I had not planned to write this particular post. In fact, I had an entirely different post in mind, but I decided I needed to write on this topic, for it touches on important aspects of this disease: relapse and remission.
What does one do when an episode hits you like a ton of bricks out of the blue?
I should first tell you that I have only actively dealt with and sought treatment for my depression for just shy of a year. Compared to the length of time I have experienced symptoms, that's hardly any time at all. That is to say I'm still learning - every day - more about what this illness is, and what it means for me and the people in my life.
There came a point this summer where I was fed up with not knowing what was going on with me. I was tired of constantly feeling out of control. Anyone who has battled with depression knows just how terrifying it can be to surrender yourself to a disease that essentially robs you of who you are. When you are in the eye of the storm of a depressive episode, your will cannot help but submit to it, and you often feel robbed of your own body and mind. For these reasons, I was (am) on medication, but I wasn't quite sure what it was actually doing for me. I continued to seek therapy, but I wondered whether it was really helping me. I repeated the same worries and frustrations over and over again. I even began to feel sorry for my therapist - I couldn't have been a fulfilling case. Week after week the same complaints with seemingly little progress. But I went anyway. Still, I knew there had to be more ways to become better acquainted with what depression IS.
I discovered this is a huge task.
I began with the Internet. The information I found was at first overwhelming, and eventually redundant. (You can only take an on-line screening test for depression so many times). Each site - even the national professional organizations - presented me with similar information: "see a doctor if you experience four or more of these symptoms for longer than two-weeks: loss of interest in normal activities, isolation, sleeplessness (or sleeping too much), changes eating patterns, blah-di-blah-di blah..."
Not good enough.
I wanted something or someone to speak directly to me, to tell me that these swirling emotions and painful uncertainties I was feeling were legitimate. Sometimes my mind travels in circles when it comes to thinking about my depression. I have a way of talking myself in and out of owning up to the disease. When I feel good, I wonder how I could have ever had times when I felt so low. I ask myself, "Do I need to keep taking the meds? Maybe I'll talk to my doctor about going off of them." Or, the most horrifying of all, "maybe I'm not really depressed. Maybe I just had a few bad days."
Forging ahead, I decided to read everything I could get my hands on. Some articles, but mainly books. I just couldn't find what I was looking for. Nothing seemed to be clear-cut. No one book had definitive answers, helpful and sometimes hopeful as they were to me. It turns out that this is just a feature of the disease. No one, from the doctors to the sufferers, knows for sure what causes depression and what can be done to prevent it. So, we treat the symptoms in a variety of ways. Andrew Solomon's book The Noonday Demon recently put it in perspective for me:
"Luck plays a significant role, bringing on us as if by chance those dews of happiness. Some people respond well to one treatment, some to another. Some people remit spontaneously after a brief struggle. Some who do not tolerate medication can in fact achieve much through talking therapies; some who have given thousands of hours to psychoanalysis get better the minute they take a pill. Some people drag themselves out of one episode with one treatment only to descend into another that requires a different treatment. Some people have refractory depression that never lifts, no matter what they do. Some people have dismaying side effects from every form of treatment, and some people never encounter the slightest trouble from hideous-sounding therapies. There may come a time when we can analyze the brain and all its functions, when we will be able to explain not only the origins of depression but also the reasons for all these differences. I am not holding my breath. For the time being, we must accept that fate has given some of us a strong vulnerability to depression, and that among those who carry such vulnerability, some have treatment-responsive brains and some have treatment-resistant brains. Those of us who get substantially better in any way must count ourselves, no matter how dire our breakdowns may have been, among the lucky ones. We must, further, treat those for whom there can be no recovery with forbearance. Resilience is a frequent, but not a universal, gift, and no secret in this book or elsewhere can help the unluckiest of all." (page 134).
To return to my opening question...
Up until about two weeks ago, I was feeling great! The stress of our wedding was over. I was working on my goals with an eye towards graduation and upcoming recitals. I was focused and motivated. I woke up most mornings ready to begin my work and cross off items on my list of tasks. My hopes were so high. Maybe the worst was over. Maybe everything had finally aligned itself - the medication, the therapy, all the work I had put forth towards understanding and accepting the challenges I had been given. It was all coming together and settled in a place where I had a handle on my life again. There it was - that consistent feeling of control over my own life that had gone missing for so long!
