Tag Archives: depression

Psychopharmacology

Medication against mental illness has always been an iffy topic full of taboo. Many believe we are being over-medicated, that mental illness should be treated mentally through therapy and not physically through medication, and so on and so forth. I tend to fall more towards the “no medication” than the “yes medication” end of the discussion. But I also think it is unwise to refuse medication entirely. I realize that my feelings on the matter are just feelings, not actual facts, and ultimately irrational.

I’ve never been a fan of antidepressants and am even less inclined to like antipsychotics. A big part of it is an irrational fear that the drugs will turn me into a completely different person somehow. Like the drugs will make me think and feel different than I normally do. But you could also say that my disorder makes me think and feel differently than I normally would. When you’re sick for so long, it can be difficult to discern where you end and the illness or disorder begins. Am I me or am I just the drugs?

Another big part of my reluctance to take any medication is, I’m embarrassed to take them. Especially when I visit my dad on the weekends. I don’t want him to see me take any pills. It’s a stupid, stupid reason not to take medication, I know. Even so, when I was on antidepressants, I often found myself “forgetting” to bring the pills or forgetting to take them when I did bring them. When I finally took them, I’d always covertly swallow them while no one was looking.

Because of my own stance on medication and the fact my symptoms have always been relatively mild as far as I can tell, my experience with medication is very limited. I’ve been on mild antidepressants twice in my life. Both times I abruptly stopped taking the medication. I’ve never been on antipsychotics. Why would I want antipsychotics when I’m not psychotic? Although, perhaps the classification is a little misleading. Perhaps it’s more helpful to think of them as thought-regulating medication? On second thought, that might actually be worse… It’s silly to get hung up on names and specification, I know but what can you do? My brain’s just full of excuses.

I’ve heard some medication can help with excessive thoughts. I considered something like that, but my thoughts feel more slow and rusty than excessive and I was afraid the medication would somehow slow my thinking to a crawl or even stop completely. I should probably have talked more about this with my psychologist at OPUS. Probably he would have been able to clarify what sort of medication does what and what might be a better fit for me. But I didn’t.

My biggest hang-up against psychopharmacology is perhaps the side effects. Sometimes, the side effects of some medication can be quite severe and it can feel a bit like cutting off a leg to save the arm. It’s a different kind of debility but still one way or the other, you’re still not whole. There are other medications you can take to treat some of the worse side effects, which is good. But at the end of the day, it’s just more pills to take and that can get a little exhausting just to think about.

The first time I took antidepressants, I was 18 and living at home in Nuuk, Greenland. I was diagnosed with mild depression and a visiting psychiatrist (meaning he worked there for a short time before returning to Denmark) prescribed me with Citalopram, I believe. It worked great for a couple of months. Then it stopped working. So I stopped taking them. I didn’t like my psychologist at the time either and when she failed to make a new appointment one session, I simply stopped coming. Instead of ineffective medication and useless psychologists, I decided to treat my own depression by making a point of exaggerating the enjoyment of the few things I still enjoyed. It worked well enough for a while. Focusing on the good things in life is helpful short-term, but if you don’t treat whatever’s making you miserable, eventually all those bottled up emotions are going to come crashing down. It may take years, but it’ll happen sooner or later.

The second time, I started taking basically the same drug, but a different brand because I felt mildly depressed while I was at OPUS and I had a lot of trouble sleeping. This time, I felt no difference at all from the drug after taking it for about a month. Rather, I suffered the unfortunate but very common side effect of being unable to orgasm or taking ages and ages to get there, without the actual intended benefit of the drug. And so, when I forgot to pick up my new prescription just before Christmas the year before last, I simply stopped taking the pills when I ran out. This turned out to be a very reckless move. As it turns out, going cold turkey on antidepressants can have some pretty uncomfortable side effects. Like dizzy spells. At first I thought it was simply lack of sleep that caused the dizziness, but after talking to my psychologist, I realized it was probably the drug. Thankfully, I didn’t suffer any worse side effects and the dizzy spells disappeared on their own.

I’ve heard a few other horror stories about medication, like the schizophrenic patient who spent her time drugged into a stupor and her medication messed with her hormones making her obese and grow unsightly facial hair that she hated so much she would escape into another world where she wasn’t sick and had a successful life with a career and family. Sometimes, I dream about being able to just park my body in some institution and disappear into my own head and live in my own dream world where everything is exactly how I want it. I feel like I’d be happier that way. But I’m much too proud to allow myself to live out my days like some institutionalized drugged-out potato.

