Thoughts on depression
Dec. 13th, 2010 08:03 pm![[personal profile]](https://www.dreamwidth.org/img/silk/identity/user.png){kind=small}
moominmuppetI was writing this last night, but didn't finish it. It's still not "finished", but it's probably as close as a ramble like this will get.
One of the things I really can't stand about the depression is the existential angst. It's like a mid-life crisis every few months; obsessing over how short life is, interactions with everyone and everything tainted by a sour touch of "...and they're going to die..." (this happens about both people and critters) Blah. Boring, repetitive, obnoxious, and paradoxically paralysing (since one would expect the logical outcome of "this won't be around forever" to be "let's appreciate the hell out of it now!", but it seems to have much more to do with hiding under blankets and sleeping a lot, alternating with ruminating on how I'm wasting my brief spark of time and how I suck even worse for that). I can't complain too much, though. It's part of what keeps me safest -- the last thing I'm ever likely to do is kill myself when I'm depressed. Least logical response ever to a "death comes for all of us too soon" obsession *snort*. (Worth noting -- death doesn't particularly bother me when I'm not depressed; it's not a worldview issue, it's a psychological one)
I'm pretty personally familiar with a lot of manifestations of mental illness, and all in all I have to say that I'm pretty lucky with the presentation of mine, even if it does make me into a rather insufferably pretentious pseudo-emo-kid some of the time. Damned brainmeats. And really, most of the time that I know I'm depressed, I'm not actually doing too badly moodwise, as long as I have company and distraction. Alone with the brain is a different story, and is the primary characteristic I use to determine my level of depression; that's when I can tell the brainmice are nibbling and gnawing. If I can't comfortably spend time with my own brain and nothing else to distract me, I'm not in good shape. The distraction thing can be tricky, though. Sometimes it's helpful or neutral, but sometimes, combined with my tendency to get avoidant about stressors when I'm depressed, it can get really out of hand. The past few weeks have been a good example of that, because I've been failing at the basic maintenance that prevents life from getting worse, which just makes the depression worse (and more anxious). That's the spiral I spent my twenties learning how to avoid; the lesson should be pretty well beaten into me by now after the number of times I collapsed my life around my ears back then. I'm getting better and faster about calling a halt to the collapse, though. This time, it was asking for help from the housemates, and that's made a big difference. Sometimes it's about being hyper-rational -- "I may not believe one little bit that action X will make anything better, but my data so far shows that most of the times I've tried it, it actually has, so I'm going to ignore what I believe and do what makes sense" -- this has saved me a number of times, too.
I tend to subscribe to the notion that was put to me once that one of the most misleading things about depression is the mistaken notion that if you wade deep enough into the swamp that you'll find some treasure of understanding. Basically, the concept that pain must equal truth. Spending a lot of time following those depressive chains of thought, trying desperately to wring meaning out of the pain, is often just a good way to spend more time getting deeper into the swamp. I tend toward a "ride it out as unmiserably as possible, and ignore the brainmice for the misleading and meaningless chatterers that they are" approach most of the time. When I'm depressed, I don't generally "want to talk about it" beyond keeping people basically updated on my overall status and issues. It's not helpful beyond that, because too many of my original premises are flawed, my decision-making is screwed, and I'm as likely to create self-fulfilling prophecies as I am to uncover anything resembling a "truth" (I generally have a two-week rule for relationship decisions because of this, too -- I'd rather not put my partners through breakups every time I get convinced by my biochemistry that our relationship is hopeless).
Things that break when I'm depressed:
One of my bigger frustrations is that I cease feeling like I can put words together in any manner that isn't embarrassing. They flow like sludge, and I hate that. It's part of why I started doing the linketies; it's a way of doing several things at once that are useful to me: it allows me a way of reaching out and making contact with the world without having to come up with anything specific to say, it's a way of usefully sharing and educating (and often clarifying my own positions, too), even if on a small scale, and that feeds my activist side. And it encourages me to keep up on things in the world, both the amazing and the horrifying. It also gives me a small concrete project to keep up on; something I can look at and say "well, if I didn't accomplish much else today, at least I accomplished that". When my "linketies to read" folder is empty, I win (I'm close at the moment -- 15 open tabs to read, and another eight emails waiting).
