My Lucky Depression

I have major depressive disorder.

Depression is one of those conditions that comes with baggage. It is misunderstood. Before I understood what I struggled with, I thought that people took too many medications to manage imaginary or overwrought problems. ‘If your life sucks, don’t take meds to ignore it; fix your life!’ Or, ‘I think 90% of Americans are on antidepressants, next it will be in the water like fluoride, hahaha.’ You see the stigma in the worst question a person struggling with depression hears: "What do you have to be depressed about?" So I want to take a minute to explain how it feels to me and how I manage my condition. I do this in the hopes that it loses some of its stigma for everyone.

To me, depression is all in my head but it isn’t imaginary. It is a medical problem that exists within and is caused by my brain. This is true as much as with asthma or cancer. It isn’t my choice and it isn’t a sign of weakness, any more than asthma or cancer is.

Depression feels like a roller coaster, with highs and lows. The highs for me are normalcy, but the lows are the depressive periods. Whenever I am doing well, it is the roller coaster ascending or staying level. Sometimes, though, I can feel the apex of my mood coaster. There is a crest on the hill, that when I pass it, nothing can stop the descent. Once I pass that crest, there is no easy return. I have to go all the way down. I don’t know how deep this valley will be, or how long it will last. I could be a short dip or it could be a massive crash. I don’t know; I’m not the guy that built the coaster. The anticipation knowing that the crest is ahead is unbearable. There is usually no specific event that causes it. It feels random: "Oh, shit. I feel the crest coming up. The descent is ahead. Shitshitshitshit..." It is a horrible feeling to know that I am passing the summit just before the stomach-churning downhill rush. Thinking about it - ruminating on avoiding it - doesn't help. It makes it worse.

The depressive lows feel like a massive burden. I am not a good enough writer to explain how uncomfortable a depressive state is. It is mentally, emotionally, and physically unbearable all at once. It is like weights are pressing down on me, but also squeezing me. Everything is heavier. Lights seem dimmer. Insomnia is a big problem. When in the pit of depression, I can get an hour or two of sleep per night for a week straight. Nothing feels good on an emotional level, even when I know that intellectually good things are happening. It is a struggle to do anything – it is a chore to get out of bed, but it is a chore to go to bed. It isn’t quite like sadness for me. It is more complex than that, which makes it hard to describe. I am sad, but I am also apathetic, tired, lazy, angry, ashamed, and frightened, all jumbled up into one steaming pile of negativity with a false smile on my face.

Outwardly, I don’t think that I show the struggle. People that know me especially well may be able to tell. I get irritable. Angry. I am short-tempered with my family and co-workers. I hate my bosses and I hate my peers. My decisions get reckless. My temper is on a hair trigger. I get impulsive and make hasty bad decisions.

I think depression has affected my job and my family. I don’t see how it couldn’t have. I waited too long to get help and manage my condition. I am sure that depression has slowed the progression of my career. I hope it hasn’t affected my family too much. 

The first time I asked for help was three years ago. I made an appointment to see my doctor. Thankfully, he could see me in only about a day or two. My doctor knows me as a tough guy. (I walked around with a hot appendix for two weeks claiming it was just gas. When I finally went to see him for that, he gave me some barium to drink before going to CT two hours later. I asked to go back to my office so I could finish up two hours of work before getting the scan. With what turned out to be appendicitis. So that is the kind of patient that my doctor knows me as.) Anyway, I was waiting in his office when he walked in. He asked what was going on, with a smile. I told him that I needed help, that I thought I had depression, and then I commenced to bawl for 15 minutes about nothing. It was one of the most embarrassing things I have ever done. But it shouldn't have been embarrassing. I just needed help.

I was never suicidal, but that can go along with depression. I think that suicide can be one of those impulsive decisions, and I fear that I have been lucky to not accidentally crash through the wall of hopelessness and get that impulse. If the impulse can be delayed, the urge passes. Even when suicide is attempted, only about 15% of survivors reattempt. I’ve read stories of people who survived jumping off the Golden Gate Bridge who were regretting the decision on the way down. Just slowing the impulse can end it – that is why simple, easy to climb barriers on bridges work to lower suicide rates. Winston Churchill was a depressive – he described it as a black dog that followed him. He understood the impulsivity of suicide. He said: “I don’t like standing near the edge of a platform when the express train is passing through… A second’s action would end everything. A few drips of desperation.” I’m very glad I haven’t had a few drips of the suicidal impulse.

In 2005, this fence was added to Tromsø Bridge in Tromsø, Norway, because at the time the bridge was commonly used as a suicide location. It is not hard to climb if motivated to do so, but barriers like this are highly successful at lowering suicide rates. (By Kagee [Public domain], via Wikimedia Commons)

My depression is just related to ions and neurotransmitting chemicals inside my brain. It is just the way that I am. It isn’t related to PTSD, or abuse, or my upbringing. I rarely think of calls after I run them. I’m not carrying along a memory full of faces, or anything like that. I had a happy childhood. I wasn’t mistreated or molested. My family loves me and I have plenty of friends. In that I am lucky, as well.

Finally, I am lucky that my condition has been treatable, for the most part. What works for me is medication – 10 milligrams of citalopram, daily. The Celexa helps level out the roller coaster. It doesn't stop the valleys from existing, but it makes them much more shallow. If I miss a few doses, I can feel the roller coaster start to crest the hill. Along with the medication, I need to exercise out the angry thoughts. So I need to exercise almost daily. I find that the exhaustion of CrossFit helps me the most. Missing sleep causes valleys to grow on my roller coaster track, so I try to get plenty of sleep. (It is ironic that depression causes me insomnia.) When I can feel an emotional valley ahead, I need to back off the booze and I need to avoid current events. I have to make an effort to find happy thoughts. I strive for contentment.

Studies show that antidepressants are more successful when combined with talk therapy of some sort. I haven’t found therapy to be helpful. I attempted therapy twice. Therapy ended twice, and not at my choice. Therapists tell me that I am a minor case of mental illness and I am taking up appointment space that could be used for people with more severe illness. I’m okay with that, because I wasn’t getting a lot out of talking. There are also a lot of Christian therapists, but I am not a Christian. So that doesn’t help. The medication seems to help even without talking to a professional, so maybe I just don’t need therapy.

One of the other things that has helped is to understand that sometimes you just have to go in the valley of the roller coaster. But now I know the screaming descent isn't real. The valley is in my head. My brain is lying to me that I am rushing downhill. I only feel that way. So there is a limit to the valley. Knowing that makes it easier. For me.

All of the stuff above is how depression feels to me. Your experience, or the experience of a loved one, may be different. One way or the other, depression is not something that needs to be hidden. It needs to be managed. Hiding my struggles made it harder to manage the condition because I was too embarrassed to get help. There is only a stigma associated with the condition if we allow the stigma to exist. There is no shame to depression. Don’t be afraid to talk about it.