So, do I believe psychopharmacology’s all bad and should be avoided at all costs? No. I do believe drugs can be helpful, even necessary. For all the horror stories, there are many more happy stories where drugs bring relief from internal torment and allow for a relatively normal life. I know someone who takes medication for her anxiety and it relieved her of the terrible stomach pains she suffered from due to the anxiety. I know of a family friend who takes antidepressants because he simply can’t function without them. I don’t think medication is the ultimate solution, but it can bring relief where it’s needed. Recognizing that need is an important step towards recovery.

If your own brain torments you so badly you can’t be in your own skin, if your anxiety is so bad it causes physical pain and leaves you trapped in your own head, if you feel so awful death seems the only escape? Then perhaps trading off happy-fun times with your favorite sex toy doesn’t feel like such a bad deal. And perhaps it won’t have to be for the rest of your life, but just until you’re in a better place overall. The important thing is, you get to a point where you can live well.

Over-inflated Regret

I don’t know if anyone else has this experience, but I am frequently haunted by my own perceived mistakes. Not only actual, real mistakes, but stupid mistakes too; like mistaking a duck for another bird or a minor misunderstanding in an otherwise perfectly innocent conversation. Even forgetting a timed quest in a game cab just about ruin my day. It’s supremely annoying to say the least. It can also be downright crippling. It can be hard to initiate a conversation or go out and do something – anything, when there’s a good chance I’ll sorely regret it and end my day buried under my comforter wishing I never left.

 

I haven’t found any good sure-fire way to work around this other than try to practice patience, forgiveness and live in the here and now as much as possible. I know logically that my reaction is disproportionate to what’s actually happening but I can’t control my feelings. Eventually, I forget most things, but there’s always some that linger and pile up over time. On my worst days, they become suffocating. Each and every memory becoming a mental hammer to beat myself down with. It leaves me feeling like the next time I go out and make a “mistake” it’ll be like the straw that breaks the camel’s back so to speak. It also makes it very hard to feel motivated to venture out of my comfort zone at all.

 

It’s about as difficult to explain to others as it is to avoid. Failure to make myself understood absolutely will and often does trigger the mental wrecking ball of regret. Talking about it even now, I feel like I’m exaggerating and that it’s just an excuse to stay home, do nothing and feel sorry for myself. Phrases like “suck it up, Buttercup” and “put on your big girl pants” come to mind. And yet, attempts to arbitrarily push myself to ignore my emotional state only pushes me straight into depression. On the other hand, I can’t very well spend my life cocooned in my own bedroom. I’d not only bore myself to death, but also guilt myself into depression.

 

Being stuck in a position where doing anything and doing nothing both leads to unhappiness is really uncomfortable. I end up choosing one or the other more or less at random depending on how optimistic and impulsive I’m feeling in any given moment and just hope for the best.

 

I’ve a sense that doing something is generally better than doing nothing, but I don’t really feel it to be true enough to always keep me motivated. In the end, I fear I end up doing nothing more often than doing something and so my fear of doing anything is too rarely challenged. The only way I know of conquering fear is to challenge it. I just wish it didn’t feel so awful every single time.

 

Sickness – reason or excuse?

One thing I tend to struggle with a lot is distinguishing between genuine need for rest and laziness. I’m constantly second-guessing myself whenever I decide to call in sick from work for instance, because there’s nothing physically wrong with me. I know I could technically go to work and get it done, although not as well and I’d be exhausted and utterly miserable. On top of that, I’d usually be looking forward to an even more miserable time the following day.

Eventually, if I kept pushing myself, I’d reach a point where I can’t make myself do anything at all. That’s surely not a healthy work ethic. I certainly don’t think it’s very constructive to push myself to the breaking point. But when is it okay to stop up and take a break? And how long should that break last? At which point does need for restitution become plain laziness?

I’ve been on a very long sick leave from job-hunting and even though I don’t at all feel ready to go back to that particularly unpleasant rat-race, I felt more or less forced to. It was either that, or stay in an internship I felt entirely unsuited for and found increasingly more stressful and confining.

