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We Are Legion: Clinical Depression

March 9, 2017

Depression is one of those things that creeps so slowly up on you that you never notice you’re in its grasp until it is too late.  And it is a bit different for everyone who has it. According to the National Institute of Mental Health, depression can be expressed as: 

Persistent depressive disorder (dysthymia) – a persistent depressive episode lasting two years or longer;
Perinatal depression – this is not the mild “baby blues” that many women experience after childbirth but is a.k.a. postpartum depression, extreme sadness, anxiety, exhaustion prior to or after giving birth;
Psychotic depression – severe depression coupled with false beliefs/delusion, hallucinations, and can follow a delusional theme such as guilt, poverty, or illness;
Seasonal affective disorder – usually happening during winter months where there is less natural sunlight, lifting during the spring and summer and predictably returns every year;
Bipolar disorder – not really depression but is included as the disorder has a pendulum swing from hypomania or mania to major depression and back again.

To use the Biblical phrase, “We are Legion,” would not be an understatement. The World Health Organization states that depression is a common mental disorder and that, globally, over 300 million people of all ages suffer from it in one form or another. That’s just shy of the entire 2014 population of the United States. Let that number sink in. A group of people almost equaling in number of the entire population of the United States has depression of one kind or another.

For me, I fall firmly into the “Persistent Depressive Disorder” category. And here is my story just to let someone reading this that they are not alone.

Approximately 17 years ago, I exhibited signs that my spouse recognized as very unhealthy. It was like that all the joy had been sucked out of my life. Nothing was pleasurable. I had forgotten what fun was anymore as I had not experienced it for months if not years. Even sex no longer held my interest nor gave me pleasure. I wasn’t sad. I wasn’t forgetting to eat or overeat. I had no suicidal thoughts. I was just… existing. It had gotten to the point that my wife, after only two years of marriage, saw this was not right nor normal. I needed help. Which I resisted for months. It took her threatening to leave for me to schedule a doctor’s appointment and later visits with the first of many psychiatrists (or p-doc for short).

 

The first thing the p-doc did was order a complete blood work analysis. This test showed that my Serotonin levels were far below normal. Serotonin is the neurotransmitter your brain produces when you are feeling good and experiencing pleasure. I still produced Serotonin but in abysmal amounts. This placed me into the “Clinical Depression” category; meaning that there was not an outside trigger nor seasonal cause for my depression (e.g., I had not lived through the loss of a loved one nor had the “winter blues”) but biochemical. So in my case, I take a classification of drugs called Selective Serotonin Re-uptake Inhibitors (SSRIs)

Every person I know who has some kind of mental disorder (depression, schizophrenia, bipolar, et al) has had to change or find doctors that worked best with them. In this realm, you are your best advocate. If you feel you are not getting the correct or enough of a treatment, then you have the right to fire your doctor – yet be civil about it – and find another whom you click with. I’ve had to “fire” two of my p-docs because they decided to play games (one for withholding prescriptions, the other for putting my driver’s license in jeopardy) and find new ones. Not fun but almost everyone I know tackling mental issues has had to do this.

 

 

There is no one wonder drug that is going to fix my or anyone else’s problems. Antidepressants usually take three weeks or longer to get into your system; which can feel like forever as we all expect instantaneous results. Nope, it doesn’t work that way. Once the antidepressant starts to work, it is strongly suggested that you start working with a psychotherapist. Even though my core problem was biochemical, I still needed to talk to someone about things that were bothering me. My own insecurities and issues were amplified because the Serotonin was not there to balance things out for years at this point. But talking to someone about problems, things that annoyed or bothered me, and getting an outside perspective can and did greatly help me feel better. Just like with a psychiatrist, you may have to change therapists to find one that is sensitive or open to your needs such as being kink/BDSM friendly, non-mainstream religions, alternative lifestyles, et cetera.

There are going to be some sort of side-effects from taking antidepressants. I’ve experienced the following to varying degrees so far: nausea; dry mouth; metallic taste in mouth; weight gain; insomnia; diarrhea; anxiety; fatigue; agitation; irritability; and my personal favorite – decreased sex drive and orgasm capacity. Most side-effects greatly diminish within the first month or two of being put onto a new medication. But some can last longer or be a constant side-effect while on the medication. I had visual trails the entire time – two years – I was on one particular medication. It was amusing for a bit (night-time driving was an adventure until I learned how to compensate) but then it got old. And you may try one medication that is horrible but the next one is awesome. It really depends on your chemical and genetic make-up as to which ones work/don’t work for you.


 

Normally, a p-doc will prescribe a “cocktail:” a mix of different meds to help with the depression, the antidepressant’s side effects, and other issues that were masked by the depression. What kind of other issues? Aggression was the one that came up for me. The idea of going into a biker bar to start a fight sounded like a fun time and totally out of character for my personality. Never even knew this was inside of me. So we tried a couple of different medications to stabilize my aggressiveness. Again, everyone is different. Person A may have sudden bouts of laughter or crying for no reason, while Person B has no additional problems, Person C has newfound anxiety attacks, and so forth.

I’ve been on four or five different SSRIs so far; either the side effects did not abate, or a new medication was released, or one just suddenly stopped working (commonly referred to the “Prozac poop-out”). I’ve been doing this for roughly 17 years and it is always a battle. But some days the battle is hard-fought and other times the battle is easily won. And if you’re battling depression, you are very much not alone. You have a legion of 300+ million other people in a similar situation as you. It can get better and life can be fun again but it’s not easy. But I’ve yet to discover something worthwhile ever is easy to do or reach.

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