Herding Cats: Managing Depression

I was ten years old the first time I remember thinking that I should just kill myself.  I had been having a rough day, and it was an unbidden response to the frustration that I was feeling.  Immediately on the heels of that thought, I knew that I had depression and that I was going to be in for a long, long haul of treatment.

That might be an out-of-the-ordinary thing for a ten-year-old to think she knows, but I was fortunate; I grew up in a home with out-of-the-ordinary fluency in mental health matters, the best possible circumstance for someone at genetic risk for anxiety and major depression on both sides of her family.  I knew what suicidal ideations were; I knew the difference between a clinical diagnosis of depression and regular sadness; I knew that going to a psychiatrist and a therapist was as much a part of life as going to the dentist.  In our house, we discussed mental health diagnoses and treatments as casually as most people talk about broken bones and diabetes.  In fact, diabetes was my mother’s favorite metaphor: if you have diabetes you can’t live without treatment, and if you have depression, she always said, your life is similarly at risk.

My ten-year-old self was right.  I reported my distress to my mother, who decided to bring me to a psychologist, and rather than go on any medications, I went to therapy for a time.  It was productive and helpful, and I had positive relationships with every counselor I had in my tens and teens.  I managed my depression well through talk therapy until I was 17, at which point both I and my doctor decided that an antidepressant would be the best next step for me.  In retrospect, I think the combination of puberty and a particularly stressful adolescence exacerbated the biochemical landscape I had until then, managed with cognitive behavioral therapy.  Under a psychiatrist’s care I got started with Zoloft; after a bumpy start (and one or two med changes), we landed on exactly the right medicine and dosage that worked for me.  The difference was so extreme it was almost unbelievable.  I couldn’t believe that my emotions could be so smooth and so positive or at least neutral; that I could focus so well; and most of all, that so many people could feel like this ALL THE TIME.  It was a moment of profound enlightenment in my life that was at once devastating and transformative.

Although the antidepressants worked wonders for my functionality and peace of mind, I kept tapering myself off, always for the same reason – it was annoying to take pills every day – and with the same inevitable downward spiral as a result.  I went around and around this pointless psychological cul-de-sac for a few years, never understanding that much less of my depression was under my control than I thought and having to make the forced march back to the doctor’s office drenched in shame and failure.  Getting back onto medication was always a tortured mix of resignation, psychic relief and self-blame, and I hated associating such horrible feelings with the substance that kept me alive.

There was no single decision to go med-free for good; only a slow acknowledgement over several years that if I was going to continue to deny myself chemical remediation for a biochemical imbalance, then I was going to need to be much more articulate about my condition much more proactive about treating it.

I have to have a super-clear definition of my baseline, so I know almost the minute I start sliding down into a depression cycle.  I have to have a constant, intimate understanding of what I’m feeling and thinking, what those feelings and thoughts mean, and how to identify subtle trends in both in order to catch a depression cycle early.  I have to know what my triggers are.  I have to know when I am more fragile or sensitive than usual and how to manage myself appropriately.  I have to know when I am starting to get out of control.  Most importantly, I have to know when to ask for help.  This is the hardest one because if I miss the signs, I back myself to a dangerous emotional corner: my depression tells me I can’t ask for help, I can do this, I got this, it’s weakness to ask, I’m not as sick as I think I am – and before I know it I’ve isolated myself the most when I can care for myself the least.  This continues to be my hardest battle.

I have a big bag of tricks that are anything but magic, and I pull out every single one to stay on top of things.  I have to get enough sleep.  I have to be eating properly.  (I have to be eating at all – one of my depression’s most cunning tricks is to make me forget to eat.)  I have to be getting some kind of regular exercise, even if it’s just walking around the block once a day.  I have to lean on my support network – I have to make sure I’m reaching out to my family and friends, and the less I feel like I want to, the more I know that I need to.

The tool that I’ve added to my arsenal most recently is positive language.  If I’m not paying attention to how I speak and think, my language becomes a dark mirror to my inner thoughts and feelings: depression makes me feel bad, so I think and speak from anger and hopelessness, which feeds the original bad feelings.  I have found that I am more likely to dwell on topics that make me feel hopeless and angry when depression is attempting to hold sway, and also that if I cultivate positive conversations and seek out positive stories when it feels least desirable to do so, I can lift myself out of the low swing of depression significantly faster.

As of this date, I have been entirely off of depression medication for just over ten years.  It has been a slow, infinitely surprising journey towards self-aquaintance, acceptance, and peace.  Iyanla Vanzant says, “We are blessed with a wonderful gift called intuition. Unfortunately it won’t work unless we pay attention to it!”  I am much more intimately acquainted with myself than I ever thought I could be, which I’ve come to understand is my version of intuition, and this self-awareness has played a positive and powerful role in every area of my life.

