Tag Archives: psychiatrist

The Lie of ‘Better’

11 Dec

When you have a mental illness like depression, the first and most frequent condolence people will tell you is that “it gets better.” When you tell them that you are sad, sad not just one day, but sad for nearly every day the past month, they tell you it’ll get better. When you tell them that you have been down and clouded and crying for the past half a year, they tell you to just hang in there, thing a or thing b will change, feeling x or feeling y will be spirited away by a sparkling unicorn or the glittering hand of some god or other, that something, magically, will happen and it – you – will get better.

When you begin therapy, they tell you it gets better. When you talk about short term and suicide, they tell you about long term and how it’ll be better. When you begin seeing a psychiatrist and finally trying meds, they tell you it will finally, finally get better.

When years later you’re on your fifth therapist and third psychiatrist and you’ve run the gamut of SSRI and SNRI and second-gen psych meds and third-gen atypicals and still you find yourself crying on your couch every weekend, they will all, again, tell you that it will get better.

When you graduate and have job interviews and jobs acceptances and 401k’s and lovers and partners and spouses and kids and apartments and houses and nursing homes, and you say that you are still itching for that off button, they tell you keep hold of your life-allotted joystick to maneuver yourself through life-allotted hoops because this life-allotted endless game, it will get better.

But what they don’t understand, where the syntax error lies, is that while sure, support and friends and love and loving and comfort and direction, they can make it all externally better, making it better… that’s not making it okay.

I don’t want it all to be better.

I want it to be okay.

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Depression Is

1 Oct

National Suicide Prevention Hotline: 1-800-273-8255

or visit www.suicidepreventionlifeline.org

Today, October 1st, is the start of Depression Awareness Month. Well, for those of the social media sphere who’ve had no contact with depression, it is. The rest of us, the ones with depression, and the ones next to those who do, we’re already pretty damn aware.

You see, depression, when it’s there, is a hard thing not to be aware of. The harder part, really, is not misconstruing what’s being seen. Because depression, you see, has a whole lot of flavors. And no, none of them are pumpkin spice.

I’ve been fighting depression since… well, it’s hard to pinpoint it, really. Because I came from an environment where people weren’t aware of mental health, let alone depression. I didn’t know anything could be wrong, let alone that it was. I just thought that my constant misgiving, the vague and perpetual sensation that something was wrong for years on end, my bent to remember the less-than-stellar in my life than the few moments of real sparkle – well, I just thought that was normal. I was aware of my sensations; I just wasn’t aware of their diagnosis.

Until my senior year of high school, that is. After years of walking the line between “kinda sad but functional” and “ragingly falling into a dark hole inside,” I finally teetered over the edge. Call it hormones. Call it stress. Call it whatever.

I’m calling it depression.

You see, while I was aware of my accelerating and nauseating hurtle into clinical depression, the others around me didn’t see all those sensations inside, or didn’t want to see them even when I tried to throw them in their face. I used isolation. I used words. I used self-harm and the knife I hid under my bed. I used suicide. The increasingly screaming kettle of pressuring self-hate inside me was something too loud for me not to be aware of, as day after day I just felt wrong, and, left to my own devices to deal with it, eventually came to the conclusion that I must have been the thing that was wrong. Guilt guilt guilt guilt. Never mind those other circumstances – a broken home, an ailing sister, a fracturing best friend, flat-out broken brain chemistry – no no, clearly it was all my fault. I just wasn’t trying hard enough. If I were just better, trying harder, I would have been able to fix it all. And then I would have been okay. So clearly, I was the problem. Hey, if I were the problem, then the solution seemed pretty damn apparent, right? In this equation, if X is wrong and unfixable, just remove X…

I wasn’t aware that wasn’t actually the equation.

Let’s fast-forward about six years. So you know, about nowish. I’ve still got depression. But I’m older, wiser, yada yada.

Yeah, it doesn’t suck any less.

If anything, dealing with depression, even though it’s not the blinding, numbing, mind-haze of my high school years, has become harder. Why?

Well, I am more aware.

Let’s fast-track through the past six years. I found words for what I was experiencing. Slowly learned that it’s not my fault. Went to therapy, through treatment, started meds. I’ve seen psychiatrists, psychologists, MFW’s, LCSW’s, PsyD’s, MD’s, RD’s, and fuck knows however many lettered people. After four years of concentrated obliteration, I’ve finally essentially quashed my comorbidity, the ugly Eating Disorder.

But.

There is always a “but,” isn’t there?

I’m not sure I consider myself “better.”

I have learned a great deal, yes. Become more aware of what’s going on with me. I’ve learned how to recognize patterns, spot symptoms, reroute maladaptive coping mechanisms, derail negative thought patterns, notice when my current round of meds are starting to fail again.

Yes, in the mindwork of my depression, self-awareness has helped a shit ton. At least I know what’s going on now.

Yeah, knowing what’s going on doesn’t mean I feel any better.

It’s like… so, imagine if you were shot in the leg with a bullet. Painful, right? You’re bleeding all over the place, leg is throbbing, bullet’s probably still lodged somewhere around your tibia and fibula. If only you could pull the bullet out and adequately wrap up the wound, over time, it would heal, and you would feel better.