Also, travel. As someone who spent a number of years jumping in a vehicle or on a bus and traveling all over the place on a whim and on my own, it feels very weird that I've become rather avoidant of that, too. Not just across country, but across town. Sometimes I wonder if I'm becoming borderline agoraphobic, but I don't think that's really what's going on. It's definitely tied to my anxiety levels, though. I think the issue is that I've used travel (which actually also includes spending almost all my time at other people's houses locally) as a way of running away from my problems in the past, of ignoring having utilities shut off, of having my life-at-home collapse around my ears as mentioned above. Now, if I'm having any homelife-competence anxieties at all, travel feels very dangerous, like I might be starting to run away again, or precariously balanced things may collapse while I'm gone and not there to ameliorate the damages of my own idiocy. Other factors include my health (it's just harder to travel these days, and takes me longer to recuperate, and I feel guilty about 'having a life' when I'm still taking FMLA days to function at work), and the fact that even aside from anything else, I really love home, and would rather be there with the household and the critters than just about anywhere else. Then again, I've never really liked being away from my critters, and that didn't used to stop me from getting out and doing stuff.
And, of course, Sex. To those who've been following this journal for any length of time, this one'll be a broken record; there's ten years of intermittent "what the fuck?" about my libido vagaries scattered through my posts. Again, this is an anxiety thing more than a depression thing. It'd make much more sense if it were a nice clear-cut "manic=sexytimes/depression=noneforme" kind of deal, but it isn't. I think it's a lot like the travel thing; something that's easy to use as an escape/alternate focus. Also, it's something that makes my judgment wonky, and when I'm anxious, I'm especially anxious about things that can do that. When I'm stressed, libido/relational-interest is generally the first thing to go; I think it's about marshalling my mental resources to some extent, and about avoiding my own psychological pitfalls to an even greater extent (which is why I say libidinal and relational -- I shut down romantically as well, because Sarah-in-Love is even less trustworthy and sensible than Sarah-in-Lust). "That subsystem is not reliable. Shut it down!" Very frustrating and strange to be so deeply interested in sexuality studies and have this kind of long-term pattern in my life, since it has a negative effect on my ability to pursue my own academic and personal interests. At the same time, it's an interesting insight into why asexuality does work well for a number of people; it's not uncommon for me to have 4-8 month periods where sex just seems like a rather strange concept that other people do for relatively inexplicable reasons. I think it may be similar to the experience of actual asexuality, and it's not at all unpleasant or unfulfilling, it just gives me energy and focus for different things in different directions. Then again, since I am a sexgeek, this is also relatively inconvenient for me in larger conceptual ways. Also, confusing as hell for the people in my life; I switch pretty quickly from "no interest no way no how" to "too overwhelming and kinked for most folks to cope" and back again, without a lot of middle ground. On the positive side, my actual beliefs aren't contradictory to my behavior during those surges, so I don't end up with piles of regrets or anything; although concerns about hypersexuality and hypomania are reasonable, it's not hard for me to dismiss them in my personal case, because I don't find them destructive to my life (quite the opposite), and I don't find myself with regrets even when I get to the "foreign concept" level of personal disinterest. It's something I try to be honest about with people, so they're not worrying that they're feeding into an unhealthy pattern I'll regret later (clearest indication this isn't the case -- I don't go back and hide/remove anything once I'm out of that phase; it's part of me, and a part I like a good deal and enjoy sharing).
Related to this, from a conversation elsewhere:
I have a lot of trouble identifying direction of causation myself. So much with mood disorders can work either way, or be self-perpetuating in various ways. In some ways that's helpful, since sometimes I can use changing my behavior as a way of modifying my mood in a "fake it 'til you make it" sort of way, but sometimes it's just infuriatingly confusing and frustrating, because I can't tell what's cause and what's effect in my life. -- It's often very hard for me to sort out whether I'm taking an action that impacting my mood in some way, or have finally started taking that action because my mood is starting to shift. Or both. Or neither. Or whatever. This post, for example. It seems to be actively helping me to write it, but I don't know that it would've helped to try to write it a week ago, because a week ago I was still to deep in to be able to write it. I think.
