Wednesday, September 11, 2013

Why I haven't written anything in a long time

If you ever bothered coming to this blog in the past several months, you may have noticed that there haven't been any posts since the end of December. I realize that I've gone lengthy periods without posting before, but this time has been different. I don't know when the reasons will be over, or when I'll be getting back to blogging on a (semi) regular basis. I'd like to, but we'll see.

Back in December, I started experiencing symptoms of depression. It started as just being tired, almost constantly. No matter how much sleep I got, I'd only get, at best, 5-6 hours of feeling awake. After that, my energy was gone, my eyes were heavy, and all I really wanted to do was sleep. Around the same time, my interest in socializing dropped tremendously, and I was staying home even more than usual for me. However, for whatever reason, I didn't really notice the pattern until the end of January, and recognize it for what it was. I had entered another depression phase. My illness was back.

I've had depression before, multiple times in fact. I wrote some about it in a post from March, 2012 (which I just reread, and am feeling shockingly emotional after doing so--I think I needed to read it again). In general, when someone recovers from a period of clinical depression, it's most appropriate to think of it as a form of remission. Eventually, it comes back. The sad thing is, in that post from 2012, I point out that I'm aware of the possibility that my depression could return, and yet, I'm not sure that I truly believed that it would, or could. I could intellectually grasp it, but it wasn't a visceral knowledge such that I could believe it on an emotional level. And right now, I'm having to remind myself that there's no reason to kick myself over that. It's a natural thing.

I don't know why the depression came back when it did. I remember that I had been feeling emotionally some months earlier from reading and thinking about the crap in the world, the abuse that people suffered, the people trying to force their religion on people and government (far too often in ways that would be directly harmful), the sexual abuse, etc. All that stuff that I was looking at and reading about in news and blogs, and the fact that I was letting myself feel the anger about, just wore me down for a while. But I don't remember that being a factor around December, so I can't say if it contributed to my depression's return or not. At this point, I can only say that it returned, and maybe it's just a matter of my brain being broken.

When I realized that I was (and still am) depressed, I talked to my wife about it, telling her what I noticed as a pattern, and that I should probably seek therapy. As always, she was supportive and understanding. She had noticed the changes in me as well. Just talking to her about it, getting it out in the open, seemed to help. Much of my energy returned, and I was no longer exhausted for most of the day. I was still being affected in other ways, though. I had little interest in socializing, and my desire to read, my motivation for writing, and my interest in a variety of things I generally enjoyed were all at an extreme low point. I've been an avid reader for most of my life, so a lack of desire to read is a pretty big deal. It just doesn't feel like I'm entirely "me" if I'm going weeks, and months, without wanting to read. I have books next to my bed that I had been looking forward to reading, but yet, I haven't cracked them open. They've been there, in some cases, for months.

In the past when I've had depression, it's affected my life in some major ways. I've lost jobs because it made it hard to get out of bed, and I would call in sick or be late far more often than any employer should have to deal with. It was the major factor in why I wound up homeless for a few months. When I tell people that I had to drop out of college for "medical reasons," it's the depression I'm referring to. It made it difficult to go to class, or to do the work I needed to do to even pass a class. I wound up on academic probation as a result, got my adviser to write a letter on my behalf when I thought I could actually make it work, and then dropped out when I realized I couldn't. I've wanted to return to college in the years since, but simply haven't been in a position to afford it, or give it time when I might have been able to afford it.

Medication and some rough therapy got me through it, along with the support of my good friends. From spring, 2004, until late 2012, I was depression free. I had some points when a very stressful job had me skirting the edges, but I managed. Honestly, when I think about it, eight years is a pretty damn good run. I was able to manage it because of what I learned in therapy, and the things I've learned since then.

Once I recognized that I was depressed again, I started trying to apply some of that. Greta Christina, of the appropriately named "Greta Christina's Blog," is a blogger that I quite enjoy, and who also deals with depression. She's been very open about it, and has written several pieces on what she learns, and how she manages. One of the things she learned, and that I've taken as advice, is to do something you'll enjoy, as long as you have even a slight desire to do so, even if you're not really feeling like doing it. So for example, when my best friend, Kyle, invites me to come over and hang out, maybe check out a new video game he's got, I'll do it. Even though I'm not feeling social, I know that I almost always enjoy my time with him, doing things I normally enjoy is good for me, and aids (a lot, as it turns out) in managing the depression. And yes, that is an actual example, and sure enough, I wound up having a great time. I've continued to go to meetings with RAFT (Rochester Area FreeThinkers) because that's something I generally enjoy, and is one of the few things I do of a social nature. Although, I've become a lot quieter there in these past several months, as I haven't been keeping up on many of the topics and news items that get discussed like I used to.