I didn’t want to drag myself out of bed and either spent most of the day twiddling my thumbs, waiting for customers to service, a task I’ve always despised, even if it’s really just scanning in wares and accepting payment. Most of the time. That is when there was a bar to scan and it showed the right price. Then there was the greens. At the store I worked, we sold surplus goods, so the actual wares tended to wary and the greens varied a lot in type and quality. Often times, the prices could even change throughout the day, depending on quality, quantity and how well they sold. It was confusing and I hate that kind of uncertainty.

It’s the weirdest things that can wear you down. Simply standing around all day wears on the feet and back like you wouldn’t believe. Doing nothing at all tires and stresses and simply not knowing what to expect from a workday can, when you’re not the sort of person thrilled by surprises, really, really drain your energy levels.

Then, when you’re spending all your energy out at work, you come home to dinner that needs cooking, dishes, cleaning, laundry and all the wonderful elements of being a responsible adult. I consider myself very lucky I don’t have any children to look after on top of all that. Sometimes I wonder how anyone can manage all those things. My parents have both done a pretty decent job of it for decades. In my dad’s case all alone for most of my youngest little brother’s life.

For them, simply pulling yourself together and get the job done seems to do the trick. Most of the time anyways. But for myself, I find that approach absolutely miserable.

If I can make work and chores fun on the other hand, it’s so much easier to get done. And taking lots of breaks tends to make things much easier and more fun. Trouble is, breaks can take hours, even days. And then the work piles up to epic proportions, to the point where I’m exhausted just looking at it. To the point where I feel I need to take a break before I’ve even begun.

It’s so much easier, to sit down and disappear into my own, little world instead of with all the things I should, but really just don’t feel like.

It’s understandable that when you’re sick, you can’t do as much as when you’re healthy. But in my experience it’s maybe not so much a matter of whether you’re sick or not, but how sick. For longtime sickness, you tend to have good days and bad days. It’s not like the flu or a cold, where you’re sick and then get over it. Sometimes, it’s hard to tell if it’s a good day before I get out of bed. Most mornings, I’m tired but otherwise feel okay. Most days the mood will generally hold throughout the day, other days, I can suffer a major panic attack right after breakfast or on the way out the door.

In reality, the panic attacks aren’t something that come straight out of the blue. None of my symptoms are. It’s usually a slow build-up where I feel maybe a bit stressed, a bit down, but otherwise okay. I think it’s better to alleviate some of the strain while it’s nothing but that. I just have a hard time figuring out a way to properly do that without taking the whole day off. And it feels so incredibly wrong to call in sick when I’m still more or less okay. It’s much easier to justify staying home, when I can barely get out of bed or the mere thought of stepping out the door sends me hyperventilating. It’s either one extreme or the other. Neither’s a good solution. Life shouldn’t be a choice between working yourself to death or be dismissed as lazy and selfish.

I started this post intending to write about whether or not I might be using my diagnosis as an excuse to work less and play more. Instead it became a bit of a rant about how much I dislike work. But they’re sort of connected. Work sucks, play’s fun. I’d much rather play than work.

So then, do I feel like crap because I’m actually sick, or because I’d really, really just rather stay home and play, and just can’t find any better excuse besides making myself sick? Or maybe do I dislike work so much I make myself sick to avoid it?

Thinking about it, it’s possible, isn’t it? When you’re sick, you get to stay in bed. Exactly what I most feel like doing most days. Then it feels more like a reward than a necessity. If you’re sick, you can’t be expected to work, which we’ve already established I’m not exactly a fan of.

Am I so lazy that I’m making myself sick just to have an excuse to laze about?

Not My World

 This is really more of a personal rant than anything else. It’s mostly an expression of my own depression and feeling of disconnect from the rest of the world. But perhaps you might find something familiar or useful anyways. Further down, I touch briefly on thoughts of suicide. If you struggle with thoughts of suicide yourself, my advice is: find a reason to stick around just a little longer and seek help. The way back out of depression isn’t easy, true. Sometimes you have to crest the hill yourself to see the light and find that you’re not as alone as you thought you were. Death is permanent, depression isn’t.

 Sometimes, I don’t feel as if I belong in this world, like there’s no home for me, no use or purpose. I’m just a round peg trying to fill out a square hole. I don’t understand half the things other people do or say, I’ve no connection to the world at large. If it weren’t for the far too few connections I do have, I’d have been completely lost, adrift in a cold and uncaring world.

