Tuesday, September 23, 2014

Stupid Soul-Destroying Depression

FYI, this posts talks about attempted suicide and self-mutilation.

I have a long history of depression. I was diagnosed with major depression at least ten years ago, when I was in junior high school. That's not my diagnosis anymore. I spent a year or so as a schizophrenic, but strangely enough, my depression never got the memo that it didn't exist anymore. Now it shares space in my new diagnosis with fun manic episodes, even more fun mixed episodes (manic and depressed at the same time), and, best of all, psychosis! I still hear voices sometimes--occasionally I hallucinate classical music, which I think is really cool--but they don't really bother me, and mostly that kind of stuff has been medicated away.

Then I was free of, or free from, screwy mood episodes for a year. I cannot describe what it was like for me. I planned my future, I started taking classes at my college again. As soon as I started taking classes, I felt even better. I worked hard, I got perfect grades, my professors (mostly) loved me.

And then, one day, I felt tired, and I thought, I don't have to study tonight. I can take a break. So I watched Elementary instead. And I still got perfect grades. Then, a few days later, I felt too tired to do my homework, and my professors never checked to make sure we'd done it, and I thought, I don't have to do my homework tonight. I could take a break. And I was really tired, so I didn't do it. Then I a few days later, I thought, You know, I'm tired. I don't really have to go to class. So I didn't go. I didn't go the next day, or the day after that, or the day after that.

It got to the point where I hadn't eaten in two days because I was tired, and I wasn't hungry, and I didn't feel like eating. Suddenly I had an epiphany--was I depressed? But, no, I wasn't depressed. I knew what depression was like. When I'd sliced my arm open with a pair of shears and nearly cut a good-sized chunk of my arm off, that was depression. When I'd overdosed spectacularly on Tylenol and lithium and spent a week in the hospital, that was depression. This? This wasn't depression. This was--was--uh--

In some ways I think the flashy, dramatic, over-the-top, self-destructive depression is easier for me to deal with because I can think of it as something external I need to fight. This is subtler. It's harder for even me to think of it as something other than my own failings: laziness or a lack or ambition or a lack of motivation or something. I know that even the laziest, least ambitious, most unmotivated slackers don't go for days without eating because they're too lazy/unambitious/unmotivated to walk into the kitchen, pick up an apple, and eat it.

But it still feels like it's all my fault.

Most people seem to think that being depressed just means you're really sad. That's only part of it. One of the symptoms in the DSM V is "loss of interest and enjoyment in usual activities."* I think most people who don't work in mental health, and probably some who do, think that means that, say, you usually like fishing or biking or music, but now that's just not fun. That's not what it's like, at least not for me.

At least for me, a better, though much more colloquial, description would be, "doesn't give a damn about things they'd normally give a damn about." It's not just losing interest in doing things you normally enjoy.

Care about your future? Not anymore. Enjoy your friends' and families' company? Not anymore. Care about your relationships with them? Not anymore. Enjoy it when your cat sits on your lap and purrs? Thing of the past.

Sometimes, you don't even care about hating the things you once hated. Person you can't stand? All you can summon up is weary resignation. It's not that you've come to accept them and the things you couldn't stand and can't change about them. It's just that you're too apathetic to care anymore.

Of course, hating everyone and everything around you is also a classic sign of depression, so it could go either way**. And people are complicated, so the two possibilities aren't at all mutually exclusive.

And neither, as I just discovered--or rediscovered--several days after beginning this post, are the two types of depression, the subtle and the dramatic. But that's another post.


*Incidentally, when I looked at the DSM V online, it was basically my life right now.

**You know what else is? "Excessive computer time."

Thursday, September 18, 2014

Lithium Is Not Really Trying to Kill Me

OK, so when I said that lithium is trying to kill me, I was exaggerating just a tiny bit. See, lithium and I are in committed, love-hate relationship. She gives me a gives me a semblance of sanity, and in return I continue taking dangerously high doses of her every day. We've been together for almost five years. I frequently dream of breaking up with her, but we both know it's never going to happen.

FYI, if you're in the business of taking medical advice from flippant blog titles, then let me very clear: lithium makes my life hell, but my life on lithium is nowhere near as hellish as it would be off it--as it was before I started taking it. Basically any hardcore mood-stabilizer or anti-psychotic is not going to be pleasant; only you can decide if it's worth it.

That said, there are some circumstances under which lithium will try to kill you. If you become too dehydrated while taking lithium, it could do serious damage to your liver and kidneys. Don't do go without water for any lengthy period of time. Not even if it's Yom Kippur. Ask your rabbi. They'll understand. (You don't have to tell them you're taking specifically lithium.) They may even tell you it would be a Desecration of God's Name to endanger your heath in such a way.

And, of course, if you swallow two months worth of lithium in one go, it'll do its best to kill you, but, trust me on this, that's not a very good idea.