~ ~ ~
I could sense it coming on - the sudden and unexplainable irritability, the loss of rational thinking, the absence of motivation, the unsettled feelings I would experience whether I was alone or with others - but I chose to fight it. It had stayed away for this long, surely I could ward it off...right?
No, I couldn't, because this is depression.
The last two weeks were just a reminder that the more I try to forget about it and the less I chose to acknowledge it when it surfaces again, the longer and more painful the depressive episode becomes.
I have decided to close with excerpts from my journal, as they put last week's experience in the most accurate perspective.
I've also decided that next time, it will be easier to error on the side of depression, even if it does turn out to be just a really bad day or series of bad days in the end. For me, it's always better to take a step back and really look at what's going on, and what led up to it. It's only after that point that I can begin to heal and find my true self again, even though it's next to impossible to be able to do so when you're in the midst of breaking down.
It's worth it.
To our health,
~ ~ ~
October 11, 2010
I feel like I've been kicked. Beaten down, and then kicked. I feel like I'm moving slowly today. I don't have a lot to say or even think. I feel blank inside. I woke up this morning in tears. They just came - unstoppable. I slept until nearly 2pm. I skipped my practice time in Auer Hall. It was the only time I'll have in there this week. I skipped my one class. All I had to do was show up and sing, but I can't even do that. It's taken a hold of that, too. I cancelled my lesson with ______. It was only a half hour lesson, but I just didn't want to set foot in school today. Today I've been completely useless. I went from being a blob in our bed to being a blob on the couch...Compared to the life I had been living for the last five weeks, today I haven't really lived at all.
Here I am again. I spent a week in denial that I was feeling different. I thought (again) that I could ward it off. That I could overcome these feelings and intensity of emotions. I wanted to so badly. I wanted to reclaim my life - my moods, my emotions, my behavior. For the last five weeks, I've had the power to make sound decisions; to reason with myself and the world around me; to control any overly-emotional outbursts I might feel coming on.
I couldn't do those things last week. I was easily irritated and put-out. I snapped at M. and dragged him into whatever anger I was swimming in at the time. Worst of all, as he has pointed out to me, I take out my anger and my frustrations on him. And he gets hurt.
Last week I had NO patience. I let the littlest things set me off...clearly, I wasn't in control anymore. My emotions, my thoughts were being handled by something else - something I refused to name & admit to.
I knew I was irritable. I knew I was edgy, and I kept telling myself it would pass. Maybe I would wake up the next morning with a better grip on things. Day after day, this didn't happen. That didn't stop me from trying. I WOULD will this away. I WOULD rise above it and reclaim my rational, reasonable self that I had seen for several weeks.
I just wanted to wait it out, to see if maybe - just MAYBE - I was having a "normal" person's bad week. Logic tells me that it's normal for people to have off-days, even off-weeks. Maybe that's all this was. So I continued to will and wait for my real self to reemerge. I knew I was in there! I knew it! I could do this...
I'm not sick this time.
I can now see everything that's wrong with those choices. I've spent so much time trying to accept that I am a depressed person, and that that's OK. Yet after all that work, all that reading, writing, and pondering, all those small yet such important steps I took towards accepting this disease and what it means to my life - I was in denial again.
I thought I had it this time.
I just wanted to see - is that so wrong?
And I failed. In so many ways. All that time I spent trying to "think" my way out of another episode, my husband was left in a corner wondering where the real me went. Every time he tried to scratch the surface of what was really going on, I turned off, shut down, and dismissed him. Surely it couldn't be that - I was in control, remember? And who is he - trying to be my doctor and diagnose me!
I ignored all the pain this was causing him. I selfishly expected him to wait around while I tried to sort it out on my own.
I left him alone. Again and again and again...
This is not private anymore. I am no longer on my own. We chose to get married. We share our lives now - and that means we share everything in them. I have no excuses anymore. I have nothing left to hide behind. I know what it is I'm dealing with. I've named it, admitted to it, and continue to deal with it daily.
It's the same end every time. You think I'd have learned by now. The moment I'm willing to admit to myself and to M. that I'm having a hard time, that's the moment I open myself up to the possibility of healing...