I feel as if I’ve nothing to offer the world and that the world has nothing to offer me. That I’m a waste of resources that could have been used to help someone else more deserving and in more need. I’ve no right to complain, and truthfully not much to complain about either. It’s my own fault that I’m miserable. In fact, I’ve nothing at all to be so miserable about. I don’t even know how or why I’m so miserable. Am I truly such a horrible person? That I can’t simply be content and focus on the good things in life? ‘Cause surely there are good things, even if I can’t see them right in the moment.

I’ve a place to live, an income, of sorts. Things to do. But I’ve no home, no real purpose and I’m worse than superfluous – I’m a burden. No matter where I go, I’m nothing more than a guest, a beggar or a prisoner. Living off other people’s good will. It would be ungrateful of me to complain, to express discontent. But I feel it all the same.

Why can’t I just be content with a crappy cashier job? Live in a crappy apartment, content with crappy neighbors or crappy roommates? People do that all the time. They get on with their lives. Some even enjoy it. Why do I have to be so unreasonable? I know the world isn’t fair and no amount of complaining is ever going to make it fair.

I’ve so many people working to help me. I feel like I should be more thankful than I am. And truly, I’ve come so far this past year and a half. Why is it so hard to see the improvements? Why is it such an effort to see the positives? Am I such an awful person I can’t acknowledge all the amazing help I’ve received? How lucky I am? Shouldn’t I be over these bouts of depression? Or at least better at dealing with them? Don’t get me wrong, I don’t feel entitled to comfort or better life. At least I don’t think I do. I just don’t consider a poor, miserable life worth living.

The other day, I had a pretty good meeting with a psychologist working on a project to help young people into jobs and education. We brainstormed ideas for me to find more fulfilling work and she had a lot of good ideas. She was also a good listener and all in all, I think the meeting went well and I felt fine. Still, I felt lost and adrift. And walking home from that meeting, I just wanted to step right off into traffic, preferably in front of a nice big truck. I didn’t. I had no desire to ruin anybody else’s day. I felt like I wasted everyone’s time somehow.

It made me think of the movie, Up in the Air with George Clooney. At one point, they fire a woman who seems perfectly calm and put together, who then frankly informs them she intends to throw herself off a bridge back home. If a person neither looks nor sounds desperate, how would anyone know if they truly intend on acting upon such a drastic impulse? Surely a competent, intelligent, young woman would find her own reasons to keep going, even when everything looks hopeless.

I don’t feel particularly depressed or emotionally unstable. I’m just so tired of looking for the silver lining in every cloud hanging over my head. Always trying to see the positive when everything just looks like shit.

I will say this though: I am not suicidal. No sudden or violent death appeals to me and I’ve no intention of acting on any, random suicidal impulse. I’d much prefer a comfortable, dark corner somewhere to slowly, quietly decompose over decades and decades.

If only I could kill off my soul and be content with simply a life and not have to worry about living a good life. I wonder if a lobotomy could do the trick? Pity it’s no longer practiced. Not that adding damage to problem would likely solve anything.

I’ve been told that intelligence is a resource, but my intelligence has brought me neither happiness nor fulfillment. It’s just a bigger cup to fill when all I have to fill it with is a couple of pebbles. It just feels more empty. I think I could have been happier if I was dumber; had a smaller cup to fill.

I feel broken. Irreparably broken. My brain as useless and burdensome as a pair of floppy, paralyzed legs.

If I were a dog back home in Greenland,  I’d likely have been shot or drowned. Nobody needs a useless dog. But then, if I remember correctly, Greenland still has the highest percentage of suicides in the world. I wonder how many of them felt like I feel now? Like a lame dog to be put out of its and everyone else’s misery.

Unlike them though, I have no problem finding excuses to stick around anyway. I know there’re people who would be absolutely heartbroken if I were gone and I might be useless in the grand scheme of things, but I’m not leaving my loved ones behind if it means I can’t ever come back to them. Moreover, there’re still things I want to do that I can’t do if I’m dead. And if all else fails, I’ll stick around purely out of spite. Let my two middle fingers be the last thing to disappear, when the rest of me is mulch piled in my dark, little compost-corner.

This world might not be my world, but I’m living in it. So I might as well make the best of it. With a little luck, I’ll even manage to find a way to make it a little better for others as well. And who knows, maybe somewhere down the road, I’ll even manage to find a couple pebbles of happiness for myself.