I’ve suffered from depression pretty much since adolescence. I paused for some time before finally using the expression “suffered from”. I feel like there is a better choice of words I could employ. Endured? Experienced? Whatever. Anyway. Back when I was a teenager, I briefly went to a psychiatrist and took some antidepressants (I don’t know which one, but I don’t recall it having any effect), but I didn’t really take the therapy process seriously — which is kind of ironic, given that I am pretty sure I’m the one who suggested I go to a psychiatrist in the first place. I don’t really remember for sure, though. I also don’t clearly recall exactly how my depression manifested itself. And it’s hard to say how much of it was just normal adolescent drama, and how much was the underlying chemical depression that I still have. Not really important to this blog post (although in truth, I don’t really know what the point of this post is or will be — I’ve just felt like writing about this for a while). Eventually I remember kind of deciding that I didn’t need the antidepressants or the therapy. I can no longer remember exactly what my thought process was, but I don’t remember my depression really re-surfacing until around my mid-20′s.
In my 20′s I did a lot of self-medicating with alcohol (not that I always considered it that at the time). That was only partially effective, though. Sometimes it would distract me from feeling bad, but I would almost always end up feeling worse afterward. I don’t mean a hangover. I would feel bad about the fact that I felt like I needed to drink in order to cope with things. And so maybe I’d decide not to drink for a while, but inevitably when I did drink again, I’d feel bad for giving in. It was a vicious cycle. Given that pretty much all of my immediate family has had severe drug and/or alcohol issues, I eventually decided to stop drinking altogether. I won’t say it was effortless, but it was pretty easy. I had difficulty limiting or regulating my drinking, but it’s not so tough when I just forbid it altogether — then there’s no opportunity for me to talk myself into it. This sort of strategy works well for me in many situations. Back when I would go running, I had to decide ahead of time how long I would run (either distance or time). If I allowed it to be variable, then I’d always try to convince myself to stop early, and I would end up feeling tired well before I should, just because of the whole internal mental conflict. But if I decided on the length of the run ahead of time, then there was nothing to think about — I could just turn my mind off and run. In many parts of my life, my mind can be a strength or a weakness. And in cases like this, I have to prevent my mind from getting in my way. But back to the topic at hand, I stopped drinking in 2009, at age 32.
Stopping drinking did not make the depression go away. True, I no longer had the cycle of unhappiness and regret that centered around my drinking. But I still was depressed. What do I mean by that, exactly? Well, back then I wouldn’t have been able to articulate it particularly well. I would have been able to tell you that I’d be going along fine and suddenly become sad, without clearly understanding why. I also found life to be overwhelming in a lot of ways. Now you may be saying “Sure, Mitch, everyone has those moments.” And I don’t doubt that’s true. But I would feel overwhelmed by stupid things. For example, I’d see I was out of soy milk. Just the thought of going to the grocery store to get it would make me tired. If I actually forced myself to do it, then it would be fine, but if I allowed myself to think about it ahead of time, it would seem daunting. And I often would want to sleep when the sadness descended or when things felt particularly overwhelming. I would also have a very hard time convincing myself to get out of bed unless I absolutely had to, because it just seemed more comforting to retreat to sleep rather than face the world.
In 2009 I went to a psychiatrist who put me on some antidepressants and recommended that I begin seeing a therapist (which I did). The antidepressants mainly helped me with the issue of not being able to get up in the morning. They didn’t cure the underlying thought process which would make me want to go back to sleep, but prior to being on the drugs, I often would not even allow myself to wake up enough to consciously think about whether I should get up or not. I would be mostly asleep and decide to stay asleep. The drugs allowed me to insert my conscious mind in there. I would still feel the urge to go back to sleep, but it gave me enough control that I could override that urge and get up anyway. This may seem like a small thing, but it helped a lot.
I think the therapy helped me a lot more than the drugs did, though. I’m not sure how therapy is supposed to work or what parts of it help most people, but in my case, I don’t think it was a case of me explaining my problems to my therapist, and her telling me what the solutions were. For me, I think the single biggest benefit of therapy was self-reflecting out loud, to another person. Even before I had been in therapy, I engaged in a lot of self-reflection. I considered myself intelligent and thought that I could figure myself out with enough thought. But I really needed to see myself through the eyes of another person, which I hadn’t been doing. So before therapy, I might have made an observation about myself, and then tried to see what it implied. But in therapy, I would make that observation out loud, realize how it must sound to someone else, and… well, it’s kind of hard to describe, really. Especially if you’ve never been in therapy. But a lot of my sessions would involve me saying something to my therapist, maybe even something I had thought to myself in the past, but just the act of saying it to another person made me learn more about myself. Anyway, really the point I am trying to make is that after I went to therapy for a while, it really helped me learn how to be my own therapist. Because now I can often just imagine myself being in the office and telling her something, and just imagining it is helpful.
Among other things, the therapy allowed me to better understand my mind, my emotions, etc. So for example, prior to therapy, one of my sad moods would descend and I would try to figure out what had caused me to be sad. But some strategies I’ve learned in therapy help me identify when these sad moods aren’t caused by anything real, and thus I don’t waste my time and energy trying to figure them out. And I don’t assign the emotions undue significance. That said, I still do experience the random sadness, and while being able to identify it does help, it still isn’t fun to experience.
I’m losing my train of thought here. I want to talk about my latest medication change, which has had mixed results. It has done very good things for my energy levels and motivation and tendency to be overwhelmed. But it has made my sad moods much more intense. Not suicidal intense or anything, but markedly worse than before. I kind of feel like Adam Sandler’s character in Punch Drunk Love when he says he sometimes cries for no reason. No, I’m not ACTUALLY breaking down crying. But when the moods descend now, I definitely feel the urge to. It’s pretty weird, and not fun. And I think that’s what made me want to write about this stuff in the first place, although now that I’ve created this rambling monstrosity, I’m not sure it has helped me for writing it, or you poor readers for having read it. :) However, if history is any indication, this unfocused monologue will probably bounce around in my head for a while, after which I will be able to come back and write a more concise entry to sum things up.