Using this technique (which apparently is part of cognitive behavioral therapy, though I didn't know that at first), I've managed to avoid cutting off my social life, which would only have aggravated my depression. I've pulled back, partly deliberately, from reading many of the blogs and articles that would most likely have upset me, and unbalanced my emotions further. This is a temporary measure, and I've started getting back into reading those things more. It's slow, like cautiously getting into a pool or hot tub, but I'm getting there. I used to work for two weeks straight, then would get two days off. Even before the depression hit, that was starting to burn me out. When one of my clients stopped working with me (not a happy event for me, in fact, rather upsetting), that gave me Friday's off, which meant that I could have at least one day off in the middle of that two week period. As such, I've refused to be put on a regular schedule for Friday's at work, though I'm still willing to occasionally fill in for someone. This has helped to keep my stress levels down as well. There are other things I've done as well, but there's no need to detail every little thing.

I did get into therapy, but it took longer than was ideal. My doctor gave me a referral, but it would've been a couple months before the psychiatry department at his hospital could have gotten me an appointment. As such, they gave me the names of four other places I could try. The first one or two I called had horrible phone systems. At least one of them didn't have any option to reach an operator, and it's message was "If you wish to speak to Doctor So-and-so, press 1. If you wish to speak to Doctor Other-so-and-so, press 2 . . ." and so on. Um, how the hell would I know?? I was just given the name of the company and a phone number, I have no idea which Doctor I should talk to. Isn't there an intake receptionist or something?

One of the things I've had to deal with is that when doing something has wound up upsetting me, even thinking about it would upset me all over again. After that experience, the thought of trying the other places I was referred to was simply overwhelming. It took at least several weeks, maybe even a couple months (I don't remember for sure), to bring myself to try the other places. But eventually I did, and was able to get hooked up with a therapist. After working with him for a few months, I wasn't seeing any real progress, so he suggested that it may be time to get medication. I agreed (I'd been thinking it myself anyway), and he referred me to the psychiatry department. They called me back on that referral that same day, and set me up with an evaluation appointment (if you're not aware, most therapists/psychologists are not licensed to prescribe medication, so for that they have to send you to a psychiatrist).

In the past, Effexor has worked really well for me: minimal side effects that would fade after a week or two, and benefits would start being noticed fairly quickly. As such, it's been the drug of choice for me, and is what we tried first, along with something to help me sleep (because of course I've been having trouble sleeping). Sadly, it would seem that in the eight years since I was last on it, my body chemistry has changed. In the past couple years, I've become prone to headaches. Last year, I had a three month period where I had a headache every day, and this year I've actually had migraines for the first time in my life (except maybe that one night in college). The Effexor made that worse. I had bad headaches every day for a month, with some of them entering migraine territory. As such, we're trying Wellbutrin. So far, mostly good. The headaches have decreased in frequency and intensity, and dry mouth just takes some adjustment. My general mood appears to also be improving.

Until writing this post, I've only told a few people about my depression, outside of my medical team. I've told my wife, of course, my friend Kyle, and one of my supervisors. Right now at work I work in two different departments, with two different supervisors, and very little overlap. I told the one supervisor because that department is the one that would most likely see my work suffer (as I mentioned, depression has affected my work before), simply because of the stress levels that can be involved there, and the issues of a particular client. I also had a sense that she would be understanding, and I was right. She's never pushed me for information I didn't want to give, has not given even a slight hint of any bias or prejudice toward me, and has understood that sometimes I need to step back a bit from certain situations. I'm pleased to say that there's been very little negative impact on my work as a result of my depression.

I've only told those few in part because I wasn't sure how others would react. Some people, even well-meaning people, can have unhelpful reactions. They start to view everything you do through the lens of your diagnosis. Don't want to do some get together? Oh well, he's depressed. Bad day at work making one a bit irritable? There's that depression again. Or they think that you're using your depression as an excuse. Or that you should just be able to pull yourself out of it. Or, if you don't appear to be moping about and constantly sad, in fact if you're laughing or smiling, they don't think you're depressed, which leads to the depression-as-excuse thing.