Yeah, bullet’s still in your leg and your bleeding out, sweetheart. This mental analysis, even knowing how physiologically your leg needs to heal, that all doesn’t actually make you feel any better when you’ve still just been FUCKING SHOT IN THE LEG.

My depression, now, is kind of like I’m walking around having just been shot in the leg all the time. Yeah, I know what happened to cause me to be in pain. I know what’s going on. I know that hey, maybe one week my psychiatrist and I will finally find a way to pull that goddamn bullet out of my leg and the writhing muscles and nerves and blood vessels will finally stop having to make due with a shitty, bloody situation and heal up once and for all and start working properly again.

Yeah, all that “maybe” kind of hope doesn’t mean I’m not walking around with a fucking bite of a limp.

“But you’re working on figuring out how to get the bullet out!” People will say, as if this is supposed to mean it’s not still painful while it’s in there.

“Aw, come on, you were shot like five weeks ago, can’t you just let it go now?” NO, THE BULLET’S STILL FUCKING THERE AND I’M BLEEDING OUT AND IT’S FUCKING PAINFUL, THANK YOU.

And then, should I manage to find a position to stand where the weight’s not on my leg, and it doesn’t hurt so much, and someone makes a funny joke and I manage to pull up a half-sort of smile – “Oh look! A smile! That bullet in your leg can’t hurt that badly then, can it?”

Excuse me, clinic doctor that I visit a couple weeks ago for a sinus infection, while I punch you in the face.

So, I walk around, bullet-in-leg, never knowing if it’ll ever come out, leaving the situation to fester and fall into feeling hopelessness. I wonder if maybe, instead of walking around in life with this limp that I can remember what it was like to run and skip and dance without, instead of always being reminded that if I’m not cautious my heel will slip and my leg will jolt with pain, which it wouldn’t have had I still had that life unencumbered with a bullet in my calf – well, I start wonder if maybe, it would be better if I just cut the leg off. If I can’t pull the bullet out and let the leg heal, then I just need to get rid of the leg altogether.

Problem is, the issue’s not in my leg. It’s in my brain.

Suicidality is no longer an impassioned, pained sort of self-destructive urge. The thought becomes not “I am a problem” but just “I am not working out.” It’s a weary sort of defeat. The wish is not to be dead, but to no longer live in pain. Death, this time, is just a side-effect.

That is the kind of awareness depression has for me.

I am still here, writing this blog, obviously. I have friends that pull me back, friends whose selfish wish to keep me here for themselves is something I am grateful I can keep my life tethered to. They, thankfully, are aware of what it’s like for me to carry that bullet in my leg, and they help carry me, so that the bullet doesn’t finally make its way to my brain.

They see me, and I am grateful for it.

What do you need to be aware of, around you? In you?

As despondent as I may get about my own prospects, I wish hope eternal for everyone else with those goddamn depression bullets. It’s not fair, guys. It’s just not. And I’m sorry about that. I hope that one day, we have better, more effective options than chasing after “maybe’s” or translocating where that bullet is.

It’s a fight, guys. I know we’re all way too painfully aware of that. But hey, if we’re still here and trying, at least we’ve given the world something to notice, too.

National Suicide Prevention Hotline: 1-800-273-8255

or visit www.suicidepreventionlifeline.org

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Trying To Manage Your Depression: Caution, May Cause Side Effects

23 Mar

Guys, depression is hard. Really really really hard. Obviously. That’s why it’s called depression. But you know what? I’ve been through five years of therapy, gone through intensive treatment three times, come to understand the underlying mindsets I needed to challenge, modified my thinking patterns, built up a support network, tried to prioritize what makes me happy, worked with psychiatrist after psychiatrist to find a medication regimen that works well for me and stuck to each of them in turn, held myself together long enough to graduate from college and actively work every day to keep myself from falling apart…

And depression is still really, really fucking hard.

I’m not even talking about the symptoms of depression, either. In terms of mood, I’m doing *relatively* well. I’m not entirely crippled by sadness. I don’t hate myself. I can understand ways in which the shittiness I do still occasionally feel might eventually get better… That’s all cool. But… just trying to be a normal, healthy, functioning person. That’s really fucking hard.

My impression is that being a normal, healthy, functioning person is already really fucking hard even when you don’t have an underlying mental illness trying to drag you back into a mental hell. But then, when you do have an underlying mental illness, all the extra things you have to do just make it that much harder. For example, I was on an antidepressant called Effexor for a little over a year. Before that, my list o’ pills that I’ve taken and since developed tolerance to (it’s like when an addict develops tolerance to a substance and needs more and more of it to feel the same effects, except now we’re talking actual legit healthy-making-medication that has a dosage you can’t exceed) has included Celexa, Zoloft, Prozac, and Abilify. Celexa was beautiful but wore off over the course of a year and a half to the point that it was basically like I wasn’t even on an antidepressant, Zoloft helped decrease my anxiety but obviously wasn’t working all that well, since I kinda attempted suicide on it, a short-term psychiatrist started me on Prozac improperly and I hated it and its somnolence side effect with a fiery passion (I hear it works well for some people, though), and Abilify I was taking as a sort of anti-anxiety med and antidepressant “booster” and had to stop cold when it started costing $700 a month because of insurance roll over. Yeah. The restless leg syndrome I had for months afterwards as a withdrawal symptom was lovely.

