Monday, September 25, 2017

Lessons from Depression


After about fifteen years of of RA and two of fibromyalgia, I can certainly understand how these conditions can cause depression, but in my case mental illness came first. Depression isn't fun, but I'm thankful that it was my first chronic illness. It taught me lessons that have helped me cope with RA and fibromyalgia.

1. The disease is real and help is available.

I started feeling crazy during my junior year of high school, but didn't aggressively seek treatment until after I had my first baby at 25 years old. I kept thinking it was a passing thing. When I talked to my family doctor during college, he blamed everything on stress. I gave up on doctors for a few years after that.

Ultimately, I sought treatment because I read an article about the effects of maternal depression on children. Even then, getting help took a lot of effort. I worked up the courage to make an appointment with the EAP program at work, then found out that they didn't provide counseling, just a list of psychologists and psychiatrists I could have found on my own. Finally, I went to my doctor (a different one), and told him I was depressed.

Getting diagnosed with RA was almost as bad. I didn't have the obvious joint problems at first, just the flu-like symptoms. I visited my family doctor several times over a year because this virus she thought I had contracted wasn't going away. Blood tests proved I was fighting something, but she had no clear answers.

At one point, I wavered between seeing my doctor one more pointless time or buying the magical acacia berry juice my neighbor was selling as a cure-all. A health teacher friend urged me toward the doctor.

It took a whole year before my vague symptoms became defined enough for my family doctor to send me to a rheumatologist and almost another year before I figured out how to communicate my needs and get treatment. (Over a decade later, this same specialist added fibromyalgia to my list of illnesses--a problem many other doctors refuse to believe in.)

2. It isn't my fault. 


Before I got treatment for depression, I kept making excuses for it. Maybe if I got more organized, got married, got a better job, exercised more, had a baby, prayed more, etc., I wouldn't feel miserable all the time. When the next accomplishment occurred and I still felt miserable, I would also feel guilty. How could I be so ungrateful for all my blessings? If I were a better person I would feel happy all the time.

When drugs worked almost immediately, I was able to accept that the chemistry in my brain is wonky. Period.

In a culture that values self-sufficiency, we can also blame ourselves for physical pain. Did I catch RA because I ran a half marathon without training enough, or because I did or didn't eat particular foods?

No. There is a hereditary tendency and for no particular reason my immune system flipped out.

3. Drugs can help.


I used to avoid medication. I didn't take so much as Tylenol during either pregnancy.

But kale won't cure depression or RA.

Generic Prozac keeps me from crying all the time and reduces my suicidal impulses. If it doesn't work for you, talk to your doctor and try something else.

I take several handfuls of medications and supplements now, all doctor recommended. I see myself as an old car and the meds as the duct tape and bailing wire that keep me in one piece and running, but at least I am running.

4. Self care is essential.

Kale won't cure you, but good nutrition, exercise, sunshine and rest can take the edge off. So can  good books, movies, and company.

I am an angry depressive. Whenever I found myself getting grouchy in the classroom, it was time for a day off. They offered several hundred dollars each year as a bonus for teachers who didn't use their sick leave. I never qualified and never regretted it.

Now that I'm done with full time work, I can focus on taking care of myself. I try to exercise every day. I try to make my home a pleasant place to live. I try to write and reach out to the world. But I accept that there are hours and days when I just need to sleep.

THE KNITTING

I wasn't sure I would be posting knitting today, especially this piece, because my depression is definitely weather-enhanced and the weather lately has been grayer than this natural shetland wool.

But today the sun came out. Gray is a favorite color, when it isn't raining, which is probably why I got out of control with this shawl. It is very wide, maybe too wide to wear without wrapping around twice. But it would be gorgeous on the back of a sofa I imagine owning in an alternate, cat-free existence.






3 comments:

  1. You touched a little on one of my pet peeves about depression, whenever you see depression awareness stuff, it always simply says "Get help. It's treatable." It makes it sound like it will be like going to the doctor for strep throat where you get a prescription and presto you feel better, and I guess for some lucky people it is that simple. But in general, depression is not that simple. The odds of a particular anti-depressant med working for a specific person is a dismal 20%. Even if you opt for the fancy (and expensive) epigenetic DNA testing to predict how your body will metabolize the drugs that percentage only goes up to 40%. And beyond that, there doesn't seem to be much science to predict what will work or even what dose will work. It's trial and error. So for many people that means trying 5, 6, or more different drugs. Sometimes "not working" simply equals they do nothing to ease the depression. Sometimes it means unbearable side effects like constant nausea or too sleepy to function. In those cases you have to try to evaluate (while depressed and not coping with life), is this something I should endure while my body gets used to it or do I need to change? Some make you worse-- more suicidal or in my daughter's case one made her a complete zombie. She nearly failed out of school because she simply stopped functioning and wasn't even functioning enough to realize she had stopped functioning. And each of these experiments takes weeks and weeks because most anti-depressants take time before you can decide if they are working or not. If you're lucky, after all of these months of experimenting, you eventually find something that helps you. But I've known plenty of people who, despite seeking help through both medication and therapy, never find that relief. My personal theory is that depression is more a symptom than a disease-- that there are multiple things that can cause a person to experience depression while the treatments only target the few known causes. I think we're still missing a lot of the puzzle pieces for how/why it happens and until we do, attempts at treatment are also missing pieces. So, do I want people to try to get help? Of course. Hopefully they will find some. But I also want people to understand that if someone is still suffering from depression it doesn't mean that they haven't been trying to get help.

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  2. You make some very good points. I realize how lucky I am because my disease is relatively mild and meds work for me.

    I have a sweet niece who has been fighting crippling anxiety for half her life. She has tried several meds and several therapists and is still looking for something that works.

    Our brains are so complex and science still knows so little about how we work. I think my autoimmune illnesses, are also literally all in my head. If we ever figure out how brain chemistry works, many of us will function much better.

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