Current status: Doing better, in general (as usual, I don't start writing in detail about what's going on until I'm starting to come out of it -- it's one of the clearer signs that I am, actually). My anxiety levels are coming down as Caleb and I tackle the financial stressors, and that's a major factor. I'm still spending way more time unable to imagine accomplishing anything than I'd like, and I'm still not getting my full quota of chores done (let alone anything else the least bit interesting and productive), but I'm doing better than I was in the past few weeks, and I'm back to using the spreadsheet to note them again, which is good. Still wanting to spend all my time sleeping, still having some screwed up dreams when I do, but not anywhere near as many stress dreams. Yay for that! Caleb and Grafton have been carrying the lion's share of the load for the past few weeks in terms of household projects and chores, but as unfair as that is, at least seeing progress happening even when I'm not the one making it happen helps me mostly avoid the Pit of Despair.
OK, that's enough for now. I'm sure at some point when the tides turn there'll end up being a similar post about hypomania.
Edit to Add: Oh, clarification for those who're curious -- I'm on very minimal meds, after years of trying various combinations and getting more side-effects than useful results. Instead, I prefer trying to stabilize my life and organize it such that I can ride through the swings as well as possible, only adjusting or increasing meds as a last resort. I'm in a sort of weird spot; way back when in undergrad, my major was psych, specifically focusing on psychopharmacology and physio psych. I've continued to follow the research news since then, and am generally in a decent position to make sense out of what I read. I'm a feminist science geek and skeptic, and all of that deeply influences my interpretations and decisions about my health care. I've got multiple chronic illnesses that don't respond all that well or reliably to currently available treatments (fibromyalgia and bipolar II are the major ones), and which are often subject to the worst of the misleading medical marketing currently endemic to american society. I believe wholeheartedly in science and research, but I also think most people are somewhat deluded in how far along that path we really are in regards to these things. Also worth noting: I'm ridiculously lucky that I'm in a situation and dealing with conditions where I have this option to be minimal about meds. If my psych condition were more extreme or more dangerous to me or others, it'd be a different analysis, and I'd still be working on finding meds that'd work effectively for me.
I posted both these articles recently; they're good examples of how I tend to think about things: Many treatments for depression are no more effective than placebos.
Contrariwise: Science is Not the Oppressor
One of the things I really can't stand about the depression is the existential angst. It's like a mid-life crisis every few months; obsessing over how short life is, interactions with everyone and everything tainted by a sour touch of "...and they're going to die..." (this happens about both people and critters) Blah. Boring, repetitive, obnoxious, and paradoxically paralysing (since one would expect the logical outcome of "this won't be around forever" to be "let's appreciate the hell out of it now!", but it seems to have much more to do with hiding under blankets and sleeping a lot, alternating with ruminating on how I'm wasting my brief spark of time and how I suck even worse for that). I can't complain too much, though. It's part of what keeps me safest -- the last thing I'm ever likely to do is kill myself when I'm depressed. Least logical response ever to a "death comes for all of us too soon" obsession *snort*. (Worth noting -- death doesn't particularly bother me when I'm not depressed; it's not a worldview issue, it's a psychological one)
I'm pretty personally familiar with a lot of manifestations of mental illness, and all in all I have to say that I'm pretty lucky with the presentation of mine, even if it does make me into a rather insufferably pretentious pseudo-emo-kid some of the time. Damned brainmeats. And really, most of the time that I know I'm depressed, I'm not actually doing too badly moodwise, as long as I have company and distraction. Alone with the brain is a different story, and is the primary characteristic I use to determine my level of depression; that's when I can tell the brainmice are nibbling and gnawing. If I can't comfortably spend time with my own brain and nothing else to distract me, I'm not in good shape. The distraction thing can be tricky, though. Sometimes it's helpful or neutral, but sometimes, combined with my tendency to get avoidant about stressors when I'm depressed, it can get really out of hand. The past few weeks have been a good example of that, because I've been failing at the basic maintenance that prevents life from getting worse, which just makes the depression worse (and more anxious). That's the spiral I spent my twenties learning how to avoid; the lesson should be pretty well beaten into me by now after the number of times I collapsed my life around my ears back then. I'm getting better and faster about calling a halt to the collapse, though. This time, it was asking for help from the housemates, and that's made a big difference. Sometimes it's about being hyper-rational -- "I may not believe one little bit that action X will make anything better, but my data so far shows that most of the times I've tried it, it actually has, so I'm going to ignore what I believe and do what makes sense" -- this has saved me a number of times, too.
