Depression and survival, redux
October 21, 2015
For subscribers, a version of this went up when I thought I was ready, but the writing itself wasn’t ready yet. Apologies for the confusion!
Once upon a time, I could only work lying abed. Propped up on a nest of pillows so that typing would require the least amount of effort, staying upright drained me so completely, I’d just rinse and repeat the next day. After several months, I graduated to working from the sofa sometimes. Last year, I made it to my desk.
It doesn’t mean that I’ve been without pain. Whoa, no. It’s just there are many levels of terrible and when you’ve gotten used to your particular circle of hell, lo, there is another lower one. I’ve been lucky enough to stay just out of that bottommost canto until our beloved Angry Inchworm came on the scene.
Pregnancy didn’t significantly increase my usual familiar pain but incubating a tiny human-to-be was hard on the system. I did not like the weird and uncomfortable but it was after delivery that I found myself in trouble for a second time.
It wasn’t postpartum depression. I very much wanted to take care of our newborn, dredged up every iota of energy I could to do so, and was grateful for each day that I could do what was needed. But I also wanted to feel the affection I knew I had. I wasn’t crying or irritable, nor was I having mood swings. My can-do and love for hir was just buried by the fatigue, pain, and unadulterated fear that it might not get better. Most symptoms, in my experience, don’t.
I started an antidepressant this spring. It was prescribed specifically for pain control but the on-label use is for depression. This is, I learned, not unusual. Chronic pain travels the same brain pathways that depression does so chronic pain sufferers are more prone to depression. But you know what? Even if we were biologically inclined to have it (thanks, bodies, no, really), you know what’s depressing?
Being in pain 24 hours, every day, for the rest of your life.
Know what’s not depressing? Less pain.
The trouble was that this wasn’t my first go-around with this medication. The first time was three years ago, and I’ve never spoken of it.
In my family, depression is either not spoken of, or it’s casually referred to like the common cold. A thing that comes and goes and there’s nothing you can do about it. I knew my cousin had a bout with it only because it was offhandedly mentioned that she’d lost an entire summer, curled up on the couch, when she was normally very productive. It’s not taken seriously lest it become a serious thing. And if it does become serious in their accepted range of “serious ailments”, it still isn’t directly addressed. There’s a reasoning that makes no sense at all and guarantees you won’t get help.
It’s true for many people that depression sits on their shoulder, a cruel imp whispering nastiness, sowing doubt and self loathing. Many people start to believe the things depression says, that they’re not good enough, awful and deeply negative things. And for many people, after years of this, cannot fight any longer.
That wasn’t my experience.
My fight had been of another variety, purely for survival, and it lasted years. There was no time to think or feel, just do. In some ways, that saved me from emotional turmoil, but only for a while. I was primed, starting this antidepressant, I just didn’t know it. I was taking it, then, as now, for purely physical pain. That, it did help. It helped me function, in a detached, vacant way. I didn’t precisely have energy but I was no longer feeling completely hollow. I could go to work, get home and do some housework, rise from bed in the morning and fall back into it night after night. Not much of an existence but at least my body was in motion and it would probably stay that way.
The trigger was some trivial non argument with PiC. We disagreed about some nominal thing, something so inconsequential that even though it triggered the worst experience of my life, I don’t remember what it was. My brain, ripe for the shift, turned over.
I didn’t just start wondering or believing that I wasn’t good enough or that I wasn’t deserving. I knew.
I knew that I was a failure. If not, Mom would be alive and well.
I knew that I wasn’t strong enough. If I were, I’d not need help to function on a daily basis. Anyone could live my life and make more of it than I had.
I knew that I couldn’t fix the mess that I’d made of my life because if I could, I would have.
I was absolutely certain there was no point in trying anymore. I was a failure, I didn’t know how to fix everything, and therefore, though perhaps Doggle would miss me eventually, there wasn’t any reason for me to stick around.
Probably the most terrifying part of all was how quickly I went from having a Really Bad Night to feeling like I was ready for it all to be over. I didn’t tell anyone. I wasn’t looking for help, I wasn’t afraid of the consequences. I wasn’t in the least bit interested in alternative solutions. I was tired, and I wanted to be done.
Wanting to quit, permanently, should have been a huge blinking sign that something was fundamentally wrong. Of all the things that should have triggered a fear or any response at all, that should have been it. But it didn’t feel wrong. It felt like that “Depression Lies” or that “it’s always better to choose life”, the lack of choice, was wrong. I even knew that it was possible that this state of mind was directly linked to the medication, the label states a side effect could be suicidal thoughts, a dear friend told me that it can take time to find the right medication that won’t be worse than the pain, but it simply didn’t matter.
