So, I’ve been depressed…
by Martin on 11/12/2010I have in fact been unable to work for the last nine months due to a rather severe depression. I won’t lie; It hasn’t been all fun and games, but it has been interesting.
I’d like to apologize in advance if this post comes out a bit jumbled and incoherent. There’s so many things I’ve been wanting to write about, and I do have a predisposition for rambling.
Depression hit me in March. It had been sneaking up on me for a while and then made it’s presence felt in that sudden and debilitating manner which is its custom. It was pretty clear to me that it was a big one from the get go. If you know me personally, you know I have a long history of moody extremism. To summarize for everyone else; I have bipolar disorder and have been treated for it since 2005 in some capacity or other. I’ve only ever felt depression of this magnitude and perseverance once, perhaps twice before.
So I’m having erratic sleeping patterns and I’m constantly fatigued and I’m going to my doctor getting my sick leave renewed every 2 weeks because I honestly think I’ll get over this soon and I get exhausted just looking after my daughter and I feel like shit. Depression. This was the stuff that had nearly ended me years earlier. Thankfully I’d grown a bit wiser or tougher or less melodramatic since then and I had an inkling on what to expect; Irrational thoughts and feelings. You know the kind I’m talking about. Even if you go through all the facts and it’s plain to see that 2 + 2 is indeed 4 and your family does love you, there’s this overwhelming feeling telling you that you are a worthless being and a burden to those you love. You can stare these irrational and delusional emotions in the metaphorical eye and know them for what they are, but you will still feel them.
And that’s basically what I did for a couple of months. Whenever I felt anything that I could rationally recognize as an unfounded negative emotions I put my hands over my ears and shouted until it went away, so to speak. Hardly what you’d call an ideal situation, but a hell of a lot better than last time around.
Then at some point I clicked a link to a YouTube video from a Stanford University lecture on depression given by Robert Sapolsky. I had just started taking Escitalopram which is an antidepressant that affects serotonin, the “happy hormone”, in an effort to get me out of the gutter. In fact, I’d already been regulating my mood disorder since 05 with different varieties of psychopharma, but beyond checking what side effects I might expect I had never really tried to understand anything about the drugs I was taking. I’m not a brain surgeon. This lecture however changed my point of view somewhat. A slight readjustment of my mental, hah, image of what goes on in my brain.
Never before had this stuff seemed even remotely accessible. To me, and I’m betting I’m not the only one, neurobiology seemed just as distantly removed from me as astronomy. Yet here this guy is drawing on a whiteboard and explaining in words I could understand exactly how Escitalopram works. He’s drawing pictures of what happens in my brain when I feel an irrational feeling of low self-esteem, and you don’t have to be neither a brain surgeon or a maniac to follow along.
Wow. Some people find Jesus. I found Sapolsky. I had always repeated the words “It’s biology. Some valve or drain in my brain is clogged. It’s no different than diabetes or lactose intolerance.” but now I finally actually believed it in my heart of hearts. If it’s broken, it’s fixable.
About this time I started having really bad tremors. My hands were shaking to the point where it became embarrassing to eat or have coffee with others because these activities required more dexterity than I, a 30 year old man, could muster. I decided that I was now at a point where the side effects of the drugs I was taking were so severe that they negated the supposed benefit. I started actually reading up on my medication, more than just enough to sound interesting at parties, and decided that the anti-epileptic Lamictal 1 was the most probable culprit. I (responsibly) consulted my doctor and quit the anti-epileptics altogether. My mood was turning from melancholy to a sort of dogged bloody-mindedness. I was determined to wait this shit out. But even though my mood was becoming less of a problem my other symptoms were not.
I still couldn’t predict whether I would sleep for 30 minutes or 30 hours when I went to bed. The only sleeping meds that worked were too strong for me to dare take them when I was taking care of my daughter, in case I wouldn’t wake up if she was screaming. I was still constantly fatigued and had problems focusing on any even remotely intellectual task such as reading, writing or indeed; coding.
Now, up until this point I had last been in regular treatment with a psychiatrist three years earlier. This psychiatrist, while in all probability very capable, was working under the strain of the under-staffed, over-worked public services in Norway. The care I received while being a guest of their establishment was impeccable, but I’d be lying if I said that they work without restraints and are able to custom tailor the treatment to each patients special needs.
Although it pained me as an avid supporter of public health care, I decided I had to consult a specialist on bipolar disorder in the private sector. We don’t really do that sort of thing in Norway. I also decided that now is not the time for therapy. I know a lot of people feel strongly that medication should always go hand in hand with psychotherapy, but right now I need actual bits of my brain to do their actual damn job. Like someone once said about another health reform; “The time for talk is over”.
The first thing he did was send me off to do a plethora of tests that I had never been subject to in my years of professional bipolarity. He also told me that he felt a different anti-depressant than the one I was currently taking would probably help a lot more. He asked if I wanted to start taking them right away or wait for the tests. I took the pills.
By the next session we’d determined that anti-epileptic drugs (which I have been taking for 5 years) are completely wasted on me and that a lot of my symptoms are due to my metabolism being shot to hell because I lack some obscure thyroid that I’ve never heard of nor been tested for. Also; I had started dating again after more than 2 years of sexual indifference. The new anti-depressants seem to be working is what I’m saying.
Now, I need to tack on a disclaimer right about here. One of the things that is a huge pain in the ass with mental disorders is that it’s really really hard to judge your own current status. In hindsight it’s usually easy to spot when you’ve been manic or when you’ve been depressed, but it’s a bitch to try and figure out your status right now since you are viewing it through glasses tinted with either extreme optimism or or extreme pessimism. That’s why It’s a good idea to wait a while before you decide whether a certain treatment seem to be helpful or not.
Still… I was able to write this post now, and that’s not nothing.
So, am I well? No. Not yet. My sleeping patterns are messed up and I still have problems concentrating. But I just started on yet another2 drug to help with the thyroid problem and my psychiatrist is hopeful that it’ll help with several of these issues. But even if it doesn’t work, I remain optimistic. And the reason I remain optimistic is because I am finished fighting ghosts. Now I’m just looking for the right formula, and that seems a lot easier.
They say one sign of madness is to keep doing the same thing and expecting different results. Well, I’m not doing the same thing anymore. I’m doing something different.
Fortunately I found a port, or perhaps a backwards engineered version for Chrome named, somewhat more aggressively,