I tend to subscribe to the notion that was put to me once that one of the most misleading things about depression is the mistaken notion that if you wade deep enough into the swamp that you'll find some treasure of understanding. Basically, the concept that pain must equal truth. Spending a lot of time following those depressive chains of thought, trying desperately to wring meaning out of the pain, is often just a good way to spend more time getting deeper into the swamp. I tend toward a "ride it out as unmiserably as possible, and ignore the brainmice for the misleading and meaningless chatterers that they are" approach most of the time. When I'm depressed, I don't generally "want to talk about it" beyond keeping people basically updated on my overall status and issues. It's not helpful beyond that, because too many of my original premises are flawed, my decision-making is screwed, and I'm as likely to create self-fulfilling prophecies as I am to uncover anything resembling a "truth" (I generally have a two-week rule for relationship decisions because of this, too -- I'd rather not put my partners through breakups every time I get convinced by my biochemistry that our relationship is hopeless).
Things that break when I'm depressed:
One of my bigger frustrations is that I cease feeling like I can put words together in any manner that isn't embarrassing. They flow like sludge, and I hate that. It's part of why I started doing the linketies; it's a way of doing several things at once that are useful to me: it allows me a way of reaching out and making contact with the world without having to come up with anything specific to say, it's a way of usefully sharing and educating (and often clarifying my own positions, too), even if on a small scale, and that feeds my activist side. And it encourages me to keep up on things in the world, both the amazing and the horrifying. It also gives me a small concrete project to keep up on; something I can look at and say "well, if I didn't accomplish much else today, at least I accomplished that". When my "linketies to read" folder is empty, I win (I'm close at the moment -- 15 open tabs to read, and another eight emails waiting).
Also, travel. As someone who spent a number of years jumping in a vehicle or on a bus and traveling all over the place on a whim and on my own, it feels very weird that I've become rather avoidant of that, too. Not just across country, but across town. Sometimes I wonder if I'm becoming borderline agoraphobic, but I don't think that's really what's going on. It's definitely tied to my anxiety levels, though. I think the issue is that I've used travel (which actually also includes spending almost all my time at other people's houses locally) as a way of running away from my problems in the past, of ignoring having utilities shut off, of having my life-at-home collapse around my ears as mentioned above. Now, if I'm having any homelife-competence anxieties at all, travel feels very dangerous, like I might be starting to run away again, or precariously balanced things may collapse while I'm gone and not there to ameliorate the damages of my own idiocy. Other factors include my health (it's just harder to travel these days, and takes me longer to recuperate, and I feel guilty about 'having a life' when I'm still taking FMLA days to function at work), and the fact that even aside from anything else, I really love home, and would rather be there with the household and the critters than just about anywhere else. Then again, I've never really liked being away from my critters, and that didn't used to stop me from getting out and doing stuff.