Unlike many more common descriptions of depression that I’ve read, my reaction was to become even more “rational”: in a simple calculation of worth, I was worth more dead than alive. Therefore, it made sense to stop being alive. I became even more productive than usual, sorting my affairs so that I wouldn’t leave a huge mess behind for anyone else. Coldly functional. Robotic. Unresponsive to any emotion, and unemotional myself. Except at night. Every night, after a long day of preparations and planning, I’d huddle in the bathroom corner, hot tears running down my face as I apologized to the air. To Mom, mostly. For failing her. For failing us. For failing at life. Asking for her forgiveness for things I should have done better and failed to.
Hindsight is powerful, though somewhat useless. And sometimes it’s just downright damaging. This was one of those times.
For two long months, I was a mess internally, and there was nothing anybody could have done, because I wasn’t telling anyone or asking for help.
Then one day, weeks after I stopped taking the medication and went back to being about a thousand pounds per square inch, the fog seemed to lift. The hatred, the self loathing, the despair, it was still there but it was a little lighter. Just an ounce less. Just a little bit easier to bear. Just a little bit more possible to live with.
The next day, again, it was a little bit lighter. And the next day, still a little lighter.
There was no great revelation, I wasn’t glad I didn’t follow through. I just felt like the deafening bellows of my psyche quieted down, but that it was still echoing in the back of my consciousness, and there were days I was just standing on the edge of the cliff. Months after the depression passed, there was still a weight on my chest. I couldn’t even talk about it, lest that push me over the edge. It hadn’t passed, so much as retreated to loom over my shoulder.
20 months later, I still felt that pressure and could only discuss it vaguely to a very good friend who had had experience with it. Until one day, a dear friend was helping her roommate get past a suicide attempt and said, “I don’t know how to help, because I don’t understand it.” That was the first time the words “I was suicidally depressed” came out of my mouth, and the first time PiC heard them. Hiding my pain from my family had become such an ingrained habit that it never occurred to me that he should help me through it.
***
I don’t have any grand revelations. May never, really. It’s a mystery how an entire world and sense of self can be upended, shaken and strained, then laid back down again. There’s no guarantee that next time, if there is one, when there is one?, that it will be ok.
For the first time in a very long time, though, I realize that even though I still can’t explain the experience, now that we have LB and have found peace with each other, I find myself knowing that no matter how hard it gets, as long as we have hir and each other, I want to live. I never want to deliberately cause hir the pain of having to bury hir mother as I did mine. Or of never knowing me, or never having my love, or protection. But it’s not just the negative. I also want to be here. I want to see the day to day, to be there on the special days, to watch hir grow, proudly and with wonder, hand in hand with PiC. To share that love and those memories with cherished friends, and cherished family, and to build a good life.
Life was crushing, for a long time, but we came through it. We probably can again.
And for now, that’s enough.
I’m sorry you have to go through that. I’ve been depressed, but it was acute and situational, so I’ve never known what real depression feels like. I always think it’s tough for individuals who have to deal with it because I think it’s still pretty misunderstood.
It is very misunderstood.
I am so glad you are doing better. Anyone who has trouble understanding how chronic pain can trigger depression hasn’t thought all that hard about the nature of pain. I really wish we had better treatment options for you and my other friends who have to deal with chronic pain. In the meantime, I hope things stay good for you!
Thank you!
This is a beautiful post, though my heart breaks at your description of being so alone with your sadness. I have been in a really bad place lately (I feel better now–as in yesterday and today–but know that The Bad can return quickly and easily). This post has given me the perspective to realise that my excuses for keeping everything to myself is not helping me. I don’t need to be alone in this. Thank you for sharing.
I assume we all feel quite alone, especially the first time we go through this. It’s an isolating thing. But if you can share and ask for help, I think that’s probably better.
Thank you for sharing your story. Someone asked me recently why I blogged, and this is a perfect example of my response: because I want to share what I’ve learned and experienced with others who may be in a similar situation.
I’ve never had suicidal depression or chronic pain, but I’m grateful that I’m coming to a better understanding of it through your posts. It helps me be more empathetic to others. To be more human and kind to all the people around me — not just friends and family, but strangers, acquaintances, and colleagues, too.
And thank you for this comment. I spent sometime wondering if I should share this, and it’s good to hear when it makes any difference.
I just want to put my arms around you and give you all the hugs and comfort I can offer! I’m sooo sorry to hear what you’ve been through. I’ve seen depression close up, and it’s perhaps more painful that physical suffering because you don’t feel that it’s even possible to feel better ever again. No “rational” balance sheet could ever prove that the world would be better for PiC and LB without you in it!
I’ve been on a medication for neuropathic pain that is also a treatment for depression. In my case, I didn’t develop suicidal thoughts, but I felt like my brain was stuffed with fog all day, and I had weird neurological symptoms (such as nauseating dizziness and restless leg syndrome) that have lingered on, even though I’ve been off that medication for 10 years. Worst of all, it didn’t even help with my back pain!
I don’t understand why you’re back on the same medication now. Have you told your doctor what happened last time? Surely, there are other meds that could help with the pain without causing those dangerous thought processes. Please, please, please ask your doctor about alternative meds.
