I’m here, I’m depressed, get used to it. I have the pathetic, bummed out disorder. The “Oh no, my cake is gone” thing, the “my glass is half empty” brain.
Some days, I don’t think about it, I feel fine — fantastic even! Then some days, it’s so bad, that if I can find a way, I just stay inside and interact with no one.
I’m a generally positive person. More than once when I’ve told someone I have depression their response is, “Really? You don’t seem like the type.”
That hits a nerve, even though I know it shouldn’t. They’re just saying “but you seem so happy,” which is nice, but, I’m not sure it matters if I’m the type or not. I don’t think depression discriminates. Depression shows itself in hugely different ways in different people. Some people get all Eeyore about it, and it’s pretty obvious that something is up. Others don’t want to burden the people they care about with something that can’t be solved with situational reasoning or a hug.
Because the people in your life might not get it, they might take it personally, and then you’ll have to deal with the guilt of making someone you care about feel bad.
That’s part of why I got so good at hiding it. I didn’t tell anyone when I spent the weekend not showering and over eating. I didn’t tell anyone about the terrible thoughts that went thru my head about how I wanted so badly to get sick, really sick — because then I wouldn’t have to explain how sick I was feeling, it’d be right there for everyone to see.
Don’t worry, I punished myself plenty for how much of an ungrateful jerk that made me sound like...
I’m pretty good at keep conversation going, keeping people laughing. But that’s fun for me, too, though. I also just like comedy like a normal person — that doesn’t mean that every time I’m making you laugh it’s because I’m feeling shitty. But it does mean that I’ve gotten pretty good at easing tense conversations by saying just the right thing — or dodging emotional questions that would get too close to that monster in my head...
So, how do you kill a monster you can’t see?
You don’t, because that monster is a part of you.
You say fuck your pride and you find your coping mechanisms.
I don’t have the answers, and dear god I am far from perfect and maybe I’ll never be totally healed — but I’m learning.
I take medication because it helps.
I do yoga because it helps.
I talk about it because it helps.
I write about it because it helps.
And these days, I’m pretty happy most of the time.
So, if your friends think it’s lame how much you get into yoga, then your friends suck. If someone thinks the fact that you see a therapist means you’re crazy, or weak or broken — then they’re judgmental jerks who lack empathy.
You try your hardest to accept it, and become an observer of your depression, acknowledge that it’s there and that it might get better, but it might get worse sometimes — it isn’t you, but it is a part of you. And it’s also a part of me, and part of *14.8 million people in the USA alone.
And good thing, because misery loves company.
So let’s skip off into the doom-full sunset together, my fellow depression having friends.
Or we can walk slowly, and not speak to each other. Maybe even pause to sit down halfway and revel in the awfulness of it all — that’s fine too.
We just need to keep walking. One foot, in front of the other.
*Major Depressive Disorder affects approximately 14.8 million American adults, or about 6.7 percent of the U.S. population age 18 and older in a given year.
Up to 15.7 million adults aged 18 or older in the United States in 2014 had at least one major depressive episode in the past year, and an estimated 10.2 million had at least one major depressive episode in the past year with severe impairment (2 weeks or more).
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If you — or someone you know — need help, please call 1-800-273-8255 for the National Suicide Prevention Lifeline. If you are outside of the U.S., please visit the International Association for Suicide Prevention for a database of international resources.