Not everything I do is about the depression. Not every negative feeling will stem from depression. And yes, I do have good days, where I will laugh and smile. I actually have a lot of good days, where even I find it a little hard to believe I have depression, but a part of that is because I'm doing what I need to do to manage the depression. Part of it is because I still believe everything that I wrote in that post back in March, 2012. Part of it is just the nature of depression. It waxes and wanes, and you usually don't know why.

I've also been concerned that people would think that my atheism is somehow to blame. Other atheists who deal with mental illness have been told --sometimes explicitly, sometimes "just" implicitly-- that not believing in God and an afterlife will lead to depression or other forms of mental illness, or that if they would just accept Jesus, it would be all better. And it's just ridiculous. It's disgusting. It doesn't just denigrate the atheist suffering with mental illness, but it also denigrates the THEISTS suffering with mental illness. It minimizes what is, in some cases, a fatal illness. And I really just don't want to hear that kind of crap directed toward me.

On a more personal level, I was recently told that my family's lifestyle "cannot possibly have happiness or joy in it." This was in reference to my wife's live-in boyfriend, and our polyamorous lifestyle and beliefs. It's flat out wrong, of course. I enjoy watching the two of them interact, I like him and get along with him, and it's fun to tag team with him on teasing her. She loves him, and he loves him. There is actually quite a bit of happiness and joy in our life, depression notwithstanding.

But when I got that letter/message, some of the bitterness and upset that I felt stemmed from realizing that if I did become more open about my depression, there was a good chance that they would link my depression to my lifestyle. Despite the fact that I've had depression before. Despite the fact that the depression started before this relationship. And yet, they're both happening at the same time, so it seems all-too-possible that they, and probably other relatives (yes, it was a relative who said that), would decide they're related. Here's hoping they don't.

So, I've had reasons not to be open about my depression. But I've also got reasons to write about it now. Part of it is altruistic, in that I don't think we as a society and as individuals should stigmatize mental illness. Yet mental illness still has a lot of stigma attached to it, unlike other illnesses, like, say, cancer. One way to combat that, as with combating other prejudices, is to be open about it. That way, people can start to realize that an illness is an illness, regardless of whether it attacks your emotions, your liver, or your breasts. I'm a person who has depression, but I am not the depression itself. She is a person who has cancer, but is not the cancer itself. He is a person who has autism, but is not the autism itself. And so on.

Another reason to be open about it, to write about it now, is because writing helps me think. It helps me process thoughts and emotions in a way that just staring off into space and ruminating doesn't. Many are the times that I've had some realization while writing about something, when just thinking about it got me nowhere. Even talking to other people about it isn't always as helpful. Writing's attached to my thinking. And for whatever reason, I have to write for an audience if I write. I've tried just journaling for myself before, but for some reason (I really don't know why) it doesn't seem to benefit me when I know that others won't see it in the same way that writing something I'll be showing others does. I don't think it necessarily matters that people actually DO read it for the benefit to occur, just that I've put it out there so they can if they choose. Which is good, because this blog has never had a large readership.

Usually when I write something for this blog, I link to it on my Facebook page. I don't know for sure if I'll do that this time, because of those reasons above. If you found this via my Facebook page, then I guess I decided to link it (and as I write this, the writing is helping my thoughts and emotions gel, and I'm realizing I probably will link it there anyway). I don't know if I'm going to be writing more frequently now, or not. Writing is something that I've wanted to do, but usually when I would look at my computer these days, and think about writing about the things I've wanted to write about, I get a feeling of being made of lead, of being massively heavy, only without the super-strength that would give in comic books, and like doing anything is near impossible. Maybe writing this will help with that, help me break through the barrier, so to speak.

Yet, I've also managed to read a few books in the past months with the same enjoyment I've had all my life, but when I was done, I didn't start reading anything else, and have gone more months without reading. So, no barrier breaking there. If I do write more, it might not always be on the topics that I've written on before. I've considered writing about lighter things, like gaming. For example, I've been playing a lot of Guild Wars 2, and while I haven't been able to play the Pathfinder RPG (no DM or group available when I'm available), I've still had thoughts about it, and ideas to explore. We'll just have to see.

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