Ugh, I know those side effects well. Most medications I’ve tried had the same effect on me. Did you ever find anything that did help the back pain?
I didn’t tell my doctor the extent of it. Partly because I wasn’t at a point of being able to discuss it in the spring when I needed the help, and because I didn’t have any other choice – this is the only medication that has ever alleviated my physical symptoms without making me feel more ill in the process. I was very hesitant to start it again but they also changed it to a slow increasing dose rather than a set amount across the board, so that seemed helpful. I also asked a couple friends to check on me after I started it so that if I started withdrawing or seemed to be having trouble, they could ring a alarm and that also made a difference, I think. My experience with it this second time has been *very* different, thankfully. Very few side effects, my mental state hasn’t changed considerably outside of the initial worries that it would, and even with pain I can mostly function.
Oh, I’m so glad to hear that it’s a different formulation and that you’ve got friends and PiC who are watching out for you. Maybe, in a way, it’s good to have been through it once before, so you know and recognize the danger signs. And, more importantly, you know that, if you do become depressed, there’s hope of feeling “normal” again.
As for my back pain: did you realize it started the night before we met in person? I think it began the previous day, when I lifted a heavy suitcase, but it got bad that evening and was excruciating during the meeting. (Everybody thought I was just being emotional, but I was really crying in pain!) I did go to PT for a few weeks, and that helped, but then the insurance coverage for PT ran out. The pain has just been chronic, and I deal with it every day. Some days are worse than others, but it’s always there. Early this year, however, I was diagnosed with TMJ (from yawning too widely!) and advised to go to PT for treatment. It helped tremendously with that problem (which is gone now), so I asked my doctor for another prescription for PT for my back, strengthening my core, etc. It has worked wonders! But I still have some bad days. The condition will always be there, if I get up too suddenly or turn the wrong way. At least, I now I have ways of dealing with it, so I’m very grateful. I hope this drug (or some other med) can work wonders for you.
Thanks so much for sharing this story, as heartbreaking as it is to read. I realize how few personal stories I’ve heard or read about of what it is like to be in those depths and to come back from it. It is so often just not discussed, or as you put it, mentioned so casually that there can be no depth to the discussion.
I’m glad the second round of the medication is going well, and that you were able to prepare up front for it by asking for help from friends – before you actually needed to ask for real help.
(Since this showed up on my reader a while ago, then wasn’t on the blog, I somehow missed it a few days ago.)
I’m sure I confused some people with it going live earlier than I meant to, then pulling it! I wondered if it would then show up in readers again, I guess not?
I can understand why these experiences aren’t really discussed by anyone who doesn’t experience it since before this, I had no clue what it was really like. And having been through it, sometimes finding the words to describe it accurately is like trying to pin down a whirlwind. It felt like a bad idea trying to write it down, and so it took months. 😛
[…] There were several days of being totally laid out, unable to move. That sucked. It wasn’t as bad as it could have been but still. Awful. Definitely it was bad enough for me to start worrying again about what would […]
{{hugs}} Thanks for posting this. It’s incredibly brave. I can’t even talk to my doctors about my experiences with depression and suicidal ideation without crying. Heck, I tear up checking the box beside “depression” on the new patient forms at doctors’ offices. Nothing has been more helpful, for me, than knowing I have several friends and family members who are going through what I’m going through. If nothing else, it eases the guilty thoughts of “I am a total failure as a human being.”
<3
You are fiercely in my heart.
<3
[…] over the most nonsensical things. I was participating in a volunteer project years ago when the depression set in. I felt so bad about not completing my part of it, even though it was totally voluntary and it […]
I have suicidal fantasies sometimes…have had them occasionally ever since I was 13. I think about how little I’m really changing the world, how hard I am working (or might not be working) to do so, and how little I really matter in the big scheme of things. I’ve never made an attempt, just stand in the shower for a few minutes wondering if it would just all stop – I could stop adulating, stop worrying, just be done. I generally shake off the completely useless human feeling by reaching out to my friends, volunteering more than normal, and reminding myself that I can’t make any positive changes when I’m dead. Surprisingly enough, I thought I would be bombarded by all of that with the three family deaths last year or after my miscarriage, but nope. I got sad – really, really sad – but I started taking trips with Dee and William, and took two more cruises with my husband. I just started wanting to move, not wanting to die. I can’t say I’m done with it forever, but this past year shored up a few of my self-worth issues. If nothing else, I seemed to have helped my grandparents and aunt at the end of their lives, which helped my family cope. That in turn made me feel useful. Can’t really explain any net benefits from a miscarriage but I got to bond a little with dozens and dozens of other women who have grieved similar losses. In general, my feelings seem to go to running away now more than offing myself.
Adulting…not “adulating”
“…reminding myself that I can’t make any positive changes when I’m dead…”
That’s a completely rational point that would have penetrated my feelings of failure, actually. For some reason, feeling “needed” was bad (because I was a failure) but feeling like there was a way to atone or do better seems to help a little.