And, of course, Sex. To those who've been following this journal for any length of time, this one'll be a broken record; there's ten years of intermittent "what the fuck?" about my libido vagaries scattered through my posts. Again, this is an anxiety thing more than a depression thing. It'd make much more sense if it were a nice clear-cut "manic=sexytimes/depression=noneforme" kind of deal, but it isn't. I think it's a lot like the travel thing; something that's easy to use as an escape/alternate focus. Also, it's something that makes my judgment wonky, and when I'm anxious, I'm especially anxious about things that can do that. When I'm stressed, libido/relational-interest is generally the first thing to go; I think it's about marshalling my mental resources to some extent, and about avoiding my own psychological pitfalls to an even greater extent (which is why I say libidinal and relational -- I shut down romantically as well, because Sarah-in-Love is even less trustworthy and sensible than Sarah-in-Lust). "That subsystem is not reliable. Shut it down!" Very frustrating and strange to be so deeply interested in sexuality studies and have this kind of long-term pattern in my life, since it has a negative effect on my ability to pursue my own academic and personal interests. At the same time, it's an interesting insight into why asexuality does work well for a number of people; it's not uncommon for me to have 4-8 month periods where sex just seems like a rather strange concept that other people do for relatively inexplicable reasons. I think it may be similar to the experience of actual asexuality, and it's not at all unpleasant or unfulfilling, it just gives me energy and focus for different things in different directions. Then again, since I am a sexgeek, this is also relatively inconvenient for me in larger conceptual ways. Also, confusing as hell for the people in my life; I switch pretty quickly from "no interest no way no how" to "too overwhelming and kinked for most folks to cope" and back again, without a lot of middle ground. On the positive side, my actual beliefs aren't contradictory to my behavior during those surges, so I don't end up with piles of regrets or anything; although concerns about hypersexuality and hypomania are reasonable, it's not hard for me to dismiss them in my personal case, because I don't find them destructive to my life (quite the opposite), and I don't find myself with regrets even when I get to the "foreign concept" level of personal disinterest. It's something I try to be honest about with people, so they're not worrying that they're feeding into an unhealthy pattern I'll regret later (clearest indication this isn't the case -- I don't go back and hide/remove anything once I'm out of that phase; it's part of me, and a part I like a good deal and enjoy sharing).
Related to this, from a conversation elsewhere:
I have a lot of trouble identifying direction of causation myself. So much with mood disorders can work either way, or be self-perpetuating in various ways. In some ways that's helpful, since sometimes I can use changing my behavior as a way of modifying my mood in a "fake it 'til you make it" sort of way, but sometimes it's just infuriatingly confusing and frustrating, because I can't tell what's cause and what's effect in my life. -- It's often very hard for me to sort out whether I'm taking an action that impacting my mood in some way, or have finally started taking that action because my mood is starting to shift. Or both. Or neither. Or whatever. This post, for example. It seems to be actively helping me to write it, but I don't know that it would've helped to try to write it a week ago, because a week ago I was still to deep in to be able to write it. I think.
Current status: Doing better, in general (as usual, I don't start writing in detail about what's going on until I'm starting to come out of it -- it's one of the clearer signs that I am, actually). My anxiety levels are coming down as Caleb and I tackle the financial stressors, and that's a major factor. I'm still spending way more time unable to imagine accomplishing anything than I'd like, and I'm still not getting my full quota of chores done (let alone anything else the least bit interesting and productive), but I'm doing better than I was in the past few weeks, and I'm back to using the spreadsheet to note them again, which is good. Still wanting to spend all my time sleeping, still having some screwed up dreams when I do, but not anywhere near as many stress dreams. Yay for that! Caleb and Grafton have been carrying the lion's share of the load for the past few weeks in terms of household projects and chores, but as unfair as that is, at least seeing progress happening even when I'm not the one making it happen helps me mostly avoid the Pit of Despair.
OK, that's enough for now. I'm sure at some point when the tides turn there'll end up being a similar post about hypomania.
