October 21, 2015

Depression and survival, redux

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.