This isn't me. It's Night Windows by Edward Hopper.

Saturday, July 2, 2011

My Ole Depressed Self

A century or so hence, people are bound to find it amusing that we ever thought a "selective serotonin reuptake inhibitor" would actually do something to depression. I suppose PET scans and drug research studies are a step up from those many, many centuries of thinking melancholy was caused by "too much black bile in the spleen"--treated by eating warm, moist foods (essentially a lot of salad, weirdly enough), listening to music and watching plays (will medical insurance pay for that? Please??), and lots of rest and idleness (which is pretty much all I can do when I'm depressed anyway, but it is torture, not leisure, unfortunately). Oh yes, and by bloodletting--the cure-all--which is a nice analogy for what you have to go through to affect any kind of deep psychic change, I'd say.

After a month of finally taking Zoloft, something completely unexpected happened to me. For the first time ever in my post-pubescent life, my chattering head stopped with the endless critiques and backstories and became clear. I truly had forgotten that my head could ever be that still. It was the opposite of my past experiences with chemical substances that affected the mind--those had all softened the edges to a blurry halo that kept my thoughts from cutting me up, but also kept them from being of any use to me at all. That was not what I wanted from life, or from myself. I wanted balance. I wanted clarity. I wanted to just be able to function okay, to get right down to it.

I have never had the kind of depression where you get locked up for a few weeks, or you end up unemployed living in your parents' basement, or you find yourself writing a poignant memoir about it decades later, although I do have a long-standing adoration for literature about mental illness. I've probably read them all. I did my high school sophomore year poetry report on--wait for it--Sylvia Plath. When I am depressed I reread them and find them empathetic and soothing. I reread my favorite books from childhood, too, when I'm in that state--the Little House books, Strawberry Girl, the Melendy family stories.

The kind of depression I had had me limping along on good days, and almost completely inert on the bad ones. I had a particularly nasty stretch of one that lasted from June 1997 until March 1998 when it seemed to vanish overnight and for no particular reason (much like the grasshopper swarm did in On the Banks of Plum Creek). It took every bit of energy I could find to show up for work in that time. Once I was working I could do the task in front of me adequately, in a detached, automatonic way, but right as I left the building to go home, I had nothing left. I was a balloon with no more air. The energy-suck of depression was horrible to me, and coupled with a head that wouldn't stop muttering doomsday prayers over and over, it became my personal definition of Hell.

I have spent many, many hours laying on my couch or in my bed, unable to eat or sleep, worried about all the oxygen I was taking up by the fact of my living, and certain that I would never feel differently again.

It changed. It didn't change because of the Zoloft, either--the Zoloft was actually the last stone in the series of steps that led me out of the hole. I got married and had a baby, most of all. My quality of life and my mood was a concern to me before, and I had been working pretty hard at them, but after being presented with the gift of my daughter, they became of urgent and primary significance. I had a wonderful and very effective therapist who told me, "Whatever issues we don't deal with in our own lives we pass on to our kids," and I still hang on to that. It still lights a fire under my ass when I want to give up and be a wreck.

I started Zoloft when I was toward the end of my pregnancy with my son and had shown up at the obstetrician's crying again. She had an eye on the possibility of postpartum depression and wanted to nip the cycle in the bud, even though I was skittish about taking anything with a baby growing in me. I decided to just trust her, so I took the three week "starter pack" and then got the prescription filled.

There is a lot of talk in the media now about how SSRIs work no better than placebos, and work not at all for people with serious, incapacitating depressions (the psychotic kind, the lock-you-up kind, the kind I have not quite gotten to). The treatment of mental illness is a near total crapshoot, anyway. I worked on a psychiatric unit for a couple of years, and the thing that really surprised me about it was how it was mostly just a safe space for someone to sleep off the side effects of the meds. (I've tended to think that about hospitals overall anyway, even the medical side--"How exactly do people start to heal here, again?"--so it is no mystery how I've ended up doing home care.) People got better there, though. People even had epiphanies about themselves and their lives. Healing can be found anywhere, and it is more a question of open-mindedness and willingness than anything else, I think.

Those crossroads moments come, and the choice is ours, as difficult and scary as it usually is.

That isn't the end of the story. I took Zoloft for about a year, then stopped, and then started up again in July 2005. Strangely, the worst depressions I have had (of which there are three) all started in the summertime, and July has always been a difficult month for me. I have read that Seasonal Affective Disorder is usually a wintertime affliction but a few of us weirdos get it in the summer, and maybe that is all it is...I really don't know. All I know is, I stopped taking Zoloft in August 2007, when I was feeling low and considering having the dose increased from 50mg to 100mg, but got all contrary with myself and stopped taking it altogether instead. The low feeling passed when the weather started to cool, and to my amazement...it has never returned. I was steeling myself for the dark cloud in May 2008, but the weeks went on, the summer got hot and thundery (we had storms almost every afternoon that year--Thor forgot he wasn't in Florida), and my energy level kept in balance and my head held steady. They have remained so since. This is the fourth summer in a row I have not had a trace of depression, and I am still chemical-free.

I can't descibe how wonderous that is.

Don't ask me what happened. I don't know what happened. I did take up daily meditation in 2005, but fell away from it in 2009 and have not quite been able to get back. I read somewhere obscure and unstudied that daily meditation, after being practiced over three years, can permanantly rewire your brain. Could it be that simple? Maybe. I don't know. My diet is as crappy as it has ever been, I'll tell you--no big helpings of warm, moist salads for this girl, at least, not often enough--so there is no reason there why the black bile would be dispelled. What's more, the summer of 2007 is when I started working as a hospice nurse. When people ask me, "Don't you find this work depressing?", I can honestly, and a little ironically, say, "No, I don't...not at all."

Maybe SSRIs do work--maybe Zoloft reminded my brain "this is how you do it, now get to work", and my brain finally caught on. And maybe after all those years of emotional and psychological bloodletting, the toxins purged and my head regained balance so the flow of energy could resume. I can get off the couch and do things I want to do, and what's more, I can enjoy them.

I don't know what happened...but I hope it stays this way for the rest of my life.

It's July 2nd. I'm going to play in my garden now.

2 comments:

Lianne said...

Great insight!
At the end when you say you can get off the couch are you talking about the therapy couch as well? (If so, I will look forward to the possibility for myself)
I really enjoy seeing more deeply into you and, as a result, seeing more deeply into myself. Thanks for sharing.
I have always felt a strong connection with you and, with each blog you write, am beginning to see why.

Anonymous said...

As usual, great writing. I absolutely love your last line 'It's July 2nd. I am going tot play in my garden now.' I guess I now understand the comment that you made to me the other day, about how children have a way of stopping you from falling apart.

I can relate to your celebrating the non-return of depression, but yet waiting for it to return. I have been phobia free for many years now, but I still make sure to leave my house everyday, rain, snow or shine, because I fear that if I have one day without leaving, then I may be trapped inside again. That cloud of agoraphobia was the darkest and I never want to see it again.

People always ask me if my job depresses me. No, should it? How do you explain to somebody why you love your job? I was born to be a caregiver and I do it well.

I look forward to the next time you write. You are awesome Holly!

~~~Rose~~~