Whenever I talk with people about mental health, depression, and medication, I am forthcoming about my condition and my chosen treatment, but I never recommend that people follow my path.  Non-situational depression is a biochemical issue for which science has identified highly effective treatments that are widely available.  If I am talking to someone who thinks he may be dealing with depression, I always encourage him to talk to his doctor immediately.  My story is not a recommendation I am making.  My story is a declaration that I have a condition over which I have limited control, and a description of how I choose to deal with it.  Sometimes I am proud of how I manage it.  Sometimes it feels like all the nonlinear work of herding cats; I chase my thoughts and feelings all over the place, hoping to send them in a particular direction and never totally sure whether I’m going to be successful.  Mostly, I am neither proud nor ashamed of any of this, but simply accepting of the condition and doing the best I can to address its consequences matter-of-factly.

And, ultimately, that’s what I hope for all of us in my situation: that we can do battle for our own mental health in whatever manner we feel is best for us.  I wish for us the self-acceptance to know what help we need.  I wish for us the courage to fight for it.  And I wish for us the deep, limitless, unimaginable peace that will be the reward of our battles.  –It’s an intermittent peace, because mental health is a battle we do for life, and sometimes rest feels unobtainable.  But that peace is always on the map somewhere: a clearing of understanding and unremitting hope just waiting for us to make our paths towards it.

Herd on, brothers and sisters.

— Posted on 15 November 2015 at 3:10pm by

Comments (2)

  1. there is no try Reply

    19 November 2015 at 10:13am

    I so appreciate you sharing this part of yourself. It took guts and smarts, which you obviously have in spades. You and I are even more alike than I initially thought. How about that?

    I think my suicidal ideation started in my early teens, and was a subject I didn’t discuss with anyone in a serious way until just recently. My upbringing was very strict, religious, and centered around the needs and dictates of my parents. They didn’t really understand the concept of seeing a therapist. As best as I can tell, thought therapy was reserved for “crazy people”. And we were not crazy people. No sirree. The nearest I ever got to a therapy session in my youth was shortly after I was involved in a car accident that took the life of my aunt. I was reduced to something like a robot in the aftermath, and listless almost to the point of immobility. My parents realized they had to do something and asked if I wanted to talk to our pastor. I didn’t, but I asked if I could talk to teacher instead (which amounted to the same thing, really, as I went to the private school associated with our church). I could barely process what I was feeling, and my teacher (bless him for trying) couldn’t really help other than to assure me that the accident hadn’t been my fault. I came away from that single session with the understanding that this was about as much help as I was going to get with this and that I should probably just buck up and move on. Which I did, more or less. Any other troubles I had were minimized, redirected, turned back on me, or otherwise dismissed as unimportant (as is the way of things when at least one of your parents is a narcissist). I learned to either keep stuff inside, channel it through creative work, or emulate the minimizations and redirects that had served my parents so well. And so it continued for many years.

    Fast forward to recent times, and all that scaffolding is coming unglued. I’ve spent the past few years with a very calm and reasonable voice in the back of my headspace suggesting that maybe it would be best for everyone if I just killed myself. “No really,” it assures me, “You’re only hurting everyone around you. You should probably go now.” It came to a head about a year ago, when I found myself right at the cusp of running a Google search on wait times for buying a gun. I knew then that I couldn’t minimize this. There was no redirecting this, even for a short time. I talked honestly with my spouse, and found a therapist. Sessions have been spotty, and I’ve had to change therapists as my insurance situation evolved. I’ll be back with my original therapist today, thank the gods, for my first session in a couple months.

    I’m so glad you got the help you needed when you did, and have been able to write about it here so eloquently. Though you stated that this isn’t your prescription, I’ve found a lot here that is helpful in my ongoing struggle, and plenty to light the way as I move through these tunnels. You are an inspiration for me in many ways, and now I’ve been able to add a few more to that list. So, thanks!

    1. jessicaletaw Reply

      29 January 2016 at 5:34pm

      Somehow I did not see your comment on this article until today. My deep apologies for such a tardy response.

      I am sad to know that you were in such a hard place and I was not able to help you more, even just knowing and being empathetic. On the other hand, I am incredibly proud of you for managing yourself and taking care of your family at a very challenging time for you; and even prouder that you could learn to ask for help in the middle of that.

      I am so appreciative of you sharing your story. Talking about the dark parts of ourselves is for some reason really hard, especially with people that know us IRL. I am glad you have the spouse you do and the family you do, and hope that with them and your therapist, you have the support network you need and want.

      I am rooting you on!

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