Edit to Add: Oh, clarification for those who're curious -- I'm on very minimal meds, after years of trying various combinations and getting more side-effects than useful results. Instead, I prefer trying to stabilize my life and organize it such that I can ride through the swings as well as possible, only adjusting or increasing meds as a last resort. I'm in a sort of weird spot; way back when in undergrad, my major was psych, specifically focusing on psychopharmacology and physio psych. I've continued to follow the research news since then, and am generally in a decent position to make sense out of what I read. I'm a feminist science geek and skeptic, and all of that deeply influences my interpretations and decisions about my health care. I've got multiple chronic illnesses that don't respond all that well or reliably to currently available treatments (fibromyalgia and bipolar II are the major ones), and which are often subject to the worst of the misleading medical marketing currently endemic to american society. I believe wholeheartedly in science and research, but I also think most people are somewhat deluded in how far along that path we really are in regards to these things. Also worth noting: I'm ridiculously lucky that I'm in a situation and dealing with conditions where I have this option to be minimal about meds. If my psych condition were more extreme or more dangerous to me or others, it'd be a different analysis, and I'd still be working on finding meds that'd work effectively for me.
I posted both these articles recently; they're good examples of how I tend to think about things: Many treatments for depression are no more effective than placebos.
Contrariwise: Science is Not the Oppressor
![[identity profile]](https://www.dreamwidth.org/img/silk/identity/openid.png){kind=small}
no subject
Date: 2010-12-14 04:59 am (UTC)So much I recognise, too. I think I cling to the cats right now as a way of keeping me from throwing my hands in the air and walking out the door. Drop my mom the occasional note to let her know that I'm well and otherwise disappear.
(I don't have your phone number!)
no subject
Date: 2010-12-15 04:20 am (UTC)Posting the phone number in a screened comment next.
no subject
Date: 2010-12-14 04:27 pm (UTC)The depression treatment versus placebo article was interesting. I've never chemical antidepressants to be remotely helpful, although ect has been a literal lifesaver for me. I definitely don't think it's the end all be all treatment for depression, but I'm told it pulled me out of a nearly catatonic state when I was in the hospital this past fall [I don't actually remember much of that time period so I'm relying on friends and family for my information.]
In regards to feeling housebound, I think it's can be a good thing. Spending a lot of time alone allows me to clear out a lot of my brain junk. I do make a point of going out for social time at least once a week, but mostly I follow my instincts. If I'm feeling reclusive, then I behave that way. It lets me build up more energy for socializing when I reach that point.
no subject
Date: 2010-12-15 04:24 am (UTC)In regards to feeling housebound, I think it's can be a good thing. Spending a lot of time alone allows me to clear out a lot of my brain junk. I do make a point of going out for social time at least once a week, but mostly I follow my instincts. If I'm feeling reclusive, then I behave that way. It lets me build up more energy for socializing when I reach that point.
*nod* I think overall that's true for me, but I form habits too quickly and too intensely, and so I'll often end up continuing a habit of being antisocial just because that's where I've been for a while. It generally takes an active decision to try to get back out of it again. Of course, I'm mostly a homebody introvert anyway, but I do need to get out and be more social than I have been the past year or so, definitely. It's become something of a running joke that I'm more of a rumor than a person to most people who don't actually come to our house.
no subject
Date: 2010-12-15 11:19 am (UTC)*Nods* My secret is using my Google calendar. I'm not sure exactly why, but if I schedule my social time in advance online and then set it to send me email reminders I'm much more likely to get out than if I just try to do things spontaneously.
no subject
Date: 2010-12-20 03:13 am (UTC)no subject
Date: 2010-12-14 08:43 pm (UTC)The whole self awareness point really struck a chord. I'm VERY aware of my mental state, when it dips, when it dips low enough to retreat, when it dips low enough to ask for help). I get so angry having to justify my medication needs to new doctors. It sounds really bloody arrogant (sorry) but I have a 152 IQ, I'm a smart cookie, yes, I've tried lots of things; excercise, diet changes, life changes, CBT, therapy, fucking aromatherapy, you name it, I've tried it. The only thing that makes me feel 'normal' (ie, not wanting to burst into tears watching adverts about toilet roll or wanting to throw myself under a bus) is Prozac. Just give me the damn drugs!!.
no subject
Date: 2010-12-15 04:27 am (UTC)no subject
Date: 2010-12-16 05:57 am (UTC)no subject
Date: 2010-12-20 03:14 am (UTC)