Ahem. So. Now that brings us to Effexor. Mind you, these are all drugs I’ve been taking to try to just be a normal fucking person with normal fucking problems instead of a depressed person with suicidal problems. I’m not searching for Nirvana here.

Now, unbeknownst to me when I started it, apparently Effexor has *super duper fun* withdrawal effects! And the shortest half life of like any antidepressant ever! Which means if you go 5 hours without taking it – heavens forbid an entire day – you’re fucked. We’re talking light-headedness, nausea, dizziness, disorientation, ALL THE DEPRESSION, brain shocks (it’s like your brain is being electrocuted and the whole world jolts) and oh yeah, SEIZURES. Seriously, it’s actually the worst. Like, ask the internet. Ask a fucking psychiatrist. Effexor withdrawal is universally recognized in the mental health world as one of the worst things to ever go through.

Good thing there were manufacturer recalls! And so now the medication is forever on backorder! Which means that even when I bring my prescription from the psych in a week ahead of time, it’s still not refilled by the time I’ve run out. Every. fucking. month.

Yeah. The first week I had to go without Effexor because of a refill issue and was subsequently bedridden with nausea and unable to even walk has been firmly and terrifyingly imprinted in my mind. And so when I’d take precautions and order a refill early (but not too early, because otherwise insurance would be like, uh, we just filled this, no, you can’t have more; that’s always fun timing to figure out) and I’d still be faced with a day or so of having to go without it, I eventually got a backup stock because I was sick of having a breakdown in front of the Target pharmacy every month. Like, normal people don’t have to go through hell like this! Yeah, sure, sometimes they have to go through hell, but it’s normal hell. It’s not the hell of having tried to goddamn take care of yourself and keep up on your meds, only to have other factors force you into bedridden brain malfunction.

Over time, my body did its thing and built up tolerance to Effexor, too, and once I realized I was spending the end of every day crying in a heap on my dorm room floor, I decided that hey, maaaaybe I should talk to my psychiatrist about finding another med that’d work better. Plus then, I could switch to something else and not worry about Effexor withdrawal hell every month.

Cue Cymbalta. Cymbalta’s an SNRI, just like Effexor, so it works on the same neural receptors and everything, which means that as long as you get the cross titration right, you don’t go through the Effexor withdrawal effects while you’re switching. And Cymbalta supposedly doesn’t have those withdrawal effects, so, that was a plus.

Yippee! Freedom! Now I can be a normal healthy person! Right?

Wrong.

So, I’m still in the process of switching from Effexor to Cymbalta. I went down in stages from 225 mgs of Effexor (yup, that’s a big fun dose, isn’t it?) to 75 mgs, and then stepped up through 30 mgs to 60 mgs of Cymbalta.

Aaaand still started going through Effexor withdrawal.

Cue 90 mgs of Cymbalta. Actually, cue 60 mg prescription + 30 mg prescription, because they don’t fucking make a 90 mg capsule of the generic, which means I have to pay twice as much for one month’s worth of pills. Wooo. So now I have to double my expenses every month just to keep myself healthy. Fun.

Except I’m not even fucking healthy. I’m trying to be, but I’m not. Turns out, insomnia is a side effect of Cymbalta. I’m already prone to insomnia, which means that Cymbalta hits me hard in that area. I haven’t slept for the past three days. Okay, that’s not entirely true. I got approximately six hours of nightmare-filled, panic-sweat-inducing “sleep” over the past 72 hours. So. Not exactly healthy. Here I am, trying to just get myself to a normal level of sanity, but then that ends up fucking with my sleep. I’M JUST TRYING TO BE HEALTHY. But it’s like whatever I do to help in one area ends up hurting in another area. And it’s really frustrating. Like, I just want to be able to sleep like a normal person and wake up not feeling like absolute shit and get through my day without feeling like I’m being bludgeoned every second. Is that a reasonable request? I think that’s a reasonable request…

Sigh. So here I am, typing the blog post at 7 am my time because I’ve been up all night, tossing and turning (which subsequently also leads to crampy muscles and unhappy joints) – but hey, I fixed my apartment’s wifi… And I’m stuck on this combo of 75 mgs of Effexor and 90 mgs of Cymbalta (which is higher than a normal dose already, apparently…) for at least another week, because I’m going out of the country and would at least like to be relatively stable during that, even it means I can’t really sleep… and then I’ve moved, so I’ve got to find a new psychiatrist, and schedule and appointment with them, and then finish going off of goddamn Effexor, which’ll probably mean going even higher on my Cymbalta dosage and heavens knows what that’s going to do to me and my unsleeping… and then I’ll probably have to “stabilize” on Cymbalta and then switch to yet another med in the never ending chase after my sanity…

Guys, I just wanted to be healthy. To manage my depression. I didn’t think trying to be normal was supposed to be this hard. There are so many damn side effects.

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