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 jessicaletaw