Monday, June 17, 2013

Depressing

In the not-so-distant past I lamented the cultural perceptions of mental health in the United States. This year my depression has been particularly bad so I've made the most effort to improve that aspect of my life. I recently realized that I've consciously avoided discussing my depression with my peers. This isn't to say I need to bring it to their attention, but avoiding the subject doesn't make sense if I feel like more people should be talking about it casually.

I've been on Cymbalta for a few months and it's been really, really helpful - in ways that neither Prozac nor Celexa were (SNRI vs SSRI). I've been able to see how totally out of proportion my emotional responses were in comparison to the stimuli. Things that shouldn't have bothered me had made me really angry, or really defeated, or both. Things that should have been enjoyable and fulfilling were insignificant. With the SSRIs I found that my emotional spectrum was just narrowed. Bad things weren't really bad, but good things weren't really good. Now it feels like things are pretty well sorted out. I'm not skipping around giddy, but I feel like what I think normal, healthy people feel like.

When you're depressed for a long period of time, your thought patterns get warped. You get trained to be frame everything you experience through negativity aimed at yourself. The properties you admire in others are reflections of your shortcomings. Remorse (regret for a bad action you've taken) becomes guilt (the belief that you're inherently bad). All insecurity, doubt, and discouragement are amplified. Simple tasks meet with defeat before they are started because your mental habits tell you that you can't do them.

I've been regularly seeing a therapist for most of the year. Behavioral therapy is much like physical therapy. A trained professional can discern between your healthy motions (thoughts) and your counter-productive ones and help you find the right ones. A few weeks ago my medication seemed to be less effective. My moods were crap, but I found that I was able to maintain reasonably positive thoughts. Eventually the low period passed and things were back to good. Also like physical therapy, much of the purpose of the therapist is to ensure your movements are correct; the actual rehabilitation occurs when you're away from the therapist, practicing what you've learned.

Overall, that's the gist of my situation. I intend to write about my experiences as much as I can. I'd like it if this were helpful to others, but that's out of my hands. It will certainly be helpful to me.

2 comments:

  1. Very glad to hear you are feeling better.

    Did Cymbalta narrow and increase your emotional responses or just increase? Did you try Effexor beforehand or was this the first SNRI you tried?

    ReplyDelete
  2. Sorry for the delayed response. I just now turned on comment notifications.

    This is my first SNRI. It's really subjective so it's hard to say if the spectrum was narrowed.

    There's a certain amount negativity that I think is fundamental to my personality and not really an aspect of depression. I don't think the high end of my mood has been brought up much in normal situations. I do feel like bad stuff rolls off much more easily under all circumstances.

    I recently went up from 60mg/day to 90mg/day (60 x 1 -> 30 x 3). Before that, I was finding that my mood was still drifting fairly low for no good reason. Now that's not really happening but I feel a little be more anxiety/jitters sometimes at night.

    ReplyDelete