Sunday, October 12, 2014

Depression, Medication, and Vitality

Earlier this year I came across one of the best best definitions of depression: "The opposite of depression is not happiness, but vitality." That's from Andrew Solomon in a TED Talk, "Depression, the secret we share." Given the pervasive nature of depression — whose family has not been affected by it? — why not give it a watch:

I try not to be shy about the fact that I sometimes struggle with depression and anxiety and that I have done so throughout a great deal of my life. It's strange how unpredictable depression can be, how it can strike even when life seems to be going well. A bout of depression hit me pretty hard last year just before Christmas. While wading through it all I told Sarah how awful I felt and we had a short talk about trying medication, which I had never done before. I had been working with a therapist, and through all that work, I had been able to make some progress with my mental and emotional well being. But here it was again — depression — and I had no idea how to deal with it. Given the amount of therapy work I had done up to that point, medication seemed like a logical step. A couple weeks later, in mid-January, I walked out of my doctor's office with a prescription for Lexapro.

Still, I was afraid to take the meds. I was afraid I would lose part of myself. Sure, I had just lost part of myself to depression, but I was worried that I would lose myself in some unrecoverable new way, and I worried that I would lose the complementary strengths that accompany depression. In the TED Talk mentioned above, Andrew Solomon posed the questions I was then asking myself: "If I have to take medication, is that medication making me more fully myself or is it making me someone else? And how do I feel about it if it is making me someone else?"

Having never tried meds, I knew I'd never know how to answer those questions if I didn't try, and I didn't know which aspects of my life I would lose out on in remaining depressed. So I gave it a go. The first few weeks were pretty rough, which is normal. The first few days I was trippin' balls pretty hard and those feelings were exacerbated by my existential fears of losing myself.

And then — I felt OK.

I didn't feel depressed and I didn't feel like I had lost myself. In some ways I felt better, in some ways I felt the same, in a few ways I felt a little worse. Overall, it was a net gain. The medication was working. There were side effects. There always are. I was more tired than usual and my right eye twitched if I didn't get enough sleep or if I ate sugar (read: it twitched often). But again, the medication was working.

A couple months in — I think it was in March — I noticed a slight buzz of anxiety that seemed to come and go arbitrarily throughout the day. (My doctor had told me that anxiety could be a side effect of Lexapro, which, yes, is a strange side effect for a medication often used to treat general anxiety disorder.) Maybe it was from the meds, maybe it was from the stress of adjusting to marriage (which happened in March), maybe it was something completely unknown. Whatever it was, I found myself using sugar and caffeine — a Coke or Mt Dew when I got to work in the morning and Reese’s Peanut Butter Cups in the afternoon — to try to dull the buzz. I knew this was a bad idea — sugar and caffeine only make my anxiety worse — but in the moment of consumption, the sugar helped me cope.

It wasn't long before I found myself wanting to go off the meds. But I didn't want to try another one and I worried that quitting the meds would plunge me into a deep depression. So I kept taking them, figuring that one day I would know when the time was right to try something else, whether that was quitting the meds or trying a new prescription.

Then one Friday afternoon a couple weeks ago I found myself at Walgreen's during my lunch break to refill my prescription. The pharmacy wouldn't refill it. The pharmacist supposed that the doctor wanted to see me before giving me another refill. So I called my doctor's office only to find out that they close at noon on Friday. I was without medication until Monday at the earliest.

I had missed taking my meds before — although for no longer than a day — and I could always notice a difference in my moods and feelings. Part of me was worried that I would become angry, despondent, or hopeless, but mostly I was just curious to see what those few days without medication would be like.

Saturday was interesting. I had DVR'ed a Bruce Springsteen concert that had aired at 3:00 am that morning so I spent my day watching Bruce while wandering in and out of the kitchen to bake a few loaves of ciabatta. For the most part I felt good — way better than I had expected — although I was a bit surprised when I found myself crying when Bruce and the band played "Bandlands." I guess the lines "We'll keep pushin' till it's understood / and these badlands start treating us good" seemed apropos given what I was going through.

I felt even better on Sunday, although by late afternoon I was feeling pretty dizzy and weak. Monday was about the same. Tuesday morning I told my doctor about my weekend (I left out the part about crying during "Badlands") and told him that I wanted to go off the meds. He was cool with it so he gave me a plan to taper off.

After reducing my dosage for about a week, on October first, right before bed, I took Lexapro for the last time.

As the days passed, my mood didn't dip or soar, but I found myself increasingly dizzy. Saturday the fourth was the worst of it.

Overall, I feel more in touch with myself and more capable of sorting out my feelings and being honest with myself. I've also been crying at the drop of the hat. Despite that increased honesty, it's difficult to tell if this is a well of sad energy leaving my body, if there are lots of hats dropping, if it's something else entirely, or all of the above (the likely scenario).

Here is what I believe about depression: I don't know if it will ever totally disappear from my life. It will most likely be something that continues to resurface here and there. While I am not currently at my most vital, I have the motivation, desire, and ability to care for myself in ways that will, I hope, help me increase my vitality. I can communicate with God, connect with family and friends, look for ways to love and serve others, make pizza, bread, and cookies, cook meats on the grill, read books, write, and do my best to love myself and remember that I'm a good guy who wants good things. Or maybe I can try another medication. There are a lot out there and I've only tried one.

1 comment:

  1. Thanks for sharing something so deep and personal! I love that you feel you can be so honest with yourself and the world! Also, I loved the Hot Rod clip!